Performance Reporting System Report

NATIONA L DRUG 

CONTROL STRATEGY

NATIONAL DRUG

CONTROL STRATEGY

Performance Reporting System

Report 2016
 

Table of Contents

Introduction ........................................................................................................................................ 3

Chapter 1: Progress toward Strategy Goals..................................................................................... 10

Chapter 2: Progress toward the Objectives of the Strategy..........................................................20

Objective 1 ‐ Strengthen Efforts to Prevent Drug Use in Our Communities.......................20

Objective 2 ‐ Seek Early Intervention Opportunities in Health Care.....................................23

Objective 3 ‐ Increasing Access to Treatment and Supporting Long-term Recovery .......... 26

Objective 4 ‐ Criminal Justice Reform: Making the System More Effective and Fair ............ 27

Objective 5 ‐ Disrupt Domestic Drug Trafficking and Production ...................................... 30

Objective 6 ‐ Strengthen Law Enforcement and International Partnerships to Reduce the

Availability of Foreign Produced Drugs in the United States ............................................... 33

Objective 7‐ Improve Information Systems for Analysis, Assessment,

and Local Management................................................................................................................ 39

Appendix A: Abbreviations & Acronyms......................................................................................42

Appendix B: Definitions and Performance Terms.......................................................................45

 Appendix C: Data Sources .......................................................................................................... 47

References ..........................................................................................................................................50
3

Introduction

The Obama Administration is committed to a coordinated government‐wide public health and public 

safety approach to reduce illicit drug use and its consequences. The Office of National Drug Control 

Policy (ONDCP) leads this effort through the National Drug Control Strategy (Strategy), encompassing 

prevention, early intervention, treatment, recovery support, criminal justice reform, effective law 

enforcement, international cooperation, and scientific research. The Performance Reporting System 

(PRS) assesses interagency progress toward achieving the two Goals and seven Objectives of the 

Strategy, in accordance with the ONDCP Reauthorization Act of 2006 (P.L. 109‐469).

The PRS was initially developed through an interagency process that brought together subject matter 

experts, policy and program analysts, researchers, statisticians, and leadership from Federal drug 

control agencies. The inaugural PRS report released in 2012 discussed the system’s design and the 

assessment process in detail. Using the Strategy’s overarching two Goals as a foundation, the PRS 

design process employed Working Groups that developed appropriate performance measures and 

targets for each of the seven Objectives of the Strategy. These Working Groups included 

representatives from the Departments of Defense, Education, Health and Human Services, Homeland 

Security, Interior, Justice, Labor, Transportation, Treasury, State, Veterans Affairs, and the Small 

Business Administration. The Working Groups drew upon current research and data to select 

performance measures and targets for each Objective. Research findings assisted the development of 

optimal performance measures for each Objective. In some cases, however, data limitations precluded 

the use of ideal measures. In such cases, Working Groups opted to select a suite of measures to best 

reflect performance. ONDCP developed a process to structure the identification of measures that 

were responsive to the various viewpoints of persons with different perspectives on the joint mission, 

diverse professional disciplines, and varying institutional and data constraints. The PRS is a tool that 

acts as a signal to indicate where the Strategy is on track, and when and where further attention, 

assessment, evaluation, and problem‐solving are needed.

This report is the Administration’s concluding assessment of interagency progress toward achieving the 

2015 Strategy’s two Goals and seven Objectives. The following Goals and Objectives focus on specific

substantive areas where collective progress was deemed necessary to effectively address our Nation’s

drug problem:

• Strategy Goals

o Goal 1: Curtail illicit drug consumption in America

o Goal 2: Improve the public health and public safety of the American people by 

reducing the consequences of drug abuse

• Strategy Objectives

o Objective 1: Strengthen Efforts to Prevent Drug Use in Our Communities

o Objective 2: Seek Early Intervention Opportunities in Health Care

o Objective 3: Increase Access to Treatment and Support Long-term Recovery

o Objective 4: Criminal Justice Reform: Making the System More Effective and Fair

o Objective 5: Disrupt Domestic Drug Trafficking and Production

o Objective 6: Strengthen Law Enforcement and International Partnerships to
4

Reduce the Availability of Foreign‐Produced Drugs in the United 

States

o Objective 7: Improve Information Systems for Analysis, Assessment, and Local 

Management

For the two Strategy Goals there are 13 measures1 dealing with illicit drug use and its consequences with 

which to assess the Nation’s progress toward achieving the Goals (see Table A-1 below). For the 7 

Strategy Objectives there are 28 measures dealing with prevention, brief intervention, treatment, criminal 

justice, law enforcement, international program, and research with which to assess the Nation’s progress 

toward achieving the Objectives (see Table A-2 below). In total, to assess the Nation’s progress at 

achieving the Strategy Goals and Objectives there are 41 specific measures.

For each of the Strategy Goals and Objectives, the following definitions are applied to assess progress:

• Target Met or Exceeded (Given the data available at this time, progress should be maintained.)

• Progress Sufficient to Meet Target (Given the data available at this time, there is a reasonable

expectation that the target will be met.)

• Progress Required to Meet Target (Movement toward the target is in the right direction; based

on the data available at this time, additional efforts are required.)

• Insufficient Progress (Movement toward the target is moderate; based on the data available at this

time, significant progress is required to meet target.)

• No Progress to Date, or, Target Not Met (For ‘No Progress to Date’, movement toward the 

target is stalled or not in the right direction. For ‘Target Not Met”, based on 2015 or the most recent 

available data, target was not achieved.)

• Progress Cannot be Assessed. (The category ‘Progress Cannot be Assessed” is used where data 

updates are pending or a cessation of data availability occurred before a final progress assessment could be 

determined.)

