By Judi Currie
Foster’s Daily Democrat
DOVER, N.H. — Although treatment and support for addiction are on the increase, a person with a substance use disorder in the court system must navigate an even more complicated web of waiting lists and medical coverage questions.
When a defendant is granted a suspended sentence, but getting into treatment is a condition of bail, they may end up serving several months of the suspended jail time waiting for a placement.
At a recent bail hearing in Strafford County Superior Court, defense attorney Kimberly Shoen told a judge she could not get clients into treatment from the jail and if someone were released they might find it easier to get into a program.
“I have people sitting there for months,” Shoen said. “Folks are getting into outpatient treatment a lot faster out on the street.”
Shoen said the jail has a great in-house program and it is doing better than most county jails but there just aren’t enough beds.
Assistant Superintendent Jake Collins runs the 90-day Therapeutic Community at Strafford County jail, where the success of the program increases the demand even more. Collins said the success rates stem from the length of the program and the overall coordination of all of the parts of the system.
“We have the luxury of 90 days and for any illness longer is better,” Collins said. “A lot of people are severely addicted and outside the standard is only 28 days ...; here they are a captive audience and we can dig deeper.”
Collins said their clinicians try to get to the root of what happened in the person’s background, what led them to drug use and that can help get to that level where they can really start helping people feel better.
Collins said an integrated system including the county commissioners, legislative delegation, county attorney, public defenders, community corrections and the jail means everyone works together in a united system, providing treatment to the offenders and helping them move forward.
According to Collins, they use a therapeutic boot camp model with an emphasis on personal responsibility and no tolerance for violations. Inmates must attend classes, therapy groups, AA meetings and educational programs.
Strafford County Attorney Tom Velardi said for inmates who want to get into the program the work begins while they are still on the waiting list.
“There are limited slots,” he said. “They complain they can’t get in, but they may not be doing some precursors. Some don’t want to do the work, but they sure want to complain.”
Velardi said they must demonstrate a sincere wish to start the rehabilitative process.
Velardi and Collins said they try to give preference to someone who is closer to release as opposed to a person being held on pretrial confinement.
“We try to provide treatment to the non-entrepreneurial drug users,” Collins said. “As the crisis worsens we try to do what we can.”
Velardi said getting in should be seen as a privilege for those serving jail time and if they have to wait a little while then that is the position they put themselves into.
Velardi said Rockingham County judges are also sentencing inmates to Strafford County’s program because it is one of the best.
According to Collins, Rockingham County hasn’t housed female prisoners for a long time, so it contracts with Strafford County to house them.
“We have an all-female wing so they send them here,” Collins said. “So, if you are here you can apply.”
Another stumbling block for those in jail occurs when Medicaid coverage lapses.
Velardi said the longer a person is held in jail the more likely some benefits will get cut off, so they try to hold only those who are a flight risk or a danger to themselves or the community.
“Community Corrections has councilors who work with people to help them with the paperwork to make sure they have the appropriate coverage they need to take the help that is offered,” Velardi said.
Shoen said the bottom-line is the county needs more treatment beds. She suggested a large facility such as the former Laconia School could be used as an interim shelter while people are awaiting a treatment bed. There, she said, they would be able to focus on the steps they need to complete to get into treatment.