Three years ago this month, President Bush released the Administration’s first National Drug Control Strategy. Consistent with his view of government, it was a document that clearly laid out a plan for accountable results in achieving a single goal—reducing drug use.
The President’s decision to hold his Administration accountable for helping drive down drug use followed a decade during which the use of drugs by young people had doubled. It came at a time when fully half of 12th graders had used an illegal drug at least once by graduation. It was seen, and rightly, as an audacious challenge to the skeptics, who invariably counsel despair when it comes to illegal drugs.
The President’s goal—a 10 percent reduction in youth drug use over two years—has been met and exceeded. Youth drug use has dropped by 11 percent over two years, and now a third year of data puts the program ahead of schedule for the five-year goal, with a three-year drop of 17 percent (see Figure 3). Figures for adult drug use will become available with the publication, this summer, of the 2004 National Survey on Drug Use and Health.
Figure 1: Past-Month Use of Any Illicit Drug by 8th, 10th, and 12th Graders Combined
Source: Monitoring the Future, 2004
Monitoring the Future: What the Latest Survey Tells Us
Among the Monitoring the Future survey’s findings are the following statistically significant changes since 2001 in substance use among grades 8, 10, and 12 combined:
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Use of any illicit drug in the past 30 days (so-called “current” use) declined 17 percent, from 19.4 percent to 16.1 percent. Similar declines were seen for past-year use (down 13 percent) and lifetime use (down 11 percent).
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Marijuana, the most commonly used illicit drug among youth, also declined significantly. Current use declined 18 percent, while past-year use declined 14 percent.
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Use of the hallucinogens LSD and MDMA (Ecstasy) plummeted, with past-year and current use of LSD down by nearly two-thirds and lifetime use down by 55 percent. Past year and current use of Ecstasy were each cut by more than half, while lifetime use was down 41 percent.
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Use of amphetamines, traditionally the second most commonly used illicit drug among youth, also dropped over the past three years. Lifetime use declined 20 percent, while past-year use fell 21 percent and current use fell 24 percent. Past year and current use of methamphetamine among youth declined 25 percent each.
Figure 2: Past-Month Use of MDMA (Ecstasy), by Grade
Source: Monitoring the Future (2004)
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The use of alcohol, the most commonly used substance among youth, also declined. Lifetime, past year, and current use each declined 8 percent. Cigarette smoking among youth continued to decline, with 20 percent reductions in lifetime and current use.
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Monitoring the Future began collecting data on the nonmedical use of OxyContin in 2002. In 2004, there was a 24 percent increase in past year use of OxyContin for all three grades combined compared to 2002, from 2.7 percent to 3.3 percent.
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Exposure to anti-drug advertising (of which the federally funded media campaign is the major contributor) has had an impact on improving youth anti-drug attitudes and intentions. Among all three grades, such ads have made youth to a “great extent” or “very great extent” less favorable toward drugs and less likely to use them in the future.
Figure 3: Progress Toward Two- and Five-Year Goals
Reduction in Youth Drug Use (Cumulative)
Source: Monitoring the Future (2004)
A Balanced Strategy
“Balance” is a word that is not often used in the field of drug control. As previous iterations of the Strategy have noted, effective prevention programs are helped when adults and individuals in positions of responsibility are clear and unambiguous in their opposition to drug use. When prevention works, the load on the treatment system is eased. Drug treatment programs are more effective when the market for illegal drugs is disrupted and drugs are not pure, inexpensive, and readily available. Interdiction programs take drugs off the market in tandem with the success of treatment and prevention efforts, preventing what could otherwise be a glut in availability that could draw in new users.
This balance is evident in the way the drug budget is constructed. As the Strategy and accompanying budget summary lay out in more detail, the President’s drug control budget request for fiscal year 2006 proposes to spend 38.7 percent of the drug control budget on drug treatment and prevention, including new funding in support of the President’s commitment to increase spending on drug treatment (the fiscal year 2006 treatment request is $3.25 billion, a 4.5 percent increase over 2005). The budget allocates the remaining 61.3 percent among law enforcement budgets, international programs, drug-related intelligence spending, and interdiction activities—program areas that have expanded in recent years principally because of the growth of programs combating heroin production in Afghanistan (see Figure 4).
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NATIONAL DRUG CONTROL STRATEGY GOALS
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Two-Year Goals: |
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- A 10 percent reduction in current use of
illegal drugs by 8th, 10th, and 12th graders.
