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Drug Abuse in Washington, D.C. In 1995, alcohol and other drug abuse cost the nation $276 billion (including health care expenditures, premature death, impaired productivity, motor vehicle crashes, crime and social welfare costs), according to the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).(7) Based strictly on the District's share of the U.S. population, costs to the city would be about $600 million,(8) but numerous indicators suggest a much greater price. For example:
Extrapolating from these indicators leads to the conclusion that the costs of alcohol and other drug abuse to the District probably exceed $1.2 billion -- double the population-based figure. Approximately $700 million of these costs are related to alcohol and $500 million to other drug abuse. Adding $520 million in tobacco-related illness (14) would raise the total costs to at least $1.7 billion annually -- about $3,250 per resident.(15) Any attempt to reduce these costs must begin with a current assessment of the District's drug abuse problems. Unfortunately, citywide surveys of adult alcohol and other drug use in the District have not been conducted since 1993, severely hampering policy planning. However, local and federal agencies plan to conduct surveys in 1999 and 2000 which will provide critical new information to help guide policy and program decisions. The following overview is based on the best figures now available.
The city's high alcohol consumption is often attributed to tourists and commuters. But even if nonresidents accounted for one-third of the alcohol consumed in the city, per capita consumption by city residents would still exceed the national average by 20 percent.(17) According to a survey of Americans' drinking habits conducted in 1997 for the Robert Wood Johnson Foundation (RWJF), heavy drinking is 50 percent more prevalent among District adults than among adults nationwide.(18) [FOOTNOTE: The RWJF survey defined "heavy drinking" as five or more drinks in a day, four or more times a month. The results may actually understate the prevalence of heavy drinking in the District because the definition of heavy drinking does not take into account beer sold in 40-ounce containers, which makes up 26 percent of beer consumed in the city. While a survey respondent who reports having two or three beers is not engaging in heavy drinking if the beers are in regular-sized containers, he or she would be engaging in heavy drinking if they were in 40-ounce containers. The survey did not ask respondents about container size, only the number of drinks.] In contrast to District adults, the city's high school students' drinking rates are below the national average, according to the U.S. Centers for Disease Control and Prevention (CDC). In 1997, 38 percent of D.C. high school students reported drinking in the month before the survey, compared to half of high school students nationwide.(19)
Teen drinking in the District reflects generally lower rates among African American youth nationally. Fewer than one in five D.C. teens reported binge drinking (at least five drinks at a time) in the past month -- about half the national rate for teens overall, but very close to the national rate among African American teens (16 percent).(21) However, the absence of school dropouts from the CDC surveys means that actual drinking rates among District teens are probably higher. Specific data on college student drinking are not available for Washington, D.C., but experts believe that practices among D.C. students probably reflect national patterns, and those patterns are cause for concern.(22) At least 43 percent of college students nationally are binge drinkers.(23) Seventy percent report past-month drinking, with a weekly average of five drinks per student.(24) Drinking is by far the biggest drug abuse problem among the District's Latino residents. A 1998 report prepared for the Mayor's Office on Latino Affairs and the D.C. Addiction Prevention and Recovery Administration (APRA) found that Latinos in the District are nearly twice as likely to be problem drinkers than other District residents. In focus groups, Latino residents stressed that the custom of binge drinking was brought from their countries of origin, where heavy drinking is seen as sociable.(25) The practice creates a cultural context which may condone alcohol abuse and calls for targeted prevention efforts.
Sales of alcohol for off-premise consumption create additional problems, such as street-corner drinking, which degrade neighborhoods. Beer Marketer's Insights (an industry newsletter) estimates that less than 30 percent of all beer sales for on-premise consumption in the District are attributable to African Americans, even though this group comprises 63 percent of city residents.(28) Licensing practices in Washington, D.C. may increase the likelihood of alcohol-related problems, particularly in African American neighborhoods. The 1997 RWJF survey found that 58 percent of D.C. residents favor the right of local communities to pass their own laws controlling the sale and consumption of alcohol, even if those laws are stricter than D.C. or federal laws.
Under a U.S. Department of Transportation grant, 194 outlets were targeted by ABC-Metropolitan Police Department operations from May through September 1998, resulting in 338 citations for sales to minors. According to investigators, the vast majority of sellers cited for violations do not check a young buyer's ID. [FOOTNOTE: More than three in four D.C. residents believe that stores and bars are not careful enough in preventing teenagers from buying alcohol, according to the 1997 Robert Wood Johnson Foundation survey. Participants in a 1998 Latino community meeting on underage drinking complained that some outlets sell beer to Latino youth on credit, and insert individual cigarettes in the rings of the six-pack.] ABC imposes escalating penalties on violators, ranging from a $1,500 fine and three-day suspension for a first offense to a $4,500 fine and 10-day suspension for a third offense. An outlet committing four violations within a five-year period faces revocation of its alcohol license. The problem is that ABC has only four investigators responsible for monitoring the District's more than 1,500 licensed outlets, so proprietors know they face little chance of detection. In fiscal year (FY) 1997, 32 licenses were suspended (for one to 10 days) because of illegal sales to minors -- only about eight suspensions per investigator for the entire year. ABC plans to hire 12 additional investigators by spring 1999, six of whom will focus on illegal sales to minors.