Tables A-1 and A-2 below summarize progress toward achieving the overall Strategy Goals and Objectives 

to reduce drug use and its consequences. Of the total 41 measures that constitute the PRS, 21 targets, 

or approximately 51 percent, were met or had made sufficient progress toward achieving the target. 

There were 2 measures where more progress was required and 13 measures where there was no 

progress to date or the target had not been met. There were 5 measures where progress could not be 

assessed due to pending data updates or a cessation of data availability that occurred before a final 

progress assessment could be made.). The summary of progress for both the Strategy and Objective 

measures is shown in Figure 1-1 below.

 1 For the Strategy, there are seven primary measures; three of them have multiple sub-measures: 8th grade lifetime use of alcohol, 

tobacco and illicit drugs; people who use marijuana, cocaine, heroin or methamphetamine chronically; and drug-related morbidity, 

including drug-related emergency departments and diagnoses of HIV infections attributable to drug use. For the purposes of this 

report, these 9 sub-measures are treated as individual measures in the discussion of progress toward achieving the Strategy goals, 

thereby resulting in a total of 13 measures overall for assessing the Strategy goals; individual assessments are presented for each of the 

13 measures in this report.
5

Figure 1-1: Progress Assessment Summary for Performance Reporting System Measures

Details regarding the progress for Strategy and Objective measures follow in Chapters 1 and 2.

For the goals and measures in the PRS, 2009 data were used as the baseline in accordance with the 2011 

Strategy. If 2009 data were not available, the most current year was used. While this report provides 

progress toward achieving the 2015 targets there is considerable variation in the availability of the data 

used to track progress and sometimes data are not available for 2015. For this report, the most recent 

data available were used.

Table A‐1: Summary of Interagency Progress toward Achieving the Goals of the Strategy

Progress Assessment Strategy

Measures

Objective

Measures

Total

Target Met or Exceeded 3 16 19

Progress Sufficient to Meet Target 0 2 2

Progress Required to Meet Target 0 1 1

Insufficient Progress 1 0 1

No Progress to Date 1 2 3

Target Not Met 3 7 10

Progress Cannot be Assessed 5 0 5

Total 13 28 41

National Drug Control 

Strategy Goal/Measure Progress Status

1a: Decrease the 30-day prevalence of drug use among 12–17 year olds by 15% Insufficient Progress

 Marijuana Progress Cannot be Assessed*

Progress Cannot be Assessed*

 - Data Source: National Roadside Survey No Progress to Date

Strategy Goal 2: Improve the public health and public safety of the American people by reducing the consequences of drug abuse

2c: Reduce the prevalence of drugged driving by 10%

 - HIV infections attributable to drug use Target Met or Exceeded 

**Due to cessation of data availability in 2011 final progress assessment cannot be made.

* Data last updated in 2010, data updates pending. Final progress assessment cannot be made.

2b: Reduce drug-related morbidity by 15%

 - Emergency room visits for drug misuse and abuse Progress Cannot be Assessed**

2a: Reduce drug-induced deaths by 15% Target Not Met 

 Methamphetamine

 Heroin Progress Cannot be Assessed*

1d: Reduce the number of chronic drug users by 15%

 Cocaine Progress Cannot be Assessed*

1c: Decrease the 30-day prevalence of drug use among young adults aged 18–25 by 10% Target Not Met 

Strategy Measures

Strategy Goal 1: Curtail illicit drug consumption in America

 - Tobacco Target Met or Exceeded 

 - Alcohol Target Met or Exceeded 

1b: Decrease the lifetime prevalence of 8th graders who have used drugs, alcohol, or tobacco by 15%

 - Illicit Drugs Target Not Met 
6

Table A-2: Summary of Interagency Progress toward the Objectives of the Strategy

 Objective 1: Strengthen Efforts to Prevent Drug Use in Our Communities Assessment

Measure 1.5: Average age of initiation for alcohol use Target Not Met

Objective 2: Seek Early Intervention Opportunities in Health Care Assessment

Measure 2.1: Percent of Federally Qualified Health Center grantees providing SBIRT services Target Met or Exceeded

Measure 2.2: Percent of respondents in the past year using prescription-type drugs non-medically, age 12 - 17 Target Met or Exceeded

Measure 2.3: Percent of respondents in the past year using prescription-type drugs non-medically, age 18 - 25 Target Met or Exceeded

Measure 2.4: Percent of respondents in the past year using prescription-type drugs non-medically, age 26+ Progress Required to Meet Target 

Objective 3: Increasing Access to Treatment and Supporting Long-term Recovery Assessment

Measure 3.1: Percent of treatment plans completed No Progress to Date

Measure 3.2: Percent of Health Center grantees providing substance abuse counseling and treatment services Target Not Met

Objective 4: Criminal Justice Reform: Making the System More Effective and Fair Assessment

Measure 4.1: Percent of residential facilities in the Juvenile Justice System offering substance abuse treatment Target Met or Exceeded

Measure 4.2: Percent of treatment plans completed by those referred by the Criminal Justice System No Progress to Date

Objective 5: Disrupt Domestic Drug Trafficking and Production Assessment

Measure 5.1: Number of domestic CPOT-linked organizations disrupted or dismantled Target Met or Exceeded

Measure 5.2: Number of RPOT-linked organizations disrupted or dismantled Target Met or Exceeded

Measure 5.3 Number of methamphetamine lab incidents Target Met or Exceeded

Objective 6: Strengthen Law Enforcment and International Partnerships to Reduce the

Availability of Foreign Produced Drugs in the United States

Assessment

Measure 6.1: Percent of selected countries on the Majors List that increased their commitment to demand 

reduction

Target Met or Exceeded

Measure 6.2: Percent of selected countries on the Majors List that increased their commitment to supply 

reduction

Target Met or Exceeded

Measure 6.3: Percent of Majors List countries showing progress since 2009 in reducing either cultivation or 

drug production potential

Target Not Met

Measure 6.4: Number of international CPOT-linked organizations disrupted or dismantled Target Met or Exceeded

Objective 7: Improve Information Systems for Analysis, Assessment, and Local Management Assessment

Treatment Episode Data Set (TEDS) Progress Sufficient to Meet Target 

Substance Abuse and Mental Health Data Archive (SAMHDA) Target Met or Exceeded

National Survey on Drug Use and Health (NSDUH) (Journal articles referencing NSDUH) Target Met or Exceeded

SAMHSA Funded Data Sets Target Met or Exceeded

Measure 7.3: Increase Federal data sets that establish feedback mechanisms to measure usefulness (surveys, focus groups, etc.)

