Drug Treatment

Pursuant to a congressional request, GAO assessed the funding formula for the Alcohol and Drug Abuse and Mental Health Services (ADMS) block grant to states, focusing on whether: (1) the urban population was an effective indicator of the prevalence of drug abuse; and (2) the 1984 hold-harmless provision helped or hindered the targeting of aid to states with the greatest needs.

GAO found that studies indicated that: (1) drug abuse was somewhat more prevalent in urban areas than in rural areas; (2) cocaine use was 2 to 3 times higher in urban than in rural areas; (3) the allocation formula's use of the entire urban population to represent urban-rural differences in drug abuse rates among 18- to 24-year-olds significantly overstated those differences; (4) the allocation formula's 40-percent weight for urban populations would be appropriate for an urban incidence rate 15 times higher than the rate in nonurban areas; (5) the 40-percent weight placed on urban population affected the formula's indicators of the at-risk population, and would influence the amount of funding each state would receive, once the hold-harmless provision was phased out; and (6) the 1984 hold-harmless provision prevented a more equitable distribution of ADMS funds among states based on available indicators of state needs.