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Chapter II.
Demand Reduction Goals, Objectives and Target Measurement

E. Providing Greater Accountability: Performance Measures of Effectiveness (PME) System

The pursuit of Strategy Goals and their associated Objectives is expected to yield measurable outputs and outcomes designated as "performance targets." The Administration's National Drug Control Strategy PME system recognizes that performance measures must (1) assess the Strategy's overall impact on drug use, availability, and consequences, and (2) assess the effectiveness of specific federal, state, local and private sector programs and activities that constitute the national drug control effort. Measures are the means for tracking progress toward the targets. Ultimately, data for the measures will be provided by the federal, state, and local drug control agencies.

The Impact Targets, designed to reduce drug use, availability, and drug use consequences, establish desirable outcomes or end-states by defining where the nation should aspire to be, a decade from now. Five Impact Targets are provided for demand reduction efforts and two are provided for reducing the adverse health and crime consequences of drug use. These aggressive targets are intended to motivate federal, state, local, foreign, and private partners in drug control to reduce supply and demand to levels that are realistically achievable in the future.

1. Demand Reduction

In the area of total demand reduction, we propose a 25 percent reduction by 2002 in the overall rate of illegal drug use in the United States below that of the 1996 base year. By 2007, the target is a 50 percent reduction in the rate of overall drug use below that of the 1996 base year. In 1996, the current (i.e., past month) rate of drug use across the United States was 6.1 percent. The targeted 50 percent reduction would yield a nation-wide drug use rate of 3.1 percent by 2007. The 3.1 percent rate would be the lowest verified rate since the federal government began systematically tracking such data. This ambitious undertaking is contingent on a long-term commitment by federal, state, local, foreign, and private partners in drug control to achieve the Goals and Objectives of the Strategy.

The Impact Target for overall drug use requires success in the following three key areas: drug use by our nation's youth; drug use in the workplace; and drug use by chronic drug users.

  • Focus on Youth: Two Impact Targets are related to current (past month) youth drug use. The intent is to delay the onset of drug use, as measured by the mean age of drug use. By 2002, increase the average age of first-time drug use by 12 months from the average age of first-time use in the 1996 base year. By 2007, increase the average age of first-time drug use by 36 months from that in the 1996 base year. To illustrate the value of reducing first-time drug use, consider the mean age for first- time use of marijuana (16.7 years). If a youth approaches the age of 20 without having tried drugs, the chances of becoming a drug user are much lower. Delaying the initial use of drugs such as marijuana by 36 months would, in turn, set the mean age of initial use at a high enough level to allow a larger percentage of the population to approach the A20 and older safety- zone.@ The PME system will use average age of first-time use of marijuana as a proxy measure to track progress toward the target of delaying the onset of drug use. Achieving this ambitious target would clearly demonstrate the nation's progress toward shutting down the pipeline of youth drug use.

    The Strategy also must have an impact on overall youth drug use prevalence. By 2002, reduce the prevalence of past month use of illegal drugs and alcohol among youth by 20 percent as measured against that in the 1996 base year and by 2007, reduce the prevalence by 50 percent as compared to that in 1996. To measure progress toward this target, we propose to use information collected annually in the National Household Survey on Drug Abuse on current use of any illegal drugs by youth aged 12-17. In 1996, the prevalence of drug use in the 12-17 age group was 9.0 percent. A 50 percent reduction from the 1996 base year incidence rate moves toward a targeted use rate in 2007 of 4.5 percent. Achieving this critical Impact Target by 2007 would mean that the nation would have the lowest rate of drug use among those aged 12-17 since record keeping on youth drug use began.

  • Focus on the Workplace: Approximately 74 percent of drug users are employed. Targeting the workplace with drug prevention and education programs will reduce overall drug use and protect the health, safety, and productivity of the American worker. By 2002, reduce the prevalence of drug use in the workplace by 25 percent compared with that in the 1996 base year and by 2007, reduce prevalence by 50 percent compared with that in 1996. This target focuses on users who are not necessarily chronic drug users. The workplace offers an opportunity to reach these users. In 1996, the total full-time workforce population was 99 million with a current drug use rate of 6.2 percent or approximately 6.1 million drug users. The rates were 8.6 percent for those employed part-time and 12.5 percent for those actively seeking work. To measure progress toward this target, we propose to use the National Household Survey on Drug Abuse, which reports current use of any illegal drugs for those employed full-time or part-time or who are actively seeking work. When the 1996 rates are reduced by half, drug use among those who are employed full-time will drop to 3.1 percent, a reduction of three million drug users. The rates for those employed part-time or unemployed will drop to 4.3 percent and 6.3 percent, respectively. Achieving these targets will substantially enhance productivity and safety in the workplace.

  • Focus on Chronic Drug Use: Chronic drug users consume the vast majority of available drugs in the United States. Unless their demand is substantially reduced, drug traffickers will continue to enjoy a long-term, stable market in which to provide their products. While supplying these users, suppliers will entice others to begin using drugs. If the nation's demand for drugs is to be broken, chronic drug users must be targeted aggressively. By 2002, reduce the number of chronic drug users by 20 percent compared with that in the 1996 base year and by 2007, reduce the number of chronic drug users by 50 percent compared with that in 1996. The Department of Health and Human Services (HHS) estimates that there are at least 3.6 million chronic drug users who could benefit from drug treatment. Though this estimate is subject to revision as newer and better modeling techniques are developed, meeting this Impact Target within 10 years would reduce the number of chronic drug users to 1.8 million by 2007. A decline of this magnitude in the number of chronic drug users would result in a significant reduction in the overall demand for drugs. In addition, these users place the greatest burden on society in the form of health and social costs.

2. Drug Use Consequences

In the area of drug use consequences, we aim to reduce the substantial damaging health and social costs stemming from drug use, including those from drug-related crime. These costs are estimated to be $110 billion annually with a large share being crime-related. We target two principal areas to reduce the health and social costs of drug use: crime and violence and health costs.

  • Focus on Crime and Violence: Reducing drug use, especially chronic drug use, can do much to reduce drug-related crime. Drug-related crime is not limited to highly publicized violent crimes. Drug use also spawns many other types of crime including corruption, prostitution, domestic violence, money laundering, forgery and counterfeiting, embezzlement, and weapons violations. Domestic law enforcement must aggressively target traffickers to mitigate the violence that surrounds the drug trade and decrease the entire range of drug-related crime. We propose by 2002, to reduce by 15 percent the rate of crime and violent acts associated with drug trafficking and drug abuse, as compared with the 1996 base year, and by 2007, to reduce drug-related crime and violence by 30 percent, as compared with the base year. In 1996, the rate of arrests for drug law violations was 594 per 100,000. Reducing this rate by 30 percent over 10 years to 416 per 100,000 arrests will significantly increase the safety of our nation's streets.

  • Focus on Health: Drug users engage in high-risk behaviors making them and their associates susceptible to a range of infectious diseases such as tuberculosis (TB), HIV/AIDS, and hepatitis. Drug use also contributes to birth defects and infant mortality, undermines workplace safety, and leads to premature death. We propose by 2002, to reduce health and social costs attributable to illegal drug trafficking and use by 10 percent, as expressed in constant dollars, as compared to the 1996 base year, and by 2007, to reduce such costs by 25 percent as compared to the base year. To illustrate the implication of this Impact Target, consider the following example: According to the Centers for Disease Control and Prevention, 1,919 cases of TB reported in 1996 were related to drug use (11.5 percent of all cases reported). Achieving the Impact Target would reduce this figure to 1,727 in 2002 and to 1,439 in 2007.