Measure 7.2: Increase the utilization (number of annual web hits, or number of documents referencing the source) of select Federal data sets by 10% 

from the baseline

Measure 7.1: Increase timeliness (year-end to date-of-release) of select Federal data sets above their baseline by 10% 

Measure 3.3: Percent of treatment facilities offering at least 4 of the standard spectrum of recovery services Target Met or Exceeded

(child care, transportation assistance, employment assistance, housing assistance, discharge planning, and aftercare counseling)

 - Smokeless tobacco Target Met or Exceeded 

 - Cigars Target Met or Exceeded 

Measure 1.6: Average age of initiation for tobacco use

 - Cigarettes Target Not Met

Measure 1.4: Average age of initiation for all illicit drugs Progress Sufficient to Meet Target 

Measure 1.3: Percent of respondents, ages 12–17, who perceive a great risk in consuming four or five drinks 

once or twice a week

Target Not Met

Measure 1.2: Percent of respondents, ages 12–17, who perceive a great risk in consumption of one or more 

packs of cigarettes per day

Target Not Met

Measure 1.1: Percent of respondents, ages 12–17, who perceive a great risk in smoking marijuana once or twice 

a week

Target Not Met
7

Data Challenges

One of the greatest impediments to acquiring a clear understanding of drug trends is the adequacy of 

data on the outcomes of drug control activities. The PRS development process resulted in the 

selection of measures that were supported by the best data available. In cases where optimal measures 

were not useable because of the lack of data, proxy measures were used. There are limitations to using 

proxy measures since they represent an option where data choices are imperfect. For instance, the 

absence of nationally representative data on treatment effectiveness necessitates reliance on proxy 

measures of rates of treatment completion. In this same vein, the lack of adequate data sources, as 

they relate to the effectiveness of juvenile and criminal justice reform efforts (beyond treatment 

provision), similarly prohibits the assessment of these efforts on recidivism. Additionally, deficiencies 

in national data suitable for performance monitoring required the reliance on proxy measures. An 

example of such a proxy measure is information collected on the Health Resources and Services 

Administration’s (HRSA) health centers used to assess efforts to integrate substance use disorder 

treatment services into the nationwide network of treatment facilities. While the use of such proxies 

is reasonable given the limited data available, it does not provide a full understanding of the issues, 

challenges, and opportunities present when assessing the progress of interagency efforts toward 

reducing substance use and its consequences.

Another challenge is the lack of availability of some data sets which can impede understanding of 

trends and monitoring performance. For example, The Drug Abuse Warning Network (DAWN), 

discontinued in 2011, was a public health surveillance system that monitored drug-related hospital 

emergency department visits. DAWN provided data on the consequences of substance use nationally 

and for selected metropolitan areas. Other data sources on drug-related emergency department visits

are in development. In another example, the most recent iteration of the study “What Americans 

Spend on Illicit Drugs” provided data through 2010 thereby not permitting the tracking of trends 

through 2015.2 For the measures informed by DAWN and the study “What Americans Spend on 

Illicit Drugs” it was not possible to make a final progress assessment. While the data sources for these 

measures are not currently available, other data sources can provide some context regarding trends. 

This information is provided in the sections on the affected measures.

Periodically, many Federal data systems undergo redesigns or other enhancements to improve 

estimation of the variables of interest or to keep pace with improvements in survey technology. In 

2015, SAMHSA implemented a long-planned partial redesign of the National Survey on Drug Use 

and Health (NSDUH) to clarify and provide more accurate estimates of methamphetamine use and 

the nonmedical use of prescription drugs (especially opioid medications). Previously, questions 

concerning the use of methamphetamine were asked as part of the prescription drug module. Though 

methamphetamine is a Schedule II drug and can be prescribed for some conditions, such as attentiondeficit disorder, it rarely is. The 2015 NSDUH administered the methamphetamine questions in a 

manner similar to the questions on the use of other illicit drugs. 

Prior to 2015, the screening question on the nonmedical use of prescription drugs did not differentiate 

among the various motives for such nonmedical use, including taking more than your prescription 

indicated, continuing to use the medication beyond the date of the prescription, taking someone else’s 

medication for a similar condition (i.e., to relieve pain), or for its psychoactive effect (i.e., to get 

 2 The next iteration of the report is being planned; it will update the estimates through 2014.
8

“high”). The 2015 redesigned questionnaire now permits such disaggregation of motive for using 

prescription drugs non-medically, which has implications for the responses to address the varying 

types of motives.

While the NSDUH redesign will ultimately improve data quality and utility, these enhancements to 

the survey questions resulted in changes in the estimates that cannot be differentiated between 

methodological artifacts and actual changes in the behavior of interest; therefore, SAMHSA is 

recommending that data for these measures not be compared to those from 2002-2014. Since the 

prescription drug and methamphetamine data contribute to the summary prevalence estimate of “any 

illicit drug use” SAMHSA also recommends that the 2015 data for this indicator not be compared to 

the estimates for 2002-2014. These changes affect 10 of the 13 PRS measures informed by NSDUH 

data.3 The implications for the assessment for each of the affected measures are discussed below.

