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Original article: www.huffingtonpost.com/john-carnevale/the-failure-of-the-office_b_112693.html As an insider in the nation's war against drugs, I spent almost fifteen years in the executive office of the President. Eleven of these years were in the Office of National Drug Control Policy where I served four of the nation's so-called drug czars preparing the federal drug control budget, writing many of the national drug control strategies, and conducting performance measurement and analysis of the efficacy of those strategies. I left government in 2000, but continue to be highly involved in shaping drug policies and measuring performance in drug policy both nationally and internationally. In the latest 2008 National Drug Control Strategy, the Office of National Drug Control Policy (ONDCP) -- the federal executive office agency charged with shaping this nation's national drug control strategy -- claims that America has reached a turning point in the war on drugs. In reality, we have little reason to believe a significant change has occurred. ONDCP based its claim on declining use for youth -- a trend that long precedes this administration's tenure -- but ignores the lack of progress with regard to adult drug use, rates of drug addiction, the inaccessibility of substance abuse treatment, and new emerging drugs of demand such as pharmaceutical drugs and methamphetamine. If America is to be successful in the fight against drugs, the first priority for the next administration -- Republican or Democrat -- must be to reinventing ONDCP as an effective policy office capable of leading the nation's struggle with drugs. In the 1980's, the United States essentially focused on supply reduction, largely in response to a cocaine epidemic, and with the belief that source and transit zone interdiction was the most effective means of reducing drug use in the United States. By the 1990's we had learned that interdiction was a relatively ineffective way of reducing drug use -- and expensive besides. So we focused our efforts on demand reduction. Now, at the beginning of the new millennium we have...inexplicably...come to believe again that source and transit zone interdiction is an effective way to reduce drug use in America. There is no evidence to support this belief. And it is all the more surprising that we have refocused our efforts in this way at a time when many of the major drugs of abuse -- including marijuana, methamphetamine, and controlled pharmaceuticals, are produced domestically. The central task of ONDCP -- and what must now become the central political debate -- is determining how best to combine and fund the five essential ingredients of drug control policy: prevention, treatment, domestic law enforcement, international or source country programs, and interdiction. Though Congress created ONDCP to formulate research-driven and performance-based policy, assess and modify policy through performance measures, and give a precise accounting of the federal drug control budget, ONDCP fails at all of those tasks. In the 90's ONDCP created a performance measurement system for evaluating the effects of its policies on drug use, drug availability, and the negative consequences of drug use; however, this decade, no such performance measurement system has been utilized. As a consequence, policy is now flying blind resulting in lost opportunities for more success. Simply put: the cornerstone of all evidence-based policy driven by reliable performance data. Currently, ONDCP has failed to establish baseline measures link to the ingredients of an effective drug policy. This is inhibiting our nation's ability to better assess future action. The first step of any administration must be to reassert ONDCP as the flagship substance abuse organization by instituting a performance measurement system to allow Congress, the American people, and ONDCP itself access to crucial data. To stay ahead of emerging drug trends, ONDCP must once again make knowledge development, data systems and research a priority. Leading drug use indicators must steer drug control policy rather than outdated trends. Second, ONDCP's budgetary role must be fixed. A review of the Federal drug control budget for this decade shows the following: the Administration's drug control budget since FY02 has emphasized supply reduction programs over demand reduction programs; resources for supply reduction (interdiction of drugs, source country programs, and law enforcement), grew by almost 57% from the FY 02 baseline level to the FY 09 request now before Congress; and by comparison, demand reduction resources (prevention and treatment, including resources for research for agencies like the National Institute on Drug Abuse) grew by only 2.7 percent--prevention is actually cut 25 percent. This budget trend runs counter to what research would otherwise suggest: that efforts to reduce demand are best addressed through treatment and prevention rather than supply reduction.ONDCP must fully exercise its budgetary authority. Working with the Office of Management and Budget to formulate and distribute an accurate drug control budget to implement its policy priorities is the only way to ensure that research findings are reflected in the drug control budget. Finally, a new administration must retool and reemphasize ONDCP as an effective policy leadership organization. Right now, ONDCP administers many programs that could be better managed by other federal agencies responsible for drug program administration. ONDCP rediscover its roots by again becoming a leader in policy formulation to develop a drug policy that is evidence-based and includes performance measurement to hold it accountable for results. An outdated organizational structure reflecting the 1980's cocaine war must be abandoned in favor of one that addresses today's multifaceted drug threat, recognizing that drug use occurs in drug markets where the most common drugs are more often domestically produced. Programs which distract from ONDCP's policy-setting mission must be jettisoned to agencies more suited to those particular tasks (e.g. Drug Free Communities to SAMHSA). ONDCP must focus exclusively on policy and budget. The new administration will face a unique opportunity to reshape American drug policy. ONDCP must develop a strategy that is research- and performance-based. It must present a federal drug control budget that emphasizes effective programs that support an evidence-based, comprehensive drug control policy. It is now up to the next president, be he or she Democrat or Republican, to enable ONDCP to meet the nation's needs to reduce drug use and its damaging consequences. |
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