2004 National Drug Control Strategy · National Drug Control Strategy Office of National Drug Control Policy Washington, D.C. 20503 The White House March 2004. National Drug Control

NationalDrug ControlStrategy

Office of National Drug Control Policy

Washington, D.C. 20503

The White HouseMarch 2004

National Drug Control Strategy

U P D A T E


*ncj~203722*

CONTENTS

INTRODUCTION page 1

NATIONAL PRIORITIES page 9

I Stopping Use Before It Starts: page 11

Education and Community Action

II Healing America’s Drug Users: page 19

Getting Treatment Resources Where They Are Needed

III Disrupting the Market: page 31

Attacking the Economic Basis of the Drug Trade

APPENDIXES page 49

A National Drug Control Budget Summary page 51

B Acknowledgments page 53

1

Two years ago, the President’s first National Drug Control Strategy reported the unsettlingnews that for the sixth straight year, more than 50 percent of 12th graders had used an illegal drug at least once by graduation.In his 2002 State of the Union address, the President set a national goal of reducing youth drug use by 10 percent within two years.It was an ambitious goal, and to many it seemed improbable in light of the string of serial increases that preceded it. Yet that goal has been met.

The most recent Monitoring the Future survey of high school students shows an 11 percent dropin the past-month use of illicit drugs between2001 and 2003 (see Figure 1). Monitoring theFuture, which measured behavior at the 8th,10th, and 12th grades found significant reductionsamong all three levels.

This finding represents the first decline in druguse across all three grades in more than a decade.Moreover, it is a decline now in its second year.These remarkable survey results apply to nearly all

INTRODUCTION

’91 ’92 ’93 ’94 ’95 ’96 ’97 ’98 ’99 ’00 ’01 ’02 ’03

24

20

16

12

8

4

0

Source: Monitoring the Future, 2003

Percent

Year

Figure 1: Past-Month Use of Any Illicit Drug by 8th, 10th, and 12th Graders Combined

of the most commonly used substances, butparticularly to marijuana and dangeroushallucinogens. Use of the “rave” drug MDMA(Ecstasy) has been cut in half, while LSD use has dropped by nearly two-thirds, to the lowestlevel measured in nearly three decades.

These findings confirm the wisdom of a balancedstrategy, with appropriate emphasis on treatment,prevention, and enforcement. The decline in LSD use, for instance—after a period of rapidgrowth during the 1990s followed a lawenforcement-led disruption of U.S. supply.Declines in Ecstasy use are the result of successfulprevention efforts, as the understanding of theharm caused by this drug has increased over thepast two years. Finally, individuals striving to

overcome their drug use often need the assistanceof a drug treatment program, and we are workingto make such treatment more available.

The decrease in youth drug use means that400,000 fewer young people are using drugs todaythan in 2001. Less drug use means better schoolperformance, stronger families, and fewer youngpeople lost to a life of addiction and degradation.Fewer users mean that kids are safer and theirfamilies are more secure. When we push drug usedown, we not only save lives and improvecommunities, we make an investment that paysdividends for years to come, because thelikelihood that young people will ever use drugsplummets dramatically if they do not start usingduring their school years.

National Drug Control Strategy2

’97 ’98 ’99 ’00 ’01 ’02 ’03

4

3

2

1

0

8th Grade10th Grade12th Grade

Figure 2: Past-Month Use of MDMA (Ecstasy), by Grade

Source: Monitoring the Future, 2003

Percent

Year

3INTRODUCTION

Among the Monitoring the Future survey’s findings:

● Any illicit drug: Use of any illicit drug in the past30 days (“current” use) among students declined11 percent, from 19.4 to 17.3 percent. Similartrends were seen for past-year use (down 11percent) and lifetime use (down 9 percent).

● Marijuana: Use of marijuana—the illicit drugmost commonly used among youth, the drugprincipally responsible for dependence amongyoung people, and the drug of primary interestto the National Youth Anti-Drug MediaCampaign—also declined significantly. Past-year and current use both declined 11 percent;lifetime use declined 8.2 percent.

● Ecstasy and LSD: The use of the hallucinogensLSD and Ecstasy among youth has plummeted.Lifetime use of LSD fell 43 percent, to 3.7

percent, and past-year and current use bothdropped nearly two-thirds. Past-year andcurrent use of Ecstasy were both cut in half.

● Inhalants: Lifetime and past-year use ofinhalants declined 12 and 11 percent,respectively. Past-year use of inhalants among8th graders was up 14 percent between 2002and 2003—the only increase reported byMonitoring the Future during that period.

● Amphetamines: Use of amphetamines, includingmethamphetamine, dropped 17 percent forboth past-year and current use.

● Alcohol: The use of alcohol, the most commonlyused intoxicant among youth, also declined, withpast-year and current use both declining 7 percent.Reports of having “been drunk” declined 11percent in each of the three prevalence categories.

NATIONAL DRUG CONTROL STRATEGY GOALS

Two-Year Goals: A 10 percent reduction in current use of illegal drugs by 8th, 10th, and 12th graders.

A 10 percent reduction in current use of illegal drugs by adults age 18 and older.

Five-Year Goals: A 25 percent reduction in current use of illegal drugs by 8th, 10th, and 12th graders.

A 25 percent reduction in current use of illegal drugs by adults age 18 and older.

Progress toward youth goals will be measured from the baseline established by the Monitoring the Future survey for the 2000–2001 school year. Progress toward adult goals will be measured from the baseline of the 2002 National Survey on Drug Use and Health. All Strategy goals seek to reduce current use of any illicit drug.(Use of alcohol and tobacco products, although illegal for youths, is not captured under “any illegal drug.”)

● Impact of Anti-Drug Advertising: Exposure to anti-drug advertising (of which the Media Campaignis the major contributor) has had an impact onimproving youth anti-drug attitudes andintentions. Youth in all three grades surveyed(8th, 10th, and 12th) say that such ads havemade their attitudes less favorable toward drugs to a“great extent” or “very great extent,” and madethem less likely to use drugs in the future.

These gains are a new foundation for saving morelives. The difference we are now making will befelt in the life of each young person not victimizedby drugs, and in the families and communities inwhich they live. When our Nation pushes backagainst illegal drugs, the problem recedes.

Moreover, when fewer Americans use drugs,international drug traffickers are denied profits

and power. Our international partners recognizethat the United States is doing its part to drivedown demand. Our allies in Latin America have shown genuine leadership in this fight.President Uribe in Colombia and President Fox in Mexico both fight drug trafficking because they understand that no country is free when itsuffers from the corruption and terror the drugtrade fosters.

Counseling Despair

The findings are more than just good news forAmerican families; they counter the arguments of defeatists that an engaged public cannot make a difference in the fight to protect our youth.


(9.7%)

Figure 3: Treating Drugs Like Alcohol and Cigarettes?

Current Users by Substance (in thousands)

Illicit drugs 19,522

Alcohol 119,820

Cigarettes 61,136

5INTRODUCTION

Those who would legalize the use of illicit drugstend to fall back on familiar arguments, perhapsthe most common of which is that we should treat illegal drugs “like we treat alcohol orcigarettes.” They neglect to point out that thereare 120 million regular drinkers in the UnitedStates and some 61 million smokers (see Figure3). The comparable figure for illegal drugs isabout 20 million—a large number to be sure,but far smaller than would be the case if drugswere legal.

Although sometimes acknowledging that illicitdrug use would probably rise if drugs werelegalized, critics of our current, balanced drugpolicy also neglect to note that the greatestsuffering, the greatest impact of cheap, legal drugswould be felt by the young and the poor. Anespecially vulnerable group is people with co-occurring mental disorders, since drug users

are more likely to develop mental problems,while individuals with mental disorders are more likely to use illegal drugs than the population at large.

Some argue that the Federal Government isspending vast sums on drug interdiction andenforcement while drug treatment and educationprograms receive pennies on the dollar. Acorollary myth holds that the goal of drug controlpolicy is to “arrest our way” out of the drugproblem, filling America’s prisons with masses of low-level drug offenders.

As the Strategy lays out in more detail, thePresident’s drug control budget request for fiscalyear 2005 proposes to spend 45 percent of thedrug control budget on drug treatment andprevention, including new funding in support ofthe President’s commitment to increase spending

(8.9%)

Current Users Who are Dependent (in thousands)

Illicit drugs 5,338

Alcohol 16,272

*Dependence on cigarettes is based on daily use. Source: National Survey on Drug Use and Health, 2002

Cigarettes 38,700*

on drug treatment (the fiscal year 2005 treatmentrequest is $2.3 billion, a 6 percent increase over2004). The Budget apportions the remaining 55percent among law enforcement budgets,international programs, drug-related intelligencespending, and interdiction activities.

We are a long way from seeking to “arrest ourway” out of the drug problem. Only a smallpercentage of drug arrestees are ever sent toprison, and the vast majority of those behind barsfor drug offenses are guilty of substantialtrafficking, not possession. Indeed, one of themore promising trends in the criminal justicesystem is the creation of drug courts, which referthose in need of treatment not to incarcerationbut to genuine help, and which offer hundreds ofthousands of arrestees the prospect of zero prisontime, provided they attend counseling and drug

treatment sessions. The fiscal year 2005 budgetsupports this policy innovation with an increase of$32 million for drug courts.

According to the U.S. Sentencing Commission,the median quantity involved in federal cocaine-trafficking cases is 3,016 grams for powder and 62grams for crack cocaine—more than 600 “rocks”of crack. The relevant figures for heroin andmarijuana are 649 and 58,060 grams, respectively—enough, in either case, for tens of thousands ofdoses. The additional claim that law enforcementagencies are focused on locking up individuals forpossession of, as opposed to trafficking in, illegaldrugs is likewise inaccurate. In fiscal year 2001,the most recent year for which there is data, out of24,299 Federal drug cases, there were just 384federal possession convictions for cocaine,marijuana, and heroin combined.


All other offenses 88.8%

Drug violation arrests 11.2%

Figure 4: Drug Violation Arrests Accounted for 11 Percent of All Arrests in 2002

Source: Federal Bureau of Investigation

Legalization proponents dismiss such facts,even as they minimize the harm drug users inflict on themselves, and on family andcommunity. They focus instead on the supposedharm inflicted on the individual and communityby the government, particularly law enforcement.Yet the cost of drug use overwhelmingly falls not simply on the drug user—although userscertainly pay a high price—but also on spouses,parents, society, and taxpayers.

We invite the skeptics to attend a few meetings ofa local Al-Anon chapter and listen to what familiesin their own communities are going through on a daily basis. They should listen closely to whathas helped these families’ drug-using loved onesstart to get well. As psychiatrist Robert DuPontnotes, “They are unlikely to hear that the answerwas more drugs in their neighborhoods.”

The President’sManagement Agenda:Budgeting for Results

The budget volume that accompanies thisNational Drug Control Strategy presentsperformance information for each of the drugcontrol programs. As part of this Administration’seffort to integrate budget and performance,the new drug budget, first presented last year inthe National Drug Control Strategy, not only tiesto identifiable line items in the President’s Budgetbut also includes key performance information for each program. The performance informationpresented here was used by the Administration to formulate the fiscal year 2005 budget.

Building on agency efforts under the GovernmentPerformance and Results Act, and working withthe Office of Management and Budget inimplementing its Program Assessment RatingTool (PART), the Office of National DrugControl Policy has made data on programperformance central to budget decisionmaking.In the President’s fiscal year 2004 budget,programs comprising about one-third of the drug budget were assessed. With new assessmentsconducted for the fiscal year 2005 budget andupdates of prior assessments, 45 percent of thedrug budget was assessed.

The goals of the National Drug Control Strategyand its three national priorities—Stopping UseBefore It Starts, Healing America’s Drug Users,and Disrupting the Market—drive the budgetingprocess. Each program’s effectiveness incontributing to the accomplishment of those goalshelps determine its resource level. Demonstrablyeffective programs receive continued support.Ineffective programs and programs for whichresults have not been demonstrated have actionplans for improvement and, in some cases,reduced resource levels.

By integrating program goals and effectivenessinformation into the National Drug ControlStrategy, the Administration has laid thefoundation for increased accountability for Federalfunds and enhanced program performance.

7INTRODUCTION


National Drug Control Strategy:

NATIONAL PRIORITIES

9


BUDGET HIGHLIGHTS● Education—Student Drug Testing: up $23 million. The budget proposes $25 million

for student drug testing programs. This initiative will provide competitive grants to support schools in the design and implementation of school-based drug testing, assessment, referral, and intervention programs.

● During fiscal year 2003, several schools sought funding for the design and support of their ownstudent drug testing programs. The President’s Budget expands this program in fiscal year 2005.

● ONDCP—National Youth Anti-Drug Media Campaign: $145 million. The President’sfiscal year 2005 Budget continues funding for ONDCP’s media campaign, an integrated effort thatcombines paid and donated advertising with public communications outreach. Anti-drug messagesconveyed in advertising are supported by Web sites, clearinghouses, media events, outreach to theentertainment industry, and strategic partnerships that enable messages to resonate in ways thatgenerate awareness and ultimately change teen beliefs and intentions toward drug use. In 2005,the media campaign will expand its strategy to include information for teens and parents to promoteearly intervention against drug use.

● ONDCP—Drug-Free Communities Program: up $10.4 million. Building on the success ofthis program, these additional resources will fund approximately 100 new local community anti-drugcoalitions working to prevent substance abuse among young people. This program provides matchinggrant monies, with priority given to coalitions serving economically disadvantaged areas.

● The President’s Budget recommends increasing funding to $80 million in fiscal year 2005, withup to 5 percent of available grant funds provided to selected “mentor coalitions” that will helpdevelop new community anti-drug coalitions in areas that do not currently have them.

