Office of National Drug Control Policy (ONDCP)

1. Office of National Drug Control Policy (ONDCP) Primary Mission: TO LEAD NATIONAL EFFORTS TO REDUCE ILLICIT DRUG USE AND ITS CONSEQUENCES.

2. ONDCP • Created by the Anti-Drug Abuse Act of 1988, as amended • Develops National Drug Control Strategies and • Coordinates and Oversees Implementation • Develops Federal National Drug Control Budgets • Recommends improvements in management and • organization of drug control efforts • Conducts evaluations and performance measurement • to improve program effectiveness

3. National Drug Control StrategyNational Priorities • Stopping Use Before It Starts: Education and Community Action • Healing America’s Drug Users: Getting Treatment Resources Where They Are Needed • Disrupting the Market: Attacking the Economic Basis of the Drug Trade

4. Two and Five Year Goals Two-Year Goals: • A 10 percent reduction in current use of illegal drugs by the 12-17 age group • A 10 percent reduction in current use of illegal drugs by those aged 18 and older Five-Year Goals: • A 25 percent reduction in current use of illegal drugs by the 12-17 age group • A 25 percent reduction in current use of illegal drugs by those aged 18 and older

5. These Goals translate into these declines in Past Month Drug Use Source of 1999 and 2000 data: SAMHSA, National Household Survey on Drug Abuse, 2000.

6. Budget Highlights:Funding by Major Initiatives

7. Stopping Use Before It Starts Education and Community Action Safe and Drug-Free Schools Program: $644 million ($634.8 million drug-related) National Youth Media Campaign: $180 million Drug-Free Communities Program: $60 million Parents Drug Corps Program: +$5 million Drug-Free Workplace Programs: $3 million

8. Healing America’s Drug Users: Getting Treatment Resources Where They Are Needed: HHS Drug Abuse Treatment Programs: Substance Abuse Mental Health Services Administration • Targeted Capacity Expansion Program: +$109 million • Substance Abuse Prevention and Treatment Block Grant: +$60 million HHS Drug Abuse Treatment Research: • National Institute on Drug Abuse: +$57.5 million

9. Healing America’s Drug Users: Getting Treatment Resources Where They Are Needed: (continued) DOJ Drug Abuse Treatment Programs: Promoting Drug Treatment in the Criminal Justice System • Residential Substance Abuse Treatment: +$7 million ($77 million total) • Drug Courts: +$2 million ($52 million total)

10. Disrupting the Market: Attacking the Economic Basis of the Drug Trade: Andean Counterdrug Initiative: $731 million Coast Guard’s Deepwater Project: +$500 million Border Control and Enforcement: +$76.3 million ($11.4 million drug-related) Southwest Border Prosecutor Initiative: $50 million

11. The Federal Drug Control Budget has more than quadrupled since ONDCP was established in 1988. Dollars, in Billions FY 2003: President’s Request FY 2002: Enacted Level All Other Year: Actual Expenditures

12. Fiscal Year 1986 -2003 Dollars, in Billions Demand Reduction and Domestic Law Enforcement account for the bulk of Federal Drug Control Spending

13. (Dollars in Millions) International (6%) Treatment w/Research (20%) Fiscal Year 2003 President’s Request, by Area Total Resources: $19.2 Billion Interdiction (12%) Prevention w/Research (13%) Domestic Law Enforcement (49%)

14. Restructuring the NationalDrug Control Budget • One of the key changes in the new National Drug Control Strategy is a restructuring of the Drug Control Budget. The budget has partly been based on imperfect estimation techniques that gauge the portion of a program related to drug control. Under the new approach, all drug programs will tie directly to actual line items in agency budgets – establishing clearer lines of authority and accountability for results. Principles: • All funding items displayed in the drug budget should be readily identifiable line items in the Budget of the President or agency budget justifications; and • The budget presentation should be simplified by eliminating several supporting agencies from the drug tabulation. Only agencies with a primary demand reduction or supply reduction mission would be displayed in the drug budget

