The Government Accountability Office (GAO) has issued a report reviewing how agencies coordinate drug abuse prevention and treatment, and the extent to which they evaluate their programs. The GAO specifically looked at the National Drug Control Strategy of 2010 to determine the extent to which it had been implemented, as requested by Sen. Dianne Feinstein (D-Calif.) and Sen. Charles E. Grassley (R-Iowa), chair and co-chair of the Caucus on International Narcotics Control. The Office of National Drug Control Policy (ONDCP) develops the national strategy.

“In light of the increase in the rate of illicit drug use among Americans, efforts to oversee and coordinate the implementation of the Strategy and ensure that the ONDCP and federal agencies invest in the most effective drug abuse prevention and treatment programs become more important,” according to the GAO report, which was released August 6.

The ONDCP told the GAO that the 2010 strategy’s objectives were developed by consulting with federal, state and local drug control agencies, as well as other stakeholders. Of the 113 “action items” in the 2010 strategy, 84 percent were “on track or complete” by November 2011, with the remaining 16 percent at risk, delayed or facing budget problems.

The Department of Health and Human Services (HHS), the Department of Justice (DOJ) and the Department of Education (DOE) allocated almost 85 percent of the drug abuse prevention and treatment funding in the drug control budget in fiscal year 2012, the GAO reported, adding in a footnote that just because the funding was allocated doesn’t necessarily mean it was spent. Of the $10.1 billion allocated for drug abuse prevention and treatment for fiscal year 2012, the HHS allocated $8.3 billion, the DOJ $186.1 million for prevention and treatment, and the DOE almost $64.9 million for prevention.

The Substance Abuse and Mental Health Services Administration (SAMHSA), through the block grant, awards funds to implement and evaluate “prevention, early intervention, treatment, and recovery support services,” according to the GAO report. “Not less than 20 percent of funds awarded under this program must be spent by SAMHSA’s grantees for drug abuse education, counseling, and risk reduction activities.”

The HHS, DOJ and DOE officials told the GAO that they coordinate with each other to provide services. Often, whether a program “counts” as a drug prevention program is in the eye of the beholder, as ADAW has found in frequent reports. SAMHSA, for example, considers trauma intervention, employment and a host of other services as drug prevention. This GAO report echoed the ONDCP in counting Safe Schools/Healthy Students as drug prevention; however, this is not mainly a drug abuse prevention initiative (see ADAW, April 23).

Challenges to determining what prevention interventions are effective include (1) the availability of needed data, (2) the ability to determine impact and (3) the applicability of interventions to different population groups. Prevention interventions are successful when something doesn’t happen — for example, when a youth doesn’t use a drug — and that is a difficult outcome to measure, the GAO found.

There will be more reports from the GAO in response to the request of the Senate caucus to assess implementation of the 2010 strategy, which was the first strategy from the Obama administration. “We will continue our work on these issues and plan to evaluate the extent to which the 2010 Strategy has been implemented and coordinated across agencies and how the ONDCP assesses the effectiveness of the Strategy in preventing and reducing drug use,” the GAO concluded.

For the report, go to