Text: White House Drug Office Response to NRC Study

29 March 2001

Text: White House Drug Office Response to NRC Study

New steps to improve drug-enforcement already underway

The White House Office of National Drug Control Policy has responded to a critical National Research Council analysis of U.S. anti-drug enforcement activities, outlining steps being taken to improve anti-drug efforts.

After a 20-year build-up in U.S. anti-drug programs, the NRC analysis finds that the actual effectiveness of these activities cannot be measured because of a lack of reliable data.

ONDCP commissioned the NRC report in 1998 and commends the findings in a March 29 press release. ONDCP Acting Director Edward H. Jurith said, "We will review the report carefully and discuss its conclusions and recommendations with our federal, state and local partners. We will pay close attention to the report's findings, particularly the need for improved data and research in the area of law enforcement because of the critical policy implications and substantial resources involved."

The NRC report makes extensive recommendations on how agencies engaged in the anti-drug effort should work to improve research and data collection methods to better inform drug enforcement policy-making.

ONDCP reports that the number of people included in the National Household Survey on Drug Abuse has been significantly increased -- from 18,000 to 70,000 -- in order to gather more comprehensive information on drug-use prevalence and drug dependence. This survey has served as one of the principal national tools to gauge the level of drug abuse in the United States.

Further data should also be produced from a new kind of study in which ONDCP will be focusing on a population of habitual drug users who are expected to provide better information on the patterns of drug abuse and the pursuit of treatment.

ONDCP, the U.S. Coast Guard and the U.S. Customs Service are conducting a study to determine how drug interdiction activities may actually work to deter individuals from attempting to smuggle drugs.

Following is the text of the ONDCP press release:

(begin text)

EXECUTIVE OFFICE OF THE PRESIDENT
OFFICE ON NATIONAL DRUG CONTROL POLICY
Washington, D.C.

March 29, 2001

STEPS ONDCP IS TAKING TO ADDRESS MAIN RECOMMENDATIONS OF NRC REPORT

The following are the 11 main recommendations contained in the NRC report to improve drug-related data and research to inform U.S. drug policy and the steps that ONDCP and its Federal partners are taking, or have taken, to address them:

1. The committee recommends that work be started to develop better methods for acquiring consumption data.

The major population surveys periodically undergo review to improve the methodology and questionnaire design. For example, in 1999 the sample for the National Household Survey on Drug Abuse (NHSDA) was expanded from 18,000 persons to nearly 70,000, thereby permitting state-level estimates of drug use prevalence and drug dependence. This recommendation focuses on a critical issue for population surveys of drug use. ONDCP regularly works with the Office of Management and Budget and the drug control Departments and agencies to improve and expand our knowledge base on drug consumption.

2. The committee recommends that work be started to develop methods for improving existing drug price data and acquiring more reliable data.

During the period the NRC was conducting its study, ONDCP funded a study to review the DEA's System to Retrieve Information on Drug Evidence (STRIDE) -- the source of data on the price and purity of illicit drugs -- to determine whether improvements in how the data are collected could be made. These improvements would make the data more representative of U.S. drug markets.

3. The committee recommends that the Office of National Drug Control Policy should encourage research agencies to develop a sustained program of information gathering and empirical research aiming to discover how drug production, transport, and distribution respond to interdiction and domestic enforcement activities. The committee strongly recommends that empirical research address the three critical issues of geographic substitution, deterrence, and adaptation.

Currently, ONDCP is conducting a joint study with the U.S. Coast Guard and the U.S. Customs Service to develop a strategic and operational assessment of deterrence. The study is addressing some of the questions posed by the NRC, including what aspects of U.S. interdiction policy deters individuals from smuggling. Research for this has included detailed interviews with incarcerated high-level drug smugglers.

4. The committee recommends that the National Institute of Justice and the National Institute on Drug Abuse collaboratively undertake research on the declarative and deterrent effects, costs, and cost-effectiveness of sanctions against the use of illegal drugs. Particular attention should be paid to the relation between severity of prescribed sanctions and conditions of enforcement and the rates of initiation and termination of illegal drug use among different segments of the population.

