Action Needed To Improve Management and Effectiveness of Drug Abuse Treatment
HRD-80-32: Published: Apr 14, 1980. Publicly Released: Apr 14, 1980.
- Full Report:
The Nation's drug abuse treatment system has grown from a handful of clinics in the early 1970's to a network of over 3,200 treatment units. Nationwide, approximately $518 million is spent annually on treatment programs. The National Institute on Drug Abuse (NIDA) supports about 1,500 clinics at an annual cost of $130 million. A GAO review identified a number of program policies and management problems that operated as disincentives to providing adequate treatment to the greatest number of drug abusers and revealed that NIDA spends millions on some treatment methods that may not be effective.
The NIDA treatment program does not serve the maximum possible number of high-priority abusers. GAO found that some treatment slots are taken by ineligible people, that others go unused, and that providers are not treating as many people as reported. The current funding method employed by NIDA, which requires providers to show only that minimal services are furnished, does not motivate providers to furnish their clients with adequate treatment. In addition, NIDA cost ceilings may not reflect the amounts required to provide necessary treatment, and providers rely on incomplete medical histories and treatment plans and fail to follow NIDA guidelines. NIDA contributes about $3.6 million annually to support a methadone detoxification program, although studies have shown the treatment method employed to be ineffective; and NIDA supports another treatment program that a NIDA-financed study showed was relatively ineffective. Certain elements of the criteria used to determine NIDA funding to providers are so vague that they cannot be uniformly interpreted and/or enforced, and the criteria do not address certain important elements necessary for quality drug abuse treatment programs.
Recommendation for Executive Action
Comments: Please call 202/512-6100 for additional information.
Recommendation: The Secretary of Health, Education, and Welfare should: (1) evaluate reasons for the wide variance in slot utilization rates and apply the knowledge gained to increase overall utilization; (2) increase the minimum required number of monthly client contacts and establish criteria defining what should be considered as contacts; (3) increase efforts to convince the States to require providers to keep adequate treatment records; (4) require that providers offering outpatient methadone detoxification incorporate it into a longer-term treatment plan; (5) assure that the necessary evaluation procedures for the revised funding method are completed in a timely manner and, if proven successful, assure that the revised method is implemented by early 1982; and (6) upgrade and clarify the funding criteria.