Over 70,000 people died of drug overdoses in the United States in 2017. Overdoses are at their highest ever-recorded level.

This testimony includes our preliminary observations on the 2019 National Drug Control Strategy—which is intended to help coordinate more than a dozen agencies’ efforts to address illicit drug use.

The strategy does not include certain legally required information, such as specific targets against which agency success can be measured.

In prior work, we recommended that agencies establish such measures. Without them, agencies cannot truly assess whether their efforts are achieving desired outcomes.

Photo illustration of lines of cocaine, a syringe, and pills spilling out of a bottle.

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What GAO Found

The Office of National Drug Control Policy (ONDCP)—responsible for coordinating and overseeing efforts by more than a dozen federal agencies to address illicit drug use—issued the 2019 National Drug Control Strategy on January 31, 2019. ONDCP describes the strategy as a high-level vision of federal drug control efforts, focused on prevention, treatment and recovery. The strategy designates one overarching objective to reduce the number of lives lost to drug addiction, and provides some description of federal agencies' activities, including steps to reduce the availability of illicit drugs. However, it does not include certain information required by law, such as annual objectives that are quantifiable and measurable, or a 5-year projection for program and budget priorities. This required information could help prioritize activities across federal agencies and measure progress over time, which previous GAO work has shown to be important for achieving results. GAO will continue to assess the strategy as part of ongoing work, and make recommendations as appropriate.

The lack of information in the 2019 National Drug Control Strategy on measuring progress toward its objective to reduce lives lost is particularly concerning in light of previous GAO reports. These reports found that individual agencies could do more to assess their particular efforts related to opioids. For example, GAO reported in March 2018 on five agency-specific strategies to combat illicit opioids, and also reported in October 2017 on the Department of Health and Human Services' (HHS) efforts to expand access to medication-assisted treatment for opioid use disorder. In these reports, GAO recommended, among other things, that federal agencies establish performance measures to better determine progress toward their goals. While federal agencies have taken some action to implement these recommendations, such as establishing performance measures for access to medication-assisted treatment, additional actions to measure the effectiveness of related drug control efforts would further help to gauge agencies' success, determine if new approaches are needed, and efficiently target resources.

Why GAO Did This Study

Over 70,000 people died from drug overdoses in 2017, according to the most recently available Centers for Disease Control and Prevention data. Overdoses have become the leading cause of death due to injuries in the United States, and most of these deaths involve opioids. GAO has a body of work on drug policy and ongoing work on ONDCP's efforts, including issuance of the National Drug Control Strategy. GAO also noted in its March 2019 High Risk report that federal efforts to prevent drug misuse is an emerging issue requiring close attention.

This statement includes preliminary GAO observations on the 2019 National Drug Control Strategy and related findings from select GAO reports on federal opioid-related efforts. It is based on ongoing GAO work, two reports that GAO issued in March 2018 and October 2017, and selected updates on recommendations from these reports as of February 2019. For ongoing work and recommendation updates, GAO assessed the 2019 National Drug Control Strategy against statutory requirements, reviewed ONDCP and HHS documents, and interviewed ONDCP officials.

What GAO Recommends

GAO has made prior recommendations to ONDCP, HHS, and other federal agencies to address drug misuse, including establishing performance measures with targets to better gauge progress toward achieving agency goals.

For more information, contact Triana McNeil at (202) 512-8777 or McNeilT@gao.gov or Mary Denigan-Macauley at (202) 512-7114 or DeniganMacauleyM@gao.gov.