The National Drug Control Strategy - Highlights Of The Current Strategy

The 2004 National Drug Control Policy, which features the FY 2005 budget request, takes as its main theme performance-based management of the drug problem in America. One element of this is the already-described reorganization of the budget categories so that actual control activities are featured, rather than expenditures forced on the nation by the fact that people use and trade in drugs. The managerial emphasis is further underlined by streamlining and rationalizing authority for programs within the federal departments. The newly created DHS thus takes control of all interdiction activities and funding for the Organized Crime Drug Enforcement Task Forces (OCDETF) Program, which is an interagency effort and is consolidated in the DOJ.

Within the prevention functionality, the strategy includes an investment of $25 million in programs for drug testing of young people. Another highlight is a $145 million national youth antidrug media campaign. It also features funding for one hundred new local community antidrug coalitions working to prevent substance abuse among young people.

A closer look at two of the strategy's initiatives follows.

Drug Testing of Kids

NDCS 2004 calls for and funds expansion of a program introduced the previous year for testing high school students for drugs. Grants are available to schools that implement appropriate programs. Students who test positive will also have access to treatment under the provisions of the program.

The initiative was based on findings cited in the strategy that drug use in some Oregon schools, where athletes were tested, was 25% less than in schools that did not test. Similar but lower declines were also noted in a New Jersey regional high school after a two-year testing program. The national program was launched in part because the legality of testing students was clarified by a Supreme Court decision in 2002.

The legal situation is broadly defined by the Fourth Amendment of the Constitution, which protects "the right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures." In 1989, in Skinner v. Railway Labor Executives' Association, the Supreme Court held that state-compelled collection and testing of urine constituted a "search." It would thus appear that mandatory drug testing of youths was unconstitutional without a showing of probable cause for a "search"—such as unruly and strange behavior.

In 1995, however, the Court ruled in an Oregon case that drug testing of high school athletes was constitutional, even if individuals were not suspected of drug use. The Court held that special needs governed the school environment and that determining "probable cause" for each individual in the school environment was unnecessary (Vernonia School District v. Wayne Acton, 515 U.S. 646, 1995).

Vernonia involved only school athletes and was not seen as unambiguously permitting "suspicion-free" drug testing in the context of other schools activities. In 2002, however, in the case of Board of Education of Independent School District No. 92 of Pottawatomie County et al. v. Earls et al. (536 U.S., 2002), the Supreme Court extended its judgment to all activities. The case involved drug testing for all extracurricular activities before students could take part in them, testing at random during their participation, and also testing when suspicions arose. This Oklahoma case provides broad authority for school districts and thus represents the "go ahead" for the strategy first adopted in NDCS 2003.

Vouchers for Treatment

According to data from the Substance Abuse and Mental Health Services Administrations (SAMHSA), cited in NDCS 2004, there were an estimated 7.7 million individuals in need of drug abuse treatment in 2002—yet more than three quarters of such individuals did not feel that they were in need of treatment. (See Figure 10.1.) These findings underlie the initiative, announced in 2003, to expend $1.6 billion on drug abuse treatment over the next three years. In the FY 2004 budget, the government allocated $600 million as a down payment toward this

FIGURE 10.1
Estimated number of persons aged 12 and older classified as needing treatment for an illicit drug problem, 2002
SOURCE: "Figure 7. Most of Those in Need of Drug Treatment Do Not Seek It," in National Drug Control Strategy: Update, The White House, March 2004, http://www.whitehousedrugpolicy.gov/publications/policy/ndcs04/2004ndcs.pdf (accessed March 31, 2005)

TABLE 10.5
Key elements of Access to Recovery
SOURCE: "Key Elements of Access to Recovery," in National Drug Control Strategy: Update, The White House, March 2004, http://www.whitehousedrugpolicy.gov/publications/policy/ndcs04/2004ndcs.pdf (accessed March 31, 2005)

• Flexibility. With a voucher, people in need of treatment or recovery support services will have the freedom to select the programs and providers that will help them most—including programs run by faith-based organizations.

• Results Oriented. Grantee institutions will be asked to develop systems to provide an incentive for positive outcomes.

• Increased Capacity. Access to Recovery is projected to support treatment or recovery support services for approximately 100,000 people per year.

goal, the money to be dispensed to individuals in the form of vouchers that can be exchanged for actual treatment services. The FY 2005 budget request increased funding for this voucher program, known as the Access to Recovery (ATR) initiative, by another $100 million. Table 10.5 outlines the key elements of the program.

Vouchers are made available to health professionals in hospital emergency rooms, in clinics, and in private practice; vouchers are also available from justice system officials and others able to determine an individual's need for treatment. The concept is to use such professionals, in contact with those who require treatment but do not perceive the need themselves, to suggest that treatment is in order while also enabling the professional to give the individual the means of obtaining treatment at whatever facility the individual may choose to use. The program is aimed principally at people who do not have provisions in their health policies (if they have such policies) that pay for drug abuse treatment.

Unique features of this approach to drug abuse treatment include provisions that individuals can "cash in" the vouchers at all kinds of drug treatment facilities, including those operated by religious organizations, and that the redemption value of the vouchers, from the treatment provider's point of vantage, will be on a sliding scale that rewards treatment effectiveness. The incentive for the person counseled to seek treatment is that the treatment is paid for; the incentive for the provider is to help the treatment-seeker to succeed so that a higher reward is paid out. The strategy calls this a "consumer-driven path to treatment."

Vouchers will cover the full range of services—from working with youths who need help detaching from the drug culture, to outpatient services, and finally to intensive residential treatment. Which level of service is required will be determined by the health professionals involved.