- A 10 percent reduction in current use of
illegal drugs by adults age 18 and older.
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Five-Year Goals: |
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- A 25 percent reduction in current use of
illegal drugs by 8th, 10th, and 12th graders.
- A 25 percent reduction in current use of
illegal drugs by adults age 18 and older.
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Note: Progress toward youth goals is measured from the baseline established by the 2001 Monitoring the Future
survey. Progress toward adult goals is measured from the baseline of the 2002 National Household Survey on Drug
Use and Health. All Strategy goals seek to reduce current use of any illicit drug. Use of alcohol and tobacco
products, although illegal for youths, is not captured by �any illicit drug.�
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The chapters that follow are keyed to the Strategy’s three priorities—Stopping Use Before It Starts, Healing America’s Drug Users, and Disrupting the Market, with each chapter offering concrete examples for each priority. The chapter on Stopping Use Before It Starts examines the distinct roles of schools, communities, and the media in making parents more effective in the crucial challenge of guiding young people to avoid drugs and alcohol. It describes the remarkable promise of tools such as student drug testing, follows the efforts of one community to protect young people from underage drinking, and summarizes new research on the development of the adolescent brain.
The section on Healing America’s Drug Users addresses the special challenge of helping the dependent and profiles the Nation’s first Access to Recovery voucher recipient as she navigates life after prison and the competing demands of drug treatment and a job search. Chapter II describes a treatment facility that has been highly successful in helping addicted mothers with children, and a faith-based program in Harlem that helps former prisoners cope with the challenge of life on the outside. It describes a new effort that uses physicians to target drug users still on the pathway to addiction, screening them in emergency rooms for evidence of drug dependence and referring them to treatment as needed, and highlights the role of drug courts, where the power of the criminal justice system is combined with the skillful healing of treatment providers in service of the drug dependent individual.
The section on Disrupting the Market provides a progress report on the efforts we are making—both foreign and domestic—to disrupt the availability and purity of illegal drugs, through source country efforts, interdiction programs, and investigative operations. Chapter III profiles source country programs such as the coca eradication effort in Colombia, which have led to major reductions in the production of cocaine, reducing the amount of the drug available worldwide in a way that is not even close to being made up by neighboring countries. Also profiled are our interdiction programs, which seize a large and growing proportion of South America’s cocaine output; the efforts of law enforcement to dismantle trafficker organizations root and branch while seizing their funds; and the strategy for disrupting the drug trade in Afghanistan.
Figure 4: A Balanced Strategy
Fiscal Year 2006 Drug Budget
Undermining Our Cities: Drug Use Exports Needed Resources
Drug use as a phenomenon is not limited to urban or rural settings, but new estimates of the amount of money Americans spend on illegal drugs reveal something remarkable about the extent to which the concentration of drug users in our cities hurts those cities economically (see Figure 7 and 8).
Figure 5: Making Drugs Harder to Find Means Fewer Teens Using Drugs: Ecstasy
In seven American cities, estimated annual expenditures by drug users total $1 billion or more—money that is drained out of the legitimate economy. Not surprisingly, three of the same cities have to spend $1 billion or more in costs directly attributable to their residents’ drug use, with health care costs the single biggest expense. (An additional 18 cities broke the barrier of $1 billion in costs when indirect costs such as drug-related illnesses and opportunity costs are included.)
Such costs represent an unacceptable drain on the economies of America’s cities—an underreported problem that exports vast amounts of individual and government capital that could be put to work in the service of everything from job creation to education reform.
The enormous social consequences of drug use would be far worse were the price and availability of illegal drugs not so successfully circumscribed by the activities of interdiction and law enforcement. The drug trade is a market phenomenon. As we interrupt the supply of drugs we make them more scarce and more expensive, diminishing drug use and leading some to seek treatment. We also know that an even greater impact than price of drugs on behavior is the overall legal status of substances. Sixteen million Americans are dependent on alcohol compared to 5 million who are dependent on an illegal drug (see Figure 9).
Figure 6: Making Drugs Harder to Find Means Fewer Teens Using Drugs: LSD
Past-year use of Ecstasy or LSD by 12th graders, and percent of 12th graders saying and Ecstasy or LSD is �fairly easy� or �easy� to get.
