Narconon PSA  

Sen. Jim Webb (D-Va.), whose name has cropped up as a possible vice-presidential candidate for Barack Obama, last week called for a major overhaul of U.S. national drug-control policy, the Newport News Daily Press reported June 20.

"Despite the number of people we have arrested, the illegal drug industry and the flow of drugs to our citizens remain undiminished," Webb said during a hearing of the Joint Economic Committee. The hearing featured testimony from a number of witnesses who said that the current enforcement- and incarceration-oriented approach to drug policy has been expensive and ineffective.

Webb said that more treatment alternatives to prison should be considered. Members of the House and Senate attended the hearing, but no Republicans took part.

In his new book, "A Time to Fight," Webb wrote that, "The time has come to stop locking up people for mere possession and use of marijuana ... Drug addiction is not in and of itself a criminal act. It is a medical condition, indeed a disease, just as alcoholism is, and we don't lock people up for being alcoholics."

Performance-based government funding may be the wave of the future, but Congress still isn't quite ready to base its budgetary decisions on formalized performance measures, as the FY2008 budget process makes clear.

The Senate voted 75-19 on Oct. 23 to approve the budget for the Department of Health and Human Services, Education and Related Agencies, which includes funding for all programs within the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Health research agencies (the National Institute on Drug Abuse and the National Institute of Alcohol Abuse and Alcoholism), and the Department of Education's Safe and Drug-Free Schools and Communities (SDFS) program.
 

The $149-billion Senate-approved budget calls for spending a total of $5.4 billion more in 2008 than 2007, and also exceeds President Bush's budget request by $9.8 billion.

Following the vote, the White House issued a statement threatening to veto the bill, accusing the Democrat-led Congress of "failing to identify priorities, increasing spending, and avoiding the hard choices."
 

The Senate measure still must be reconciled with the House appropriations bill before any legislation is sent to the president. House and Senate members met this week to discuss the bill, and a conference report is expected within days. A vote on the bill could be held as early as Tuesday.

"Ineffective" Block Grant

During the budget debate, the Senate voted 68-21 to table a proposed amendment that would have required a 10-percent cut to all programs rated "ineffective" by the federal Program Assessment Rating Tool (PART), administered by the Office of Management and Budget. That would have included the centerpiece, $1.758-billion substance abuse prevention and treatment (SAPT) block grant. Also rejected was the Bush administration's plan to cut 5 percent of SAPT block grant funding for states that fail to report National Outcome Measures (NOM) data to the federal government. About 40 percent of states now voluntarily provide outcomes data to SAMHSA.

"The Committee strongly opposes this proposal and believes that punitive policies could threaten or interrupt service delivery," the appropriations panel said in its budget report.
 

Sen. Tom Harkin (D-Iowa), chair of the Senate Appropriations Subcommittee on Labor, HHS and Education helped lead opposition to the PART amendment introduced by Sen. Allard (R-Colo.). Harkin said the poor PART scores were the result of poor federal investment in some cases and also could hurt programs serving vulnerable populations.

Still, the Senate failed to follow the House of Representatives' lead in recommending a $35-million increase in the SAPT block grant, instead recommending that the FY2008 funding remain the same as in 2007.
 

The National Association of State Alcohol and Drug Abuse Directors (NASADAD) disputed the "ineffective" PART score laid on the SAPT block grant. "States have worked diligently with SAMHSA to report a more consistent set of core measures for prevention and treatment services through the NOM initiative," NASADAD noted in a budget summary. "The launch of a more standardized set of data represents another tool in educating stakeholders on the effectiveness of the SAPT Block Grant." NASADAD also defended the block grant by releasing a state-by-state outcomes list that highlighted treatment admissions, abstinence rates, and declines in criminal behavior.

Increases in Research Funding

The SAMHSA budget approved by the Senate allocates $425.6 million to the Center for Substance Abuse Treatment, up $26.7 million over 2007 and $73.5 million more than the Bush administration's request. The appropriation includes $98 million for the Access to Recovery program -- a favorite of the administration -- of which $25 million is set aside for methamphetamine treatment. CSAT's Screening and Brief Intervention and Referral to Treatment (SBIRT) program is level funded at $29.8 million, and the budget for treatment drug-court grants would be increased from $10 million to $31.8 million.

The $197.1 million budget approved by the Senate for the Center for Substance Abuse Prevention (CSAP) represents a $4.2 million increase over 2007, and is $40.6 million more than the president's budget request. The CSAP budget includes level funding for the $105.5 million State Prevention Framework State Incentive Grants and the $9.8 million Fetal Alcohol Spectrum Disorders Center for Excellence, as well as $1 million to continue the national media campaign authorized under the Sober Truth on Prevention Underage Drinking Act and $3 million in assistance for community coalitions fighting underage alcohol use.

The steady erosion of funding for the SDFS program would continue under the Senate's budget, which would cut funding for school-based prevention programs to $300 million, $46.5 million less than in 2007. That's still better than the administration's budget, however, which called for slashing $200 million from the program.

The Senate called for adding $22 million to the billion-dollar NIDA budget, relatively in line with the administration's proposal. NIAAA would get $445.7 million in FY2008, up $9.8 million from 2007 and again in general agreement with the Bush administration's budget plan.

However, the Senate disagreed with the administration's plan to eliminate the Centers for the Application of Prevention Technologies (CAPTs) and also declined to cut a proposed $1.7 million from the Addiction Technology Transfer Centers -- both regional resource centers that help translate addiction research into practice.

Teenage girls tend to enter addiction treatment at a younger age than boys and are more likely to be primary users of alcohol or inhalants, whereas boys are most likely to report that marijuana is their favorite drug, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Girls also were more likely (23 percent vs. 18 percent) to have a co-occurring psychiatric disorder, noted the report, Adolescent Treatment Admissions by Gender: 2005.

The study found that marijuana was the most common drug of abuse for both male (72 percent) and female (51 percent) teens in treatment, but girls differed from boys in a number of significant ways. "As we continue to work on reducing youth drug use overall, we must pay special attention to the needs of teen girls," said SAMHSA administrator Terry Cline, Ph.D. "Because research shows that girls use alcohol and drugs to boost their confidence, reduce tension and cope with problems, our prevention efforts must address these needs."

The study found that 23 percent of girls were admitted to treatment for alcohol, compared to 16 percent of male teens. Inhalants were the primary substance abused by 12 percent of girls, but only 4 percent of boys.

The full report is available online.