FACING FACTS

Drug Strategies

Facing Facts

Endnotes

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1. Kristan Trugman, "Users take risks coming into D.C." The Washington Times, September 7, 1998.

2. Michael Powell, "Steep Expenses, Low Quality Are The Rule in D.C." The Washington Post, July 21, 1997, p. A1.

3. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998.

4. George Grier, Washington Area Growth and Change in the 1990s. Washington, DC: Greater Washington Research Center, November 1998.

5. Margery A. Turner & Chris Hayes, Poor People and Poor Neighborhoods in the Washington Metropolitan Region. Washington, DC: The Urban Institute,1997.

6. Carol O'Cleireacain, The Orphaned Capital: Adopting the Right Revenues for the District of Columbia. Washington, DC: Brookings InstitutionPress, 1997.

7. NIDA and NIAAA, The Economic Costs of Alcohol and Drug Abuse in the United States, 1992. May 1998.

8. NIDA and NIAAA, 1998: 1995 costs of alcohol ($166.5 billion) and other drug abuse ($109.8 billion) in the United States ($276.3 billion)

1995 U.S. population = 262.755 million; 1995 D.C. population = 0.554 million

D.C. = 0.21084% of U.S. population, so D.C. costs in proportion to population are: alcohol: $351 million; drugs: $231.5 million; total: $582.5 million

9. University of Minnesota Alcohol Epidemiology Program, Youth Access to Alcohol Survey. Prepared for the Robert Wood Johnson Foundation, 1998. (Survey was conducted in 1997.)

10. NIAAA, County Alcohol Problem Indicators, 1986-1990. 1994. Alcohol-related mortality: (86.6 to 44.0 = 1.96 times national rate)

11. NIDA and NIAAA, 1998: U.S. proportion in need of alcohol and other drug treatment = 8.9%. APRA cites an outdated figure of 65,000 D.C. residents in need of treatment, 12.45 of the population. But it may be that 15 to 20 percent of residents are in need of treatment, as in 1989, when the last needs assessment was completed.

12. NIDA and NIAAA, 1998

13. FBI, Crime in the United States: Uniform Crime Reports 1997. 1998

crime rate (9,839.1 to 4,922.7 = 2.0 times national rate)
murder rate (56.9 to 6.8 = 8.4 times national rate)

Bureau of Justice Statistics, Prison and Jail Inmates at Midyear 1998. 1999, p. 2, table 1 and p. 3 table 2.

incarceration rate (1,329 to 668 = 2.0 times national rate)
1,329 per 100,000 D.C. residents are held in D.C. jails and prisons or in federal prisons
668 per 100,000 U.S. residents are held in local jails or in state or federal prisons

14. Figure of $520 million in tobacco-related illness comes from a combination of three sources:

Berkeley Economic Research Associates, Smoking Attributable Medical Care Costs: Model and Results. (Berkeley, CA: BERA, 1997). BERA estimates D.C.'s 1993 direct medical costs attributable to smoking to be $178.49 million, with a per adult cost of $385.03.

Leonard S. Miller, Xiulan Zhang, Dorothy P. Rice & Wendy Max, "State Estimates of Total Medical Expenditures Attributable to Cigarette Smoking, 1993," Public Health Reports 113:447-458, September/October1998. Miller et al. estimate D.C.'s 1993 direct medical costs attributable to smoking to be $315.57 million, 76.80 percent higher than BERA's estimate (derived by dividing the total D.C. cost by 463,574 adults, the 1993 population figure used by BERA). Adjusting BERA's per adult cost accordingly yields a per adult cost estimate of $680.73.

BERA estimated U.S. total costs at $53,150.44 million, and U.S. per adult costs at $277.99. Miller et al.'s U.S. total cost estimate of $72,732.49 million translates to a U.S. per adult cost of $380.41 (derived by dividing the total U.S. cost by 191,195,510 adults, the 1993 population figure used by BERA). Thus the D.C. cost per adult is 79.95 percent higher than the national average.

CDC estimates national indirect costs of smoking, including productivity loss from illness and premature death, at $47.2 billion in 1990. Proportionally to D.C. population, District costs would be $115 million. Given that direct medical care costs are 79.95 percent higher than the national average, the indirect costs can also be raised by 79.95 percent, to equal $206.94 million.

1990 U.S. population = 248.718 million; 1990 D.C. population = 0.607 million
D.C. = 0.24405% of U.S. population, so D.C. costs in proportion to populationare:
$115 million; increased by 79.95 percent = $206.94 million.

15. $1.7 billion divided by 523,000 residents = $3,250 per person.