Among other data challenges was tracking new and unanticipated trends in use and harmful 

consequences. Examples include the opioid epidemic, the efforts in some states to legalize marijuana

use, and increased use of hookahs and e-cigarettes among young people over the time period covered 

by the PRS.

Future Challenges

A key challenge will be identifying measures and data sources suitable for tracking progress on current 

issues while at the same time monitoring a range of data to identify emerging threats. In the future an 

investment in new or expanded data sources may be necessary. There may be a need to assess current 

data sources to determine if new data items can or should be added. Challenges remain in securing 

data suitable for tracking performance. Ideally, data appropriate for performance monitoring should 

be able to:

• Reflect the collective work of multiple contributors;

• Allow documentation of small changes;

• Be regarded as unbiased and from a reliable source;

• Have multi-year funding and be continuous; and

• Be unambiguous and understandable.

Measures that are informed by these data should be:

• Quantifiable;

• Clear in meaning to both analysts and lay readers; and

• A valid indicator (i.e., a plausible indication of success in achieving the measure).

 3 The measures affected are: Measure 1a: Decrease the 30-day prevalence of drug use among 12–17 year olds by 15%; Measure 1c: 

Decrease the 30-day prevalence of drug use among young adults aged 18–25 by 10%; Measure 1.1: Percent of respondents, ages 12–

17, who perceive a great risk in smoking marijuana once or twice a week; Measure 1.2: Percent of respondents, ages 12–17, who 

perceive a great risk in consumption of one or more packs of cigarettes per day; Measure 1.3: Percent of respondents, ages 12–17, 

who perceive a great risk in consuming four or five drinks once or twice a week; Measure 1.4: Average age of initiation for all illicit 

drugs; Measure 1.6: Average age of initiation for tobacco use (smokeless tobacco); Measure 2.2: Percent of respondents in the past 

year using prescription-type drugs non-medically, age 12 – 17; Measure 2.3: Percent of respondents in the past year using prescriptiontype drugs non-medically, age 18 – 25; and Measure 2.4: Percent of respondents in the past year using prescription-type drugs nonmedically, age 26+.
9

Given the complexity of drug policy issues and interplay between supply and demand influences, 

bringing together the collective knowledge and experience of a wide range of individuals will increase 

the likelihood of success in designing an effective assessment approach. Participating individuals 

include subject matter experts, policy and program analysts, statisticians, researchers, operational 

experts, economists, and data experts.
10

Chapter 1: Progress toward Achieving 

the Strategy Goals

The Obama Administration’s inaugural Strategy, published in 2010, established the following two 

overarching Goals to reduce drug use and its consequences by 2015:

• Goal 1: Curtail illicit drug consumption in America; and

• Goal 2: Improve the public health and public safety of the American people by reducing the 

consequences of substance use.

For each of the Strategy Goals and Objectives, the following definitions are applied to assess progress:

• Target Met or Exceeded (Given the data available at this time, progress should be maintained.)

• Progress Sufficient to Meet Target (Given the data available at this time, there is a reasonable

expectation that the target will be met.)

• Progress Required to Meet Target (Movement toward the target is in the right direction; based

on the data available at this time, additional efforts are required.)

• Insufficient Progress (Movement toward the target is moderate; based on the data available at this

time, significant progress is required to meet target.)

• No Progress to Date, or, Target Not Met (For ‘No Progress to Date’, movement toward the 

target is stalled or not in the right direction. For ‘Target Not Met’, based on 2015 or the most recent 

available data, target was not achieved.)

• Progress Cannot be Assessed (The category ‘Progress Cannot be Assessed’ is used where data updates 

are pending or a cessation of data availability occurred before a final progress assessment could be determined.)

The Strategy, developed through an extensive consultation process with Federal, state, local, and tribal 

partners, addressed the Nation’s call for a balanced policy of prevention, treatment, recovery, 

enforcement, and international cooperation. It also reflected the close collaboration between 

ONDCP and its Federal drug control agency partners in undertaking evidence-based programs, 

policies, and practices to achieve desired performance outcomes by 2015. 

Both of the Strategy’s Goals have been strongly supported by domestic and international programs and 

activities to reduce the availability of illicit drugs. Efforts to reduce the supply of drugs and enforce 

the laws of the United States are focused on decreasing crime, increasing the protection of U.S. 

borders, disrupting trafficking networks, and curtailing the international and domestic production of

drugs.

The Strategy calls for a 10‐15 percent reduction over 5 years in the rate of young adult drug use, chronic 

drug use, and drug‐related consequences, such as drug‐related morbidity and drugged driving. Seven 

measures (3 of the measures have more than one sub-measure so that, in effect, there are 13 measures 

in total) were developed to assess progress (see Table 1‐1) toward achieving the two Goals of curtailing 

illicit drug consumption in America and improving the public health and public safety of the American 

people by reducing the consequences of drug use. This chapter describes each of the seven Strategy

measures along with their baselines, 2015 targets, data sources, and assessments of progress‐to‐date.
11

Table 1-1: National Drug Control Strategy Goals & Measures, Baselines, Targets, and 

Progress to Date – Strategy Goal 1, Measures 1a, 1b, and 1c

See 

Appendix C for information about data sources

National Drug Control 

Strategy Goal/Measure Progress Status

2015: NC* Insufficient Progress 

2014: 9.4%

2013: 8.8%

2012: 9.5%

2011: 10.1%

2010: 10.1%

2015: 20.5%

2014: 20.3%

2013: 21.1%

2012: 18.5%

2011: 20.1%

2010: 21.4%

2015: 26.1%

2014: 26.8%

2013: 27.8%

2012: 29.5%

2011: 33.1%

2010: 35.8%

2015: 13.3%

2014: 13.5%

2013: 14.8%

2012: 15.5%

2011: 18.4%

2010: 20.0%

2015: NC*

2014: 22.0%

2013: 21.5%

2012: 21.3%

2011: 21.4%

2010: 21.6%

(2009)