15. Department of Defense Department of Education Safe and Drug-Free Schools Health and Human ServicesSAMHSANIDA Department of JusticeDEAOCDETFINSOJP ONDCP Department of State Department of Transportation Coast Guard Department of TreasuryCustoms ServiceOCDETF Department of Veterans Affairs Other Presidential Initiatives Drug-Free Workplace Programs Parents Drug Corps Program SWB Prosecutor Initiative Restructuring the NationalDrug Control Budget Proposed Agencies Included Under Budget Restructuring:

16. Restructuring the NationalDrug Control Budget Modified Pro Forma Drug Control Budget Federal Drug Control Funding by Function ($ in Millions) (Detail may not add to totals due to rounding)

17. ONDCP The Current Drug Situation Including Prevention and Treatment

18. The main finding in the 2000 National Household Survey on Drug Abuse (NHSDA) is that overall drug use remains level. The rate of current (past month) illicit drug use is unchanged from 1999, with 6.3 percent of the population 12 years and older reporting past month use of an illicit drug in both 1999 and 2000. This represents an estimated 14.0 million current users in 2000. None of the major drug categories registered any significant change in their rates of current use. • Marijuana is the most commonly used illicit drug--76 percent of current illicit drug users used marijuana, and approximately 59 percent consumed only marijuana. The remaining 41 percent of current illicit drug users, those who used illicit drugs other than marijuana, total about 5.7 million Americans. Of these, 3.8 million were using psychotherapeutics, non-medically. This includes pain relievers (2.8 million users), tranquilizers (1 million users), stimulants (800,000 users), and sedatives (200,000 users). • This Nation is clearly moving away from cocaine. Current use of cocaine in the household population is down from its peak of 5.7 million users in 1985 to 1.2 million in 2000. The estimated number of current crack users in 2000 was 265,000. • Almost 3 million persons (2.8 million) reported having tried heroin in their lifetime (1.4 percent), but only 130,000 (0.1% of the household population) reported heroin use in the past month. • Lifetime use of methamphetamine was reported by 8.8 million persons (4.0 percent), but only 387,000 (0.2%) reported use in the past month. • Lifetime inhalant use was reported by 16.7 million persons (7.5 percent), with 622,000 reporting use in the past month (0.3 percent). Among youth, 8.9 percent reported having tried inhalants, while 1.0 percent reported current use. As noted above, a significant decline was noted among those aged 12-13. • Lifetime use of MDMA in 2000 is estimated at 6.4 million persons, compared to 5.1 million in 1999. The 2000 NHSDA was not designed to report past month or past year use of MDMA. Summary of Current Situation: The National Household Survey

19. Estimates of substance abuse incidence, or initiation (I.e., number of new users during a given year) provide a valuable measure of the Nation’s drug use problem. They can suggest emerging patterns of use, particularly among young people. The initiation estimates in the 2000 NHSDA are based on combined 1999 and 2000 data, so direct comparison to older data is problematic. The key findings on initiation for 2000 follow: Summary of Current Situation: Continued • There were 2 million new marijuana users in 1999 – 18 percent fewer than the 2.5 million new users in 1998. This continues the gradual decline that begun in 1995, when there were 2.6 million new users. The average age at first use was 17.0 years. • Youths aged 12 to 17 have constituted about two-thirds of the new users of marijuana in recent years, with young adults aged 18 to 25 constituting most of the remaining third. Rates of use for both youth and young adults decreased between 1998 and 1999. • New cocaine users in 1999 numbered about 768,000, down 13 percent from 1998 (882,000). However, average age at first dropped from 19.9 years in 1998 to 19.5 years in 1999. • Initiates to heroin use were estimated at 104,000 in 1991, 26 percent less than in 1998 with 140,000 new users. Average age at first use was 19.8 years, younger than the 23.5 and 21.9 years estimated for 1997 and 1998, respectively. • Initiates to hallucinogen use (incl.. LSD and PCP) were estimated at 1.2 million, the highest estimate since 1965.

