Fact Sheet

Overview: In 2002, nearly 20 million Americans age 12 and older were using illegal drugs -- over 8 percent of the population. Each year, drug and alcohol abuse contributes to the death of more than 120,000 Americans. According to the Office of National Drug Control Policy, drugs and alcohol cost taxpayers more than $143 billion annually in preventable health care costs, extra law enforcement, auto crashes, crime and lost productivity. The Department of Health and Human Services (HHS) plays a key role in the administration's substance abuse strategy, leading the federal government's programs in drug abuse research and funding programs, and in campaigns aimed at prevention and treatment, particularly programs for youth. While overall use of drugs in the United States fell by more than 50 percent between 1979 and 1992, drug use among adolescents increased during the early 1990s. Since 1996 drug use by youth has leveled off, but there were still nearly 2 million youth under age 18 who tried marijuana for the first time each year since 1996.

The President's fiscal year 2004 budget request is $2.5 billion for substance abuse treatment and prevention programs, an increase of $222 million over fiscal year 2003 funding. Included in that budget is the three-year, $600 million initiative, Access to Recovery, announced by President Bush in his January 2003 State-of-the-Union address. In addition, the 2004 budget request includes $996 million for substance abuse treatment and prevention research, an increase of $35 million from fiscal year 2003.

RECENT FINDINGS FROM HHS SUBSTANCE ABUSE SURVEYS

HHS tracks the nation's substance abuse patterns through three major surveys: the National Survey on Drug Use and Health (NSDUH), the Monitoring the Future Survey (MTF) and the Youth Risk Behavior Survey (YRBS). Information from these surveys helps the nation to identify potential drug problem areas and ensure that resources are targeted to areas of greatest need.

The National Survey on Drug Use and Health. The NSDUH, previously called the National Household Survey on Drug Abuse, is directed by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey provides annual estimates of the prevalence of illicit drug, alcohol and tobacco use in the United States and monitors trends over time. It is based on a representative sample of the U.S. population age 12 and older. Findings of the recently released 2002 National Survey are available at www.drugabusedata.samhsa.gov.

Monitoring the Future. The MTF survey, funded by the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH), tracks illicit drug use trends and attitudes by 8th, 10th and 12th grade students. The 2002 study surveyed more than 44,000 students in 394 schools across the nation about lifetime use, past year use, past month use and daily use of drugs, alcohol, cigarettes and smokeless tobacco. Findings of the 2002 MTF survey are available at www.drugabuse.gov/DrugPages/MTF.html.

Youth Risk Behavior Survey. The Centers for Disease Control and Prevention's (CDC) National Youth Risk Behavior Survey is a biennial school-based survey that collects data from a representative sample of students in grades 9-12 on health-related risks. In addition to surveying tobacco, alcohol and other drug use, the survey covers other injury-related behaviors such as weapon carrying and attempted suicide, sexual and dietary behaviors and physical activity. Findings of the 2001 YRBS are available at www.cdc.gov/YRBS.

HHS PROGRAMS AND SERVICES TO PREVENT AND TREAT SUBSTANCE ABUSE

Increasing Treatment Capacity. According to SAMHSA's 2002 National Survey, an estimated 7.7 million persons aged 12 or older needed treatment for an illicit drug problem. Of them, 1.4 million received treatment at a specialty substance abuse facility. Of those not getting needed treatment, an estimated 362,000 reported they knew they needed treatment -- among them, approximately 88,000 who had sought but were unable to get the treatment they needed.

The President's fiscal year 2004 budget requests a total of $2.34 billion for the SAMHSA's substance abuse treatment programs, including $1.78 billion for the Substance Abuse Prevention and Treatment Block Grant and $556.8 million for competitive drug treatment grants -- Programs of Regional and National Significance (PRNS). The President's 2004 budget request also includes $200 million for the Access to Recovery initiative, his new funding mechanism that complements the Block Grant and the PRNS to help those in need of substance abuse treatment receive it.

