Substance abuse program not available to all who need it at county jail

LACONIA — Although the courts recommend that as many as nine of 10 inmates at the Belknap County Jail undergo treatment for substance abuse, the capacity of the Department of Corrections to provide help has shrunk.

Superintendent Dan Ward said that the county contracts with Horizons Counseling Center, Inc. of Gilford, which offers the ADAPT (Alcohol and Drug Abuse Prevention and Treatment) program. "We have capacity and funding for 12 places," he said, "and the program is always full with a waiting list."

Jacqui Abikoff, executive director of Horizons, said that the program began in 1991 with a federal grant administered by the New Hampshire Department of Justice. Then, she explained, "we worked in cohorts of 24. Everyone started the 12-week program at the same time and finished together."

However, since the federal funding was reduced abut 10 years ago, the capacity of the program has been halved and its structure has been changed. Abikoff said that now inmates are required to complete the 12 modules of the program, but in no particular order. For example, an inmate might being with the sixth week of the program and finish with the fifth week.

Abikoff stressed that the county does not contribute to the cost of programming, which is defrayed primarily by federal funds. At the same time, she said that Horizons contracts with the New Hampshire Department of Health and Services (DHHS) to provide substance abuse treatment for indigents and is able to apportion some personnel costs incurred at the jail to that contract. "Inmates meet the standard of indigence," she remarked.

The federal funding not only limits not only the capacity but also the scope of programming. Abikoff said that funds can only be applied to services for sentenced inmates, emphasizing that they are only assessed by qualified clinicians after being sentenced. She said that the recommendation that an inmate be counseled or treated is initially a bargain struck between the prosecuting and defense attorneys and sanctioned by the judge.

"The court may recommend either the ADAPT program or a residential program, but neither may be appropriate for the individual inmate," Abikoff said. Although their have been efforts to enable clinicians to assess inmates prior to sentencing, she said that the resources required are not available.

Furthermore, Abikoff noted that since funding is restricted to sentenced inmates who are not assessed before sentencing, services cannot be provided to those incarcerated pending trial. An inmate may spend months incarcerated before receiving a one year sentence, then find that with time-served there is insufficient time remaining on the sentence to complete the treatment program. By assessing inmates pending trial, Abikoff said that their condition, together with other risk factors, could be determined, enabling some to be released under close supervision to undergo treatment, which would ease the upward pressure on the jail population.

Underlining the the value of substance abuse programs, Abikoff said that more than half the inmates who complete the ADAPT program continue with counseling and treatment following their release.

"It works," she said, adding that unfortunately while New Hampshire ranks among the top states in the incidence of substance, it ranks among the bottom 10 states in the capacity for treatment.