11N A T I O N A L P R I O R I T I E S — I

Stopping Use Before It Starts:Education and Community Action

compulsion to fit in, the type of pressure teensface every day. Debunking the mistaken view that “everyone” is using drugs is a key goal of theNational Youth Anti-Drug Media Campaign,which has contributed to the remarkable declinein drug use over the past two years.

But far too many young people find that their first experience with illegal drugs happens through contact with one person—not a pusher,

In a scene that has become a staple of televisiondramas, the neighborhood “pusher” frequents local playgrounds offering free drugs to enticefirst-time users. Such people exist, but they arenot the norm. Successful drug dealers are morecircumspect; their livelihood depends on it.They are not known for giving out samples.

The pressure young people face to use drugs is more accurately portrayed as a general

25

20

15

10

5

0

12-13 14-15 16-17 18-20 21-25 26-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+

Percent

Age

Source: National Survey of Drug Use and Health, 2002

Figure 5: Drug Use Starts With Young People

Past-Month Illicit Drug Use by Age

Youth in the early teen years may face fewchallenges greater than choosing between a friendand drug use. From the public health perspectivethat informs this Strategy, this type of friend is avector of contagion. And all too often, the illegaldrug use he proposes to his peers will lead to thepediatric onset disease of addiction.


not even a peer group, but a single friend. Thispressure to use drugs can take on a surprisinglyearnest form. A young person exposed to thepleasures of a new drug—or seeking to normalizehis own drug-using behavior—may pressure peersto join in the fun or face eventual expulsion fromthe group.

INTERVENING EARLY: MIAMI-DADECOUNTY ’S JUVENILE ASSESSMENT CENTER

Juvenile arrestees pose an unusual challenge to state criminal justice systems,requiring segregated facilities and a host of specialized services, including drugtreatment. Florida’s Miami-Dade Countytakes a different approach, one that workswell with the brief intervention approachdiscussed in more detail in the nextchapter. In Miami-Dade, all juvenilearrestees are sent to a central facility, theJuvenile Assessment Center ( JAC), whichbrings together specialists from lawenforcement and social services to providecoordinated services to youth as they enterthe juvenile justice system.

“We brought all the agencies that deal with arrested children to the JAC,” saysWansley Walters, the center’s director.“We have staff to do everything from arrest processing to treatment referrals.We have staff from the Dade Countyschool system here to check school records and notify the school that a childhas been arrested. The State Attorney’s

office is represented so that they can meet with the arresting officer andinterview the young person.” In all, theformerly bureaucratic process of arresting a juvenile has been shortened from fourweeks to less than a day.

All arrestees receive an assessment of some type. “At the root of many of thesekids’ behavior is a drug problem,” saysWalters. “Unfortunately, a lot of kids move through the system without havingtheir drug use connected to their behavior problems.”

Through careful screening, the JAC staffare able to tailor their interventionsaccordingly. “One child may need a lengthyresidential treatment,” says Walters. “Youmay have a child who needs no more thancounseling and a realistic discussion aboutthe risks of what he’s doing. Frankly, somechildren just need some attention—andthat may be all [it takes] to modify theirbehavior.”

Student drug testing is a remarkable grassrootstool that the Federal Government is movingaggressively to support with research funding as wellas support for program design and implementation.The fiscal year 2005 budget requests $25 millionfor student drug testing programs. Eightdemonstration grants have already been awardedwith prior-year funding, to expand existingprograms and evaluate the effectiveness of others.

Student drug testing programs advance theStrategy’s goal of intervening early in the youngperson’s drug career, using research-basedprevention approaches to guide users intocounseling or drug treatment, and deterring othersfrom starting in the first place. The purpose ofrandom testing is not to catch, punish, or exposestudents who use drugs but to prevent drugdependence and to help drug-dependent studentsbecome drug-free in a confidential manner.Effective testing programs include clear-cutconsequences for students who use illegal drugs,such as suspension from an athletic activity, untilthe student has completed counseling.

13Stopping Use Before It Starts

Research into youth motivations for using drugsconfirms the crucial importance of peers,particularly close friends, in fostering a climatetolerant of drug use. Just as young people who usedrugs are much more likely to continue their druguse into adulthood, the available research isunequivocal that people who make it throughtheir teenage years without using drugs are muchless likely to start using later in life.

Keeping teens from taking that first, risky step iscentral to the success of our Strategy. Yet despiteparents’ best efforts to keep their kids drug-free,every day approximately 4,800 American youthunder age 18 try marijuana for the first time—anumber roughly equal to the enrollment of sixaverage-size high schools.

Following up with brief interventions for youngpeople who do try illegal drugs (or alcohol) is critical. This Strategy highlights the importanceof student drug testing, a prevention approach thataccomplishes both goals: deterring drug use whileguiding users to needed treatment or counseling.

Marijuana 1,741,000

Cocaine 353,000

Hallucinogens 757,000

Ecstasy 590,000

Pain relievers 1,124,000

Figure 6: Drug Use Initiation Is Highest Among Young People

Initiation Among Those Under 18 in 2001


Student drug testing programs work. According to a study published in the Journal of AdolescentHealth, a school in Oregon that tested studentathletes for drugs had a rate of use that was one-quarter that of a comparable school with no drugtesting policy. After two years of a drug testingprogram, Hunterdon Central Regional High Schoolin New Jersey saw significant reductions in 20 of28 drug use categories, with cocaine use by seniorsdropping from 13 to 4 percent (see box). A studyfrom Ball State University showed that 73 percentof high school principals reported a reduction in

drug use among students subject to drug testingpolicies, with just 2 percent reporting an increase.

Our Nation needs more of the sort of communityand parental involvement that embraced Hunterdon’sschool drug testing program and made it a success.Americans serve their communities in countlessways—in our most drug-ridden communities,groups of citizens are stepping forward to servetheir neighbors, banding together to fight backagainst the drug trade and the social consequencesleft in its wake. They are doing it with techniques


STUDENT DRUG TESTING AT HUNTERDONCENTRAL REGIONAL HIGH SCHOOL

Lisa Brady, principal of Hunterdon CentralRegional High School, remembers 1997 asif it were yesterday.

The Flemington, New Jersey, school’speriodic surveys had detected a spike in druguse among the student body, prompting the school board to launch a random testingprogram for student athletes. “Our schoolboard president at the time was an Olympic track athlete,” says Brady. “Hewas extremely familiar with the benefits of drug testing.”

The psychology behind student drug testingprograms is straightforward. They give kidsan “out,” Brady says. “Kids will tell you thatthe program gives them a reason to say no.They’re just kids, after all; they need acrutch. Being able to say, ‘I’m a cheerleader,’

‘I’m in the band,’ ‘I’m a football player,’ and‘My school drug tests’—it really gives themsome tools to be able to say no.”

When a student turns up a positive drugtest (Hunterdon administers about 200random tests per year), the student andparents meet privately with a counselor.An intervention is agreed to—typically,brief counseling sessions followed byclasses emphasizing decision-making skills.“After that they have to submit a drugscreen,” says Brady. “Then they return totheir activity, safer and smarter as a resultof their counseling. The program is designedto be confidential. No records are kept.”

A lawsuit filed by the ACLU on behalf of three students eventually forced thesuspension of testing, but by this time the

as varied as videotaping dealers in open-air drugmarkets, working with zoning officials to condemncrack houses and close down drug paraphernaliastores, and forging alliances between treatmentand law enforcement. And they are succeeding,often surprising even themselves (see box on pages16 and 17). When these Americans get involvedin their communities, our whole Nation benefits.

The drug Strategy works best when Americans work together. As discussed more fully in the nextchapter, this means making the unpleasant and

seemingly thankless decision to intervene with afamily member or friend who is using drugs.Last month, the National Youth Anti-DrugMedia Campaign launched an early interventioninitiative to help parents recognize the signs ofearly use and encourage them to take actionbefore use creates problems and leads to addiction,offering information and suggested approaches fordiscussing the subject with their children.

This campaign also targets peers of teens whohave just started to use drugs and alcohol,


program had been enlarged to includestudents involved in other extracurricularactivities. More important, testing hadbeen going on long enough for the schoolto measure the program’s effects. Whatthey found was remarkable: significantreductions in drug use—school wide. Andalthough only certain categories of studentswere tested, the program had been affectingthe student body as a whole, identifyingdrug use early and buffering the peerpressure that encourages teens to use drugs.

Brady was understandably frustrated athaving to put the program on hold. “HereI’m holding data in my hands that showsthat this program clearly was effective inreducing drug use among my students,”says Brady, “but I was not able to implementthe program. I was pretty upset.”

She continues, “We have never seen aprevention curriculum that affected the

numbers this substantially. It seemed thatfinally we had a tool that was making alarge difference. And yet we’re hemmingand hawing about whether to use it.”The school eventually prevailed, but notbefore litigating all the way to the NewJersey Supreme Court. Today, the programis back in full operation.

Although the program is overwhelminglysupported by Hunterdon parents, Bradyis surprised how often the parent, not the student, questions the test results.“The kid will come in and say, ‘I was at aparty this weekend, and my drug screen isgoing to be dirty,’ says Brady. “Then theparent tries to get the kid out of thesituation. Sometimes the parent is justused to bailing the kids out of everything.A lot of parents are in denial, andsometimes,” she adds, “it takes a drug test to make kids and parents overcomethat denial.”

which is illegal in all 50 states for people underage 21, and includes television, radio, and printads as well as workplace outreach and otherefforts. The campaign takes direct aim at parents’understandable but misplaced fear that they will push their children away by talking to themabout drug use.

Children also learn by example. Athletics play an important role in our society, but,unfortunately, some in professional sports are

not setting much of an example. The use ofperformance-enhancing drugs such as steroids in baseball, football, and other sports is dangerous,and it sends the wrong message—that there areshortcuts to accomplishment, and thatperformance is more important than character.

America’s team owners, union representatives,coaches, and players must work together to end the use of performance-enhancing drugs.Use by even a small number of elite


FIGHTING BACK IN OREGON

Nobody told Shirley Morgan she couldn’tdo it.

In the beautiful rural area east of Portland,in the shadow of Mount Hood, drugdealers were taking advantage of the area’sabundance of seasonally occupied vacationhomes to cook methamphetamine, some of which they sold locally. Marijuana“grows” abounded.

Then, somebody broke into Morgan’shouse. “It wasn’t until my home wasburglarized that I asked myself how I hadmissed all the signs that the drug trade was here,” says Morgan, founder of theMount Hood Coalition Against DrugCrime. “All of a sudden we had carsspeeding along what had been quietmountain roads. We had people cookingmeth in their house, dumping thechemicals into the yard, and contaminatingthe water supply.”

Morgan, a marketing and advertisingconsultant, gathered business, civic, andfaith leaders, and her neighbors. Together,they reached the bold conclusion that withsome help from law enforcement, theycould drive off the drug dealers and methcookers in their midst. “At any given time,”says Morgan “we have one police officerpatrolling a 35-mile-long strip. The policejust can’t be everywhere. So we, theresidents of the Mount Hood corridor,formed a volunteer coalition against drugcrime in our community.”

Members of the coalition collectintelligence such as digital photos ofsuspicious vehicles and license platenumbers and pass it to law enforcement,often using email. Their Web site,www.hadit.org (the residents had “had it”), lists outstanding arrest warrants andphotographs of criminals known to beactive in the area. The coalition also

athletes sets a dangerous example for the millions of young Americans, encouraging young people to take dangerous risks with their health and safety. Ending the use of steroids will require sports leagues and athletes to implement stringent drug policies to set a healthier and more positive example for America’s young people. These policies will also protect the integrity of their sports andensure the health and well-being of athletes.


educates property owners about the long-term effects of drug manufacturing in theirrental properties (a single meth cook canturn a split-level ranch house with a viewinto a hazardous materials site).

The coalition works. In a lesson that has beenlearned time and again by community groupsand Orange Hat citizen patrols in some ofAmerica’s most crime-ridden inner cities,dealers respond to unwanted attention bytaking their business elsewhere. Morgancounts six people who were involved withthe drug trade who picked up and moved.Another five had their homes repossessed, andseveral others just went back to their day jobs.

“People ask me, ‘Aren’t you afraid ofretaliation?’ I say, ‘They’re alreadyretaliating, burglarizing our homes, andabusing the environment.’”

Some of her neighbors have sought drugtreatment, and Morgan, with the help of alocal church ministry, is happy to help place

them, with a strong dose of communityinvolvement. “One of the guys in theprogram, who used meth, marijuana, andalcohol said, ‘I can’t do this anymore. Everytime I turn around, somebody’s looking.’”

Morgan, who is active in the FoursquareChurch, works with more than 50neighbors from all types of backgrounds,but she is happy to explain her pluck anddedication in the context of her Christianfaith. “It’s sort of a calling—you don’t wantto go somewhere but you go anyway,” saysMorgan. “It’s like the Samaritan story. Youfind drugs on your street, and you askyourself, ‘Can I look the other way?’ I waschallenged by my faith to do something.”

In addition to radically changing theclimate in the Mount Hood region,Morgan is poised to take her lessons onthe road: the coalition recently received amentoring grant to train and improve theeffectiveness of other coalitions in thePacific Northwest.


BUDGET HIGHLIGHTS● Substance Abuse and Mental Health Services Administration (SAMHSA)—Access

to Recovery: up $100.6 million. The President has committed to expand the drug treatmentsystem over five years, including through the Access to Recovery initiative (ATR). The fiscal year 2005 budget proposes $200 million for ATR, an increase of $100.6 million over the 2004 enacted level.

