Emerging Drug Problems

Although the prevalence of illicit drug use in the past year has declined overall since the 1980s--when crack cocaine use in the United States was reported to have reached epidemic proportions--drug use remains a serious national public health problem. In 1996, an estimated 13 million Americans aged 12 and older had used an illicit drug in the past month. Moreover, national survey data indicate that the recent downward trend in illicit drug use among youth has reversed. The costs of drug abuse to society--from drug treatment to lost earnings--were pegged at about $110 billion in 1995. Each year since the mid-1980s, Congress has set aside billions of dollars for federal agencies to reduce the supply of and demand for illegal drugs. In light of continuing concerns about the demand for drugs and emerging drug use problems, this report examines the efforts of federal public health agencies to detect the spread of drug use in the United States and their ability to respond to potential drug crises. This report (1) describes how public health service agencies have detected and responded to the crack cocaine epidemic, (2) identifies any changes made to improve the United State's drug detection and response capability, and (3) identifies any remaining issues that could compromise the nation's ability to detect and respond to emerging drug problems.

GAO noted that: (1) despite certain limitations in its sources of information, the National Institute on Drug Abuse (NIDA) was able to track the use of a number of illicit drugs, including cocaine, during the late 1970s and early 1980s; (2) two drug detection mechanisms NIDA used as a part of that effort helped detect the emergence of crack--a smokable form of cocaine; (3) NIDA had become aware of the rapid spread of crack in 17 metropolitan areas by 1986, but the prevalence of crack use in the national household population was not known until the late 1980s; (4) federal public health agencies primarily directed their response efforts to the problem of cocaine and drug abuse in general, rather than to crack specifically; (5) the response, orchestrated largely by NIDA, focused primarily on drug abuse research and education; (6) the Alcohol, Drug Abuse, and Mental Health Administration provided funding to state and local entities for substance abuse prevention and treatment services through the federal block grant program during the 1980s; (7) following the height of the crack epidemic around 1985, concerns were raised in Congress about efforts to detect and respond to the problem--in particular about the timeliness and accuracy of drug use data, lack of data on certain populations and geographic areas, limited availability of certain treatment programs, limited monitoring of the block grant program, and lack of a coordinated national drug control strategy; (8) in response, the responsible federal agencies made changes to improve drug detection capability--changes that included adding new detection mechanisms; (9) also, to help strengthen the federal response to drug problems, Congress legislated changes in the organization of the Department of Health and Human Services' major drug control agencies: the Substance Abuse and Mental Health Services Administration was created as a separate agency to focus on prevention and treatment services, and, to emphasize its research focus, NIDA was moved to the National Institutes of Health; (10) in addition, Congress created the Office of National Drug Control Policy (ONDCP) to develop a national drug control strategy and coordinate the national drug control effort; (11) despite these changes, concerns remain about the nation's ability to detect and respond to emerging drug problems; (12) ONDCP established a group to study the use of drug data that has recommended ways to improve the nation's drug data collection system; and (13) in addition, experts agree on the need for an overall strategy among key drug control agencies for managing emerging drug problems.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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