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New National Drug Control Strategy
By David F. Duncan, DrPH, FAAHB

The White House Office of National Drug Control Policy (ONDCP) today released the first National Drug Control Strategy of the Obama administration.

According to President Obama, “This Strategy calls for a balanced approach to confronting the complex challenge of drug use and its consequences.” If so, that is just the sort of national policy that the National Association for Public Health Policy and its Council on Illicit Drugs have been advocating.

Since taking office President Obama and his administration have given some cause to hope that they are prepared to adopt a sensible public health approach to drug policy in place of the disastrous War on (some) Drugs. President Obama has signed a measure repealing a two-decade old ban on the use of federal money for needle-exchange programs to reduce the spread of HIV and HCV. His Attorney General has said that the DEA won't target medical marijuana patients or caregivers as long as they comply with state laws. Earlier this year, President Obama called on Congress to eliminate the disparity in sentencing for possession of crack and powder cocaine -- the same drug with exactly the same effects in either form. While reformers supported candidates such as Ethan Nadelman, Thomas Nicholson, or David Lewis for director of the ONDCP, the President's choice of Gil Kerlikowske encouraged some hope for change.

Now, in announcing his administration's new strategy, the President promises that, “By boosting community-based prevention, expanding treatment, strengthening law enforcement, and working collaboratively with our global partners, we will reduce drug use and the great damage it causes in our communities. I am confident that when we take the steps outlined in this Strategy, we will make our country stronger and our people healthier and safer.” You can read the full text of his remarks at whitehouse.gov.

You may read the strategy and supporting documents at the ONDCP website. Following the model that public health has been following for decades, the new strategy proposes two big goals and measurable objectives, as follows:

Goal 1: Curtail illicit drug consumption in America

1a. Decrease the 30-day prevalence of drug use among 12–17 year olds by 15%

1b. Decrease the lifetime prevalence of 8th graders who have used drugs, alcohol, or tobacco by 15%

1c. Decrease the 30-day prevalence of drug use among young adults aged 18–25 by 10%

1d. Reduce the number of chronic drug users by 15%

Goal 2: Improve the public health and public safety of the American people by reducing the consequences of drug abuse

2a. Reduce drug-induced deaths by 15%

2b. Reduce drug-related morbidity by 15%

2c. Reduce the prevalence of drugged driving by 10%

The second goal is certainly consistent with the type of harm reduction strategy that NAPHP and the rest of the public health community have been advocating for several decades. The first goal would seem to signal an emphasis on the demand reduction approach to drug policy -- a reversal of the policy of previous administrations. But is that the reality of what is proposed? If you look at the budget breakdowns contained in the new strategy, you will find that it continues the historic pattern of spending roughly twice as much on supply reduction as on demand reduction -- 65.6% for supply reduction programs and 34.4% for demand reduction. Spending on prevention programs amounts to only 10.6% of the budget under the new plan. In fact, prevention is the only area in which funding is being reduced by the Obama administration. So much for the promised "balanced approach".

NAPHP has not taken an official position in response to the Obama administration's 2010 National Drug Control Strategy but I personally am very disappointed in the lack of commitment it shows to any real public health approach.

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