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US drug control efforts have made little progress, report finds

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2813 (Published 30 April 2013) Cite this as: BMJ 2013;346:f2813
  1. Michael McCarthy
  1. 1Seattle

US drug control agencies have not made progress in achieving most of the goals set in a 2010 national drug policy strategy document, concludes a report by the US Government Accounting Office (GAO), an auditing and investigative agency of the US Congress.

In the 2010 National Drug Control Strategy the US Office of National Drug Control Policy laid out strategy that President Barack Obama’s administration said would emphasize prevention and treatment. It set seven goals to be achieved by 2015 (box).

In its new report the GAO found that the government was set to achieve only one of five goals for which preliminary data were available. On that goal—to cut by 15% the lifetime prevalence of eighth graders who used illicit drugs, alcohol, or tobacco—the US had already met the target on alcohol and tobacco use and was moving towards it on illicit drug use.1

But the government had seen no gains or had lost ground on the other four goals, achieving no progress in cutting by 10% the 30 day prevalence of drug use among adults aged 18-25 and losing ground on efforts to reduce by 15% numbers of drug induced deaths and drug related illnesses, including HIV infections attributable to drug use.

In a letter responding to the GAO’s findings, the director of the Office of National Drug Control Policy, R Gil Kerlikowske, noted that an increase in marijuana use, which accounts for about 80% of overall illicit drug use, dominated the aggregate data on drug use that the report emphasized.

“With the exception of marijuana use, illicit drug use is trending down, consistent with ONDCP [Office of National Drug Control Policy] goals, especially prescription drug abuse and use of cocaine, hallucinogens, inhalants, and methamphetamine,” Kerlikowske wrote.

The GAO also found that many of the US’s drug abuse prevention and treatment programs were fragmented and that many agencies’ services overlapped, offering either similar programs or serving similar population groups. This fragmentation and overlap raised the risk of wasteful duplication of efforts, the GAO said.

Its report said, “Agency officials who administer the 21 programs that GAO reviewed in detail—programs for youth and offenders—reported making various efforts to coordinate program activities, but 29 of 76 (about 40%) surveyed programs reported no coordination with other federal agencies on drug abuse prevention or treatment activities.”

In his letter Kerlikowske noted that the GAO did not “identify any actual duplication of prevention or treatment services.”

“It is also important to recognize that ‘overlap’ can be positive, such as when it reinforces key prevention messages,” Kerlikowske added. “The fact that a student who participates in a school based prevention program also hears about the danger of illegal drugs in an afterschool setting or in the media increases the likelihood that our goal of deterring youth drug use will be achieved.”

In 2011 an estimated 22.5 million US citizens aged 12 or older, about 8.7 percent of the population, were illicit drug users. The US spent about $25.2bn (£16.3bn; €19.3bn) on drug control programs in the 2012 fiscal year, of which $10.1bn was allocated to prevention and treatment.

National drug control strategy goals to be attained by 2015

  • Cut by 15% the 30 day prevalence of drug use among 12-17 year olds

  • Cut by 15% the lifetime prevalence of eighth graders who used drugs, alcohol, or tobacco

  • Cut by 10% the 30 day prevalence of drug use among adults aged 18-25

  • Cut by 15% the number of chronic drug users

  • Cut by 15% the number of drug induced deaths

  • Cut by 15% drug related morbidity

  • Cut by 10% the prevalence of drugged driving

Notes

Cite this as: BMJ 2013;346:f2813

References