Source: Monitoring the Future (2004)
The President’s Management Agenda: Budgeting for Results
Focusing the efforts of the Federal Government on the single goal of reducing drug use is a useful reminder of the singular purpose of drug control efforts. When Americans teach young people about the dangers of drug use, when treatment specialists help free the addicted, when communities unite to drive out drug dealers, or when law enforcement agents dismantle a trafficking organization, the goal should always be the same—reducing drug use.
When we treat people for addiction, when we counsel young people to avoid drug use, and when trafficking organizations are dismantled, it means nothing unless drug use is reduced.
Programs and efforts that do not reduce drug use must be restructured or eliminated, an effort to use taxpayer money wisely that this Administration takes seriously. As part of this Administration’s effort to integrate budget and performance, the new drug budget, proposed and outlined for Congress in detail in 2002 and first presented in 2003, not only ties to identifiable line items in the President’s budget but also includes key performance information for each program. The performance information presented here was used by the Administration to formulate the fiscal year 2006 budget.
Figure 7: What America�s Users Spend on Illegal Drugs
Building on agency efforts under the Government Performance and Results Act, and working with the Office of Management and Budget in implementing its Program Assessment Rating Tool (PART), the Office of National Drug Control Policy has made data on program performance central to budget decision making. In the President’s fiscal year 2005 budget, programs comprising about 45 percent of the drug budget were assessed. With new assessments conducted for the fiscal year 2006 budget and updates of prior assessments, just over 50 percent of the drug budget was assessed.
The goal of the National Drug Control Strategy and its three national priorities—Stopping Use Before It Starts, Healing America’s Drug Users, and Disrupting the Market—drive the budgeting process. Each program’s effectiveness in contributing to the accomplishment of those goals helps determine its resource level. Demonstrably effective programs receive continued support. Programs for which results have not been demonstrated, in some cases, receive reduced resources.
The PART process has encouraged the development of a variety of data collection initiatives, designed to ensure that programs are being managed efficiently. The effectiveness of the President’s Access to Recovery initiative, for example, is being measured to ensure that it provides real outcomes for people using a set of seven measures, including abstinence from drugs, increased employment, and decreased involvement with the criminal justice system. Ultimately, these seven “national outcomes” will be aligned across other programs, including the Community Mental Health Services Block Grant and the Substance Abuse Prevention and Treatment Block Grant.
Figure 8: Estimated Direct Costs of Drug Abuse
Sources: Unpublished analyses from The Economic Costs of Drug Abuse to Society and What America�s Users Spend on Illegal
Drugs 1998–2003.
For fiscal year 2006, two prominent drug control initiatives modified as a result of their performance are the High Intensity Drug Trafficking (HIDTA) and the Safe and Drug-Free Schools programs. The PART assessment finds that the HIDTA program has not been able to demonstrate results.
The HIDTA program will be moved to the Department of Justice (DOJ) at a reduced funding level of $100 million. This will enable law enforcement managers to target the drug trade in a manner that is strategic, complements the retooled Organized Crime Drug Enforcement Task Force (OCDETF) program, and preserves the program’s worthy elements such as intelligence sharing and fostering coordination among State and local officials. DOJ will retain the program’s strong focus on supporting State and local law enforcement efforts, but will reformulate its operations to function within current funding levels. Criteria for retaining HIDTA designation will favor regions best able to support the goals of the President’s National Drug Control Strategy and the DOJ drug strategy.
Figure 9: Treating Drugs Like Alcohol and Cigarettes?: Current Users by Substance
The Administration proposes to terminate funding for the state grants portion of the Safe and Drug-Free Schools program because of its inability to demonstrate effectiveness and the fact that grant funds are spread too thinly to support quality interventions. Instead, the request includes significant increases for SDFSC national program activities that provide direct support to local educational agencies, in amounts sufficient to make a real difference, so that the Department of Education can support drug prevention and school safety projects that are structured in a manner that permits grantees and independent evaluators to measure progress, hold projects accountable, and determine which interventions are most effective.
By integrating program goals and effectiveness information into the National Drug Control Strategy, the Administration has provided a sound basis for program accountability through the adjustment and reallocation of Federal resources to programs that are successful and can demonstrate results.
Dependent Users by Substance (in thousands)
Source: Special tabulation from the National Household Survey on Drug Use and Health (2002 and 2003).
Last Updated: February 23, 2005
