Introduction
A Record of Accomplishment
The National Drug Control Strategy is a response to the situation the President found when he took office 6 years ago. Drug use had been on the rise over the previous decade and had reached a plateau. This trend had been met with ambivalence in many quarters, and the annual reports on drug use rarely made headlines. Worse, many felt there was nothing that could be done on a national level to combat drug use. Underlying this was the idea that drugs, addiction and the wide spectrum of related social ills could only be managed at best, not tackled head-on.
The Administration’s record flies in the face of these notions. The significant declines in drug use since the President took office show that, with effective policy combining enforcement, treatment, and prevention, coupled with the support of State and local officials, and the work of faith-based and community organizations, real advances are possible.
To focus the Nation’s drug control efforts directly on the problem of drug abuse, the President set ambitious goals for driving down illicit substance use in America. Using the category of past-month drug use as a benchmark, the Administration sought to reduce youth drug use by 10 percent within 2 years, and by 25 percent within 5 years. Actual youth use declined by 11 percent within the first 2 years, and now, in the fifth year, youth use has declined an astonishing 23.2 percent—just 1.8 percentage points short of the 25 percent goal. Encouragingly, the number of young people reporting any use of specific drugs in their lifetime has declined even more over 5 years, dropping 62 percent for LSD, 41 percent for methamphetamine, nearly 45 percent for Ecstasy, 40 percent for steroids, and 18 percent for marijuana. These percentages mean that 840,000 fewer young people were using illicit drugs in 2006 than in 2001.
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| PERCENT REPORTING PAST MONTH USE | |||
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| 2001 | 2006 | Change as a % of 2001 |
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| Any Illicit Drug | 19.40 | 14.90 | -23* |
| Marijuana | 16.60 | 12.50 | -25* |
| MDMA (Ectasy) | 2.30 | 1.00 | -56* |
| LSD | 1.50 | 0.60 | -60* |
| Amphetamines | 4.70 | 3.10 | -34* |
| Inhalants | 3.00 | 2.90 | -3 |
| Methamphetamine | 1.40 | 0.70 | -50* |
| Steroids | 0.90 | 0.70 | -21* |
| Cocaine | 1.00 | 0.90 | -10 |
| Heroin | 0.50 | 0.40 | -20 |
| Alcohol | 35.70 | 31.10 | -13* |
| Cigarettes | 20.30 | 14.40 | -29* |
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*Denotes statistically significant change from 2001. Note: Past-month use, 8th, 10th, and 12th grades combined; percent change calculated from figures having more precision than shown. Source: 2006 Monitoring the Future (MTF) study special tabulations for combined 8th, 10th, and 12th graders, December 2006. | |||
Lessons Learned: Successes and Challenges
The success of the President’s National Drug Control Strategy demonstrates that a robust drug control policy can achieve measurable progress in reducing drug abuse. Six years into the President’s first National Drug Control Strategy, a review of trends in drug use provides important insights into what works in drug control. It also provides lessons in dealing with current challenges such as continued high rates of drug use by adults, and the continued need to target young people in prevention and intervention efforts.
The following is a synopsis of key trends in drug use and the lessons they provide.
Target Youth Use and Set Goals To Measure Progress
Since 2001, researchers at the University of Michigan’s Monitoring the Future (MTF) study of 8th, 10th, and 12th grade students have provided the Office of National Drug Control Policy (ONDCP) with special analyses that combine data from all three grades. These analyses help to assess our progress toward achieving the President’s goal of reducing youth drug use by 25 percent by 2006. These data indicate that the lowest levels of youth drug use were achieved in 1992, when past-month use of any illicit drug for all three grades combined was 10.5 percent. This rate then rose sharply, nearly doubling, through 1996, after which it remained stable at about 20 percent through 2001. Between 2001 and 2006 there was a 23 percent decline in youth drug use.Studies demonstrate that adolescence is a critical period in determining a person’s risk for drug dependency. Young people who initiate drug use early in their teen years are at far greater risk for dependency than those who initiate later in life. Even more compelling, young people who do not initiate drug use by age 18-20 are unlikely ever to develop a drug dependency problem—a protective effect that lasts for life. Therefore, driving down youth drug use is a key priority for the Administration, as it holds the greatest promise to reduce overall drug use in America over time.
Targeting Heavily Dependent Users Can Reduce Demand Significantly
Getting users into treatment not only offers the opportunity for individuals to break free from the cruel grip of addiction, but also can help to undermine local drug markets and reduce the profitability of drug dealing. Although the drug problem can seem large and intractable, the profile of past-year drug users indicates that approximately 25 percent of the annual drug using population consumes illicit drugs 75 percent of the time. Changing the behavior of this relatively small number of chronic drug users can have enormously beneficial consequences for society, not the least of which is to deprive illegal drug traffickers of their largest source of revenue—the addicted, frequent, high-volume drug user. In market terms these drug users are the “best customers” of the whole illicit drug enterprise.Removing chronic users’ demand for drugs has the potential to cripple drug profits. Expanded treatment options provided by the President’s Access to Recovery (ATR) initiative and screening and brief intervention services can stem the progression to addiction and play an important role in reducing drug trade profits. The higher the percentage of chronic user demand that is removed from the market, the more dramatic the disruption will be, as traffickers are forced to withdraw from the market. Healing drug users through effective treatment programs will lead to long-term reductions in drug profits which can shrink local drug markets to levels that can be more easily managed by local authorities.