NSDUH

1c: Decrease the 30-day prevalence of 

drug use among young adults aged 

18–25 by 10%

21.4% 19.3%

1b: Decrease the lifetime prevalence of 8th graders who have used drugs, alcohol, or tobacco by 15%

 - Illicit Drugs 19.9% 16.9% Target Not Met 

Target Met or Exceeded 

Target Met or Exceeded 

(2009)

MTF

 - Alcohol 36.6% 31.1%

(2009)

MTF

(2009)

MTF

Target Not Met 

 - Tobacco 20.1% 17.1%

* 2015 values are not comparable due to methodological changes in NSDUH.

Baseline Progressto-date 2015 Target

Strategy Goal 1: Curtail illicit drug consumption in America

(2009)

NSDUH

Strategy Measures

1a: Decrease the 30-day prevalence of 

drug use among 12–17 year olds by 

15%

10.1% 8.6%
12

Table 1-1, continued: National Drug Control Strategy Goals & Measures, Baselines, 

Targets, and Progress to Date – Strategy Goal 1, Measure 1d

Table 1-1, continued: National Drug Control Strategy Goals & Measures, Baselines, 

Targets, and Progress to Date – Strategy Goal 2

National Drug Control 

Strategy Goal/Measure Progress Status

2010: 2.5 million

2010: 1.5 million

2010: 17.6 million

2010: 1.6 million

* Data last updated in 2010, data updates pending. Final progress assessment cannot be made.

 Heroin 1.5 million 1.3 million

1d: Reduce the number of chronic drug users by 15%

 Cocaine 2.7 million 2.3 million Progress Cannot be Assessed *

Progress Cannot be Assessed*

(2009)

What Americans 

Spend on Illicit 

Drugs

(2009)

What Americans 

Spend on Illicit 

Drugs

 Methamphetamine 1.8 million 1.5 million

 Marijuana 16.2 million 13.8 million

Progress Cannot be Assessed*

(2009)

What Americans 

Spend on Illicit 

Drugs

Progress Cannot be Assessed*

(2009)

What Americans 

Spend on Illicit 

Drugs

Baseline Progressto-date 2015 Target

National Drug Control 

Strategy Goal/Measure Progress Status

2015: 55,403

2014: 49,714

2013: 46,471

2012: 43,819

2011: 43,544

2010: 40,393

2012: NA

2011: 2,462,948

2010: 2,301,050

2014: 3,852

2013: 4,366

2012: 4,342

2011: 4,513

2010: 5,138

2013-2014 20.0% No Progress to Date

Baseline Progressto-date 2015 Target

Strategy Goal 2: Improve the public health and public safety of the American people by reducing the

consequences of drug abuse

 - Data Source: National 

 Roadside Survey

16.3% 14.7%

(2007)

NHTSA

(2009)

CDC

(2009)

DAWN

2c: Reduce the prevalence of drugged driving by 10%

 - HIV infections 

 attributable to drug use

5,799 4,929

2b: Reduce drug-related morbidity by 15%

 - Emergency room visits 

 for drug misuse and abuse

2,070,452 1,759,884 Progress Cannot be Assessed*

Target Met or Exceeded 

Target Not Met

(2009)

Statistics

2a: Reduce drug-induced deaths by 

15%

39,147 33,275

National Vital

* Due to cessation of data availability in 2011, final progress assessment cannot be made.
13

Assessment of Progress

Thirteen performance measures are used to assess progress toward achieving the Strategy’s goals of 

curtailing illicit drug consumption in America and improving the public health and public safety of the 

American people by reducing the consequences of drug use. The following paragraphs discuss the 

final assessment of the Nation’s progress toward reaching these goals. 

Of the 13 performance measures identified to assess progress in the Strategy, three met or exceeded 

the targets set in 2009. The first two measures include decreasing the lifetime prevalence of alcohol 

use and tobacco use among 8th graders by 15 percent by 2015. By 2015, alcohol use among 8th 

graders had dropped to 26.1 percent, and tobacco use had fallen to 17.1 percent. These numbers are 

16 percent and 22 percent, respectively, below the targets set in 2009. The third measure, reducing 

HIV infections attributable to injection drug use, exceeded the target of 4,929 newly diagnosed HIV 

infections attributable to drug use by 22 percent (3,852) newly diagnosed HIV infections attributable 

to drug use) one year earlier than the target of 2015. One measure, 30-day prevalence of drug use by 

youth ages 12 to 17, shows insufficient progress toward its goal of 8.6 percent.

Two measures, the prevalence of lifetime illicit drug use by 8th graders and 30-day prevalence of drug 

use among young adults aged 18-25 did not meet their targets of 16.9 percent and 19.3 percent 

respectively. Two other measures, the prevalence of people who drive after using drugs and reducing 

the number of drug-induced deaths showed no progress to date in reaching their targets of 14.7% and 

33,275 respectively. Lifetime prevalence of drug use by 8th graders increased to 20.5 percent in 2015, 

which is 0.6 of a percentage point above the 2009 baseline and nearly 4 percentage points above the 

2015 target. The most recent prevalence data available indicate that past 30-day drug use among young 

adults aged 18-25 has remained unchanged since 2009. This measure is driven primarily by the 

prevalence of marijuana use, which was unchanged over this period of time. Prevalence of drugged 

driving increased to 20.0, percent which is 23 percent above the 2009 baseline of 16.3 percent.4 Below 

is a specific discussion of the progress for each of the measures.

