Key Issues > Illicit Drug Use
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Illicit Drug Use

In the United States in 2014, at least 27 million people (ages 12 and older) engaged in illicit drug use—including the misuse of prescription drugs. Drug overdoses are now the leading cause of death by injury, surpassing auto accidents. Federal spending on drug control programs has increased over the last decade, but further strategies and actions are needed to curb illicit drug use, as well as the availability of illicit drugs.

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Illicit drug use is widespread in the United States and has significant consequences. The Department of Justice’s (DOJ) National Drug Intelligence Center estimated that the economic impact of illicit drug use, including the costs of health care, crime, and lost productivity, was over $193 billion in 2007—and the number is likely higher today.

  • 47,055 people died of drug overdoses in 2014, according to the Centers for Disease Control and Prevention (CDC)—the rate has more than doubled since 2000.
  • 383% more infants were born exposed to illicit drugs in 2012 than in 2000—an increase from 1.2 babies per 1000 to 5.8—according to the CDC. Postnatal drug withdrawal can cause tremors, seizures, and feeding difficulties, among other things.  
  • Parental drug abuse has been one of the main reasons for children’s placement in foster care.
  • According to the U.S. Department of Veterans Affairs, nearly one-third of veterans seeking substance abuse treatment also have post-traumatic stress disorder (PTSD). For these individuals, turning to alcohol or drugs may be perceived as a way to help cope with their PTSD symptoms.
  • According to Federal Bureau of Prisons data, almost half of the current federal prison population is serving a sentence for drug-related crimes.
  • Based on the Drug Enforcement Administration’s recent National Drug Threat Assessment, there are more than 33,000 domestic gangs involved in violent crimes related to drug trafficking and distribution.

Federal Spending on Drug Control

The amount of money that the federal government spent on drug control increased from $21.7 billion in fiscal year 2007 to about $30.6 billion in fiscal year 2016. However, while federal spending on treatment and prevention increased, money spent to reduce the drug supply (such as on domestic law enforcement) remained relatively constant.

Additionally, of the $14.7 billion allocated for treatment and prevention in fiscal year 2016, $13.2 billion was spent on treatment and $1.5 billion on prevention.

Figure: Federal Drug Control Spending for Fiscal Years 2007 through 2016

Federal Drug Control Spending for Fiscal Years 2007 through 2016

The Office of National Drug Control Policy

The Office of National Drug Control Policy (ONDCP) develops an annual strategy to reduce illicit drug use through prevention and treatment programs, as well as by decreasing the availability of illicit drugs. ONDCP’s 2010 strategy established seven specific goals to reduce illicit drug use and its consequences by 2015. However, ONDCP and federal agencies have only made moderate progress toward achieving one goal, limited progress on three goals, and no demonstrated progress on the remaining three goals. For example, no progress has been made to decrease the prevalence of drug use among young adults (ages 18 to 25) by 10 percent. In fact, the rate of drug use for this group increased from 21.4 percent in 2009 to 22 percent in 2014—primarily driven by marijuana use.

Limiting the Misuse of Prescription Drugs

Current federal law seeks to ensure that controlled substances, including certain prescription drugs, are available for legitimate uses while limiting their availability for abuse. For example, quotas limit the amount of certain substances that manufacturers can make available in the United States. Additionally, people handling controlled substances must register with the Drug Enforcement Agency (DEA). DEA also works to investigate, disrupt, and dismantle major drug trafficking organizations, although its efforts could be improved in a number of ways, particularly in these areas:

  • administering the quota process for controlled substances,
  • providing information and guidance to registrants, and
  • complying with guidelines for overseeing confidential informants.

High Priority Areas for Action

Experts have identified several high priority areas for future action to help prevent illicit drug use, including the misuse of prescription drugs. Some examples include:

  • supporting community coalitions comprising the health care, education, and law enforcement sectors that work in concert to prevent illicit drug use at the local level;
  • consolidating federal funding streams for multiple prevention programs  into a single fund used to address the risk factors for range of unhealthy behaviors, including illicit drug use;
  • increasing the use of prevention programs that research has shown to be effective, such as those that are well-designed and deliver persuasive drug prevention messages on a regular basis;
  • supporting drug prevention efforts in primary-care settings, such as exploring ways to reimburse providers for conducting preventative drug screenings
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