• Access to Recovery (ATR). Proposed by the President and to be implemented by SAMHSA, ATR uses vouchers to purchase substance abuse treatment and support services. It empowers individuals to choose the provider who best needs their needs, rewards provider performance by rewarding treatment successes, and increases treatment capacity by expanding access to treatment. The initial $200 million investment is expected to result in treatment availability for as many as 100,000 people per year.
• Substance Abuse Prevention and Treatment Block Grant. The block grant provides funds for state substance abuse prevention and treatment programs. The grants account for approximately 40 percent of public funds expended by states for substance abuse prevention and treatment. Using these federal resources, states support more than 10,500 community-based substance abuse prevention and treatment programs. Block grant services often target populations in greatest need, including high-risk youth, including those involved with the criminal justice system, pregnant and postpartum women, and people with HIV/AIDS.
• Programs of Regional and National Significance (PRNS). PRNS provide direct substance abuse prevention treatment services and include the Targeted Capacity Expansion (TCE) Grants program, which identifies emerging regional or local substance abuse trends and related public health problems and contains them before they intensify and enables officials from municipalities, including American Indian tribal governments, to provide a rapid, strategic response. A new $23 million TCE grant program for states, being implemented in 2003, focuses on early identification of people in need of substance abuse treatment through screening, brief interventions and referral to treatment (SBIRT) for substance abuse in general medical and other community settings. The 2004 President's Budget expands SBIRT to a $50 million program providing services to approximately 65,000 persons. The PRNS also includes the substance abuse prevention-oriented State Incentive Grant program that supports innovative programs to help communities prevent drug abuse in the first place. Over 40 states and territories have joined the program, representing over 2,700 communities implementing prevention programs that are reaching over 1 million young people. Both programs have helped SAMHSA build partnerships with governors nationwide. More on SAMHSA discretionary grant programs can be found at www.samhsa.gov/grants/grants.html.

Programs through the Administration for Children and Families (ACF). ACF's Community-Based Resource Centers serve as comprehensive family service centers that can provide referrals to treatment programs for parents and other family members. The Head Start program, also administered by ACF, helps families access substance abuse services and provides training for Head Start workers in substance abuse issues. In addition, ACF provides counseling, education, referral and other services to high-risk, runaway and homeless youth. More information on ACF programs is available at www.acf.dhhs.gov.

Programs Serving American Indians and Alaska Natives. Substance abuse continues to be a leading contributor to health problems among American Indians and Alaska Natives. The Indian Health Service (IHS) funds approximately 400 alcoholism and substance abuse programs and establishes cooperative agreements with other federal and private programs to provide a number of treatment and prevention services to rural and urban communities. More information on IHS programs is available at www.ihs.gov/medicalprograms/alcohol/.

Inpatient/Outpatient Benefits. The Medicaid program helps thousands of Americans each year overcome drug addiction. Medicaid may cover some emergency treatment of drug-related symptoms, detoxification and rehabilitation as well as some outpatient services. Many states have also used Medicaid waivers to implement managed care programs targeted at substance abuse. Information on Medicaid is available at www.cms.hhs.gov/medicaid/.

Recovery Community Programs. Twenty-nine community-based organizations with new or ongoing involvement in substance abuse treatment activities have received SAMHSA grants - totaling $8.1 million - to foster participation of people in recovery and their family members in the programs' dialogue about addiction, treatment and recovery. Grantees are expected to develop, design, deliver and document peer-drive recovery support services that help prevent relapse and promote long-term recovery from alcohol and drug use disorders.

Workplace Programs. Working with private corporations and managed care organizations, SAMHSA helps improve substance abuse prevention and education programs in the workplace. A SAMHSA-supported Workplace Helpline, 1-800-967-5752 (WORKPLACE), also provides assistance to employers who are developing and implementing substance abuse prevention programs. More information on workplace programs is available at www.drugfreeworkplace.gov.

HHS CAMPAIGNS TO PREVENT AND TREAT SUBSTANCE ABUSE

In addition to the programs and services that the department supports, HHS has joined with numerous private and public partners to establish comprehensive prevention campaigns to educate the public about the dangers of illicit drug use, particularly among youth. Following are just a few examples of those initiatives:

Marijuana. To reduce marijuana use among American youth, HHS maintains a comprehensive marijuana initiative including support for new research on the effects of marijuana and the launch of campaigns to help parents educate children about the dangers of drugs. The"NIDA Goes Back to School" initiative was launched in 2003 to keep teachers and parents informed of current scientific findings on drug abuse. Information about NIDA's campaign may be obtained at www.backtoschool.drugabuse.gov or by calling 1-800-729-6686. SAMHSA has been working with ONDCP to promote its educational programs about marijuana use and recently has published a 4-volume education and training series for health professionals focusing on cannabis use among youth. Information about SAMHSA's activities may be obtained at www.samhsa.gov.