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Strong Stance Against Steroids Led to Downturn in Use
The use of dangerous performance-enhancing drugs, such as steroids, has become a troubling trend among youth in recent years. News accounts involving sports celebrities have provided negative role models for youth, whose use of these substances threatens not only their own health but also the integrity and character of sportsmanship. The President addressed this issue directly in his 2004 State of the Union Address. Congress subsequently passed, and the President signed into law, the Anabolic Steroid Control Act of 2004, which increased the number of banned steroids and precursor chemicals. This legislation, building on earlier governmental and nongovernmental efforts to educate youth about the risks of steroid use, has made a clear difference. Data show that lifetime use of steroids has fallen sharply over the last several years and is down by more than 40 percent since 2001.Lowered Rates Show Importance of Culture: Biometrics Echo Self-Reporting Surveys
Most findings about drug use over time come from self-reported survey data. Although valuable, such findings can be supplemented by objective evidence from biological markers of drug use. Although not representative of the general population, many years of results from drug testing in the workplace population (with more than seven million such test results being available every year) have shown significant patterns of change. For example, the number of positive tests for cocaine use, which had been rising through the mid-1990s, dropped 44 percent between 1995 and 2003 and has since leveled off.Also, declines in youth marijuana use as self- reported in the MTF survey (a 23.2 percent drop over the past four years) coincided with a comparable decline in the number of positive tests in the adult workplace population. ONDCP believes that effective media messaging about the risks of drug use and cultural norms regarding the unacceptability of drug use combined to drive down marijuana use. As the President said in his 2006 State of the Union Address, characterizing declines in drug use, crime, abortion, and welfare cases: “These gains are evidence of a quiet transformation—a revolution of conscience, in which a rising generation is finding that a life of personal responsibility is a life of fulfillment.”
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Progress in Combating Methamphetamine and Amphetamine Abuse
Data from MTF and workplace drug testing suggest that the use of amphetamines, particularly methamphetamine, has dropped dramatically in recent years among youth and adults. According to the 2006 MTF, use of amphetamines among all three grades combined in each of the three prevalence categories dropped by more than one-quarter between 2001 and 2006: 27.4 percent for lifetime use, 29.1 percent for past-year use, and 34.0 percent for past-month use.Use of methamphetamines in this population declined even more for each of the three prevalence categories during the same period of time: 41.4 percent for lifetime use, 41.2 percent for past year use, and 50.0 percent for past-month use.
Among adults, data from workplace drug testing indicate that positives for amphetamines declined 17 percent between 2004 and May 2006, and positives for methamphetamines declined 45 percent during the same period of time.
Continuing Challenge of High Rates of Drug Use and Rising Prescription Drug Abuse
According to the National Survey on Drug Use and Health (NSDUH), more than 19 million Americans 12 years and older are current users of an illicit drug. Approximately seven million of them exhibit the diagnostic criteria for abuse or dependence, with use of marijuana being by far the biggest contributor to the need for illicit drug treatment.The MTF survey also shows important and disturbing news that the non-medical use of the prescription drug pain reliever OxyContin® has risen—the only category of illicit drug use among youth that has risen between 2002 and 2006.
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Source: SAMHSA, 2005 National Survey on Drug Use and Health, September 2006. | ||
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For Younger Users, Marijuana Is Dangerous and Addictive
One in five 12-to 17-year-olds who report ever using marijuana display the characteristics of abuse or dependence. That number rises to more than one in four for those reporting past-year use of the drug. NSDUH has shown that the risk for marijuana abuse and dependency in younger users now exceeds that for alcohol and tobacco use, with 26.8 percent of past-year marijuana users between the ages of 12 and 17 displaying characteristics of abuse or dependency. The rate of abuse or dependency for past-year users of alcohol and cigarettes in the same age group is 16.6 percent and 16.0 percent, respectively.Recent research has strengthened the view that marijuana is a particularly troubling drug for youth. Use of the drug is dangerous to the health and well-being of the user, particularly for young people. Aside from the predictable effects of smoking marijuana on an individual’s physical health (increasing the risk of respiratory ailments and cancer), marijuana has been associated with emotional, behavioral, and academic problems. For example, studies have found that marijuana abusers are four times more likely to report symptoms of depression. Furthermore, using marijuana has been found to increase the risk for abuse and dependency on other drugs such as heroin and cocaine later in life.
Some believe that focusing on youth marijuana use could have a “balloon effect,” in which driving down marijuana use could result in rising rates of youth smoking and alcohol consumption. In fact, rates of marijuana, alcohol and cigarette smoking among young people have declined since 2001; the MTF survey reports that past month use of alcohol is down 13 percent, cigarette use is down 29 percent, and marijuana use is down 25 percent.