16. NIAAA, Surveillance Report #43. Apparent Per Capita Alcohol Consumption:National, State, and Regional Trends, 1977-95. December 1997. Purealcohol to beer equivalency calculation: at .045 pure alcohol, an average12-ounce beer contains .54 ounces of pure alcohol. One gallon (128 ounces)of pure alcohol is equivalent to 237 12-ounce beers; 3.89 gallons or purealcohol is therefore equal to 921.9 12-ounce beers per person per year,or 17.7 beers per week, almost the same as three 6-packs (18 beers).

17. NIAAA, Surveillance Report #43, December 1997.

18. University of Minnesota Alcohol Epidemiology Program, Youth Access to Alcohol Survey. Prepared for the Robert Wood Johnson Foundation, 1998. (Survey was conducted in 1997.)

19. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention.

20. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998.

21. CDC, Youth Risk Behavior Surveillance System, 1995.

22. Based on a December 21, 1998 conversation with Dr. David Anderson, George Mason University.

23. Henry Wechsler, George W. Dowdall, Gretchen Maenner, Jeana Gledhill-Hoyt, Hang Lee, "Changes in Binge Drinking and Related Problems Among American College Students Between 1993 and 1997: Results of the Harvard School of Public Health College Alcohol Study." Journal of American College Health, 1998, 47: 57-68.

24. Core Institute. Statistics drawn from a sample of 89,874 college students from two- and four-year colleges in the United States who completed the Core survey during 1995-1996. All institutions used methods to ensure random representation of their respective student bodies.

25. Continuum of Care for Latino Substance Abusers. Washington,DC: George Washington University Center for International Health and the Council of Latino Agencies and Catholic University-Life Cycle Institute, November 6, 1998.

26. Paul J. Gruenewald, Alexander B. Millar & Peter Roeper, "Access to Alcohol: Geography and Prevention for Local Communities." Alcohol Health & Research World, 1996, 20(4): 244-251.

27. "Access to alcohol, and the effects of availability on consumption and alcohol-related problems." (pp. 125-152). In Griffith Edwards et al. (eds.), Alcohol Policy and the Public Good. New York: Oxford University Press, 1997.

28. "A Different World: More Details on Distributing in DC." Beer Marketer's Insights, 28 (4), February 24, 1997.

29. Assistant Chief Ronald Monroe, Metropolitan Police Department, personal communication, December 4, 1998.

30. GAO, District of Columbia: Taxes and Other Strategies to Reduce Alcohol Abuse. May 1998.

31. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention.

32. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention

33. Behavioral Risk Factor Surveillance System, CDC, District of Columbia Statewide Survey Data, 1996.

34. BRFSS Online Prevalence Data, www.cdc.gov/nccdphp/brfss/

35. "Where's the Smoke?" The Washington Post, November10, 1998. Health Section, p. 5.

36. D.C. Office of Tax and Revenue.

37. Office of Prevention, APRA, DC Department of Health.

38. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention.

39. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention.

40. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention.

41. Prevalence of Drug Use in the DC Metropolitan Area Household Population:1991 (Washington, DC, Metropolitan Area Drug Study, Technical Report #8). U.S. Department of Health and Human Services, 1994.

42. Marjorie J. Robertson, Cheryl Zlotnick and Alex Westerfelt, "Drug Use Disorders and Treatment Contact Among Homeless Adults in Alameda County, California." American Journal of Public Health, 1997, 87(2):221-228.

43. Prevalence of Drug Use in the DC Metropolitan Area Homeless and Transient Population: 1991 (Washington, DC, Metropolitan Area Drug Study, Technical Report #2). U.S. Department of Health and Human Services,1993.

44. Peter F. Gruden, U.S. Drug Enforcement Administration, testimony before the U.S. House Committee on Government Reform and Oversight, Subcommittee on the District of Columbia, May 8, 1998.

45. GAO, Drug Control: Information on High Intensity Drug Trafficking Areas Program, September 1998.

46. Linda Wheeler, "Federal Drug Office Boosts Efforts to Cut Sales Near D.C.-Md. Line." The Washington Post, December 5, 1998.

47. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998.

48. Figures from MPD and National Council on Crime and Deliquency, Crime and Justice Trends in the District of Columbia. 1997.

49. NCCD, Crime and Justice Trends in the District of Columbia. 1996 and 1997.

50. NCCD, 1996 and 1997.

51. NCCD, 1996 and 1997.

52. Peter Reuter, Robert MacCoun & Patrick Murphy, Money from Crime: A Study of the Economics of Drug Dealing in Washington, D.C. Santa Monica, CA: RAND, 1990.

