FACING FACTS

Drug Strategies

Facing Facts

Looking to the Future

To address the multiple social, economic, health and criminal justice consequences of alcohol, tobacco and other drug problems, the District needs strong policies and programs that balance prevention, treatment and criminal justice strategies. In some cases, the District must receive cooperation and assistance from the federal government and surrounding jurisdictions.

Since drugs exacerbate a myriad of other problems in the District, effectively addressing drug problems could improve many aspects of life in the city. The city's new leadership is well-positioned to begin capitalizing on numerous lessons that have been learned through research and hard experience, both in Washington and nationwide. Seizing this opportunity now can revitalize the District's efforts for years to come.

The following policy recommendations, addressed to District and federal government leaders, are intended to build on areas of recent progress while also addressing key areas of concern.

Criminal Justice

Drug use is widespread among criminal offenders throughout the city's justice system and is closely linked to violent crime. Currently, few offenders receive treatment while in prison, on probation or on parole. Much of the District's criminal justice system has been put under federal control. The District, Congress, and the relevant federal agencies must ensure access to drug treatment for all offenders in need.

Federal funding of the D.C. court system and federal jurisdiction over the District's sentenced felons, both stipulated by the 1997 Revitalization Act, will contribute to net savings for the city of about $170 million a year through 2002. A portion of these savings should be dedicated to ensuring access to drug treatment for those offenders remaining in the District's custody. Sentenced felons will be in the custody of the federal Bureau of Prisons, where drug treatment should prove more accessible than has been the case under D.C. Department of Corrections.

The District's innovative drug court and the federal High Intensity Drug Trafficking Areas (HIDTA) program combine regular testing with swift, escalating sanctions to discourage offenders from resuming drug use. These measures-- and even the mere threat of them -- have proven effective deterrents for many offenders. The new D.C. Court Services and Offender Supervision Agency (CSOSA) intends to build on the work of the drug court and HIDTA. Therefore:

The District should ensure access to drug treatment for addicted criminal offenders remaining under District jurisdiction.
Congress and the U.S. Justice Department should ensure access to drug treatment for addicted prisoners placed under jurisdiction of the federal Bureau of Prisons.
Congress should overturn its ban on using High Intensity Drug Trafficking Area (HIDTA) funds to establish new treatment programs or expand existing ones.
Congress should support the D.C. Court Services and Offender Supervision Agency's (CSOSA) plans to expand drug testing and treatment for offenders.

Prevention

The District's hike in cigarette excise taxes has had a preventive impact, as cigarette sales have fallen, but alcohol excise taxes remain among the nation's lowest.

Overall, little is known about the effectiveness of Washington's publicly funded prevention efforts, due to lack of evaluation. For example, certain of the drug prevention programs used in the D.C. public schools have shown no sustained effects on drug use. One prevention effort that is clearly inadequate is the District's Alcohol Beverage Control (ABC) activities to prevent alcohol sales to minors; the program is severely limited by the small number of investigators.

Although HIV prevention efforts have saved countless lives in the District and elsewhere, Congress has prohibited the District from using locally raised public funds for needle exchange programs, thus leaving the future of these prevention programs in doubt. Meanwhile, District residents have signaled their commitment to increased drug prevention by donating hundreds of thousands of dollars to local prevention organizations when paying income taxes. Therefore:

The District should increase alcohol excise taxes significantly.
The District should index both alcohol excise taxes and cigarette excise taxes to inflation.
Alcohol and tobacco excise tax revenues should be earmarked for drug abuse prevention and treatment programs.
The District's tobacco settlement money should also be dedicated to alcohol, tobacco, and other drug prevention, and tobacco-related heath care.
The District's prevention efforts should include restrictions on tobacco and alcohol advertising in areas accessible to children.
The D.C. Department of Consumer and Regulatory Affairs (DCRA) should be authorized to impose fines and suspend and revoke the licenses of vendors who sell tobacco to minors.
Although an increase from four to 16 Alcohol Beverage Control (ABC) investigators is underway, the sheer number of licensed alcohol outlets in the District (more than 1,500) requires an even greater ABC presence.
The large number of alcohol outlets in the District, and their concentration in certain neighborhoods should be addressed directly. Neighborhood referenda in other cities give residents the ability to limit the number of alcohol outlets in their neighborhoods.
District schools should implement prevention programs based on research and with proven track records, starting in the earliest grades.
Schools should also initiate systematic evaluation to determine the efficacy of these programs.
Schools should coordinate their efforts closely with after-school programs, coalition activities, and the D.C. Addiction Prevention and Recovery Administration's (APRA) prevention efforts to produce a comprehensive prevention education strategy.
The Mayor and the D.C. Council should encourage strong private sector support for the District's needle exchange program, and Congress should end its prohibition on the use of local D.C. revenues to fund the needle exchange program.

Treatment

Despite treatment's proven effectiveness in reducing drug use and drug-related crime, publicly funded treatment is scarce in the District. So, too, are current data on the actual treatment needs of D.C. residents. Long waiting lists for existing treatment programs make it clear that current efforts are inadequate. Therefore:

Direct District funding for treatment services should be significantly increased.
The District should proceed with proposed expansions in Medicaid eligibility and coverage that would ensure access to drug treatment services for all of the city's lower income residents. Providing treatment services through an insurance model would fold drug treatment into comprehensive health services and reduce dependence on inconsistent agency funding levels.
Continuity of care, which is crucial to long-term treatment success, should be built into contracts with treatment providers.

Information

Data on alcohol, tobacco and other drug use and its consequences in the District have been gathered only sporadically in recent years, and the lack of accurate, current information has seriously hampered policy planning. Although a federal survey will soon update the District's prevalence data, the District must build its own capacity for data gathering and policy analysis.

The pretrial release drug test data gathered by the District is often described as the nation's most comprehensive source of data on offender drug use and its relationship to criminal recidivism and sentencing outcomes. However, coding problems and missing data have severely limited the value of this promising resource. Therefore:

To plan and evaluate drug policies and programs, to determine how much money needs to be spent and how best to spend it, the District should establish its own state-of-the-art research facility, capable of continuous data gathering and interdisciplinary analysis.
Research on the prevalence of drug use ad its consequences should extend beyond typical household surveys to include populations known to be at high risk, such as homeless and institutionalized persons.
The District should eliminate problems of improper coding and missing data from its pretrial services drug test database.
The District should consistently test for alcohol and other drug involvement in traffic accidents and fatalities.

Leadership

The wide-ranging effects of alcohol, tobacco and other drugs in the District require that the government's response be formulated at the highest level -- including the mayor, relevant department heads, the D.C. Council, and while it exists, the Control Board. Therefore:

To sustain leadership, the District government should create a new cabinet agency, perhaps a "drug czar," or an interdepartmental council. In any case, one high-level official who reports directly to the mayor must be empowered to coordinate the city's overall drug abuse response, bring all the necessary players to the table and increase interagency cooperation.
The mayor should ensure that drug issues receive the attention they require in Congress.
District leadership should work with leaders in surrounding counties to ensure coordinated prevention, treatment and law enforcement efforts.
Government leaders should make sure to involve community leaders in planning and implementing programs.

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