Moreover, the District's excise taxes are not indexed for inflation, so their value erodes over time. For example, the current excise tax on liquor is worth only 45 percent of its value in 1978, when the tax was last changed. The city's excise taxes amount to about 1 cent per 12-ounce beer and 6-ounce glass of wine, and 2 cents per shot of liquor. Seventy-five percent of District residents would favor increasing alcohol taxes by 5 cents per drink, if the revenues were used to pay for programs to prevent underage drinking and to treat alcohol problems, according to the 1997 RWJF survey. [FOOTNOTE: In a 1974 strategy paper aiming to reduce D.C. alcohol taxes, the District of Columbia Alcohol Beverage Industry noted that four of the city's five excise tax increases between 1954 and 1969 had immediately preceded or accompanied declines in consumption.] A dozen states earmark a portion of their alcohol excise tax revenues for prevention and treatment programs. In contrast, all revenues from Washington's alcohol excise and sales tax -- millions of dollars per year -- go to the city's general fund (except for 10 percent of on-premise alcohol sales taxes, which are earmarked for the Washington Convention Center Authority Fund).
Smoking rates among District adults are lower than nationwide rates. According to the CDC's Behavioral Risk Factor Surveillance System, about one in five adults in the city smoked cigarettes in 1996, compared to the national rate of 23 percent and the national African American rate of 24 percent.(33/34)
The District's high tax has helped reduce sales significantly. In 1990, 54 million packs of cigarettes were sold in Washington, D.C. -- 107 packs for every resident age 15 and older. In 1997, that number declined to 54 packs per resident.(35) Since 1990, cigarette excise taxes have generated more than $17 million annually for the city.(36) However, these funds go the city's general fund and are not designated for prevention or treatment. In November 1998, the city accepted an invitation to join the $206 billion out-of-court national settlement with the tobacco industry, which could provide the District with an estimated $1.2 billion over the next 25 years. To defray the costs of the settlement, tobacco companies have already raised cigarette prices by 45 cents per pack.
Addiction Prevention and Recovery Administration (APRA) officials monitor illegal tobacco sales using teens posing as potential buyers. During more than 1,000 random compliance inspections throughout the city in 1998, teens were able to purchase tobacco products in 34 percent of tobacco outlets -- a drop from the 1996 rate of 51 percent.(37) However, this encouraging reduction contrasts with 1997 CDC findings that 67 percent of D.C. high school students who purchased cigarettes reported that they were not asked to show proof of age.(38) The data suggest that experienced teen smokers can purchase cigarettes without detection far more frequently than is apparent in staged monitoring activities with volunteer youth. In 1999, APRA will begin a new round of inspections funded through a contract with the U.S. Food and Drug Administration (FDA). APRA will present evidence of violations to the FDA, which will use its authority under federal law to assess fines against vendors ranging from $250 for the second offense to $10,000 for the fifth offense. Under D.C. law, selling tobacco to a minor is a misdemeanor, punishable by a maximum fine of $500 or 30 days in jail (and $1,000 or 90 days in jail for a subsequent offense). The Metropolitan Police Department is responsible for enforcing the law, but officers rarely make such arrests. Allowing the police to simply issue a misdemeanor citation rather than having to conduct a full-fledged arrest could increase the level of enforcement significantly. The D.C. Department of Consumer and Regulatory Affairs (DCRA) issues licenses to sell tobacco in the city, but lacks the authority to impose fines or to suspend and revoke a license because a vendor has sold to minors. The FDA's ability to impose steep fines against repeat offenders may go far to reduce sales of tobacco to minors in the District. But local officials suggest that even more could be achieved by enabling DCRA to impose fines and to suspend and revoke the licenses of vendors who sell to minors, in the same way that Alcohol Beverage Control (ABC) investigators can regulate alcohol licensees who engage in underage sales.
Illicit Drug Use in the District. In 1997 half of D.C. high school students had tried marijuana -- a dramatic increase over the 12 percent of 1991. This increase is consistent with national trends, including rates among African American teens. While District teens report lower rates of cocaine use than do youth nationwide, past month cocaine use among D.C. students (2.6 percent) more than doubled from 1995 to 1997. In 1997, fewer than 3 percent of D.C. teens reported having ever injected drugs such as heroin. However, snorting high-purity heroin is reportedly on the rise among teens and young adults in the District and other U.S. cities. As for inhalants, in 1997, 11 percent of D.C. youth reported having tried them, compared to 16 percent nationwide.(39)
The most recent comprehensive surveys of illicit drug use among District adults were conducted by NIDA from 1990-1992 as part of the Washington, D.C., Metropolitan Area Drug Study (DC*MADS). The federal Substance Abuse and Mental Health Services Administration (SAMHSA) also has unpublished D.C. prevalence data for 1991-1993. DC*MADS found that in 1991, 6 percent of city residents had used illicit drugs in the preceding month -- the same as the national rate.(41) Past month marijuana use among D.C. adults in 1991 was about the same as the national rate, as were estimates of past month illicit drug use from 1991 through 1993 (7 percent vs. 6 percent). However, past month cocaine use and past year heroin use were about double the national rate from 1990 through 1993. The D.C. Addiction Prevention and Recovery Administration (APRA) is planning to conduct a household survey of residents in 1999. In addition, the National Household Survey on Drug Abuse, scheduled for release by SAMHSA in the year 2000, will include separate prevalence estimates for each state and the District of Columbia.
Availability of Illicit Drugs. The supply of illicit drugs in the District is facilitated by the proximity of three commercial airports and Interstate 95 -- the highway to New York City and Miami, the major East Coast wholesale drug distribution centers.(44) Moreover, federal and local law enforcement agencies have identified more than 40 major drug trafficking organizations in the Washington-Baltimore corridor and more than 350 supporting organizations.(45) The Metropolitan Police Department enforces laws against illicit drug sales and possession, and the Major Narcotics Branch focuses on apprehending drug suppliers. The police have identified approximately 60 drug sales "hot-spots" in the District, many of which lie along the city's border with Maryland's Prince George's County. Washington's and Prince George's police have initiated a joint surveillance and enforcement program funded by the Office of National Drug Control Policy.(46)
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