● This initiative will provide people seeking clinical treatment or recovery services with vouchers to pay for the care they need. Vouchers may be redeemed for services at eligibleorganizations, including those that are faith based, and will allow more flexible delivery of services to individuals based on their treatment need.

● Office of Justice Programs—Drug Courts Program: up $32 million. The Administrationrecommends a funding level of $70.1 million for the drug courts program in fiscal year 2005.This represents an increase of $32 million over the 2004 enacted level. This enhancement will increase the scope and quality of drug court services with the goal of improving retention in,and successful completion of, drug court programs. Funding also is included to generate drug court program outcome data.

● The drug courts program provides alternatives to incarceration, using the coercive power of the court to force abstinence and alter behavior by drug-dependent defendants with acombination of clear expectations, escalating sanctions, mandatory drug testing, treatment,and strong aftercare programs.

● National Institute on Drug Abuse (NIDA): up $28.3 million. This increase will ensureNIDA’s continuing commitment to key research efforts, including basic research on the nature of addiction, development of science-based behavioral interventions, medications development,and the rapid translation of research findings into practice.

● NIDA’s efforts include: the National Prevention Research Initiative, Interventions and Treatment for Current Drug Users Who Are Not Yet Addicted, the National Drug AbuseTreatment Clinical Trials Network, and Research Based Treatment Approaches for Drug Abusing Criminal Offenders.

19N A T I O N A L P R I O R I T I E S — I I

Healing America’s Drug Users:Getting Treatment Resources WhereThey Are Needed

The Strategy uses the public health model as away to understand the epidemiology of drug useand control its spread. The public health model isthe only understanding of addiction that canexplain why people continue to use drugs whenthe consequences are a devastating disease of thebrain and a terrible loss of human potential.

Conventional wisdom on the topic suggests thatyoung adults use drugs because they think they areinvincible. Adults, presumably wiser but also self-destructive or simply optimistic, are thought torecognize the dangers but use drugs anyway. Theywatch an addict and tell themselves that thingswill be different for them.

But the conventional wisdom only explains somuch. Why, for instance, do people initiate theuse of methamphetamine—a drug that can causea complete unraveling of home life, work, andsocial connections in a matter of months?

The public health model suggests a deeperexplanation, one touched upon in the previouschapter’s discussion of prevention and the role ofnewly drug-using teens in proselytizing their peersto join in the fun, and seeking to normalize theirown drug using behavior. Simply put, manypeople use drugs because they know someone whois using and not suffering any apparent consequences.The disease of drug dependence spreads becausethe vectors of contagion are “asymptomatic” userswho do not yet show the consequences of theirdrug habit, and who do not have the slightestawareness of their need to seek help.

It is especially important to intervene with usersduring this “honeymoon” phase. A new approachsuggests a way ahead, using the existing medicalinfrastructure—which already has extensiveexperience in identifying problem drinkers—toscreen for drug use and offer appropriate andoften brief interventions. The Department ofHealth and Human Services has awarded seven grants in the past year to advance ourunderstanding of screening and brief interventionin treatment. In Chicago, for example, CookCounty Hospital emergency room staff as well asdoctors and nurses in other areas of the hospitalwill be trained to detect the signs of developingdrug use and direct users into treatment.

Expanding Access toRecovery

Screening and brief interventions hold promise forcutting short the drug problems of millions ofAmericans. Yet 20 million Americans are past-month, or current, users of at least one illegaldrug, and seven million Americans need drugtreatment, according to diagnostic criteriadeveloped by the American Psychiatric Association.

More than one million Americans receivetreatment each year and start on the road torecovery. In recent years, however, an average of100,000 of those who seek treatment each year

have not been able to receive it. They have animmediate need, and we have launched a newprogram to address it—Access to Recovery. Begunin fiscal year 2004, with an additional $100million requested in fiscal year 2005, the programwill expand access to clinical substance abusetreatment, including recovery support services,while encouraging accountability in the treatmentdelivery system.

The program will work as follows: Those withoutthe means to pay for treatment will be assessedand issued a voucher for the cost of treatment orrecovery services as appropriate.

Recognizing that there are many routes torecovery, this initiative envisions a pathway to helpthat is direct and open on a nondiscriminatorybasis to all, including services provided by faith-based organizations. For many Americans, the

transforming powers of faith are crucial resourcesin overcoming dependency, and this new programwill work to ensure that treatment vouchers areavailable to the programs that work the best,including those that are faith-based (see box below).

From Waiting to Denial

Most policy analyses of drug treatment begin andend with a discussion of waiting lists. Although suchlists are a staple of journalistic accounts of thedrug treatment system, even the roughly 100,000individuals seeking but unable to obtain treatmentrepresent a tiny fraction—perhaps one in 70—ofthe number in need of help. The real problem isthat a much larger number of Americans—somesix million—are dependent on an illicit drug and


KEY ELEMENTS OF ACCESS TORECOVERY:

● Flexibility. With a voucher, people in need of treatmentor recovery support services will have the freedom toselect the programs and providers that will help themmost—including programs run by faith-basedorganizations.

● Results Oriented. Grantee institutions will be asked todevelop systems to provide an incentive for positiveoutcomes.

● Increased Capacity. Access to Recovery is projected tosupport treatment or recovery support services forapproximately 100,000 people per year.

are not seeking treatment (see Figure 7). Thus thecentral problem is not waiting lists, but waitingfor individuals who are in denial about their needfor drug treatment to recognize that need.

A voucher system, for the first time, offers thoseseeking drug treatment a consumer-driven path tothe services they need; yet, the larger challenge forour society is to direct drug-dependentindividuals—one in five of whom also suffers froma serious “co-occurring” mental illness—to thehelp they so desperately need but fail to consider.

Closing this “denial gap” is a vast undertaking.Helping our brothers and sisters in need and staringdown the social discomfort and risk of alienationto offer the hope of recovery requires the energyand commitment of all Americans. We must createa climate in which Americans confront drug use

honestly and directly, offering the compassionatecoercion of family, friends, and the community,including colleagues in the workplace, to motivatethe change that brings recovery.

When such efforts fail, and when individuals runafoul of the criminal justice system, we must makeall reasonable efforts to identify and direct individualsin need into court-supervised drug treatment. Inthis connection, the Administration has requesteda $32 million increase in Federal support for thedrug courts program in fiscal year 2005.

Drug courts use the authority of a judge to requireabstinence and altered behavior through acombination of clear expectations, graduatedsanctions, mandatory drug testing, case management,supervised treatment, and aftercare programs—aremarkable example of a public health approach

21Healing America’s Drug Users

(1.1%)

Figure 7: Most of Those in Need of Drug Treatment Do Not Seek It

Received treatment 1,400,000

Sought but did not get treatment 88,000

Felt need but did not seek treatment 274,000


Did not feel need for treatment 5,938,000 .

America’s borders by traffickers. By contrast, withfew exceptions, prescription drugs are legalmedicines, legitimately manufactured, distributedby licensed pharmacists, and prescribed in goodfaith by physicians. And while most Americansunderstand the risks of addiction or even deathfrom drugs like heroin or cocaine, they are lesslikely to appreciate the risks associated withprescription drugs, which are approved andcertified by the government. Yet, throughnegligence, theft, fraud, or forgery, these addictivesubstances are being diverted and abused withalarming frequency.

Surveys confirm that the nonmedical use ofprescription drugs has emerged in the last decade


linked to a public safety strategy. Carefullymodulated programs like drug courts are often theonly way to free a drug user from the grip ofaddiction. More than 1,183 drug courts operate inall 50 states, with an additional 414 courts in theplanning stages (see Figure 8 on page 26).

Focus on Prescription Drug Safety

Traditional drug threats involve illicit substancesgrown or produced abroad and smuggled across

OPERATION PAR’S THERAPEU TICCOMMUNITY WITH A DIFFERENCE

Operation PAR (Parental Awareness andResponsibility) got its start the way manyeffective programs do: a parent concernedabout her child’s drug use took action.That parent was Shirley Coletti. The westcentral Florida-based nonprofit shefounded in 1970 has grown to more than625 employees in four counties serving9,800 individuals a year, from juvenilefelons to outpatient heroin addicts onmethadone maintenance.

One of the group’s many remarkableprograms is PAR Village, a residential,therapeutic community-type drugtreatment campus spread over three acres.At PAR Village, 25 to 30 mothers and

expectant mothers spend up to 18 monthsliving with their young children. Another20 mothers with older children live alonebut can have their children stay overnight.

The program grew out of in-houseresearch. As Nancy Hamilton, OperationPAR’s CEO, explains, “We studied thequestion of whether mothers did better if they were able to keep their children[while] in treatment,” says Hamilton. “Wefound that they did.”

Some of the women at PAR Village are atrisk of losing their children and come as acondition of maintaining parental rights.Some have been sentenced by a drug court

as a major problem. The illegal diversion, theft, andmedical mismanagement of prescription drugs(particularly opioid pain medications) have increasedand, in some areas, present a larger public health andlaw enforcement challenge than cocaine or heroin.

According to the most recent National Survey of Drug Use and Health, the misuse ofpsychotherapeutic drugs—pain relievers,tranquilizers, stimulants, and sedatives—was the second leading category of illicit drug use in 2002, following marijuana. An estimated 6.2 million Americans (approximately 2.6 percentof the population age 12 and older) had used apsychotherapeutic drug for nonmedical reasons in the month prior to the survey.


The bulk of this abuse involves narcoticanalgesics—an estimated 4.4 million Americansare past-month (so-called current) nonmedicalusers of pain relievers. OxyContin, a powerfultime-release painkiller with an addiction potentialsimilar to morphine, was used nonmedically atleast once by 1.9 million Americans in 2002. Therate of OxyContin abuse in 2002 was ten timeshigher than in 1999.

The University of Michigan’s Monitoring theFuture survey for 2003 finds a similar patternamong young people, with the nonmedical use of prescription drugs second only tomarijuana. The abuse by high-school seniors ofthe brand-name narcotic Vicodin is more than

but are given a chance to have theirchildren join them.

Drug use by parents and its effects on childrenare treated simultaneously. “You have twoclients—the mom and the child,” saysHamilton. “While you are doing treatmentwith the mom, you are doing preventionwith the child.”

Many of the women who enter PAR Villageare hard cases, but Hamilton is impatient withtreatment providers who take only the mostpromising clients. “A lot of programs explaintheir failures by saying that they just need abetter class of clients. We think there’s no suchthing as client failure—only program failure.”

“These moms come in and they are prettymuch unsuccessful in every area of their

lives,” says Hamilton. “And they come inhere and we create an environment wherethey can be successful. But it’s not easy.Our counselors and staff have to teachthem how to bathe their kids, how to feedtheir kids dinner, how to put the kids tobed. We tell the nurses who want to workhere that they have to be prepared for theunexpected.”

The unexpected sometimes has to do withclarifying the line between discipline andabuse. “Often, we have to teach parentshow to discipline their children withoutbeing abusive,” says Hamilton. “But it is ajoy to watch children flourish as theirrecovering mothers learn better parentingskills and as their recovering mothers learnto give them the greatest gift of all—thetime that drugs used to occupy.”

double their use of cocaine, Ecstasy, ormethamphetamine. This drug has become adeadly youth fad, with one out of every ten

high-school seniors reporting nonmedical use.Some 5 percent of seniors report nonmedical useof OxyContin.


ONE-STOP SHOPPING AT NASHVILLE’SDRUG COURT

Judge Seth Norman spent five years as acriminal court judge in Nashville beforetiring of the parade of familiar faces anddeciding to try something different. “I sawthe same person coming through the doortime and time again,” says Judge Norman.He and colleagues investigated thepossibility of securing funding for a drugcourt, and even after being awarded aFederal grant, found that he still had toscrounge for furniture.

“I took five guys out of jail,” says JudgeNorman. “I took them to an abandonedstate mental hospital—it was in terribleshape—and I told them that if they’d cleanit up, I’d find them some counseling.”

Eight years later, the Davidson County DrugCourt is nationally known as much for itsimpressive results as for its unusual approach.In the reverse of the usual pattern, the drugcourt refers the majority of its clients notto outpatient treatment but to an intensive,year long residential treatment regimenknown as a therapeutic community.

“Most of the people we deal with haveserious enough problems that they aregoing into inpatient treatment,” says Judge

Norman. “Drugs like crack cocaine are justso potent that [users] are going to have tospend some time in treatment before theyare going to be better.” The remainder, lessthan 20 percent of referrals, is assigned tooutpatient treatment with weekly hearingsand regular drug testing.

The drug court is unusual for anotherreason: the inpatient therapeuticcommunity to which it refers clients, whichhouses up to 100 long-term residents, isco-located with the drug court. Supervisionis intense. “The Judge and the treatmentcounselors know all of the residents byname,” says Jeri H. Bills, the court’sprogram coordinator. “People here learn tobe responsible—and these people havenever had any responsibility. They’ve neverhad a job, paid taxes, gotten up early towalk their kids to the school bus. Here,they get up every day before six, they runthe place, they keep the grounds.”

The program comprises three phases, anacclimation phase for roughly the first sixto eight weeks is followed by six to eightmonths during which residents haveminimal freedom of movement. They canearn passes to leave for four hours at a

emergency room episodes, nonmedical use ofnarcotic analgesics as a reason for an emergencyroom visit rose 163 percent between 1995 and

25

Additionally, according to the Drug AbuseWarning Network (DAWN), a nationwidesentinel system that monitors drug-related

Healing America’s Drug Users

time, with the understanding that they willbe drug tested on their return.

