Officials struggle to fund treatment for those with drug addictions

Most crime comes down to drugs, criminal justice professionals say.

Beyond the crime of illicit drugs, the vast majority of people who commit crimes have problems with drugs or alcohol, and locking them up without trying to address those problems would be a waste of money, the National Institutes of Health suggests.

New Hampshire corrections officials try to strike a balance between penny pinching and public policy.

Some 85 percent of inmates arrive at the state prison with a history of substance abuse, and the New Hampshire Department of Corrections has long recognized that the state doesn’t do enough to treat addiction, spokesman Jeff Lyons said.

“This is an area that needs a lot more attention by the state, not only in this facility, but in the communities,” Lyons said.

While New Hampshire’s state prison has long offered long-term substance abuse treatment to virtually every inmate who needs it, the state’s county jails have only recently begun to offer programs beyond voluntary Alcoholics and Narcotics Anonymous meetings. Funding for the new programs is scant, however, and they reach only a fraction of inmates.

In addition, the state’s courts have begun to work with law enforcement to create special “drug courts” to divert offenders into supervision and treatment programs rather than jail. So far, that effort has focused on juveniles, not adult offenders.

New Hampshire’s county jails hold people detained while awaiting trial and inmates serving sentences of one year or less. The state prison houses convicts serving sentences of more than one year, and thus has an inherent advantage in offering long-term treatment, Lyons said.

The state prison once had an entire facility and program (Summit House) devoted to long-term drug treatment until federal funding for the program was cut in 2003, Lyons said.

Since then, the department has offered programs within the walls of its prisons in Berlin, Concord, Goffstown and Laconia, and has recently developed a new, updated Intervention Services program, with funding from another federal grant from the National Institute of Drug Abuse, Lyons said.

The new Living in Balance program starts with screening and evaluations, and inmates who need it are referred to a 12-week program, with sessions three days a week. After completing that program, inmates continue with weekly counseling sessions.

The prison screens every inmate, Lyons said, and except for those who refuse to take part, all inmates who need treatment can get it, he said.

Treating drug abuse is cheap compared with the cost of coping with it, according to the NIDA. An article on the agency’s Web site (www. nida.nih.gov) cites a 2004 federal study estimating the total annual social cost of drug abuse at $181 billion, including crime and the criminal justice system.

“The cost of treating drug abuse (including research, training and prevention efforts) was estimated to be $15.8 billion, a fraction of these overall societal costs,” the article states.

In 2005, state Attorney General Kelly Ayotte announced her office had secured federal matching grants to hire substance abuse counselors for five county jails, including those in Hillsborough and Rockingham counties.

The $20,000 annual grants required about $6,000 in local matching funds and a great deal of paperwork. Rockingham County Corrections Superintendent Al Wright gave up on the application after his staff found it too time consuming, the Portsmouth Herald reported later that year.

Corrections officials in Hillsborough, Belknap, Grafton and Strafford counties persisted, however, and those jails continue to receive annual grants, as does the Youth Detention Center in Manchester, said Jane Brezosky, grants manager for the attorney general’s office.

The jails generally use the money to contract with a licensed counselor to run the programs, she said. The funds have been reduced, however, to a total of about $50,000 for all five agencies, she said.

“It’s a limited funding source,” she said, so the program only reaches a fraction of inmates. Collectively, the four jails and YDC programs reached 452 inmates in 2008, Brezosky said.

Hillsborough County alone holds more than 5,000 inmates during the course of a year. Despite dwindling federal funding, the Hillsborough County jail has hired a licensed substance abuse counselor to keep the 12-week program going year round, Corrections Superintendent James O’Mara said.

Because the program can handle only 15 inmates at once, spaces are limited to inmates who will be around long enough to complete the 12-week sessions, O’Mara said. Last year, 50 inmates completed it, he said.

The Hillsborough County jail also offers voluntary and volunteer-run AA and NA meetings weekly, and a faith-based program – Breaking the Chains of Addiction, operated by the Christian Aftercare Ministries, a group that also helps inmates transition back into the community, O’Mara said.

In 2008, total attendance in the Breaking Chains program was 967 inmate visits, counting time any inmate attended a session. Total attendance in the AA and NA meetings was 1,663 inmate visits, O’Mara said.

Although not part of the federal grant program, the Strafford County jail has an extensive treatment program, according to its Web site, and Sullivan County officials have proposed building a treatment center along with their new jail, county meeting minutes show.

The state courts also have begun to experiment with diversionary “drug courts,” designed to supervise offenders and require treatment and rehabilitation in exchange for keeping them out of jail. Drug courts have been established in Grafton County Superior Court and in the juvenile divisions of district courts in Nashua, Berlin, Claremont, Concord, Derry, Laconia and Ossippee.

Plans to expand the program have been put on hold, however, because of budget constraints and cutbacks, court spokeswoman Laura Kiernan said.

While the National Institutes on Drug Abuse is a strong proponent of drug treatment within the criminal justice system, the agency cautions that overcoming addiction is like any tough fight: You win some, you lose some.

“Because addiction is a chronic disease, drug relapse and return to treatment are common features of an individual’s path to recovery, so treatment may need to extend over a long period of time and across multiple episodes of care,” the Web site states, adding, “It is also the case that those with the most severe problems can participate in treatment and achieve positive outcomes.”

On the Net

Information on NH drug courts:
www.courts.state.nh.us/press/graftondrgct.htm

Information on heroin and addiction:
www.nida.nih.gov/infofacts/heroin.html

NIDA articles on treatment:
www.drugabuse.gov/Infofacts/

CJtreatment.html
www.drugabuse.gov/infofacts/treatmeth.html