Four measures addressing chronic use of cocaine, heroin, marijuana, and methamphetamine progress 

could not be assessed due to a lack of availability of updated data. Though 2015 data are not available 

for these measures at the time of publication of this report, the available data or other related data 

suggest that is unlikely that the Nation will achieve these targets. The most recent data available on the 

use of marijuana and heroin indicate that the prevalence of use of these drugs may be moving in the 

wrong direction, which suggests that the number of people who use these two drugs chronically also 

may be increasing. Vital statistics data show that the number of drug-induced deaths rose 27 percent 

from 2009 to 2014, and preliminary information suggests that this metric may continue to move in the 

wrong direction, even though progress has been made in the implementation of overdose reversal 

protocols across many states. Similarly, progress could not be assessed regarding the number of drugrelated emergency room visits. This measure was informed by data from the Drug Abuse Warning 

System (DAWN); the DAWN data system was discontinued in 2011. The Substance Abuse and 

Mental Health Services Administration (SAMHSA), the National Center for Health Statistics, and the 

Food and Drug Administration are collaborating on a new effort to collect drug-related emergency 

department data. Data collection began in calendar year 2016, and preliminary findings are expected 

to be available by the end of calendar year 2017. 

 4 The 2013/2014 National Roadside Survey results are used as the terminal data for this measure.
14

Measure 1 a: Decrease the 30‐day prevalence of drug use among 12‐ to 17‐year‐olds by 15%

The data for this measure are drawn from SAMHSA’s National Survey on Drug Use and Health 

(NSDUH),which provides annual data on the substance use behavior of civilian, non‐institutionalized 

populations 12 years of age and older, including ages of initiation for each substance. Included in the 

nearly 70,000 annual respondents are college students in dormitories, people living in homeless 

shelters, and civilians living on military bases. A 2009 baseline estimate of 10.1 percent was established 

for the measure, with a 2015 target of 8.6 percent. 

After two years of trending toward achieving the 2015 target of 8.6 percent, estimates for past 30-day 

illicit drug use among 12-to-17-year-olds, increased from 8.8 percent in 2013 to 9.4 percent in 2014. 

This is approximately 9 percent above the 2015 target. This most recent increase appears to be driven 

by a 20 percent increase in illicit drug use other than marijuana (from 3.0% in 2013 to 3.6% in 2014). 

However, prior to 2014 the rate of use of illicit drugs other than marijuana among youth had been 

dropping steadily from 4.6 percent in 2009 to 3.0 percent in 2013. 

As noted above, this measure is one of the two used to assess the Nation’s progress toward achieving 

the Strategy’s goals that is affected by the 2015 redesign of the NSDUH. In order to achieve the target, 

the 2015 estimate would have had to drop by 0.8 of a percentage point. The 2015 NSDUH for the 

prevalence of marijuana use among youth, for which there is not a break in the trend, indicates there 

was no change from the 2014 estimate. Coupled with the trend for the rate of use of drugs other than 

marijuana, it is possible that the Nation may have achieved this target, but due to the break in the 

trend resulting from the 2015 re-design, it is not possible to make a definitive statement; therefore, 

this measure has been rated as “insufficient progress”.

Measure 1 b: Decrease the lifetime prevalence of 8th graders who have used drugs, alcohol,

or tobacco by 15 percent

The data for this measure are taken from the Monitoring the Future (MTF) study, which is supported 

by the National Institute on Drug Abuse (NIDA). The MTF data on the use of drugs, alcohol, or 

tobacco5 by 8th grade students are not combined within the study and are presented here separately, 

resulting in three measures. The 2009 baselines are (1) any illicit drug, 19.9 percent; (2) alcohol, 36.6 

percent; and (3) tobacco/cigarettes, 20.1 percent. The 2015 targets are (1) any illicit drug, 16.9 percent; 

(2) alcohol, 31.1 percent; and (3) tobacco/cigarettes, 17.1 percent.

According to data from the 2015 MTF study, the Nation met the targets for reducing lifetime use of 

alcohol and cigarettes among 8th graders: 27 percent for alcohol and 33 percent for cigarettes. Until 

2012, the Nation was on target for achieving the goal for illicit drugs; however, by 2015, illicit drug 

use among 8th graders had increased to 20.5 percent which is 3 percent above the 2009 baseline level 

of 19.9 percent and 21 percent above the 2015 target of 16.9 percent; therefore, the Nation did not 

meet the target for this measure. Figures 2-1, 2-2, and 2-3 below depict the trends for this measure.

 5 For the purposes of the PRS, tobacco use was defined as the use of cigarettes. Although the Monitoring the Future Study —the data 

source for this measure—asks questions about other forms of tobacco use, including small cigars, smokeless, hookahs, dissolvable, 

and in 2014, e‐cigarettes, some of these are asked only of seniors. The MTF does not report an overall estimate for all tobacco 

products combined. It was the consensus of the interagency group who assisted in developing the PRS measures that cigarette use 

would be the proxy measure for tobacco use.
15

Figure 2‐1: Illicit Drug Use by 8th Graders Over Time in Reference to 2015 Target

Figure 2‐2: Alcohol Use by 8th Graders Over Time in Reference to 2015 Target

Figure 2‐3: Cigarette Use by 8th Graders Over Time in Reference to 2015 Target
16

Measure 1c: Decrease the 30‐day prevalence of drug use among young adults aged 18–25 by

10 percent

The data for this measure are taken from the NSDUH, with a 2009 baseline estimate of 21.4 percent 

and a 2015 target of 19.3 percent. As noted above, the 2015 NSDUH underwent a partial re-design 

that resulted in data from 2015 not being comparable to data from earlier years. This is the second of 

two Strategy goal measures for which there is a break in the trend due to the re-design. With respect 

to the reduction in the use of any illicit drug among young adults, the Strategy set a goal of reducing 

such use by 10 percent, from 21.4 percent in 2009 to 19.3 percent by 2015. Between 2009 and 2014, 

past 30 day use of any illicit drug showed no change from the 2009 baseline estimate. It is therefore 

unlikely that in the absence of the re-design the data would suggest that the Nation made up the 

needed deficit in one year and achieved the 2015 target. Consequently, this measure is assessed as 

“target not met”.