To enter the third and final phase, residentsmust find work. “We provide all residentswith a bus pass,” says Judge Norman, “and wecoach those with literacy issues, but they haveto go out and find their own job.” One-thirdof residents’ pay goes back into the programto cover costs, one-third goes to a savingsaccount to provide some stability whenresidents return to the outside world, andone-third goes to court-related costs suchas child support and restitution to victims.

Keeping a job for 90 days is onerequirement for “coining out” (graduatesget a commemorative coin on graduationfrom the residential portion of theprogram). Coining out is followed byanother six months of supervision whileclients reintegrate into society.

Recidivism—here defined as beingconvicted of any crime after graduation—isabout 18 percent. “We take each of our 260graduates and we run them through anNCIC [National Crime InformationCenter] check and a local police arrestquery,” says Judge Norman. Not that theprogram’s graduates are all that hard totrack down. An alumni association meets inthe courtroom every other Tuesday night.

The program’s graduation rate is about 65 percent. “Some people come in and just say ‘to heck with this—I’ll just do my10 years,’” says Judge Norman. “Many ofthem have done time so many times thatfor them, it’s just another trip to prison.Here, you’re not going to find a boom boxor a TV. You have to do exactly what youare told to do, when you are told to do it.And you know what? These folks find that they love having some structure intheir lives.”

Judge Norman and the drug court staff feel strongly about the supportive rolefamily members can play in a resident’srecovery. “We don’t push it until midwaythrough phase two,” says Jeri Bills.“The family wants to help the person,but often they haven’t known what to do. Having them there says that the person in treatment is not doing it on their own—they have the support of afamily that has probably been alienated for so long.”

Judge Norman still has his day job in thecriminal court, but he looks forward to the time he spends in drug court. “It’s justabout one of the most satisfying things a person can do is see a person become a successful citizen after they have beenaddicted to drugs for many years.”

2002. More alarming, trend data from DAWN forthe years 1995–2002 shows a dramatic rise inemergency room mentions of single-entityoxycodone (formulations of the narcotic withoutother drug combinations), from 100 mentions in1996 to nearly 15,000 mentions in 2002.

Curtailing DoctorShopping

Pharmaceuticals can be diverted in multiple ways.The most popular form of diversion is known asdoctor shopping—visiting many doctors to

acquire large amounts of controlled substances.Other diversion methods focus on the pharmaciesthemselves, which may experience theft orinappropriate distribution of controlled drugs bypharmacists or employees or may receive forgedprescriptions. Physicians may inappropriatelyprescribe controlled substances through eitherinsufficient risk-management of patients with apotential for abuse or outright fraudulent medicalpractice. Those who acquire diverted substancesmay themselves abuse them or sell them to othersat enormous profit.

The most alarming form of prescription drugabuse involves substances classified under theControlled Substances Act as Schedule II or IIIdrugs. By definition, these drugs have a high


’90 ’91 ’92 ’93 ’94 ’95 ’96 ’97 ’98 ’99 ’00 ’01 ’02 ’03

1,200

1,000

800

600

400

200

0

Source: National Drug Court Institute

Figure 8: Number of Drug Courts Nationwide

Year

Number of courts

potential for abuse, but also an accepted medicaluse. Simply to ban such substances wouldundermine the legitimate medical purposes thatthey serve and would increase the suffering ofmany. The challenge for policymakers is tosuppress the abuse of prescription drugs without infringing unnecessarily on legitimatemedical practice.

The Federal Government has sophisticatedsystems in place for tracking and controlling drugswith high potential for abuse, from themanufacturer down to the wholesale level. TheDrug Enforcement Administration (DEA) hasregulatory and investigative jurisdiction over thediversion of controlled pharmaceuticals, andaccomplishes its control and monitoring functionsthrough a nationwide database. As a result,

relatively little of the diversion problem originatesin the manufacturing-to-wholesaling system.

It is at the retail level, the most frequent site of diversion, where the need for increasedmonitoring is greatest. We are now closing this gap in part through the development ofsomething most Americans assume alreadyexists—state-level prescription monitoringprograms. PMPs, as they are known, are designedto facilitate the collection, analysis, and reportingof information on the prescribing, dispensing,and use of pharmaceuticals.

The data generated by PMPs is analyzed bylicensing, regulatory, or law enforcement agenciesto track a patient’s use of prescription medicines.When cases of inappropriate prescribing or


FIGHTING PRESCRIP TION DRUG ABUSEAT THE STATE LEVEL

In Nevada, pharmacies are required todownload prescription information to the state’s Prescription ControlledSubstance Abuse Prevention Task Force,which sifts through the data to identifydoctor shoppers. The Task Force then sends informational letters to each of the patient’s practitioners and pharmaciesasking them to intervene, referring the patient to appropriate treatment or counseling.

The program has had the added benefit of encouraging both practitioners andpharmacies to recognize the potential

doctor-shopping problem and encouragesthem to review their patients’ drug history,soliciting reports instead of waiting to becontacted. When the program began in1997, the task force received 480 suchrequests for reports; by 2003 this numberhad risen to 13,925.

The benefits of the program have faroutweighed its annual $131,000 budget.Nevada instituted the system in 1997, andin just the first year alone, the number ofnarcotic drug doses dispensed to suspectedabusers was cut by 46 percent—a resulttypical of other states’ experiences.

dispensing of controlled substances appear,regulatory and law enforcement officials arealerted. PMPs also offer physicians a way toobtain information on whether their patients orprospective patients have obtained the same orsimilar prescription drugs from other doctors.

State programs like these do not interfere with legitimate prescribing and dispensing ofpharmaceuticals. Nor do they violate patientconfidentiality requirements. Currently, 21 stateshave some form of reporting mechanism, withadditional states in the development stage.

The effectiveness of PMPs can be seen in a simplestatistic: in 2000, the five states with the lowestnumber of OxyContin prescriptions per capita allhad PMPs. According to DEA, the five stateswith the highest number of prescriptions percapita all lacked them.

An important feature of successful PMPs isdeveloping the authority to share data across statelines to combat border-crossing abusers trying toavoid detection. The startup cost of a PMP issurprisingly modest—approximately $300,000 per state, with most states able to operate themcontinually for between $150,000 and $1 millionper year. Internet monitoring tools are essentialfor establishing an effective system. DEA is alsocurrently developing a method to track andmonitor illegitimate Internet prescription offers.

Prescription monitoring programs offer real hope for effective diversion control and restoringprescription safety, but they cannot succeed inisolation. The pharmaceutical industry itself mustbecome a part of this partnership in a constructiveway. Manufacturers must commit to responsibleadvertising and risk announcements involvingtheir products.

The Food and Drug Administration (FDA) willcontinue to monitor promotional materials forcontrolled substances, particularly for sustained-release products, to ensure that false andpotentially misleading claims are not made.The FDA Office of Criminal Investigations isworking with DEA on investigations involvingthe illegal sale, use, and diversion of controlledsubstances, including illegal sales over theInternet. DEA will improve its training on therecognition and pursuit of diversion cases so thatthey can pursue cases aggressively withoutlimiting proper pain management by physicians.

Finally, physicians must perform risk assessmentson patients at risk for potential abuse. This isparticularly true for patients entering opiatetherapy for chronic pain. Physician licensingboards must insist on more effective education forfuture doctors, and on remedial courses in riskmanagement and awareness of dangerous newdrugs for existing practitioners. State licensingboards must exercise appropriate oversight andtake action against physicians who undermine theintegrity of medical practice.


29


BUDGET HIGHLIGHTS ● DEA—Priority Targeting Initiative: up $34.7 million. This initiative will strengthen

DEA’s efforts to disrupt or dismantle Priority Target Organizations, including those linked totrafficking organizations on the Attorney General’s Consolidated Priority Organization Target list.

● Organized Crime Drug Enforcement Task Forces (OCDETF) Assistant U.S. AttorneyInitiative: up $9.6 million. This proposal includes 113 positions to address existing staffingimbalances within the U.S. Attorney workforce, thereby achieving an appropriate balance betweeninvestigative and prosecutorial resources. This request represents the first phase of a four-year plan to achieve a ratio of one Assistant U.S. Attorney for every 4.5 investigative agents.

● OCDETF Fusion Center Initiative: up $6.3 million. This request supports and expands the capacity of the fusion center, which analyzes drug trafficking and related financial investigativeinformation and disseminates investigative leads to OCDETF participants. This enhancementprovides a total of 60 positions to coordinate and conduct nationwide investigations generated as a result of analysis by fusion center personnel.

● OCDETF Financial Initiative: up $4.5 million. This enhancement funds 28 additional positions to include Internal Revenue Service (IRS) participation in all OCDETF investigations.The IRS’s expertise is critical to identifying, disrupting, and dismantling the financial infrastructure ofdrug trafficking organizations.

● Immigration and Customs Enforcement—P-3 Flight Hours: up $28 million. P-3 aircraftare critical to interdiction operations in the source and transit zones because they provide vital radarcoverage in regions where mountainous terrain, expansive jungles, or large bodies of water limit the effectiveness of ground-based radar. This request will increase P-3 flight hours from 200 to 600 per month.

● Department of State—Andean Counterdrug Initiative (ACI): $731 million. The fiscalyear 2005 request will fund projects needed to continue enforcement, border control, crop reduction,alternative development, institution building, and administration of justice and human rights programs in the region. The ACI budget provides support to Colombia, Peru, Bolivia, Ecuador,Brazil, Venezuela, and Panama.

The drug trade is a profit-making business, onewhose necessary balance of costs and rewards canbe disrupted, damaged, and even destroyed. Themain reason supply reduction matters to drugpolicy is that it makes drugs more expensive,less potent, and less available. Price, potency, andavailability are significant drivers of both addicteduse and casual use.

The drug trade is a worldwide market, embodyingthe strengths of a flexible, multinational enterpriseand the weaknesses of a complex, far-flung illegalnetwork that has to launder proceeds, pay bribes,and deal with the risks of betrayal bycoconspirators and violence from competitors.The agencies that implement supply controlmeasures face a challenge: how to identify andexploit the key vulnerabilities of a business thatoperates in secrecy.

Both abroad and at home, for the past two yearsthe Strategy has focused on such sectors as thedrug trade’s agricultural sources, its processing and transportation systems, its organizationalhierarchy, and its financing mechanisms. We are now attacking the drug trade in all of itscomponent parts, and we have made progress onall fronts.

The U.S. Government’s master list of targetedtrafficking organizations is shorter this year, thanks tothe elimination of eight major trafficking organizationsduring the past fiscal year (see box on pages 34 and35). Another seven organizations were weakenedenough to be classified as “significantly disrupted.”

Interdiction forces from the Departments ofDefense and Homeland Security registeredimpressive interdiction successes during 2003.These successes are partly the result of OperationPanama Express, an intelligence-driven programmanaged by the Departments of Justice andHomeland Security that targets fishing and othervessels departing from Colombia’s Pacific andCaribbean coasts.

Data available as of the end of 2003 showed aconsistent, high level of cocaine interdictiondespite four Orange Threat Level alerts thatforced the reallocation of certain interdictionassets to homeland security missions (see Figure9). A surge in the air trafficking of cocaine fromColombia—128 documented flights during thefirst nine months of 2003, compared to 34 in allof 2002—was met with the reinstitution of theAirbridge Denial program in Colombia.

In Latin America, in a reverse of the pattern ofthe 1990s, cocaine production is down inColombia, by far the world’s largest supplier of raw coca. Colombia saw a 25,000 hectare dropin cultivation in 2002, representing a 15 percentreduction from 2001. The Putumayo growingregion, which in 2001 produced almost 20 percent of the world’s coca, was left with just 1,500 hectares of coca in April 2003. Thisnumber was down from nearly 40,000 hectares two years before—a 96 percent reduction—asfarmers moved to replant in other parts of thecountry. Opium poppy cultivation dropped aswell, by 25 percent.

31N A T I O N A L P R I O R I T I E S — I I I

Disrupting the Market: Attacking the Economic Basis of the Drug Trade

This performance was followed by a secondconsecutive record year for eradication, with127,112 hectares sprayed by the eradication forcesof the Colombian National Police during 2003(see Figure 10). Opium poppy cultivation was hithard as well, with over 2,800 hectares sprayedduring 2003.

Standing at the ready to dismiss such progress arecritics of supply-control activities. The critics’metaphor for the drug trade is a “balloon” that,when pressed in one place, simply pops up inanother. It is true that criminal enterprisesinvariably attempt to reestablish themselves in an environment with the most permissive rule oflaw. It is also true that traffickers have more than

once been driven out of a country by drug controlefforts only to reconstitute their business in aneighboring country—as in the mid-1990s, whenplummeting coca cultivation in Peru was offset byrapid planting in neighboring Colombia.

But not this time. Crucially, progress in Colombiahas not been offset in traditional growing areas inPeru. Nor have regular increases in cultivation inBolivia come close to offsetting the drop inColombia. A small increase in cultivation inBolivia during 2002 (taking back less than a thirdof the reduction in cultivation in Colombia) wasfollowed in 2003 by a net decrease in the totalarea cultivated for Bolivia and Peru—including aremarkable 15 percent drop in Peru. Nor has


70

60

50

40

30

20

10

01Q ’02 2Q ’02 3Q ’02 4Q ’02 1Q ’03 2Q ’03 3Q ’03 4Q ’03

Seizures and disruptions (metric tons)

Source: Consolidated Counterdrug Database

Figure 9: Cocaine Interdiction Trends by Quarter

Quarter

production expanded to Venezuela, Ecuador,Panama, or Brazil, where only trace amounts ofcoca are cultivated.