The ONDCP-led Data Subcommittee includes representatives from both the National Institute on Justice (NIJ) and the National Institute on Drug Abuse (NIDA). This recommendation will be discussed at the next meeting of the Subcommittee. However, it should be noted that a number of such research efforts have been funded by the Departments of Justice and Health and Human Services, the U.S. Customs Service, and the U.S. Coast Guard.

5. The committee recommends that the National Institute of Justice, the Bureau of Justice Statistics, and the National Science Foundation be assigned joint responsibility for data collection and research on illegal drug markets, and the effects of drug control interventions.

ONDCP and NIJ recently published a report on cocaine markets in 6 U.S. cities using data from the Drug Use Forecasting program (now called the Arrestee Drug Abuse Monitoring Program). As noted by the NRC, much more of this type of research needs to be done.

6. The committee recommends that methods be developed to supplement the data collected in the National Household Survey of Drug Abuse and Monitoring the Future in order to obtain adequate coverage of subpopulations with high rates of drug use.

ONDCP is currently conducting a study of hardcore drug users -- one of the most important segments of the population not traditionally sampled by the major drug use surveys. The purpose of the study is to provide additional information on users presenting for treatment to capture information on a population not currently covered by the national data sets.

7. The committee recommends a systemic and rigorous research program (1) to understand and monitor inaccurate response and (2) to develop methods to reduce it to the extent possible.

Non-response or inaccurate response in survey samples is a serious and recurring problem in population surveys, particularly in surveys of illegal behavior, such as drug use. However, there are steps that can be taken to mitigate or minimize them. For example, the NHSDA is exploring different incentive options to increase response rates. Additionally this major survey is conducting a study to confirm self reports of drug use with hair sample analysis. ONDCP has conducted its own incentive study to improve response rates for a major polling effort. OMB is also involved in ongoing efforts to better understand and address non-response or inaccurate responses. The Government Accounting Office is also involved in work in this area.

8. The committee recommends that the Office of National Drug Control Policy and the granting agency (currently National Institute on Drug Abuse) establish an oversight committee of statisticians and other experts who are able to balance the need for access with goal of confidentiality; this committee should establish guidelines for opening up the Monitoring The Future database and continue to operate to ensure that access is quickly and easily provided.

The Monitoring the Future study, conducted for the past 26 years by the University of Michigan's Institute for Social Research, is a grant funded by NIDA. Specific procedures are currently in place to provide access to the data while maintaining confidentiality. However, ONDCP will refer this recommendation to NIDA for consideration.

9. The committee recommends a major increase in current efforts to evaluate drug prevention strategies. Further research is needed to understand (1) the effects of the entire spectrum of plausible approaches to prevention, rather than those that are mostly easily evaluated; (2) the effects of drug prevention programs implemented under normal conditions, outside the tightly controlled boundaries of experimental tests that rely on optimal conditions; (3) the effects of different combinations of prevention programs -- with particular attention to how they complement or detract from one another; and (4) the extent to which delays in tobacco, alcohol, and marijuana use yield reductions in later involvement with cocaine and other illegal drugs, and the long-term effects of prevention programming more generally.

In recent years, the Federal Government has made great strides in requiring the evaluation of drug prevention programs. For example, with respect to the two prevention programs currently funded by ONDCP -- the National Youth Anti-Drug Media Campaign and the Drug-Free Community Coalition program -- extensive and rigorous evaluations are being conducted. Both of these evaluations are of programs being implemented under normal conditions. In addition, NIDA has set as a priority an increase for prevention research funding. In addition, it should be noted that all major federal prevention agencies have guidelines on research-based prevention and are implementing the principles through program dissemination and technical assistance. This issue will be referred to the Interagency Working Group for further study.

10. The committee recommends that treatment researchers take greater advantage of possible opportunities for randomization to no-treatment control groups. For example, we strongly encourage studies of incarcerated and post-incarcerated prisoners as outlined in the report. The committee urges federal and state agencies and private institutions to minimize organizational obstacles to such studies while maintaining ethical and legal bounds.