Club Drugs. In 1999, NIDA launched a new national education, prevention and research initiative to combat the increased use of club drugs such as ecstasy, which are often used at all night "raves" or dance parties and have potentially life-threatening effects. More information is available at www.clubdrugs.org. This year, NIDA launched a site designed especially for teens that includes information on ecstasy and other drugs of abuse and shares stories from teens who have struggled with addiction. Information about that site can be found at www.teens.drugabuse.gov. This year, SAMHSA is making $4 million in grant funds available to States and communities expand prevention activities related to use of ecstasy and other club drugs, including GHB, ketamine, Rohypnol, and LSD. SAMHSA also focuses on the dangers of club drugs in its national drug abuse data collection efforts, its substance abuse publications and in other awareness programs. Information from SAMHSA -- including the latest data on club drug use -- is available at www.samhsa.gov.

Steroids. Recognizing several years ago from MTF data that steroid abuse may be on the rise, NIDA joined with seven national partners in 2000 to launch an initiative to alert the public about the risks associated with anabolic steroid use. The Institute's partners in the initiative include the National Collegiate Athletic Association, American College of Sports Medicine, American Academy of Pediatrics, National Association of School Nurses, National Federation of High Schools, International Students in Action, and Dr. Drew Pinsky, co-host of MTV's Loveline and drDrew.com. More information is available at www.steroidabuse.org

Alcohol. To combat the major public health problem of drinking by children aged 9 to 15, NIH's National Institute on Alcohol Abuse and Alcoholism (NIAAA) launched "Leadership to Keep Children Alcohol Free," an alliance of governors' spouses and emeritus spouses with funding from NIAAA, SAMHSA and other organizations. More information about the activities of the initiative is available at www.alcoholfreechildren.org. In another campaign, SAMHSA will be joining with Scholastic, Inc., for the third consecutive year to produce and distribute to every 5th grade teacher a package of materials targeted to students, teachers and parents to encourage conversations about underage drinking. This year, a further set of materials will be distributed to 6th grade classrooms as well. Finally, with support from CDC, SAMHSA continues its educational campaign to help influence the attitudes of youths aged 9-13 about alcohol use and abuse. The initiative is part of CDC's larger "Youth Media Campaign" to help youth develop habits that foster good health over a lifetime.

National Alcohol and Drug Addiction Recovery Month. This annual September public education campaign, now in its 14th consecutive year, celebrates the gains made by people in recovery from alcohol or substance abuse and lauds the benefits of substance abuse treatment. The theme for the 2003 observance is "Join the Voices for Recovery: Celebrating Health." More information on the observance is available at www.samhsa.gov.

National Alcohol Screening Day (NASD). NASD is a national outreach, education and screening event conducted by hospitals, clinics, treatment centers, colleges and primary care offices. NASD offers screening, education, intervention and referral to treatment when necessary for at-risk drinking and a range of alcohol problems. NASD is the result of a collaboration between NIAAA, SAMHSA and Screening for Mental Health, Inc. More information on the fifth annual NASD observance is available at www.mentalhealthscreening.org.

Prescription Drug Abuse. To raise awareness about and increase research efforts on the misuse and abuse of prescription drugs, NIDA has launched a Prescription Drug Abuse Initiative. Seven organizations, including AARP, have joined NIDA in this effort to reduce the non-medical use of prescription drugs, which appears to be on the rise. More information on the initiative is available at www.drugabuse.gov/DrugPages/Prescription.html. In addition, the Food and Drug Administration and SAMHSA have joined together to increase the knowledge of health care professionals and consumers about this topic. This two-part effort was launched in early 2003 with materials targeting youth and young adults ages 15-25; materials focusing on older Americans will be released to coincide with the May 2004 celebration of Older Americans month.