The coming year may be a critical juncture for the U.S. cocaine market. During 2004, for the first time in more than a decade, as enforcementpressure in Colombia works its way through the system, we may begin to see a meaningfulreduction in the supply of cocaine available for domestic consumption—a remarkableaccomplishment for Colombian President AlvaroUribe, and further incentive for cocaine addicts to enter drug treatment. The possibility of areduction in cocaine availability underscores theimportance of the President’s Access to Recovery

treatment initiative, described in Chapter II,which will offer treatment services to anadditional 100,000 people each year.

Colombia’s Cocaine Trade

In the 30 years since Colombian marijuanagrowers began exporting cocaine to the United States, the business has expanded into aworldwide drug trafficking empire, producingroughly 700 metric tons of pure cocaine annuallyfor three markets: the United States (whichconsumes 250 metric tons), Europe (roughly 150

33Disrupting the Market

140

120

100

80

60

40

20

02000 2001 2002 2003

Hectares sprayed (in thousands)

Source: Department of State

Figure 10: Eradicating Coca in Colombia

Year

metric tons), and Brazil (up to 50 metric tons).Additional quantities are accounted for by seizures and other losses.

Over the years, as the cocaine business changed,Colombian traffickers retained their preeminence as the only group capable ofexporting hundreds of tons of cocaine annually.Even the mid-1990s shift of cultivation out ofPeru and Bolivia turned out, in the end, to be a boon to Colombian traffickers. As cultivationretreated into Colombia, it moved closer to

cocaine processing laboratories and was less proneto air interdiction.

Cocaine shipments originating in Colombia were also that much closer to that country’s north and west coasts, historic departure pointsfor off-continent distribution. Growinginvolvement by leftist rebels seemed to cement Colombia’s connection to the drug trade, the more so in 1998, when Colombia’spresident granted FARC guerrillas a 42,000-square-kilometer safe haven as an inducement


TARGETING THE TOP OF THETRAFFICKING PYRAMID

Confronting a hidden, illicit business requiresdiscipline, intelligence, and creativity. To adegree not commonly imagined, it alsorequires coordination, since traffickingorganizations can span dozens of states andhundreds of jurisdictions, and investigatingthem can involve dozens of law enforcementagencies. The multi-agency SpecialOperations Division (SOD) has performeda critical role in coordinating investigationsthat, like the trafficking organizations theypursue, span many jurisdictions and extendacross national boundaries.

The recent indictment of Mexican drug lordIsmael Zambada-Garcia and members of histrafficking organization, for instance, resultedfrom the coordination by SOD of more than 80separate investigations involving seven Federalagencies and over 60 state and local agencieswithin the United States. Also instrumental

were the cooperation and assistance offoreign counterparts, particularly theFederal Investigative Agency in Mexicoand the Colombian National Police.

Yet, focusing Federal as well as state andlocal law enforcement agencies on thesame set of targets—and inducing them toshare intelligence—has been a perennialchallenge. Agencies have not always beendisciplined enough to forego targets ofopportunity in favor of more time-consuming, coordinated investigations.

As the Zambada-Garcia case suggests, thatis beginning to change, thanks in large partto leadership from the Department of Justice.In 2002, Attorney General John Ashcroftcalled upon Federal law enforcementagencies to create a single list of the mostsignificant international drug trafficking

to peace talks, only to see the area used tofacilitate drug processing.

The subsequent remarkable turnaround inColombia owes much to President Uribe and hiscontinuing commitment to attack and eliminateall coca cultivation in Colombia. President Uribeseeks to cut off the revenue that sustains armedgroups of the extreme right and extreme left, as amilestone on the way to the defeat andelimination of the guerrillas who control theremote areas of Colombia and who are slowing


the country’s economic and democraticdevelopment. (The renewed campaign againstColombia’s insurgent armies has brought neededattention to the role of the American drugconsumer as the single largest financial supporterof antidemocratic forces in this hemisphere.)

Coca cultivation is an attractive target for lawenforcement for precisely the same reasons that it offered an opportunity to rebel groups andparamilitaries seeking to control and tax growers:the crop is critically vulnerable. Virtually the

and money laundering organizations andthose primarily responsible for the Nation’sdrug supply. The first Consolidated PriorityOrganization Target (CPOT) list wasissued later that year.

The CPOT list is not public. The listrepresents the collective judgment ofinvestigators and intelligence analysts fromthe DEA, FBI, the IRS, U.S. Immigrationand Customs Enforcement, the U.S.Marshals Service, and other agencies. TheCPOT organizations thus identified are atop priority for the Department of Justiceand for the Organized Crime DrugEnforcement Task Forces Program, betterknown by its acronym, OCDETF.

The CPOT list for fiscal year 2004contains 40 targets, including organizationheads, drug manufacturers, transporters,major distributors, and money launderers.In addition, the list identifies the hundredsof active investigations not only of the

CPOT targets themselves but also ofmajor associates and related distributionnetworks, which move and market theillegal drugs throughout the United States.

The CPOT strategy seeks to incapacitatethe foreign-based organization heads, theirtransportation and smuggling systems, theirregional and local distribution networks, andtheir financial operations, thereby interruptingthe flow of drugs into the United Statesand diminishing the capacity of theorganizations to reconstitute themselves.

The fact that all CPOT targets are based inforeign countries places a particular premiumon extradition, a favorite tool of prosecutorsand one that has led to substantial progressin some countries. Colombia’s PresidentAlvaro Uribe, for instance, has moveddecisively to extradite high-level traffickersto the United States, 68 of whom weresent to this country for prosecution duringUribe’s first full year in office.

entire crop is visible from the air; most coca growson terrain level enough to permit effective sprayoperations using crop duster aircraft to dispenseherbicides; and the coca bush is a perennial thatrequires roughly twelve months to mature afterinitial planting.

Confronting Colombia’sHeroin Problem

Heroin users in the United States consume 13 to 18 metric tons of the drug per year, accordingto consumption-based models, with supplies

historically originating in Southeast andSouthwest Asia, as well as Mexico. Since the early1990s, especially in the eastern United States, anincreasing portion of the heroin market has beensupplied by traffickers from Colombia sellingheroin produced in that country. While estimatesof heroin “market share” are based on analysis ofselected seizures and are inherently imprecise,most analysts believe that the majority of theheroin sold in the United States is of SouthAmerican origin (principally from Colombia).

South American heroin also carries the distinction of being, on average, the purest heroin available on U.S. streets. DEA’s DomesticMonitor Program, a retail heroin purchaseprogram, tracks the price and purity of urban


FOLLOWING THE MONEY: TARGETINGTHE BLACK MARKET PESO EXCHANGE

Recognizing that the drug trade is profitdriven, drug enforcement agencies arestrategically refocusing resources to attackthe financial infrastructure of traffickingorganizations. Attacking the financialunderpinnings of drug traffickingorganizations places a premium oncooperation among various agencies andwith the private sector.

Law enforcement is working with thefinancial services industry and Federalregulators to close the financial system todrug traffickers. As progress is made onclosing down the legitimate financialsystem to drug money, traffickers resort to

bulk cash smuggling and the use of theColombian Black Market Peso Exchangesystem to move their drug proceeds.Coordinated efforts are under way with thegovernments of Colombia and otheraffected nations and with the private sectorto attack and disrupt this system as well.

Toward that end, the Departments ofJustice, Homeland Security, and theTreasury are working jointly to plan thecreation of a Financial Attack Center.The center will bring together our mostexperienced financial investigators andanalysts to prioritize targets and developplans to attack them.

street-level heroin. The most recent data availableshow that in 2002, the average purity for retailpurchases of South American heroin was 46percent. The purity of Mexican-source heroin,by contrast, averaged 27.3 percent, while heroin from Southwest Asia averaged 29.8 percent pure. Southeast Asian heroin averaged23.9 percent pure.

Our strategy for attacking the heroin trade inColombia has three principal components:eradication, organizational attack, and airportinterdiction.

Eradication: The cultivation of opium poppies in Colombia expanded from just over 1,100hectares in 1991 to 6,000 hectares (two annual

harvests of 3,000 hectares each) by the mid-1990s. Unlike the coca crop, poppy has provedstubbornly resistant to aerial eradication effortsbecause it is a four- to six-month annual plant that can be inexpensively replanted after eradication.The 2002 cultivation estimate is 4,900 hectares,a 25 percent reduction from 2001 but still enough to produce 11.3 metric tons of pureheroin (see Figure 11). The U.S. Government and the Government of Colombia have moveddecisively to redouble efforts to counter thisthreat, using both eradication and lawenforcement resources. In 2003, during hundredsof surveillance and eradication missions, theColombian Government sprayed 2,821 hectares of poppy—a surface area equal to the entireknown area of poppy cultivation.


1999 2000 2001 2002

16

14

12

10

8

6

4

2

0

Source: Major Narcotics Producing Nations: Cultivation and Production Estimates, 1998–2002

Figure 11: Colombia: Potential Heroin Production

Pure metric tons

Year

In recent years, propagation of more and smallerpoppy fields in the high, cloud-covered Andes hashindered eradication efforts, but the program hasresponded with a comprehensive reconnaissanceand targeting approach that now seeks to spray alllocatable poppy every 120 days. Programmanagers maintain logs of previous cultivationareas as a guide for searching out new fields, andmore recently have begun incorporating informantinformation from DEA’s toll-free informant “tipline” and law enforcement sources such as theColombian National Police.

Attacking the Organization: Investigators andprosecutors on the East Coast of the UnitedStates, an area facing a particular threat from

South American heroin, have stepped up theirefforts to disrupt and dismantle organizationstrafficking heroin in the region.

DEA has transferred agent positions from officesin nearby countries to create a heroin task force inColombia. This 13-person Bogota heroin group isworking with the Colombian National Police oncases involving high-level traffickers supplyingU.S. markets and has scored a number ofimportant enforcement successes. DEA plans toadd a second dedicated heroin group this year tofurther its efforts to disrupt, arrest, and prosecutemembers of the 20 identified Colombian herointrafficking organizations, along with other groups.This second group will be part of a 28-position


3,000

2,500

2,000

1,500

1,000

500

01999 2000 2001 2002 2003

Kilograms

Source: DEA, Federal-wide Drug Seizure System

Figure 12: Federal Heroin Seizures (All Types of Heroin)

Year

DEA enhancement in Colombia that is also toinclude a money laundering group that will focuson identifying and seizing illicit proceeds flowingback into Colombia.

Airport Interdiction: DEA’s Bogota office isassisting with the installation of X-ray systems atall Colombian international airports to furtherincrease the seizures of heroin shipments thattypically depart by commercial air on their journeyto the United States. More than 1.3 metric tonswas seized in 2002 in South American airports.Airport interdiction efforts in Colombia aresupplemented by similar programs in the UnitedStates, with encouraging results—1.8 metric tonsof heroin was seized at U.S. airports during 2002,much of it from South America. Additionalamounts were seized at other ports of entry andthrough investigative activities (see Figure 12),equating to more than 20 percent of exportableColombian heroin production. The results shouldimprove this year, as more X-ray equipmentbecomes operational in Colombia and as U.S. lawenforcement at arrival airports on the East Coastbecome even more effective at seizing heroindelivered by courier.

Tightening the Coca Belt: Colombia’s Andean Neighbors

Although massive cultivation increases are notthreatening Peru and Bolivia, there have beeninternal shifts that bear watching, as in Bolivia’sYungas region, which has seen cultivationintensify. Controlling Bolivia’s shifting growing

areas has been complicated by a renewedpoliticization of the coca industry and politicalinstability generally (in the past year, radicalgroups launched violent protests that damaged the economy and led to the ousting of PresidentSanchez de Lozada). Coca farmers in Bolivia have protested against coca eradication, and these demonstrations have turned violent on occasion, with radical leaders using thedemonstrations to advance their politicalambitions and undermine the government’slegitimacy. There have been direct attacks on coca eradicators in some areas.

These leaders purport to seek the expansion oflegal coca cultivation (some areas of the Andespermit the chewing of unprocessed coca leaf ) as acash crop for indigenous farmers, even though thelegal market is amply supplied and any additionalcoca leaf will eventually be processed into illicitcocaine. The lack of economic opportunity in Bolivia has sustained a modest level of support among the Bolivian populace for thisrationalization of supporting an internationalcriminal business. In addition, in the wake of theprotests that ousted President Sanchez de Lozada,Bolivia’s new president, Carlos Mesa, will bepressed to grant concessions that could undo drugcontrol gains made by previous administrations.

In 2002, Peru produced about 140 metric tons ofpure cocaine, leaving 120 metric tons available forexport once Peruvian use and internal seizures aresubtracted. Peruvian cocaine is believed to beexported in roughly equal amounts along threevectors: through Bolivia to Brazil/Argentina andto Chile, to the Peruvian west coast for off-continent shipment to Europe and the UnitedStates, and to Colombia. Peru’s sheer vastnessmakes interdiction of cocaine most feasible atchokepoints, such as the roads west of the Andes


and at maritime departure ports, where the drug isstored before being loaded onto freighters.

Also of note in Peru, the Shining Path guerrillamovement has revived a cadre of nominally 500members. Clearly, it poses a threat to security andis cause for concern. But at this point, the scope of the problem is small and the Peruvian forceshave shown their ability to intervene against theShining Path when necessary. At this time, theShining Path has not made significant inroadsinto the Peruvian coca business.

Responding to the two differing threats in Peruand Bolivia, the United States will continue toconstruct programs that are country specific,while providing basic support for manualeradication, interdiction, law enforcement,alternative development, and criminal justicereform. Complementing these efforts will beinitiatives to work with government andinternational financial institutions to help ease the economic challenges that have gripped these countries in recent years.

