Response to 2011 National Drug Control Strategy

Some 210 million people worldwide use illicit drugs each year, and 200,000 of them die from substance abuse. These figures point to the ongoing threat illicit drugs pose for individuals, families, and communities around the globe. Not included here are the numbers, costs, and deaths from misuse of prescription drugs, a significant and growing problem in our country. The ONDCP 2011 National Drug Control Strategy seems to be aware of the fact that we cannot simply battle illicit drugs; we must dig deeper and address the root of the problem -- widespread drug demand for both licit and illicit drugs.

As the nation's largest non-profit provider of substance abuse, mental health, treatment and prevention services and as advocates for people in recovery and their families, we at Phoenix House were particularly struck by the strategy's position of "Relying on Science and Research to Support our Nation's Drug Control Strategies." Then, we have to ask ourselves, why are they asking for just a 1.1 percent increase for intervention and treatment services for substance abusers? Does this sound like they are "working to expand access to evidence-based treatment and recovery support services"?

There are 3 "Key Accomplishments" listed in the June 2011 ONDCP update to Obama's first (May 2010) National Drug Control strategy under the heading "Increasing Access to Treatment and Recovery Support": (1) Increased access to screening and early intervention in FQHCs, (2) the addition of questions in the US Medical Licensing Exam, and (3) co-sponsored a Young People's Networking Dialogue on Recovery. Really? To increase access to treatment and recovery ONDCP has taken steps to make it possible to get screening and brief interventions in FQHCs, added questions to an exam and co-sponsored a dialogue? It is accomplishments like these that leave me disheartened.

Conversely, though, I see that there are 106 Action Items in the new strategy and a Performance Reporting System (to be released later in 2011) that will monitor each agency's contribution to accomplishing the goals of the strategy. Having come from an evaluation/research background and having recently designed a Performance Monitoring System for our 120+ programs across the country, I applaud this effort and look forward to seeing the system. I will measure our efforts similarly.

I agree with the sentiment -- we do need to direct our efforts and spending towards prevention, education, and intervention early on, as opposed to "shoveling up the wreckage" of drug use once it's too late -- but the commitment to providing services we know can work is limited by the marginal funding available. Director Kerlikowski knows better than most of us that filling our prisons with non-violent drug offenders -- because they test positive for marijuana while on parole or probation -- is not the answer. And indeed, I do commend the administration and our president for signing into law the Fair Sentencing Act -- eliminating "the mandatory minimum sentence for simple possession...(and increasing) penalties for major drug traffickers." This has allowed the field and the public to differentiate between drug victims and drug criminals, and was a major victory for our field.

We must also recognize that addiction is a chronic medical condition for which treatment is far more effective than punishment. In the United States, more than 90 percent of those who need substance abuse treatment do not receive it. Sometimes, this is due to lack of access/transportation problems; other times, due to lack of insurance or means to pay. For a sizeable group it is due to lack of interest in the types of treatment available, and still others do not seek help due to the stigma surrounding substance abuse treatment that still persists in our society.

The 2011 National Drug Control Strategy and the provisions of healthcare reform reflect a growing awareness that substance abuse isn't a moral failure, but rather a public health issue; stigma should be placed on illicit drug use, not on substance abusers who are trying to get well. Sadly, in the midst of this new awareness, U.S. drug treatment programs are facing widespread budget cuts. In many cases, this loss of funding has severely curtailed the ability of treatment organizations to provide these much-needed services.

I applaud the National Drug Control Strategy for drawing attention to the role of prevention and early intervention in ending the cycle of addiction, both at home and abroad. Having finally officially ended our own "War on Drugs," can we also end the war on substance abusers by removing the barriers that prevent far too many from receiving the care they need? It's time for our country to step up and make sure we can provide the services that so many of our citizens need.