53. Metropolitan Washington Council of Governments, How Safe Are Our Roads? A Data Report on the Impact of Drunk and Drugged Driving on Highway Safety in the Washington Metropolitan Region. 1997.

54. MADD, Rating the States: A Report Card on the Nation's Attention to the Problem of Alcohol- and Other Drug-Impaired Driving.1993.

55. Homicide in Eight U.S. Cities: Trends, Context, and Policy Implications. NIJ, 1997. Additional figures taken from FBI, Crime in the United States: Uniform Crime Reports, 1995-1997.

56. Figures from NCCD (1992-1996) and MPD (1997)

57. Substance Abuse and Treatment, State and Federal Prisoners, 1997. Washington, DC: Office of Justice Programs, U.S. Department of Justice,January 1999.

58. Alcohol and Crime: An Analysis of National Data on the Prevalence of Alcohol Involvement in Crime. U.S. Department of Justice, April1998. (Survey of jails, state prisons and federal prisons.)

59. Some homicides may be related both to alcohol and to other drugs, so the separate alcohol- and other drug-related estimates cannot simply be added together.

60. Date of 1983 provided by Marcello Marcerelli at the D.C. Pretrial Services Agency.

61. NCCD, 1996 and 1997.

62. Includes felons serving a prison sentence; does not include non-sentenced people or sentenced misdemeanants.

63. Figure of 21 percent of state prisoners on drug charges comes from: Bureau of Justice Statistics, Substance Abuse and Treatment, State and Federal Prisoners, 1997. January 1999, p. 15, Appendix table 1.

64. D.C. figures (1995, NCRP data) are from report prepared for D.C. Sentencing Commission. National averages taken from the 1996 National Corrections Reporting Program as found in Bureau of Justice Statistics, Truth in Sentencing in State Prisons, January 1999, p. 8, table 7.

65. Using 75 percent of 7,687 as the base population (5,765) x $28,500 per year = $164.3 million.

66. Bureau of Justice Assistance, National Assessment of Structured Sentencing, 1996. Thirty-one of the 50 states have mandatory minimum sentencing for drug offenses.

67. Personal communication from Darryl J. Madden, Department of Corrections, December 1998.

68. National Criminal Justice Association, A Guide to State Controlled Substances Acts. Prepared for the U.S. Department of Justice. Washington, D.C.: NCJA, 1991; 1999 revision forthcoming.

69. National Criminal Justice Association, A Guide to State Controlled Substances Acts. Prepared for the U.S. Department of Justice. Washington, D.C.: NCJA, 1991; 1999 revision forthcoming.

70. Beginning in Fiscal Year 1998, the Bureau of Prisons was required to provide treatment to all inmates who BOP "determines has a treatable condition of substance addiction or abuse" and who request treatment by the Violent Crime Control and Law Enforcement Act of 1994.

71. Figures provided by Beth Weinman, federal Bureau of Prisons.

72. Reflects the difference between arrest rates among participants of drug court sanctions docket (11 percent) vs. those in standard docket (17percent).

73. Steven Belenko, "Research on Drug Courts: A Critical Review," in National Drug Court Institute Review. Vol. 1, Issue 1, Summer1998.

74. Adele Harrell and Shannon Cavanagh, "Preliminary Results from the Evaluation of the DC Superior Court Drug Intervention Program for Drug Felony Defendants." Washington, DC: The Urban Institute, 1997.

75. Adele Harrell, the Urban Institute, personal communication, December1998.

76. Faye Taxman, November 19, 1998.

77. Faye Taxman, November 19, 1998.

78. Almost half = 46 percent

79. National Opinion Research Center at the University of Chicago & Lewin-VHI, Inc., Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA). Prepared for the State of California Department of Alcohol and Drug Programs. April 1994.

80. Doug Struck and Hamil Harris, "Death in the City." The Washington Post, June 29, 1998, p. A1.

81. Data come from unpublished SAMHSA data. Calculations for 1996 areas follows:

DC Metro Area population = 3,749,162
Rate of ER Visits in DC Metro Area = 93,098 per 100,000
Total ER Visits in DC Metro Area = est. 1,203,414
38% of Total ER visits in DC Metro Area = 457,297

82. The 38% figure in the previous footnote comes from the following citation: Linda C. Degutis, Gail D'Onofrio, Karen Burch, John A. Shriver, "Changing the Emergency Department Physician's Role in Screening and Intervention for Alcohol Use." Paper presented at the American Medical Association Alcohol Policy Conference XI, Chicago, IL, May 1998.