Ecuador, sandwiched between Colombia and Peru on the Andean Ridge, is a significant transitcountry for cocaine and Colombian heroin, as isColombia’s eastern neighbor, Venezuela. Estimatesindicate that upwards of 50 to 80 metric tons ofexport-quality cocaine is exported fromEcuadorian ports annually headed for the UnitedStates and Europe, with an additional 100 to 150metric tons exported from Venezuelan ports,much of it toward Europe, where cocaineconsumption has been on the increase. TheUnited States is providing support to theGovernment of Ecuador to improve securitymeasures on the border with Colombia and topush forward needed economic reforms. U.S.counterdrug efforts in 2004 will continue to

support Ecuadorian National Police efforts tocombat traffickers, especially along the northernborder and at maritime ports.

Venezuela poses a more difficult challenge.Narco-terrorists take advantage of the long,porous border between Venezuela and Colombia,often using remote areas of Venezuela as asanctuary. The United States will continue tosupport law enforcement port interdiction effortsin Venezuela and will provide training to improveVenezuelan counterdrug law enforcementcapabilities to counter the increased drugmovement through Venezuela.

Exploiting Opportunitiesfor Success in Mexico

Since taking office, President Vicente Fox hasmade historic progress against some of the mostpowerful drug trafficking organizations in theworld. Cooperation between the United Statesand Mexico continues to grow, with the goal ofreducing the 5,000 metric tons of Mexicanmarijuana and more than 300 metric tons ofexport-quality cocaine (roughly two-thirds of U.S.consumption) that Mexican traffickers movethrough Mexico and to the Southwest border ofthe United States.

Mexico is also a source of other illegal drugs.About ten metric tons of export-quality (roughly50 percent pure) Mexican heroin enters theUnited States each year. In recent years, Mexicantraffickers have also become majormethamphetamine producers, smuggling into theUnited States both the finished drug (rough


estimates place it at twelve metric tons per year)and the pseudoephedrine and other chemicalsneeded to make it.

Drug trafficking clearly remains a critical issue forU.S. and Mexican security interests, and for bilateralrelations. During the past year, the Governmentof Mexico, working in close coordination with theDEA, apprehended Osiel Cardenas-Guillen andArmando Valencia-Cornelio, the leaders of twotrafficking organizations on the CPOT list.

The bilateral exchange of real-time intelligence,fostered by these takedowns, has resulted in highlyproductive initiatives. One example is OperationTrifecta, which targeted a “cell” of the IsmaelZambada-Garcia organization, a CPOT-listedorganization that transported drugs from Mexicoto Arizona and New York. This investigation ledto simultaneous arrests on both sides of theborder, including the “cell head,” ManuelCampas-Medina in Mexico. Other high-levelarrests last year included Arturo Hernandez-Gonzalez, and a key Guzman-Loera organizationlieutenant, Jose Ramon Laija-Serrano.

In addition to these organizational attack efforts,the Mexican Attorney General’s Office (PGR)and the Mexican Army continue to wageaggressive marijuana and poppy eradicationcampaigns, using aerial spraying and manualeradication. The results are very promising—about80 percent of each crop has been eradicated inrecent years, and in addition to limiting theoverall supply, eradication has led to heroinshortages on the U.S. West Coast in years whenthe weather does not support a good poppy crop.

There may also be an opportunity for theGovernment of Mexico to seriously affect theinternal flow of cocaine by establishing land

checkpoints along key roads in the Isthmus ofTehuantepec. Over a hundred metric tons ofcocaine that arrives in Central America and insouthern Mexico is moved by road through theisthmus. Because of the mountainous terrain, theflow must move along two major roads, providinga natural chokepoint for inspections andinterdiction. Flying the drugs over the isthmuswould represent a difficult and costly logisticschallenge for traffickers, and would require morethan 200 flights annually—a major change fromthe current smuggling pattern and, again, one thatwould force traffickers to raise the price of thedrugs they sell.

Depending on Marijuana

It would surprise few people to learn thatmarijuana is the most widely used illegal drug inthe United States—with more than 14 millioncurrent users. A lesser-known fact is that marijuanasmokers account for the lion’s share of Americanswho are dependent on illegal drugs—more thanfour million of a total of seven million individualswhose use of illegal drugs of all types is seriousenough to be labeled as abuse or dependence.

To establish a diagnosis of abuse or dependence,an individual’s drug use must have progressed tothe point where it typically is causing them somecombination of health problems, difficulties withwork, or conflict with a spouse or loved one. Bythis standard, elaborated in detail by the AmericanPsychiatric Association’s Diagnostic and StatisticalManual of Mental Disorders (DSM-IV), twice asmany Americans confront problems of abuse anddependence stemming from marijuana smoking asfrom cocaine and heroin use combined.


The marijuana Americans smoke comes fromthree main sources: U.S. outdoor and indoorcultivation, Mexican outdoor cultivation, andhigh-potency indoor cultivation from Canada.Although estimating marijuana production is an imprecise science, and while formal estimates of domestic production on public landsare a work in progress, a rough estimate formarijuana consumed in the United States per year would place U.S. imports from Mexico at approximately 5,000 metric tons, with roughly another 1,000 metric tons coming from Canada, and more than 2,500 metric tonsproduced domestically.

Marijuana cultivation is prevalent in many regions of the United States, with substantialconcentrations in California, Hawaii, Kentucky,and Tennessee. In a national survey, 75 percent

of law enforcement respondents reported outdoormarijuana cultivation in their areas. Some 74percent reported “indoor grow” cultivation as well.

Outdoor cultivation typically involves small plotswhere significant profits can be made with limitedrisks, but larger plots have been observed inlocations such as National Forest Service lands inCalifornia, where cannabis eradication rose from a reported 443,595 plants in 2000 to 495,536plants in 2001, the most recent year for whichdata is available. Indeed, much of the outdoorcannabis cultivation in the United States isbelieved to take place on public lands because of their relative remoteness.

Nationally, the National Drug Intelligence Center(NDIC) reports that cannabis cultivation onpublic lands has been on the rise. In response to


Figure 13: Depending on Marijuana: Dependence or Abuse by Illicit Drug

Hallucinogens 0.4 million

Cocaine 1.5 million

Inhalants 0.2 million

Note: Methamphetamine abuse and dependence are classified separately, under nonmedical use of stimulants.Source: National Survey on Drug Use and Health, 2002

Marijuana 4.3 million

this threat, during the 2004 growing season,NDIC will conduct a limited-scope pilot projectthat seeks to estimate the amount of cannabisbeing cultivated on public lands in California,with the eventual goal of producing an annualscientific estimate of total domestic cannabiscultivation and production.

In addition, over the coming year, Federal, state,and local law enforcement agencies will expandtheir efforts to target the organizations misusingpublic lands to grow millions of dollars’ worth ofmarijuana. Law enforcement agencies typicallywait to find marijuana plots on public lands untilthe marijuana is ready for harvest. This year, bycontrast, Federal, state, and local law enforcementin key areas will begin efforts much earlier, usingthe pre-harvest months to train officers andreview actionable intelligence. And while muchemphasis historically has been placed oneradicating already-cultivated marijuana in thelate summer, law enforcement will increase effortsto prevent the planting of marijuana itself, whichtypically occurs in the spring.

Mexico: Mexico is the largest foreign source ofmarijuana consumed in the United States,including both the relatively low-THCcommercial grade (1–6 percent THC) and morepotent sinsemilla varieties (averaging 10–15percent THC).

The Government of Mexico has maintained an aggressive eradication program to countermarijuana production, with Mexican military andpolice units eradicating almost 80 percent of thetotal estimated cultivation—some 36,000 hectaresof cannabis—during 2003. While productionestimates are not available for 2003, in recentyears Mexico has produced roughly 8,000 metrictons of marijuana.

Mexico’s marijuana interdiction program seized2,100 metric tons in 2003, and the United States seized another 863 metric tons along theSouthwest border during the first nine months of2003—meaning that eradication and interdictionremoved more than four-fifths of Mexico’smarijuana supply stream, leaving approximately5,000 metric tons of Mexican marijuana fordistribution to the U.S. market.

Mexico has devoted more funds to interdictionand has restructured its institutions to increaseinterdiction capacity to more effectively stop the flow of drugs, including the use of X-raytechnology to identify contraband in cars andtrucks. In 2004 and 2005, the United States will intensify its support to the Government of Mexico’s marijuana control efforts throughoperational planning and technology assistance,with a goal of eradicating almost all of the crop.

Canada: The United States remains concernedabout widespread Canadian cultivation of high-potency marijuana, significant amounts of whichare smuggled into the United States. The RoyalCanadian Mounted Police, Customs Canada, andother dedicated Canadian law enforcementagencies have worked hard to close down growhouses and to arrest and prosecute their operators.Despite their efforts, the problem remainsextremely serious.

Consider the sheer numbers of producers. In2001, more than 2,000 grow operations wereseized throughout the United States. In Canada,the previous year, 2,800 indoor grow operationswere seized in British Columbia alone, accordingto the Royal Canadian Mounted Police. Nor aresuch grow operations confined to western Canada:one Canadian Government report estimated thatthere may be “as many as 15,000 grow ops active


in Ontario.” The United States is a likely marketfor a large percentage of the high-potencymarijuana produced at such sites. Building onCanadian Government estimates for the numberof indoor cultivation sites and their average size, we estimate that Canadian shipments ofmarijuana to the United States could exceed 1,000metric tons annually.

Both Canada and the United States facechallenges in estimating marijuana production.The United States Government is currentlystudying ways to improve our estimates fordomestic production, but we cannot wait forperfect intelligence before beginning to deal more aggressively with the serious problem ofhigh-potency indoor grows, at home and abroad.

The U.S. Government is committed to workingclosely with Canadian authorities to address this serious problem. The United States intends toengage in frequent consultations with the newCanadian Government on an array of importantdrug control issues, including the importance ofhaving and enforcing appropriate criminalpenalties for marijuana traffickers, engaging incombined efforts at border interdiction, andattacking organized criminal groups that aredirectly involved in marijuana production and trafficking.

Afghanistan: AcceleratingAnti-drug Efforts

Afghanistan remains the world’s largest cultivatorof poppy and producer of opiates. If all the poppygrown in Afghanistan in 2003 were converted to

heroin, the result would be 337 metric tons (seeFigure 14). This compares with about 46 metric tonsproduced in Burma in 2003. Colombia and Mexicoproduce less than 20 metric tons combined, morethan enough to satisfy annual U.S. consumption of13 to 18 metric tons. Burma’s production largelysupplies the Chinese market, whereas Afghanistan’soutsized production is directed at Europe andfeeds large addicted populations in Iran, Pakistan,Russia, and to a lesser extent, Central Asia.

Poppy cultivation is a major and growing problem for Afghanistan. According to UnitedNations estimates, illicit poppy cultivation andheroin production generate more than $2 billionof illicit income, a sum equivalent to between one-half and one-third of the nation’s legitimategross domestic product. The drug trade inAfghanistan fosters instability, and supportscriminals, terrorists, and militias. Historic highprices now being commanded by opium areinhibiting the normal development of the Afghaneconomy by sidetracking the labor pool anddiminishing the attractiveness of legal farmingand economic activities.

Still, the drug trade does not dominateAfghanistan. Poppy is planted on 1 percent of the arable land, and its cultivation and processinginvolve roughly 5 percent of the population. Achallenging security situation on the groundduring the past year has significantly complicatedthe task of implementing counternarcoticsassistance programs and will continue to do so for the immediate future. A more stableenvironment will facilitate such programs, whichhave stabilized or reduced cultivation where theyhave been attempted, as in Nangarhar andHelmand provinces. Almost all of the growth that occurred during 2003 was driven bycultivation that spread to more remote valleys.


We are working closely with the UnitedKingdom, which is taking the lead in coordinatinginternational counternarcotics assistance toAfghanistan’s transitional authority, to implementa strategy that focuses on promoting alternativelivelihoods for farmers; strengthening drug lawenforcement and interdiction programs; supportingcapacity-building for Afghan institutions; andraising public awareness to promote the centralgovernment’s anti-drug policies and help thecountry’s leaders tackle drug use and production.

In addition, the Afghan Government is planningan aggressive eradication plan that calls forsignificant efforts to reduce poppy cultivation over the next two years. Eradication efforts will

be tied to development of alternative livelihoodswhere practical, but such programs are less criticalin regions where opium poppy is not a historiccrop and was grown for the first time during 2003.In addition to the obvious reason, eradication isneeded to begin instilling in the minds of thepopulace that the government is serious about nottolerating opium cultivation—and that byextension there is significant monetary risk inplanting opium poppy.

The eradication program will be followed by thefirst substantial deployment of law enforcementforces in Afghanistan. As part of the current $1.6 billion acceleration initiative for Afghanistan,roughly 20,000 new provincial and border police

45

400

350

300

250

200

150

100

50

01998 1999 2000 2001 2002 2003

Metric tons

Sources: Major Narcotics Producing Nations: Cultivation and Production Estimates, 1998–2002, and U.S. Government estimates.

Figure 14: Potential Heroin Production in Afghanistan

Year

policies and methods that allow us to adaptquickly and seize every opportunity to disrupt thetrade, with a particular emphasis on chemicalcontrol efforts.

Most of the methamphetamine consumed in theUnited States is manufactured using divertedpseudoephedrine and ephedrine. This internalproduction is dispersed among thousands of labsoperating throughout the United States, althougha relatively small number of “super labs” areresponsible for most of the methamphetamineproduced.

To counter the threat from methamphetamine,we and our neighbors, Mexico and Canada, mustcontinue to tighten regulatory controls onpseudoephedrine and ephedrine, thousands oftons of which are smuggled illegally into theUnited States each year. Controls on otherprecursor chemicals, such as iodine and redphosphorus, are equally important.