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| Source: SAMHSA, 2005 National Survey on Drug Use and Health, September 2006. | ||
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Both Domestic Methamphetamine Superlab and Small Toxic Lab Incidents Are Now in Decline
In 2001, the number of incidents such as lab Percent Testing Positive for Amphetamines seizures, dumpsites, and/or equipment seizures involving Small Toxic Laboratories, or STLs—labs that produce less than 10 pounds of methamphetamine per production cycle, began to rise sharply, reaching 17,460 in 2003 according to monthly reports by law enforcement to state authorities. By 2004, however, the number of incidents hit a plateau at approximately 17,560 incidents, and then began to decline to approximately 12,000 in 2005. Superlabs, nearly all of which were in California, spiked in 2001, then declined in 2002, and are now at a 10-year low. The decline in superlabs coincided with effective international control efforts directed at the importation of precursor chemicals in large quantities, mostly from Canada. Given the extraordinary danger that these labs pose to local communities, the steep and continuing decline is welcome news.
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Methamphetamine Use Is Regional
The methamphetamine problem, fueled initially by production from large-capacity clandestine superlabs in the far western United States, has spread geographically across the country, but nevertheless remains regionally concentrated. STLs proliferated in the Midwest and Southeast as the role of superlabs declined, leading to an increase in reported lab “incidents” by law enforcement between 2001 and 2004. Yet the number of meth users as measured by positive workplace drug tests still was highest in the West. Additionally, steep drops in use have occurred precisely where there was the highest concentration of early users – the western region.Diversion of Prescription Medications Contributes to Abuse
Improper diversion of prescription drugs occurs via multiple routes, including theft, prescription fraud, exploitation of the Internet, and even criminal medical dispensing. But the majority of misuse is attributable to people with a legitimate prescription giving or selling their drugs to others illegitimately. Effective prescription monitoring programs, coupled with physician and consumer education about the proper handling and disposal of medicines, can curtail the excessive diversion of prescription drugs.Although significant progress has been made in our efforts to reduce drug use in the United States, challenges remain. The progress can in large part be attributed to the President’s efforts to tackle drug abuse head-on and challenge the Nation to reduce rates of use, particularly among young people. However, the hardest work is done in communities across the country, by State and local officials, police officers, health care professionals, counselors, coaches, and perhaps most importantly, in families.
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Source: SAMHSA, 2005 National Survey on Drug Use and Health, September 2006. | ||
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Source: SAMHSA, 2005 National Survey on Drug Use and Health, September 2006. | ||
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A Balanced Approach
The overarching goal of President George W. Bush’s drug control policy has been to reduce drug use in the Nation. The President’s National Drug Control Strategy, now in its sixth version, is based on a balanced policy to achieve this goal. The Strategy has three key elements: preventing drug use before it starts, intervening and healing those who already use drugs, and disrupting the market for illicit substances.
Each of these three elements is critical to the success of the overall strategy. Chapter 1 provides an overview of efforts to prevent drug use before it starts. The primary targets of prevention efforts are young people and their parents. Young people face the most severe consequences of using drugs and are the most susceptible to initiating drug use.
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Chapter 2 describes intervention and treatment of drug users, a key priority of this Administration. A major obstacle to intervening and treating drug users is reaching the users who do not realize they have a problem. This group is the vast majority of drug users in America, and reaching them before they become addicted makes it more likely they will change their habits and thereby avoid the serious health and behavioral consequences of addiction.
To address this, the Administration has focused on screening for substance abuse in a range of settings, from schools to hospitals. Screening by medical professionals in health care settings can help identify those in need of counseling or more intensive treatment. For those who need treatment, the ATR initiative is an innovative approach to provide individuals with an expanded array of treatment providers from which to choose, including faith-based and community organizations. The program also provides recovery support services—from child care to mentoring—so that people can access services to help them on the road to recovery.
Chapter 3 covers the third priority of the National Drug Control Strategy: attacking the market for illicit substances. The direct link between the availability of illicit substances and rates of abuse makes it imperative that we disrupt the drug market at home and abroad. The illicit drug trade operates as any other market does: changes in supply affect demand. Reducing the availability of drugs in the United States can cause a decline in purity or an increase in price. In such cases, initiation becomes less likely and dependence more difficult to sustain.
The core elements of the Administration’s market-disruption strategy—eradicating illicit crops, interdicting illegal drugs, and attacking drug organizations—are designed to reduce availability by attacking the pressure points of the illegal drug market. Because of these actions, a drug trafficker’s costs will increase, which will reduce the overall profits associated with drug trafficking. Increased risk of arrest will also deter traffickers from entering the market and encourage others to leave. The biggest impact, however, is that a shrinking international supply of drugs will result in less drugs on U.S. streets. Chapter 3 covers this topic in more detail.
ONDCP presents this National Drug Control Strategy to the Nation as a guide for next steps and a call to continued action by the thousands of families, individuals, and organizations that fight the scourge of drug abuse in our communities.
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