83. Year-End Preliminary Estimates from the 1996 Drug Abuse Warning Network (DAWN). Substance Abuse and Mental Health Services Administration (SAMHSA), November 1997.

84. Unpublished DAWN data from SAMHSA.

85. Data are based on the a report from CDC's Office of Smoking and Health which reported a death rate due to smoking of 444.7 per 100,000 in 1990. For 1996, the rate was 332.8 per 100,000, according to the D.C. Bureau of Cancer Control. Based on this rate and the 1998 D.C. population of 523,000, there were an estimated 1,740 smoking attributable deaths in the city in1996.

86. Figure of $520 million in tobacco-related illness comes from a combination of three sources:

Leonard S. Miller, Xiulan Zhang, Dorothy P. Rice & Wendy Max, "State Estimates of Total Medical Expenditures Attributable to Cigarette Smoking, 1993," Public Health Reports 113:447-458, September/October 1998. Miller et al. estimate D.C.'s 1993 direct medical costs attributable to smoking to be $315.57 million, 76.80 percent higher than BERA's estimate (derived by dividing the total D.C. cost by 463,574 adults, the 1993 population figure used by BERA). Adjusting BERA's per adult cost accordingly yields a per adult cost estimate of $680.73.

1990 U.S. population = 248.718 million; 1990 D.C. population = 0.607 million
D.C. = 0.24405% of U.S. population, so D.C. costs in proportion to population are:
$115 million; increased by 79.95 percent = $206.94 million.

87. Mortality figures obtained from the CDC's mortality database located on the Internet at http://wonder.cdc.gov using the ICD-9 codes from the National Center for Health Statistics when calculating deaths due to alcohol and other drugs.

88. Metropolitan Washington Council of Governments, How Safe Are Our Roads? A Data Report on the Impact of Drunk and Drugged Driving on Highway Safety in the Washington Metropolitan Region. 1997.

89. Testimony of Marlene Kelley, Interim Director, D.C. Department of Health, July 8, 1998, before the D.C. Council's Committee on Human Services.

90. Metropolitan Washington Council of Governments, Why Are So Many Kids in Foster Care: The Principal Causes of Placement in the Washington, D.C. Metropolitan Region. September 1994.

91. GAO, Foster Care: Parental Drug Abuse Has Alarming Impact on Young Children. 1994.

92. 75 percent of 3,000 cases = 2,250 cases.

93. Metropolitan Washington Council of Governments, Why Are So Many Kids in Foster Care: The Principal Causes of Placement in the Washington, D.C. Metropolitan Region. September 1994.

94. According to unpublished data from the D.C. Child and Family Services Agency, there are 3,000 children in foster care in an average month in the city.

95. NIDA, Prevalence of Drug Use Among DC Women Delivering Livebirths in DC Hospitals: 1992 (Washington, DC, Metropolitan Area Drug Study, Technical Report #7). 1995.

96. The figures provided in the report are unweighted estimates. The urine tests represented only 48.8 percent of women who presented for delivery during the sampling period, and may not be representative of true rates.

97. NIDA, Prevalence of Drug Use Among DC Women Delivering Livebirths in DC Hospitals: 1992 (Washington, DC, Metropolitan Area Drug Study, Technical Report #7). 1995.

98. NIDA, Prevalence of Drug Use Among DC Women Delivering Livebirths in DC Hospitals: 1992 (Washington, DC, Metropolitan Area Drug Study, Technical Report #7). 1995.

99. DC Kids Count Collaborative, Every Kid Counts in the District of Columbia: 5th Annual Fact Book. 1998.

100. Keeping Score 1998, represents a national average, not local, which is probably higher.

101. "Prevention of Fetal Alcohol Syndrome." National Center for Environmental Health, CDC, July 1998.

102. Doug Struck and Hamil Harris, "Death in the City." The Washington Post, June 29, 1998, p. A1.

103. "City Urged to Begin Tracking HIV Cases," The Washington Post, December 11, 1998, p. C3.

104. Each new IDU case has an annual health care cost of $5,150 (not counting protease inhibitors). Of the 5,033 living with AIDS, approximately 40 percent are IDU (2,013 cases). At $5,150 per case per year, annual costs are 2,013 x $5,150 = $10,366,950.

105. Hugh Klein, Jeffrey A. Hoffman, & Dwight C. Clark, "Risk Behavior Changes Demonstrated by NEP Clients." Washington, DC: Project Neighborhoods in Action, October 1997.

106. Figures provided by Dr. Patricia Hawkins, Associate Executive Director, Whitman-Walker Clinic. Figures based on estimate that in New York, two-thirds of IDU-HIV infections would have been prevented by needle exchange programs.

