Drug Use Measurement: Strengths, Limitations, and Recommendations for Improvement
PEMD-93-18
Published: Jun 25, 1993. Publicly Released: Aug 02, 1993.
Skip to Highlights
Highlights
Pursuant to a congressional request, GAO evaluated three prominent drug prevalence studies currently sponsored by the federal government, focusing on the: (1) degree of data concordance; and (2) strengths and limitations of each study.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| To reduce costs with no meaningful loss of information, Congress should amend part A of title V of the Public Health Service Act to provide that the Secretary of Health and Human Services collect survey data only biennially, rather than each year, on the national prevalence of the various forms of substance abuse among high school students and among the general population. But if local or regional indicators portend an increase in drug use, then the Secretary should have the authority to initiate new or augment current studies to determine the nature and degree of the problem. |
Closed – Not Implemented
|
Congressional interest in annual reporting of drug use estimates was reiterated in the Crime Control Act of 1994. Congress has not subsequently taken action on the issue. |
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of Health and Human Services should develop or improve supplementary data sources to more appropriately determine heroin and cocaine prevalence patterns and trends. |
Closed – Implemented
The Department concurred. Analyses and evaluations of available data are being planned to study issues related to underreporting undercoverage and overlaps between data. The development of supplemental surveys is intended. The Office of Applied Studies, SAMHSA, is continuing to work on drug prevalence measurement, using ratio estimation methods. NIDA has solicited grants for small area analysis covering heroin and cocaine. These efforts are ongoing.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should design and conduct a systematic program for the study of drug use prevalence rates among underrepresented, high-risk groups. |
Closed – Implemented
The Department concurred. The Public Health Service conducted studies of drug use prevalence rates among various hard-to-reach populations, including a 3-year study of drug use in a large metropolitan area. NIDA has solicited research on high-risk groups, including the homeless, AIDS populations, border populations, Native Americans, rural populations, and Mexican-Americans.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should give high priority to validating self-reports of the use of illicit drugs, particularly focusing on objective techniques such as hair testing. |
Closed – Implemented
The Department concurred. The National Institute of Drug Abuse has begun to investigate methods to improve the validity of self-reported data, including the use of objective techniques. NIDA conducted a technical review of alternative methods to address validity and reliability issues on September 8 and 9, 1994, as part of an overall review of this issue. A national health and pregnancy survey collected hair and urine samples to validate self-reports. Further studies on the validity of self-reports are being solicited, along with a SBIR project on collecting self-report data through interactive computers.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should incorporate methodological design changes into HSSS so that nonwhite individuals are adequately sampled. |
Closed – Not Implemented
The Department concurred. However, the Department argues that HSSS is performed under a grant that has been approved through 1997 and that the principal investigator has jurisdiction over the survey. Any modifications in sample design would have to be proposed by the principal investigator, would take at least 1 school year to incorporate, and would require additional funding.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should retain the current design of NHSDA to provide national estimates only, and not expand the design to provide state-level estimates of drug use. |
Closed – Implemented
The Department concurred with this recommendation and does not intend to change the current design of this instrument.
|
| National Institute of Justice | The Director, National Institute of Justice, should review the practicality of improving the Drug Use Forecasting (DUF) design, such as by using a standardized methodology across sites. |
Closed – Implemented
The Department concurred. New training procedures and methodological guidelines have been instituted to support standardization.
|
| National Institute of Justice | The Director, National Institute of Justice, should give priority to creating a DUF arrestee database that can be generalized to booked arrestees in the geographic areas surveyed. |
Closed – Implemented
The Department concurred. A new director has been appointed and the program moved to the Office of Research and Evaluation. Catchment areas and arrest categories have been clarified to permit greater generalization. Representativeness of past samples is being checked. Other improvements are planned.
|
Full Report
Office of Public Affairs
Topics
Controlled substancesCriminalsData integritySubstance abuseNarcoticsSecondary school studentsStatistical dataSurveysParticipation ratesDrugs