HHS RESEARCH INTO DRUG ABUSE PREVENTION AND TREATMENT

Drug Abuse Research. NIDA provides more than 85 percent of the support for research on drug abuse and drug addiction in the world, providing the scientific foundation for prevention and treatment programs all across America. Examples of recent and ongoing research include: studying the environmental and genetic bases of addiction; developing medications to treat drug addiction; assessing and improving behavioral and psychosocial treatments; studying the organization and financing of drug abuse treatment and linkage to primary medical care; studying abused drugs and their health consequences; studying the long-term consequences of prenatal exposure to drugs; applying state-of-the-art neuroimaging and genetics techniques to advance drug abuse prevention and treatment efforts; and designing and testing prevention programs designed for use with adolescents. NIDA's fiscal year 2003 budget is $961 million. The President's fiscal year 2004 budget increases that investment by $35 million to $996 million. More information about NIDA research is available at www.drugabuse.gov.

Alcohol Research. NIAAA provides leadership and financial support for approximately 90 percent of all alcohol-related research in the United States. NIAAA supports research on the causes, consequences, treatment and prevention of alcohol-related problems. Highlights of NIAAA research include: determining how genetic and environmental factors interact in the development of alcoholism; researching the brain mechanisms involved in alcoholism; developing new treatment approaches and medications; assessing alcohol's effects on the body; studying the risk/benefit tradeoffs of moderate alcohol use; developing and testing prevention strategies; evaluating the effects of alcohol in the development of birth defects and identifying prevention approaches; and assessing alcohol treatment and prevention services. NIAAA's fiscal year 2003 budget is $416 million. The President's fiscal year 2004 budget increases NIAAA's budget by $14 million to more than $430 million. More information on NIAAA research is available at www.niaaa.nih.gov/

HHS RESOURCES FOR CONSUMERS AND PROVIDERS

Treatment Referral Services. SAMHSA's online locator system provides a private, convenient way to find treatment programs for substance abuse problems. Information on nearly 15,000 facilities recognized by states as appropriate sources of care can be found through this database at www.findtreatment.samhsa.gov. The service augments the locator services available through SAMHSA's National Drug and Alcohol Treatment Referral Hotline at 1-800-662-HELP.

Hablemos en Confianza. This program built around Latino strengths is helping Hispanic families bring critical anti-drug messages home to their pre-teens and young teens. The materials for this initiative were built upon input from key leaders and focus groups from Latino communities across the country. An intergenerational communications book provides parents clear examples of ways to discuss substance abuse with family members. Supplementary products include both a children's healthy behaviors activity book (designed for ages 4-6) and a community action guide to help community leaders organize, enhance and expand local substance abuse prevention activities. Information is available at SAMHSA's website at www.samhsa.gov.

Model Programs for Substance Abuse Prevention. SAMHSA makes available a series of proven and promising prevention programs that have produced consistent, replicable results in substance abuse prevention. To date, over 50 model programs have been identified through a rigorous peer review process. The information is available at SAMHSA's website at www.modelprograms.samhsa.gov

Alcohol and Women: Alcohol: A Women's Health issue is a 12-minute video for women of all ages, describing the health consequences of heavy drinking. Both the video and an accompanying brochure were developed by NIAAA and the NIH Office of Research on Women's Health.

Guides for Treatment Providers. The SAMHSA Treatment Improvement Protocol (TIP) series provides substance abuse treatment professionals with "best practices" in treatment. SAMHSA, drawing on the experience and knowledge of clinical, research and administrative experts to produce each TIP. Copies of the guides are available through the SAMHSA Web site at www.samhsa.gov. NIAAA has developed Alcohol Problems: A Health Practitioner's Guide, a research-based publication, pocket guide and other tools that provides a quick, easy, and effective way to identify and assist patients with drinking problems. It is available online at www.niaaa.nih.gov/publications/practitioner/helpingpatients.htm.

National Clearinghouse. SAMHSA maintains the National Clearinghouse for Alcohol and Drug Information, which can be reached at 1-800-729-6686 for assistance in English or Spanish, or at TDD 1-800-487-4889 for hearing-impaired callers. It is estimated that more than 100 million Americans benefit from Clearinghouse services each year. PREVLine (PREVention-on-Line), a 24-hour Web-based prevention information portal and search engine, is maintained by SAMHSA and is accessible at www.samhsa.gov/centers/clearinghouse/clearinghouses.html

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Note: All HHS press releases, fact sheets and other press materials are available at www.hhs.gov/news.

Last Revised: September 17, 2003

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