The primary reason for this lack of success is the continued and unchanging high prevalence of past 

month marijuana use among young adults – nearly 20 percent since 2009. However, when marijuana 

is excluded from the estimation of illicit drug use, the Nation more than doubled the targeted reduction 

by 2014 – a 24 percent decline from 2009 to 2014. This decline was been driven by a 25 percent decline 

in past-month non-medical use of prescription drugs overall, which, in turn, was driven by a 31 percent 

decline in past-month non-medical use of opioid medications.
17

Measure 1 d: Reduce the number of chronic drug users by 15 percent

There are four measures for assessing progress in reducing the number of people who use drugs 

chronically, one for each of the four major drugs: cocaine, heroin, marijuana, and methamphetamine. 

The data for assessing these measures are from the 2010 report, What America’s Users Spend on 

Illegal Drugs: 2000-20106 (ONDCP 2014). As noted above, data from this report are available only 

through 2010, and therefore, a final progress assessment for this measure cannot be made. This report 

estimates the retail value of the illicit drug market. In producing these estimates, two other estimates 

are calculated: the number of people who use (occasional and chronic) each of the four major drugs 

(marijuana, cocaine, heroin, and methamphetamine) and the amount of each drug consumed by these

individuals. The latest estimates of drug consumption, including the number of people who used 

drugs chronically, are only available through 2010. Other measures such as illicit crop cultivation, 

mortality, seizures, and workplace drug testing positive rates provide indications of trends since 2010. 

Progress toward achieving each of these measures is discussed below.

Cocaine: In 2010, there were 200,000 fewer individuals estimated to be using cocaine chronically than 

in 2009 (2.7 million). This reduction was consistent with the downward trending estimates of the 

amount of drugs consumed from 2009 (161 metric tons) to 2010 (145 metric tons). However, several 

cocaine indicators focusing on availability and initiation appear to be moving in the wrong direction 

including a doubling in Colombian coca cultivation from 2013 to 2015 and a 27 percent increase the 

number of Americans initiating use of cocaine (601,000 in 2013 to 766,000 in 2014). 

Heroin: The number of people who used heroin chronically remained stable at 1.5 million between 

2009 and 2010. However, several other indicators used to measure heroin availability and its 

consequences suggest that the number of people using heroin chronically may have increased since 

2010 including a 150 percent increase Mexican opium poppy cultivation from 2013 to 2015 and a 248 

percent increase in drug overdose deaths involving heroin from 2010 to 2014. 

Marijuana: The 2009 estimate of the number of people who used marijuana chronically (16.2 

million) increased to 17.6 million in 2010, moving away from the 2015 target number of 13.8 million. 

Indicators that estimate the amount of drugs consumed increased from 5.1 metric tons in 2009 to 

5.7 metric tons in 2010 and NSDUH found that marijuana use has increased from 8.7 percent in 

2009 to 10.2 percent in 2014 among the general population 12 and older. 

Methamphetamine: The 2009 estimate of 1.9 million people who use methamphetamine

chronically decreased to 1.6 million in 2010 and it appeared to be on track to meet the 2015 target of 1.5

million people who chronically used methamphetamine. However, other data indicators of 

methamphetamine use and availability appear to be moving in the wrong direction. The amount of

consumed methamphetamine increased during this same period from 40 metric tons consumed in

2009 to 42 metric tons consumed in 2010. Estimated methamphetamine use among individuals 12 

and older doubled from 0.1 percent in 2010 to 0.2 percent 2011 and remained constant through 2014.

Domestic seizure submissions to forensic labs increased 48 percent between 2010 and 2014 and 

Southwest Border seizures rose 215 percent between 2010 and 2015. 

 6 The report defines chronic use of cocaine, heroin, and methamphetamine as use of the drug on four or more days per month—

essentially once per week. For marijuana there are three categories of chronic use: weekly (4 to 10 days per month); more than weekly 

(11 to 20 days per month); and daily/near daily (21 or more days per month). Occasional use for all four drugs is defined as use less 

than four times per month.
18

Measure 2 a: Reduce drug‐induced deaths by 15 percent

The data for this measure are taken from Vital Statistics Data compiled by the Centers for Disease 

Control and Prevention’s (CDC) National Center for Health Statistics (NCHS), which includes data 

from all death certificates filed in the 50 states and the District of Columbia. NCHS tabulates deaths 

attributable to various causes, including drug‐induced mortality. Causes of death attributable to drugs 

include accidental or intentional poisonings by drugs, drug psychoses, drug dependence, and 

nondependent use of drugs. Drug‐induced causes exclude accidents, homicides, and other causes 

indirectly related to drug use. 

