Politicking Is the Big Enemy on Anti-Drug Battleground
Drug abuse in America has failed to decline despite an increasingly expensive war against it. In the last 15 years, federal anti-drug expenditures have skyrocketed from $1 billion to more than $16 billion, while teenage drug abuse has doubled and annual cocaine consumption has remained unchanged.
Science magazine’s current issue gives the persuasive viewpoint of scientists on the reasons for these costly failures. In it, six new studies point out what Alan L. Leshner, director of the National Institute on Drug Abuse and one of the authors, calls a “dramatic lag” between advances in the scientific understanding of substance abuse “and their appreciation by the general public or their application in either practice or public policy settings.”
A conclusion shared by all of the Science authors is that decisions on how to spend substance abuse prevention dollars are guided by politicking that wastes taxpayer dollars on failed approaches, not by knowledge of programs that have proven effective. For example, officials at the Office of National Drug Control Policy (including current director Barry McCaffrey) have long called for more expenditures on prevention and proven treatment programs and fewer for historically ineffective interdiction and law enforcement programs. But the funding equation, determined mostly by Congress, has remained unchanged since the early 1980s: one-third for treatment, two-thirds for enforcement.
Worse, the treatment and prevention dollars are often handed out to untested, unsupervised regional programs without expertise in the new science regarding drug treatment strategies. After the Bush administration committed to cutting teenage drug use 50% by 2000, regional “substance abuse treatment campuses” were hurriedly created. Despite a cost of nearly $70 million, substance abuse policy experts say the experiment failed to dent drug abuse.
Earlier this year, McCaffrey took a promising step away from this helter-skelter approach, submitting a mostly scientifically sound, 10-year drug abuse prevention plan and asking for funding in advance to help keep politics out of the yearly allocation process.
But Congress and the Clinton administration have failed to grant him the funding and the backing he needs to implement strategies that go beyond politically safe seizures of truckloads of drugs. These include ensuring the availability of methadone treatment for heroin addicts and substance abuse prevention programs for prisoners (which federal studies have shown could save the nation $67 billion a year in social, health and criminal costs).
Because of the lack of leadership, the nation’s drug policy is administered by half a dozen competing federal agencies doing redundant work. For example, four federal agencies currently duplicate drug abuse monitoring, from telephone surveys of individual households to analysis of county health records. The redundancy drains federal dollars, and the data are not coherently combined or analyzed. To remedy the problem, Health and Human Services Secretary Donna Shalala should appoint a single agency, along the lines of the Center for Health Statistics, to coordinate drug abuse studies and findings.
Better approaches are out there; what we lack, the Science studies show, is not scientific knowledge but political will. As McCaffrey recently lamented, “getting the U.S. government to do anything is like herding ducks with a broom.” Congress could at least give him enough no-strings-attached money to buy a bigger broom.