107. Lou Chibbaro, "Needle exchange ban kept in budget." The Washington Blade, October 23, 1998, p. 6

108. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention.

109. Data from the Youth Risk Behavior Surveillance System, 1991-1997. Centers for Disease Control and Prevention.

110. C. Peter Rydell & Susan S. Everingham, Controlling Cocaine: Supply Versus Demand Programs. Santa Monica, CA: RAND, 1994.

111. Belden & Russonello Research and Communications, Washington, D.C. Residents Study: Research Findings of a Citywide Survey for the District of Columbia Financial Responsibility and Management Assistance Authority. Washington, D.C.: June 1997.

112. Testimony of Marlene Kelley, Interim Director, D.C. Department of Health, July 8, 1998, before the D.C. Council's Committee on Human Services.

113. Phone interview with Linda Holifield, Administrative Officer, APRA. The $1.9 million included $518,000 in federal Safe and Drug-Free School and Communities (SDFSC) funds; these funds were in addition to SDFSC spent on school-based programs.

114. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998.

115. SDFSC budget figures provided by Christine Fletcher at the Safe & Drug-Free School Program, U.S. Department of Education.

116. Information on D.C. Public Schools drug prevention programming is found in two letters, dated January 8, 1999 and January 26, 1999 from Mark Enoch Robertson, Assistant Superintendent, to Drug Strategies.

117. D.C. Alcohol and Drug Abuse Services Administration, Substance Abuse Treatment Services, February 1989.

118. The ADASA Substance Abuse Treatment Services 1989 report specifies the number of addicts and abusers and the number at risk for substance abuse synonymously.

119. George Washington University Center for International Health and the D.C. Council of Latino Agencies and Catholic University-Life Cycle Institute, Continuum of Care for Latino Substance Abusers. Washington, DC: November 6, 1998.

120. NASADAD, State Resources and Services Related to Alcohol and Other Drug Problems for Fiscal Year 1995. Washington, DC: National Association of State Alcohol and Drug Abuse Directors, 1997.

121. NASADAD, State Resources and Services Related to Alcohol and Other Drug Problems for Fiscal Year 1995. Washington, DC: National Association of State Alcohol and Drug Abuse Directors, 1997.

122. Linda Holifield, Administrative Officer, APRA.

123. Unpublished data provided by Charles Brown, APRA, in February, 1999.

124. Peter Slevin, "In D.C., Many Addicts and Few Services." The Washington Post, August 25, 1998, p. A1.

125. Rachel Swarns, "Giuliani Wants to Phase Out Addicts' Methadone Programs." The New York Times, July 21, 1998, p. A15.

126. Charles Brown, APRA, February 1999.

127. Charles Brown, APRA, February 1999.

128. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998. Also, Americans Look at the Drug Problem. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1995.

129. George Washington University Center for International Health and the D.C. Council of Latino Agencies and Catholic University-Life Cycle Institute, Continuum of Care for Latino Substance Abusers. Washington, DC: November 6, 1998. Also: Jasper Ormond, personal communication, October 30, 1998.

130. Figures provided by Julie Maxwell of the D.C. Commission on Mental Health, November 2, 1998.

131. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998.

132. The District of Columbia Treatment Initiative (DCI). College Park, MD: National Evaluation Data and Technical Assistance Center, Center for Substance Abuse Research, February 1998.

133. Testimony of Marlene Kelley, Interim Director, D.C. Department of Health, July 8, 1998, before the D.C. Council's Committee on Human Services.

134. Statistical Abstract of the United States. U.S. Bureau of the Census, 1997.

135. Statistical Abstract of the United States. U.S. Bureau of the Census, 1997.

136. Statistical Abstract of the United States. U.S. Bureau of the Census, 1997.

137. George Grier, Washington Area Growth and Change in the 1990s. Washington, DC: Greater Washington Research Center, November 1998.

138. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998.

139. City Views on Drug Abuse: A Washington, DC Survey. Washington, DC: Peter D. Hart Research Associates and Drug Strategies, 1998.

140. Robert J. Blendon and John T. Young, "The Public and the War on Illicit Drugs." Journal of the American Medical Association, 1998, 279: 827-832.

141. Kristan Trugman, "Users take risks coming into D.C." The Washington Times, September, 7, 1998.

142. Washington, DC Convention and Visitors Association, November 4,1998.

143. Peter Behr & David A. Vise, "Growth Plan in the Works for District." The Washington Post, November 8, 1998, p. B1.

144. Carol O'Cleireacain, The Orphaned Capital: Adopting the Right Revenues for the District of Columbia. Washington, DC: Brookings Institution Press, 1997.

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