20. Among youth (ages 12-17), the rate of any illicit drug use in the past month is statistically unchanged, from 9.8 percent in 1999 to 9.7 percent in 2000. Heroin use in the past month declined significantly from 0.2 percent in 1999 to 0.1 percent in 2000, while rates of current use for other major drugs did not change significantly from the previous year. • The youngest subset of youth (ages 12-13) reported a significantly lower rate of current use of any illicit drug, from 3.9 percent in 1999 to 3.0 percent in 2000. Inhalant use in the past month decreased significantly from 1.3 percent in 1999 to 0.7 percent in 2000. Rates of use for other specific drugs did not change significantly over the same period. • However, for the oldest subset of youth (ages 16-17), some significant increases in current use were noted. There was a significant increase in past month nonmedical use of psychotherapeutic drugs, from 3.4 percent in 1999 to 4.3 percent in 2000. Within the psychotherapeutics category, past month nonmedical use of pain relievers increased significantly from 2.6 percent in 1999 to 3.3 percent in 2000. Current use of stimulants also increased significantly, from 0.8 percent to 1.2 percent. Methamphetamines, a category of stimulants, also showed a significant increase in this age subgroup, doubling from 0.3 percent in 1999 to 0.6 percent in 2000. • Youth attitudes are unchanged from last year. Perceptions of risk of drug use among youth show no statistically significant increases or decreases from 1999 to 2000. While perceptions of risk of marijuana, cocaine, heroin, and LSD use are stable, the percentage of youth reporting great risk in smoking one or more packs of cigarettes per day increased significantly from 60.7 percent in 1999 to 64.1 percent in 2000. Also showing improvement is the percentage of youth reporting great risk in drinking five or more drinks once or twice a week, from 42.0 percent to 43.2 percent. • Youth perception of the availability of drugs declined for each drug class. Significant declines in the percentage of youth reporting that marijuana was fairly or very easy to obtain declined from 56.5 percent in 1999 to 54.1 percent in 2000. Significant declines also were reported for cocaine (27.5 percent to 25.2 percent), crack (28.4 percent to 26.8 percent), heroin (18.1 to 17.0), and LSD (24.9 to 23.0). Summary of Current Situation: Continued

21. Drug use among young adults (age 18-25): • Among young adults, the subgroup that has the highest rate of drug use, 15.9 percent reported current use in 2000 compared to 16.4 in 1999 (this change is not statistically significant). A significant reduction was found for current stimulant use, from 1.1 percent in 1999 to 0.8 percent in 2000. Rates of current use for the other major drugs are statistically unchanged from 1999. • For the subset of young adults aged 18-20, no significant changes were noted over the two-year period, except for a decrease in past year use of cocaine, from 5.7 percent in 1999 to 4.8 percent in 2000. • For the older young adults (ages 21-25), a significant decline in past year use of any illicit drug was noted, from 25.8 percent in 1999 to 24.1 percent in 2000. Cocaine and nonmedical use of psychotherapeutics may account for this decline. In 1999, 1.6 percent reported past month use of cocaine, declining to 1.1 percent in 2000. Current crack use also declined from 0.2 percent to 0.1 percent. Stimulant use in the past month declined significantly from 0.8 to 0.5 percent. • In the age group 26 to 34, current crack use declined significantly, from 0.4 percent in 1999 to 0.1 percent in 2000. However, nonmedical use of psychotherapeutics increased significantly for lifetime and past month use (current use increasing from 1.5 percent to 2.1 percent). Current nonmedical use of pain relievers* (a subset of psychotherapeutics) rose significantly from 0.9 percent to 1.6 percent. • The nonmedical use of this category includes drugs used when they were not prescribed for you or that you took only for the experience or feeling they caused and excludes use of over-the-counter pain relievers. It does include, among others, prescription pain relievers such as Codeine, Demerol, Hydrocodone, OxyContin, Percocet, Percodan, and Vicodin. • No statistically significant changes were noted for the age group 35 and older in any drug class. Summary of Current Situation: Continued

22. New survey series* Percent Reporting Past Month Use of Any Illicit Drug For the total population ages 12 or older, there were no significant changes in recent years. *The survey methodology was changed in 1999. Estimates based on the new survey series are not comparable to previous years. Source: SAMHSA, National Household Survey on Drug Abuse.

