What Research Tells Us About the Reasonableness of the Current Priorities of National Drug Control

RAND released a new report on American drug policy and takes the gloves off.

On federal prevention strategies (emphasis added):

So in light of the well-documented failure of the National Youth Anti-Drug Media Campaign, ONDCP’s continued promotion of this as a cornerstone of its prevention policy is puzzling. If coupled with the broad adoption of evidence-based drug prevention curricula in the classrooms it would make more sense, but the current National Drug Control Strategy does not propose such a coordinated approach. In fact, there is no discussion about using school-based drug education as part of a comprehensive strategy, and funds supporting school-based programs continue to be fragmented across Federal agencies.

ONDCP has thus missed an opportunity to demonstrate leadership in promoting school-based drug prevention curricula. Research clearly shows school-based drug prevention curricula can be effective, cost-effective, and socially beneficial due to the societal savings generated from reduced consumption of illicit drugs, alcohol and tobacco (Caulkins et al., 2002; Caulkins et al., 1999). Moreover, some studies show that particular programs have demonstrated improvements in general academic performance and school success in addition to diminishing substance abuse among youth (LoSciuto et al., 1996; Eggert et al, 1994).

Basically, there are strategies with an evidence-base and we insist on using strategies that have been proven to be ineffective. Why? It doesn’t even appear to be philosophy–there are philosophically compatible options. I suspect it has more to do with the purpose of prevention campaigns–making adults feel like we’re doing something.

Otherwise, we’d invest more energy in alcohol consumption and an obvious place to start would be to challenge adults to examine the way our culture celebrates drinking. To be clear, I’m not anti-alcohol. I’ve got no problem at all with adults drinking, but if we wanted to take underage drinking seriously, we’d have to encourage families to ask themselves questions like, “Why do so many family parties (child birthday parties, wakes, first communion, baptism, etc.) involve alcohol? And, what message does this send to our kids?” We’d also have to ask ourselves to clarify what we believe about drinking by 18 to 21 year-olds. Do we really think it should be illegal? If not, how do we change the laws and protect high school aged kids? If so, why do our responses to it communicate such ambivalence?

On treatment:

treatment remains a relatively under-funded tool, as indicated by a variety of different measures including its small budget share, its slower growth rate vis-à-vis drug enforcement strategies, and the persistently large number of dependent users who remain in need of treatment in the United States.

Conclusions:

Research at RAND and elsewhere indicates that a greater emphasis placed on treating the chronic users in our mature drug markets and tracking measures of our success with this group would be more effective at addressing this nation’s drug problems. Today, too much emphasis is placed on supply-side strategies that offer too little of a return given the stage of the epidemic we are in with cocaine, heroin and marijuana. Enforcement strategies targeting methamphetamine and prescription drugs are likely to provide high returns, given that these markets are less endemic, but the mix of strategies needs to be thoughtfully considered in light of the nuances of these markets.

The Strategy in its current form is neither balanced nor cost-effective, and as such, suggests a need for Congress to carefully scrutinize the structure of the budget request. By cutting the budget for programs lacking scientific support or strong analytic arguments and reallocating those funds to program areas that are known to be effective, the nation will have a much better chance of successfully reducing substance abuse and its many costs on society. This would produce a Strategy that more closely addresses the drug situation that exists here in the United States. I would be happy to answer any questions you may have at this time.