In recent years, an inadequate chemical controlregime has enabled individuals and firms inCanada to become major suppliers of divertedpseudoephedrine to methamphetamine producersin the United States. The imposition of aregulatory regime last January, combined withU.S.-Canadian law enforcement investigationssuch as Operation Northern Star, appears for themoment to have reduced the large-scale flow ofpseudoephedrine from Canada into the UnitedStates. There are signs that some of this reductionhas been offset by the diversion from Canada of ephedrine.

Pseudoephedrine diversion from Mexico is also aserious threat to the United States. Once the drugis diverted from legal applications, numerous drugtrafficking organizations efficiently smuggle it


will be trained and deployed this summer. Theirlaw enforcement presence will start spreading the rule of law throughout Afghanistan, furtherplacing the illicit poppy and heroin trade at risk.

A New Focus on Synthetic Drugs

Recent years have seen a significant rise in the use of synthetic drugs, a worldwide trendimplicating Europe, China, Thailand, and othercountries. In the United States, the synthetic drugmarket has centered around methamphetamineand Ecstasy. Methamphetamine use has beenmigrating from the West Coast eastward, leavingdevastating social consequences wherever it takeshold. Ecstasy remains a serious concern butappears to have peaked in popularity amongAmerican youth.

By their very nature, synthetic drugs presentspecial challenges. Production often takes place inindustrialized nations, and because the drugs aremade in laboratories and not harvested fromfields, there are no crops to eradicate, as withmarijuana, heroin, and cocaine. Supply reductionefforts must instead focus on limiting access toprecursor chemicals, shutting down illegal labs,and breaking up the organized criminal groupsthat manufacture and distribute the drugs.

Disrupting the synthetic drug market requiresstrengthening international and domestic lawenforcement mechanisms, with emphasis onflexible and rapid communications at theoperational level. We must be as nimble as thetraffickers who fuel the market, developing

across the Southwest border and ship it to majormethamphetamine labs in the United States,many of which are managed by Mexicantraffickers. During just two months last year,authorities made seizures totaling 22 millionpseudoephedrine tablets that were being shippedto Mexico from a single city in Asia. In additionto the pseudoephedrine threat from Mexico,methamphetamine is produced in Mexico foronward shipment to the United States—morethan a ton of methamphetamine was seized on the Southwest border last year.

The National Methamphetamine ChemicalInitiative targets domestic methamphetamineproduction by fostering nationwide sharing ofinformation between law enforcement agenciesand providing training to investigators andprosecutors. The initiative focuses on stopping theillegal sale and distribution of methamphetamineprecursors. It also maintains a national databasethat tracks clandestine laboratory seizures,providing Federal, state, and local law enforcementwith up-to-date information on methamphetamineproduction methods, trends, and cases.

Roughly two-thirds of the Ecstasy seizedworldwide can be traced to the Netherlands.Smugglers use methods such as express mailservice, commercial air couriers, and air freight,with shipments to the United States typicallycontaining 10,000 tablets or more. The UnitedStates is working closely with the Netherlands to disrupt this trade. Results from bilateralmeetings last year include collaboration on moreEcstasy investigations, an exchange of informationon Ecstasy seizures, and Dutch development of arisk indicator and profiles for targeting traffickers.More remains to be done, however, to dismantlethe criminal organizations responsible for thisillicit trade.

Because the chemical industry is highlyinternational, multilateral cooperation in chemical control is critical. DEA has encouragedinternational consensus for voluntary, informal,flexible, and rapid systems of internationalinformation exchange on precursor chemicalshipments. For example, under the MultilateralChemical Reporting Initiative, countries reportchemical transactions to the InternationalNarcotics Control Board, a UN-based body thattracks licit and illicit chemicals worldwide.

To target synthetic drugs, DEA has initiatedProject “Prism,” which involves 38 countries that are major manufacturers, exporters,importers, or transit countries of key chemicalsthat are illegally diverted to manufacture synthetic drugs. Project Prism helps governmentsdevelop and implement operating procedures tomore effectively supervise the trade in theprecursor chemicals that are diverted to makemethamphetamine and similar drugs. DEA is also coordinating an initiative with elevencountries in the Far East to prevent the diversionof Ecstasy precursor chemicals.

47


49

National Drug Control Strategy:

APPENDIXES


51

FY 2003 FY 2004 FY 2005Final Enacted Request

Department of Defense $905.9 $908.6 $852.7

Department of Education 644.0 624.5 611.0

Department of Health & Human ServicesNational Institute on Drug Abuse 960.9 990.8 1,019.1Substance Abuse and Mental Health 2,354.3 2,488.7 2,637.7

Services Administration

Total HHS 3,315.2 3,479.5 3,656.8Department of Homeland Security

Immigration and Customs Enforcement 518.0 538.7 575.8Customs and Border Protection 873.9 1,070.5 1,121.4U.S. Coast Guard 648.1 773.7 822.3

Total DHS 2,040.0 2,382.9 2,519.4

Department of JusticeBureau of Prisons 43.2 47.7 49.3Drug Enforcement Administration 1,639.8 1,703.0 1,815.7Interagency Crime and Drug Enforcement1 477.2 550.6 580.6Office of Justice Programs 269.6 181.3 304.3

Total DOJ 2,429.8 2,482.7 2,749.9ONDCP

Operations 26.3 27.8 27.6High Intensity Drug Trafficking Area Program 226.0 225.0 208.4Counterdrug Technology Assessment Center 46.5 41.8 40.0 Other Federal Drug Control Programs 221.8 227.6 235.0

Total ONDCP 520.6 522.2 511.0Department of State

Bureau of International Narcotics and 874.3 914.4 921.6Law Enforcement Affairs

Department of Veterans AffairsVeterans Health Administration 663.7 765.3 822.8

Other Presidential Priorities2 3.4 2.2 3.5

Total Federal Drug Budget $11,397.0 $12,082.3 $12,648.6

1 Prior to FY 2004, funds for the Interagency Crime and Drug Enforcement programs were appropriated into two accounts,one in the Justice Department and one in the Treasury Department. Beginning in FY 2004 those accounts were consolidated.In this table funding is shown as combined for all three years.

2 Includes the Small Business Administration's Drug Free Workplace grants and the National Highway Traffic Safety Administration's Drug Impaired Driving program.

APPENDIX A

National Drug Control Budget SummaryDrug Control Funding: Agency Summary,FY 2003–FY 2005 (Budget Authority in Millions)


Consultation

The Office of National Drug Control PolicyReauthorization Act of 1998 requires theONDCP Director to consult with a variety ofexperts and officials while developing andimplementing the National Drug ControlStrategy. Specified consultants include the headsof the National Drug Control Program agencies,Congress, state and local officials, citizens andorganizations with expertise in demand andsupply reduction, and appropriate representativesof foreign governments. In 2003, ONDCPconsulted with both houses of Congress and 15federal agencies. At the state and local level,55 Governors were consulted, as well as theNational Governors Association, U.S. Conferenceof Mayors, and National Association of Counties.ONDCP also solicited input from a broadspectrum of nonprofit organizations, communityanti-drug coalitions, chambers of commerce,professional associations, research and educationalinstitutions, and religious organizations. The viewsof the following individuals and organizationswere solicited during the development of theNational Drug Control Strategy.

Members of the United States Senate

Lamar Alexander – TNGeorge Allen – VARobert F. Bennett – UTJoseph R. Biden, Jr. – DEJeff Bingaman – NMChristopher S. Bond – MOBarbara Boxer – CASam Brownback – KSRobert C. Byrd – WVBen Nighthorse Campbell – COSaxby Chambliss – GAHillary Rodham Clinton – NYThad Cochran – MSNorm Coleman – MNJohn Cornyn – TXJon S. Corzine – NJLarry E. Craig – IDMike DeWine – OHChristopher J. Dodd – CTPete V. Domenici – NMByron L. Dorgan – NDRichard J. Durbin – ILJohn Edwards – NCJohn Ensign – NVMike Enzi – WYRussell D. Feingold – WIDianne Feinstein – CABill Frist – TNBob Graham – FLLindsey O. Graham – SCCharles E. Grassley – IAJudd Gregg – NH

53APPENDIX B

Acknowledgments

Chuck Hagel – NETom Harkin – IAOrrin G. Hatch – UTErnest F. Hollings – SCKay Bailey Hutchison – TXDaniel K. Inouye – HIJames M. Jeffords – VTTim Johnson – SDEdward M. Kennedy – MAJohn F. Kerry – MAHerb Kohl – WIMary L. Landrieu – LAPatrick J. Leahy – VTRichard G. Lugar – INBarbara A. Mikulski – MDPatty Murray – WABill Nelson – FLJack Reed – RIHarry Reid – NVJohn D. Rockefeller IV – WVPaul S. Sarbanes – MDCharles E. Schumer – NYJeff Sessions – ALRichard C. Shelby – ALArlen Specter – PATed Stevens – AKJohn E. Sununu – NHGeorge V. Voinovich – OHJohn W. Warner – VA

Members of the United States House of Representatives

Robert B. Aderholt – ALJoe Baca – CABrian Baird – WA

Cass Ballenger – NCJoe Barton – TXChris Bell – TXDoug Bereuter – NEShelley Berkley – NVHoward Berman – CAMarion Berry – ARJudy Biggert – ILSanford D. Bishop, Jr. – GAMarsha Blackburn – TNEarl Blumenauer – ORRoy Blunt – MOHenry Bonilla – TXMary Bono – CAJohn Boozman – ARLeonard L. Boswell – IAAllen Boyd – FLSherrod Brown – OHDan Burton – INKen Calvert – CAChris Cannon – UTBrad Carson – OKJohn Carter – TXSteve Chabot – OHWilliam Lacy Clay – MOJames E. Clyburn – SCHoward Coble – NCJim Cooper – TNJerry F. Costello – ILChristopher Cox – CARobert E. (Bud) Cramer, Jr. – ALAnder Crenshaw – FLJoseph Crowley – NYJohn Abney Culberson – TXElijah E. Cummings – MDRandy “Duke” Cunningham – CADanny K. Davis – ILJo Ann Davis – VATom Davis – VANathan Deal – GAWilliam D. Delahunt – MA


Rosa L. DeLauro – CTNorman D. Dicks – WAJohn T. Doolittle – CADavid Dreier – CAJohn J. Duncan, Jr. – TNJennifer Dunn – WAChet Edwards – TXJo Ann Emerson – MOEliot L. Engel – NYLane Evans – ILEni F. H. Faleomavaega – ASSam Farr – CAChaka Fattah – PAJeff Flake – AZErnie Fletcher – KYRodney P. Frelinghuysen – NJElton Gallegly – CAJim Gibbons – NVVirgil H. Goode, Jr. – VABob Goodlatte – VABart Gordon – TNPorter J. Goss – FLKay Granger – TXSam Graves – MOMark Green – WIKatherine Harris – FLMelissa A. Hart – PAJ. Dennis Hastert – ILDoc Hastings – WAJ.D. Hayworth – AZWally Herger – CAMaurice D. Hinchey – NYDavid L. Hobson – OHJoseph M. Hoeffel – PADarlene Hooley – ORJohn N. Hostettler – INAmo Houghton – NYSteny H. Hoyer – MDKenny C. Hulshof – MODuncan Hunter – CAHenry J. Hyde – IL

Jay Inslee – WAJohnny Isakson – GAErnest J. Istook, Jr. – OKJesse L. Jackson, Jr. – ILWilliam J. Janklow – SDPaul E. Kanjorski – PARic Keller – FLPatrick J. Kennedy – RIRon Kind – WIPeter T. King – NYJack Kingston – GAMark Steven Kirk – ILJoe Knollenberg – MIJim Kolbe – AZDennis J. Kucinich – OHRay LaHood – ILTom Lantos – CARick Larsen – WATom Latham – IASteven C. LaTourette – OHJames A. Leach – IABarbara Lee – CAJerry Lewis – CARon Lewis – KYFrank A. LoBiondo – NJNita M. Lowey – NYFrank D. Lucas – OKStephen F. Lynch – MAKaren McCarthy – MOBetty McCollum – MNThaddeus G. McCotter – MIJim McDermott – WAJohn M. McHugh – NYScott McInnis – COHoward P. “Buck” McKeon – CA Carolyn B. Maloney – NYJim Matheson – UTRobert T. Matsui – CAGregory W. Meeks – NYRobert Menendez – NJJohn L. Mica – FL

55Acknowledgments

Alan B. Mollohan – WVJames P. Moran – VAJerry Moran – KSTim Murphy – PAJohn P. Murtha – PASue Wilkins Myrick – NCGrace F. Napolitano – CAGeorge R. Nethercutt, Jr. – WAAnne M. Northup – KYEleanor Holmes Norton – DCDavid R. Obey – WIJohn W. Olver – MATom Osborne – NEDoug Ose – CAC.L. “Butch” Otter – IDMajor R. Owens – NYEd Pastor – AZRon Paul – TXDonald M. Payne – NJMike Pence – INJohn E. Peterson – PAJoseph R. Pitts – PATodd Russell Platts – PARichard W. Pombo – CAEarl Pomeroy – NDRob Portman – OHDavid E. Price – NCAdam H. Putnam – FLGeorge Radanovich – CARalph Regula – OHDennis R. Rehberg – MTSilvestre Reyes – TXHarold Rogers – KYMike Rogers – MIDana Rohrabacher – CAIleana Ros-Lehtinen – FLMike Ross – ARSteven R. Rothman – NJLucille Roybal-Allard – CAEdward R. Royce – CAC.A. Dutch Ruppersberger – MD