23. NOTE: Changes made to the design and execution of the NHSDA in 1999 make long term comparisons of trend data impossible. The second set of data provided below for 1999 and 2000 are comparable, but the data labeled “99” is the last year for long term trend data. The “99” and 1999 data differ slightly, because of the changes in the survey. Percentage of Population Reporting Past Month Use This flattening is true for all major classes of drugs. Data break Source: 2000 National Household Survey on Drug Abuse

24. Past Month Users (in Millions) • 14 million were current (past month) • users of an illicit drug in 2000. (incl. crack) (any psychotherapeutic) Source: 2000 National Household Survey on Drug Abuse

25. Percent Reporting Past Month Use of Any Illicit Drug Among youth (ages 12 to 17), current use of any illicit drugs is unchanged in the last two years. New survey series* *The survey methodology was changed in 1999. Estimates based on the new survey series are not comparable to previous years. Source: SAMHSA, National Household Survey on Drug Abuse.

26. Percent Reporting Past Month Use of Any Illicit Drug Among young adults (ages 18 to 25), current use of any illicit drugs is unchanged from 1999 to 2000. New survey series* *The survey methodology was changed in 1999. Estimates based on the new survey series are not comparable to previous years. Source: SAMHSA, National Household Survey on Drug Abuse.

27. Among Current Drug Users, Marijuana is Still the Most Abused Illicit Drug. Percent Reporting Past Month Use of Illicit Drugs, 2000 Only a drug other than marijuana Marijuana only Marijuana and some other drug Source: 2000 National Household Survey on Drug Abuse

28. Percent Reporting Past Month Use Among youth (aged 12 to 17), current use of any illicit drug in 2000 also is unchanged from 1999, except for heroin use, which is significantly lower. Source: SAMHSA, National Household Survey on Drug Abuse.

29. Percent Reporting Past Month Use Young adults have the highest drug use rates. Source: 2000 National Household Survey on Drug Abuse

30. Percent Reporting Past Month Use Drug use rates among young adults peak at age 18-20. Source: 2000 National Household Survey on Drug Abuse

31. Percent Using in Past Month Males consistently have higher rates of any illicit drug use. Source: 2000 National Household Survey on Drug Abuse

32. Persons of multiple race and American Indian/Native Alaskans have the highest rate of current use of any illicit drug. Percent Using in Past Month Source: 2000 National Household Survey on Drug Abuse

33. Percent Using in Past Month Current use of any illicit drug is lowest in rural areas. Source: 2000 National Household Survey on Drug Abuse

34. Percent Reporting Use Marijuana accounts for the largest proportion of drug use, both in the general population and among youth. Youth (12 -17) Age 12 or Older Source: 2000 National Household Survey on Drug Abuse

35. Current Drug Use Varies Widely, by Age, but the Cohort Effect Lasts a Lifetime. Percent Reporting Past Month Use of an Illicit Drug Prime example of an aging cohort of drug users -- this group began use in 1970s. Source: 2000 National Household Survey on Drug Abuse

36. Past Month Drug Use Varies by by Race/Ethnic Group: those reporting Puerto Rican and American Indian as Race/Ethnic Group show highest rates of use. Percent Reporting Past Month Use of Any Drug, Age 12 and Older, 1999 . Source: 2000 National Household Survey on Drug Abuse

37. Percent Reporting Past Month Use of Any Illicit Drug Adults on parole or supervised release and those on probation have substantially higher rates of current drug use compared to those not on parole or probation. Source: SAMHSA, National Household Survey on Drug Abuse.

38. The ONDCP Pulse Check and the Community Epidemiology Working Group Report indicate heroin use nationwide is low, but on the rise. • High purity heroin and lower prices contribute to increased use. • Increased heroin abuse in the U.S. in the 1990s may be attributable in large part to growing polydrug use. Many heroin users also use other illegal drugs, most often cocaine or methamphetamine. • Majority of users are in their 30s and injecting; younger users beginning to inhale or smoke heroin. Heroin Use is a growing concern.

39. While methamphetamine use is low, it continues to be a major concern due to the potential for rapid spread. DUF/ADAM data and the 1999 NHSDA State-level data both indicate that methamphetamine use is primarily a problem in Western and Southwestern states, especially in certain key cities. There are valid concerns about the potential impact and spread of methamphetamine use, especially into the Midwest. Using treatment admission rates as a proxy for the spread of methamphetamine use shows a dramatic shift over the last five years. The following four slides illustrate clearly the pattern of the spread and the full extent of the problem.