ONDCP agrees with the NRC that randomized no-treatment control groups would be preferred for treatment effectiveness studies. However, as noted by the NRC, there are very significant ethical and legal barriers to conducting such studies (i.e., denying treatment to people who are in need and could benefit). ONDCP does not concur with the NRC that these barriers do not exist with respect to criminal justice populations. For example, Federal law requires that all Federal prisoners in need of treatment must receive it.

11. The committee recommends that the Office of National Drug Control Policy place organizational improvements for data collection and research high on its agenda in the immediate future. If it does not move quickly to implement the charges required to improve statistical data the President and Congress should find other ways to ensure that the substantive and organizational changes are swiftly and effectively achieved.

While ONDCP recognizes that there may be advantages to consolidating drug-related statistical data collection and analysis within two independent agencies, there also are many obstacles and disadvantages to such a plan, not the least of which would be the expense. For example, many of the data sets that inform drug policy were developed to support specific agency programs. In the case of law enforcement data, many of these data sets are used operationally to investigate and prosecute criminal cases. Removing these data sets to a separate and independent agency could hamper these efforts.

In addition to the areas covered by these recommendations, ONDCP has been conducting a number of studies to fill gaps in our ability to assess certain aspects of drag policy. Some of these studies, which are ongoing and evolving as new information becomes available, include:

-- What America's Users Spend on Illicit Drugs. This report has been produced periodically since 1992 and reports on the retail value of illicit drugs consumed in the United States. This report also provides an estimate of the number of hardcore users of heroin and cocaine.

-- Drug Flow Models. An outgrowth of the report on the retail value of illicit drugs as is this study to estimate the amount of drugs (cocaine, heroin, marijuana, and methamphetamine) flowing from source countries, through the transit zone, across the border, and onto the streets of America.

-- Price and Purity of Illegal Drugs. This study uses data from DEA's STRIDE data base, adjusted for sampling limitations, to estimate quarterly and annual price and purity trends for cocaine, heroin, methamphetamine, and marijuana (price only).

-- Pulse Check. This biannual report provides information on drug markets, drug use patterns, and emerging trends collected from discussions with law enforcement officials, treatment providers, and ethnographers and epidemiologists.

-- Random Access Monitoring of Narcotics Addicts (the Hardcore User Study). This study is taking methodology developed by ONDCP's Counterdrug Technology Assessment Center to collect real-time treatment admissions data (the Drug Evaluation Network System) via laptop computers and modem to a central collection point, and combining it with in-depth interviews of a sample of treatment clients. These interviews will provide a nationally representative estimate of the size and characteristics of the hardcore user population.

-- Cost to Society Study. This project provides updated and projected estimates of the economic costs of drug abuse to society, building upon the same general approach that has been employed in prior efforts, last published as The Economic Costs of Alcohol and Drug Abuse in the United States, 1992. Included in the project is an annual updating and projection of estimates of the economic costs of drug abuse and dependence, building upon the proven approach that has been employed in prior efforts. Developing updated estimates is useful because there are steady trends in our society and the economy, which, while relatively gradual over a year or two, may have a material impact over several years. Thus, economic values which are several years (or more) different in vintage will benefit it from adjustment for major known factors between their dates.

-- Geo-mapping project ONDCP, with its Congressional mandate "to set priorities and objectives for national drug control," identified the critical need for an improved method to access and collect national data, analyze that data, and integrate it into a national risk assessment system. ONDCP is developing a system to rank U.S. counties on the basis of several quantitative indicators related to drug trafficking and criminal justice indicators, drug use data, and drug related consequences, thereby providing an assessment and ordering of overall risk. The envisioned system would be useful to ONDCP as a tool that can assist in selecting geographic areas targeted for drug supply reduction or demand reduction efforts. The primary objective of this project is to identify and locate data, including new or non-standard sources, that are related to and/or can predict drug risks for populations in specific geographic areas of die United States.

(end text)