Linda Saunders Paquette: NH needs more resources for fighting substance abuse
WE CANNOT overstate the impact on New Hampshire’s alcohol and other drug problems of expanding health coverage and including in that coverage the management of substance use disorders for existing beneficiaries.
The state criminal justice system incurs the direct costs of our woefully inadequate substance abuse disorder treatment: stolen Tide laundry detergent to fund heroin addictions, burglary of construction tools, local coffee shops being robbed at gunpoint, and drug-related parole revocations that return violators to a costly corrections system.
More than 90 percent of parole revocations in our state are due to condition violations involving parolees who used drugs or alcohol.
For excessive alcohol consumption alone, a recently released report by PolECon Research estimated the costs for New Hampshire police protection, the judicial system and state and county correctional systems totaled $88.2 million in 2011.
According to a Union Leader article published on Dec. 21, there were 291 robberies — armed and unarmed — reported in Manchester during 2013. Robberies have steadily increased not only in the last three months, but over the prior five years, police crime statistics show. Manchester Lt. Maureen Tessier said that the common denominator is drug dependency, especially heroin. There is no question that is the No. 1 motivator behind these crimes.
Expanded Medicaid coverage for low-income adults in New Hampshire will be paid 100 percent by federal funds until Dec. 31, 2016, and at least 90 percent federal funds after that. Many in the newly covered population are on probation or parole or are participating in drug or mental health courts. There are extremely limited state-funded resources to cover the cost of treatment and recovery supports for only a small fraction of those in need. As a result, alcohol and drug-related recidivism remains at such high levels.
Of the 113,000 New Hampshire residents estimated to need treatment for alcohol and other drug disorders, only 6,000 per year receive needed treatment through state-funded programs. Raw statistics reflect that the imbalance between need and treatment may continue to increase.
Our 12- 20-year-olds have the highest rates in the nation for past-month alcohol use and third-highest in the nation in past-month binge drinking. Our 18-25- year-olds are third-highest in past-month alcohol use. Without timely and adequate interventions, youthful substance use offenders are at an increased risk of developing persistent criminal careers.
Substance abuse disorder treatment, through expanded health coverage, could provide treatment options for individuals identified by the police and courts. We need to begin providing safe and therapeutic environments to assist with the reintegration of society — otherwise we’ll continue paying exponentially in other ways.
Failure to prevent and control involvement in crime and substance use directly contributes to the growth of prison and jail populations. Prison and jail inmates are seven times likelier to have a substance use disorder than the general population.
Concentration of inmates with substance use problems in correctional facilities merely exacerbates the problem. This is because, as one advocate for expanded health coverage eloquently described, the state puts everyone with substance abuse disorders together in jail, creating the perfect opposite of a sober community for somebody trying to quit.
Forced sober environments don’t address the underlying cause of addiction — you can put bars and barbed wire around somebody with addiction; without appropriate treatment and supports, they will not recover from their addiction.
When the State of Washington expanded Medicaid coverage to low-income childless adults, the state saw a reduction of up to 33 percent in rates of rearrest for those who were treated for substance use disorders, as compared to those in need of but not receiving that treatment. This resulted in saving an estimated $5,000-$10,000 for each person treated, inclusive of state, county and local resources. Those savings are available for prevention efforts and to address other public safety needs.
Implementation of expanded health insurance coverage in New Hampshire will increase access to treatment, strengthen New Hampshire’s economy, reduce recidivism and improve the health of New Hampshire’s poorest families. Accepting federal funds would allow state general fund dollars currently spent on treatment to be reallocated across disciplines for prevention, recovery supports, and other related services aimed at reducing crime associated with substance abuse. Expanding these resources can address the underlying cause of cyclical drug-related crime and incarceration in our state.
Expanding health insurance coverage for New Hampshire’s low income adults is our highest priority in 2014.
Linda Saunders Paquette is executive director of New Futures, a Concord-based non-profit group dedicated to fighting substance abuse and addiction.