40. In 1994, five states had serious methamphetamine problems -- Hawaii and four others, all in the far west. Methamphetamine Admission Rates (per 100,000) MAINE > 55 28-54 3-27 < 3 No data SOURCE: SAMHSA, OAS, TEDS

41. In 1996, ten states had serious methamphetamine problems, and the problem had spread into the midwest. Methamphetamine Admission Rates (per 100,000) MAINE > 55 28-54 3-27 < 3 No data SOURCE: SAMHSA, OAS, TEDS

42. In 1998, 13 states had serious problems, including four midwestern states -- the problem was worse all over the midwest. Methamphetamine Admission Rates (per 100,000) MAINE > 55 28-54 3-27 < 3 No data SOURCE: SAMHSA, OAS, TEDS

43. In 1999, the same 13 states still had serious problems, but two midwestern states showed improvement. Methamphetamine Admission Rates (per 100,000) MAINE > 55 28-54 3-27 < 3 No data SOURCE: SAMHSA, OAS, TEDS

44. CURRENT DRUG USE TRENDS AMONG YOUTH BASED ON TWO NATIONAL SURVEYS FROM THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES MONITORING THE FUTURE STUDY (MTF) AND NATIONAL HOUSEHOLD SURVEY ON DRUG ABUSE (NHSDA)

45. Summary of Current Situation: The Monitoring the Future Survey

46. Summary of Current Situation: The Monitoring the Future Survey (continued)

47. Summary of Current Situation: The Monitoring the Future Survey (continued)

48. Among youth (ages 12-17), the rate of any illicit drug use in the past month is statistically unchanged, from 9.8 percent in 1999 to 9.7 percent in 2000. Heroin use in the past month declined significantly from 0.2 percent in 1999 to 0.1 percent in 2000, while rates of current use for other major drugs did not change significantly from the previous year. • The youngest subset of youth (ages 12-13) reported a significantly lower rate of current use of any illicit drug, from 3.9 percent in 1999 to 3.0 percent in 2000. Inhalant use in the past month decreased significantly from 1.3 percent in 1999 to 0.7 percent in 2000. Rates of use for other specific drugs did not change significantly over the same period. • However, for the oldest subset of youth (ages 16-17), some significant increases in current use were noted. There was a significant increase in past month nonmedical use of psychotherapeutic drugs, from 3.4 percent in 1999 to 4.3 percent in 2000. Within the psychotherapeutics category, past month nonmedical use of pain relievers increased significantly from 2.6 percent in 1999 to 3.3 percent in 2000. Current use of stimulants also increased significantly, from 0.8 percent to 1.2 percent. Methamphetamines, a category of stimulants, also showed a significant increase in this age subgroup, doubling from 0.3 percent in 1999 to 0.6 percent in 2000. • Youth attitudes are unchanged from last year. Perceptions of risk of drug use among youth show no statistically significant increases or decreases from 1999 to 2000. While perceptions of risk of marijuana, cocaine, heroin, and LSD use are stable, the percentage of youth reporting great risk in smoking one or more packs of cigarettes per day increased significantly from 60.7 percent in 1999 to 64.1 percent in 2000. Also showing improvement is the percentage of youth reporting great risk in drinking five or more drinks once or twice a week, from 42.0 percent to 43.2 percent. • Youth perception of the availability of drugs declined for each drug class. Significant declines in the percentage of youth reporting that marijuana was fairly or very easy to obtain declined from 56.5 percent in 1999 to 54.1 percent in 2000. Significant declines also were reported for cocaine (27.5 percent to 25.2 percent), crack (28.4 percent to 26.8 percent), heroin (18.1 to 17.0), and LSD (24.9 to 23.0). Summary of Current Situation: 2000 National Household Survey

49. Drug use remains highest among 12th graders. More than 50 percent of them have tried an illicit drug, and more than one in four are current users. Percent Reporting Use of “Any Illicit Drug” Source: Monitoring the Future Study

50. Marijuana By the time they are seniors, almost a quarter of youth are current marijuana users and more than 1 in 20 use every day. Percent Reporting Use Source: Monitoring the Future Study