Martin Olav Sabo – MNLinda T. Sánchez – CA Loretta Sanchez – CAMax Sandlin – TXAdam B. Schiff – CAEdward L. Schrock – VAJosé E. Serrano – NYPete Sessions – TXChristopher Shays – CTBrad Sherman – CADon Sherwood – PARob Simmons – CTMichael K. Simpson – IDAdam Smith – WA Christopher H. Smith – NJLamar S. Smith – TXNick Smith – MIVic Snyder – ARMark E. Souder – INJohn Sullivan – OKJohn E. Sweeney – NYThomas G. Tancredo – COEllen O. Tauscher – CAW.J. (Billy) Tauzin – LACharles H. Taylor – NCLee Terry – NEWilliam M. Thomas – CATodd Tiahrt – KSJohn F. Tierney – MAEdolphus Towns – NYMichael R. Turner – OHTom Udall – NMChris Van Hollen – MDPeter J. Visclosky – INDavid Vitter – LAGreg Walden – ORJames T. Walsh – NYZach Wamp – TNDiane E. Watson – CAHenry A. Waxman – CACurt Weldon – PA


Jerry Weller – ILRobert Wexler – FLRoger F. Wicker – MSHeather Wilson – NMFrank R. Wolf – VALynn C. Woolsey – CADavid Wu – ORC.W. Bill Young – FL

Federal AgenciesDepartment of AgricultureDepartment of DefenseDepartment of EducationDepartment of Health and Human

ServicesDepartment of Homeland SecurityDepartment of JusticeDepartment of StateDepartment of TransportationDepartment of the TreasuryDepartment of Veterans AffairsCorporation for National and Community

ServiceSmall Business AdministrationCentral Intelligence AgencyNational Security Agency

Foreign Governments andInternational Organizations

BrazilCanadaColombiaMexicoPeru

Organization of American StatesUnited Nations Office on Drugs and Crime

GovernorsJuan N. Babauta – MP John Elias Baldacci – MECraig Benson – NHRod R. Blagojevich – ILPhil Bredesen – TNJeb Bush – FLSila M. Calderón – PR Felix Perez Camacho – GUDonald L. Carcieri – RIJames H. Douglas – VTJim Doyle – WIMichael F. Easley – NC Robert L. Ehrlich, Jr. – MDMike Foster, Jr. – LADave Freudenthall – WYJennifer M. Granholm – MIKenny C. Guinn – NV Brad Henry – OKJohn Hoeven – ND Bob Holden – MO Mike Huckabee – AR Mike Johanns – NE Dirk Kempthorne – IDJoseph E. Kernan – IN Ted Kulongoski - ORLinda Lingle – HIGary Locke – WAJames E. McGreevey – NJ Judy Martz – MT Ruth Ann Minner – DE Frank Murkowski – AKRonnie Musgrove – MS Janet Napolitano – AZBill Owens – CO

57Acknowledgments

George E. Pataki – NY Paul Patton – KY Tim Pawlenty – MNSonny Perdue – GARick Perry – TX Edward G. Rendell – PABill Richardson – NMRobert Riley – ALMitt Romney – MAM. Michael Rounds – SDJohn G. Rowland – CT Mark Sanford – SCArnold Schwarzenegger – CAKathleen Sebelius – KSBob Taft – OH Togiola T. A. Tulafono – ASCharles W. Turnbull – VI Thomas Vilsack – IAOlene S. Walker – UTMark Warner – VA Robert Wise, Jr. – WV

MayorsMichael R. Bloomberg – New York, NY Lee Brown – Houston, TX Willie Brown – San Francisco, CA Jane L. Campbell – Cleveland, OHRichard M. Daley – Chicago, IL Manuel A. Diaz – Miami, FLHeather Fargo – Sacramento, CAShirley Franklin – Atlanta, GAJames K. Hahn – Los Angeles, CA John W. Hickenlooper – Denver, COPam Iorio – Tampa, FLVera Katz – Portland, ORKwame M. Kilpatrick – Detroit, MICharles J. Luken – Cincinnati, OHThomas M. Menino – Boston, MA

Laura Miller – Dallas, TX Richard M. Murphy – San Diego, CAThomas J. Murphy – Pittsburgh, PAGreg Nickels – Seattle, WAMartin O’Malley – Baltimore, MDAlexander Penelas – Miami-Dade, FL Skip Rimsza – Phoenix, AZ R.T. Rybak – Minneapolis-St. Paul, MNFrancis G. Slay – St. Louis, MOJohn F. Street – Philadelphia, PA

Other Organizations andIndividuals

Abt AssociatesAddiction Research and Treatment

CorporationAFL-CIOAfrican American Men ProjectAlbuquerque PartnershipAlcohol and Drug Problems Association of

North AmericaAmerica CaresAmerican Association for the Treatment of

Opioid DependenceAmerican Bar AssociationAmerican Correctional AssociationAmerican Education AssociationAmerican Enterprise InstituteAmerican Federation of TeachersAmerican Medical Association American Psychological AssociationAmerican Public Health AssociationAmerican Public Human Services

AssociationAmerican Society of Addiction MedicineArizona Department of EducationArizona Science Center


Auburn UniversityBoy Scouts of AmericaBoys & Girls Clubs of AmericaBrandeis University Institute for Health PolicyThe BridgeBrookhaven National LaboratoryBroward County Commission on Substance

AbuseBrownsville Police DepartmentBuilding a Better Bensalem TodayCalifornia Institute of TechnologyCalifornians for Drug-Free YouthCatholic Charities USACenter for Problem Solving CourtsCenter PointChesterfield County Police DepartmentChild Welfare League of AmericaChildren First AmericaChildren’s Hospital of PhiladelphiaCity of Detroit Health DepartmentCivitan InternationalCoalition for a Drug-Free Greater

CincinnatiCoalition for a Drug-Free HawaiiCoalition for Outcome Based BenefitsCollege on Problems of Drug DependenceColumbia UniversityCommunity Anti-Drug Coalitions of

AmericaCommunity Behavioral HealthCommunity Resources for JusticeConcerned Women for AmericaCongress of National Black ChurchesConsulting Services and ResearchCOPACCornell UniversityCouncil of Church Based Health ProgramsCouncil of State GovernmentsCouncil on Alcohol and Drugs HoustonD.A.R.E. AmericaDetroit Empowerment Zone Coalition

Developing Resources for Education inAmerica

Drug and Alcohol Service ProvidersOrganization of Pennsylvania

Drug Free America FoundationDrug Free Mercer CountyDrug Free Noble CountyDrug Free PennsylvaniaEmployee Assistance Professionals

AssociationEmory UniversityEmpower AmericaEvergreen Treatment ServicesFederal Law Enforcement Officers

AssociationFellowship of Christian AthletesFighting BackFraternal Order of PoliceGenesis Prevention CoalitionGeorgia State University Department of

PsychologyGirl Scouts of the USAGrand Forks Youth Team CoalitionHands Across CultureHarvard UniversityHealthy TomorrowsHeritage FoundationHillsborough County Sheriff ’s OfficeHispanic American Police Command

Officers AssociationHoover InstitutionHouston Advanced Research CenterHudson InstituteHuman Resources Development InstituteIdaho Supreme CourtIndependent Order of Odd FellowsInstitute for Behavior and HealthInstitute for a Drug-Free WorkplaceInstitute for Policy InnovationInstitute for Research, Education, and

Training in Addictions

59Acknowledgments

Institute for Social ResearchInstitute for Youth DevelopmentInstitute on Global Drug PolicyInternational Association of Chiefs of PoliceInternational Association of Lions ClubsInternational Brotherhood of Police OfficersInternational City/County Management

AssociationJewish Council for Public AffairsJohns Hopkins UniversityJohnson, Bassin, & ShawJoin TogetherJunior Chamber InternationalJuvenile Assessment CenterKansas City, Missouri, Police DepartmentKing County Mental Health, Chemical

Abuse and Dependency Services DivisionLawrence Livermore National LaboratoryLegal Action CenterLehigh Valley Hospital ALERT PartnershipLewin GroupLucas County Community Prevention

PartnershipMadison County Safe and Drug-Free

Communities PartnershipMajor City Chiefs AssociationMason City Youth Task ForceMassachusetts General HospitalMassachusetts Institute of TechnologyMayo ClinicThe Metropolitan Drug CommissionMichigan State Police Investigative Services

BureauMilton & Rose D. Friedman FoundationMilton S. Eisenhower FoundationMinneapolis Police DepartmentMontana State UniversityMontreal Neurological InstituteMoose InternationalMothers Against Drunk DrivingMount Hood Coalition

Nashville Prevention PartnershipNational Alliance for Hispanic HealthNational Alliance of State Drug

Enforcement AgenciesNational Asian Pacific American Families

Against Substance AbuseNational Association for Children of

AlcoholicsNational Association of Alcoholism and

Drug Abuse CounselorsNational Association of Attorneys GeneralNational Association of CountiesNational Association of County Behavioral

Health DirectorsNational Association of Drug Court

ProfessionalsNational Association of Elementary School

PrincipalsNational Association of Native American

Children of AlcoholicsNational Association of Police OrganizationsNational Association of Secondary School

PrincipalsNational Association of State Alcohol and

Drug Abuse DirectorsNational Association of Student Assistance

ProfessionalsNational Black Child Development Institute National Center for Public Policy ResearchNational Center for State CourtsNational Center on Addiction and Substance

Abuse at Columbia UniversityNational Commission Against Drunk DrivingNational Conference of State LegislaturesNational Council of Juvenile and Family

Court JudgesNational Council of La RazaNational Crime Prevention CouncilNational Criminal Justice AssociationNational Development and Research

Institutes


National District Attorneys AssociationNational Exchange ClubNational Families in ActionNational Family PartnershipNational Federation of State High School

AssociationsNational Governors AssociationNational Hispanic Medical AssociationNational Hispanic Science Network on Drug

AbuseNational Indian Youth Leadership ProjectNational Inhalant Prevention CoalitionNational Institute of Neurological Disorders

and StrokeNational League of CitiesNational Legal Aid & Defender AssociationNational Library of MedicineNational Lieutenant Governors AssociationNational Masonic Foundation for ChildrenNational Mental Health AssociationNational Narcotic Officers’ Associations’

CoalitionNational Opinion Research CenterNational Organization of Black Law

Enforcement Executives National Parents and Teachers AssociationNational Pharmaceutical CouncilNational Research Council National School Boards AssociationNational Sheriffs’ AssociationNational Treatment ConsortiumNational Troopers Coalition Naval Research LaboratoryNew York State Psychiatric InstituteNew York University School of MedicineNortheast Community Challenge CoalitionNorthland Tri-County CoalitionOhio County Together We CareOperation PAROregon Health & Science UniversityOregon Partnership

Orleans Parish District Attorney’s OfficeParents’ Resource Institute for Drug

EducationPartnership for a Drug-Free AmericaPeers Are Staying StraightPhoenix HousePima County Sheriff ’s DepartmentPolice Executive Research ForumPolice FoundationPrairie View Prevention ServicesPrevention Think TankPrevention Through Service AllianceQuota InternationalRegional Medical Center at LubecResearch Triangle InstituteRio Arriba Family Care NetworkRio Grande Safe Communities CoalitionRiverside HouseRobert Wood Johnson FoundationOffice of the Rockland County District

AttorneyRural Virginia United CoalitionSacramento Mobilizing Against Substance

AbuseSan Diego Prevention CoalitionSanta Barbara Council on Alcoholism and

Drug AbuseScott Newman Center Seattle Department of Community and

Human ServicesSeeds of Change CoalitionSouth Carolina Law Enforcement DivisionSouthern Christian Leadership ConferenceStanford University School of MedicineState University of New YorkSubstance Abuse Program Administrators

AssociationSuffolk Coalition to Prevent Alcohol and

Drug DependenciesSupport Center for Alcohol and Drug

Research and Education

61Acknowledgments

Sussex County Coalition for Healthy andSafe Families

Talbot PartnershipTexas Christian University Institute of

Behavior ResearchTexas Tech Health Science CenterTherapeutic Communities of AmericaTorrey Mesa Research InstituteTreatment Alternatives for Safe

Communities Treatment Research InstituteTroy Community Coalition for the

Prevention of Drug and Alcohol AbuseTurning PointUnion of American Hebrew CongregationsUnion County Coalition for the Prevention

of Substance AbuseUnited Methodist Church, Washington

Episcopal AreaU.S. Anti Doping AgencyU.S. Conference of MayorsUnited Synagogue of Conservative JudaismUniversity Hospitals of ClevelandUniversity of ArizonaUniversity of California, Los AngelesUniversity of California, San DiegoUniversity of CincinnatiUniversity of Colorado Health Sciences

CenterUniversity of FloridaUniversity of IowaUniversity of Kentucky Center for

Prevention ResearchUniversity of Miami School of MedicineUniversity of MinnesotaUniversity of New MexicoUniversity of North DakotaUniversity of Pennsylvania University of Pittsburgh School of MedicineUniversity of Rhode IslandUniversity of South Carolina

University of South FloridaUniversity of WashingtonUniversity of WisconsinUniversity of TexasUtah Council for Crime PreventionWake Forest University School of MedicineThe Walsh GroupWashington Business Group on HealthWayne State University School of MedicineWhite BisonWhitehead InstituteYakima County Substance Abuse CoalitionYale University School of MedicineYMCA of America


NationalDrug ControlStrategy

Office of National Drug Control Policy

Washington, D.C. 20503


Documents

2004 National Drug Control Strategy · National Drug Control Strategy Office of National Drug Control Policy Washington, D.C. 20503 The White House March 2004. National Drug Control