The target has not been met in achieving the target for reducing drug-induced deaths. In 2009, there 

were 39,147 drug‐induced deaths; 37,004 of these were drug poisoning deaths and 20,848 of those 

were reported to involve prescription drugs. The 2015 target strives to reduce the number of drug‐

induced deaths by 15 percent (33,275). In 2015, there were 55,403 drug‐induced deaths, an increase 

of 42 percent compared to 2009. Of the 55,403 drug‐induced deaths in 2015, 52,404 (94 percent) 

were drug poisonings, the majority of which (31,181) involved prescription drugs, especially opioid 

medications (24,508).7 

Measure 2 b: Reduce drug‐related morbidity by 15 percent

There are two measures assessing drug-related morbidity. The first examines drug-related emergency 

department visits. The data source for this measure is estimates from the Drug Abuse Warning 

Network (DAWN) of drug‐related emergency department (ED) visits. The second measure assesses 

the number of people newly diagnosed with HIV who were infected through injection drug use. Data 

for the number of people newly diagnosed with HIV infection are compiled by CDC (CDC February 

2015, November 2015).8

The 2009 baseline estimate for drug-related ED visits is 2,070,452. In 2011, the latest data that is 

available from DAWN, the number of people going to the emergency room for drug misuse and abuse 

was moving in the wrong direction with 2,462,948 visits in 2011. This increase was attributable to

rises in visits related to both illicit drugs and prescription drugs. In 2011, there were 1,252,500 visits

related to illicit drugs, up from 974,392 such visits in 2009. Likewise, in 2011, there were 1,428,145 ED

visits related to prescription drugs, up from 1,243,606 in 2009. 

The 2009 baseline estimate of the number of individuals with newly diagnosed HIV infection 

acquired through injected drug use (IDU) is 5,799 (which includes those in the transmission category

of male‐to‐male sexual contact and IDU); the 2015 target strives to lower this number by 15 percent

to 4,929. The 2014 data show that 3,852 individuals were diagnosed with drug-related HIV infection,

indicating that the 2015 target has been exceeded.

 7 Of note, not all drug poisoning deaths report the drug(s) involved; a death can involve more than one drug, so any drug‐specific 

involvement in a death should be considered floor estimates.

8 The data source for this measure was changed in 2015 on the advice of CDC staff from cases of incidence of drug‐related HIV to

diagnoses of such cases since the estimates of the incident cases are not expected to be produced in time to be useful in assessing

progress toward achieving this measure.
19

Measure 2 c: Reduce the prevalence of drugged driving by 10 percent

The data source for this measure is the National Roadside Survey conducted by the National 

Highway Traffic Safety Administration (NHTSA). The Roadside Survey is a nationally representative 

survey of drivers on U.S. roads. The baseline survey, conducted in 2007, found that 16.3 percent of 

weekend, nighttime drivers tested positive for the presence of at least one illicit drug or medication 

(with the ability to impair driving skills). The 2015 target is 14.7 percent. The follow‐up survey was 

conducted in 2013-2014 and found that the prevalence of nighttime weekend driving after 

consuming drugs or medications rose to 20.0 percent. Consequently, this measure is assessed as no 

progress to date.

Conclusion

Progress in implementing the President’s Strategy over this next year and beyond will require a 

comprehensive effort that includes Federal, state, local, tribal, and territorial government agencies, 

international institutions and partner nations, nongovernmental organizations, academia, private 

industry, and American citizens from all walks of life. The Administration looks forward to a 

continued partnership with Congress to address the problem of illicit drug use, which affects all of 

our lives.
20

Chapter 2: Progress toward Achieving the

Objectives of the Strategy

The objectives of the Strategy include preventing drug use, seeking early intervention, integrating 

treatment into health care, expanding support for recovery services, breaking the cycle of drug use 

and crime, disrupting domestic drug trafficking and production, strengthening international 

partnerships, and improving information systems. Described in more detail in this chapter are the 

assessments of measures to gauge progress toward achieving each of the objectives using the most 

recent and relevant data available.

Objective 1 ‐ Strengthen Efforts to Prevent Drug Use in Our Communities

As one of the Administration’s drug policy priorities, prevention activities seek to communicate key

messages about drug use through multiple sources. Preventing drug use before it begins,

particularly among young people, is an effective and cost‐effective way to reduce drug use and

its consequences. Table 2‐1 below provides a summary of the measures, baselines, targets, and

progress assessments for this Objective. Information on data sources can be found in Appendix C.

Table 2-1: Objective 1 Measures, Baselines, Progress-to-date, Targets, and Assessment –

Measures 1.1 to 1.5

Objective 1 Measure Assessment

2015: NC*

2014: 37.4%

2013: 39.5%

2012: 43.6%

2011: 44.8%

2010: 47.2%

2015: NC*

2014: 66.3%

2013: 64.3%

2012: 65.7%

2011: 66.2%

2010: 65.3%

2015: NC*

2014: 39.2%

2013: 39.0%

2012: 39.7%

2011: 40.7%

2010: 40.4%

17.6 years 2015: NC* 19.5

2014: 19.0

2013: 19.0

2012: 18.7

2011: 18.1

2010: 19.1

16.9 years 2015: 18.0

2014: 17.3

2013: 17.3

2012: 17.4

2011: 17.1

2010: 17.1

** Target of 21 years is an ambitious stretch target consistent with the legal age for alcohol consumption.

* 2015 values are not comparable due to methodological changes in NSDUH.

Target Not Met

(2009)

NSDUH

Baseline Progress-to-date 2015 Target

Measure 1.1: Percent of respondents, 

ages 12–17, who perceive a great risk in 

smoking marijuana once or twice a 

week

49.0% 51.2%

Target Not Met

(2009)

NSDUH

Measure 1.2: Percent of respondents, 

ages 12–17, who perceive a great risk in 

consumption of one or more packs of 

cigarettes per day

65.5% 68.0%

NSDUH

Measure 1.4: Average age of initiation 

for all illicit drugs

Progress Sufficient to Meet 

Target 

Target Not Met

(2009)

NSDUH

Measure 1.3: Percent of respondents, 

ages 12–17, who perceive a great risk in 

consuming four or five drinks once or 

twice a week

39.6% 41.4%

21.0 years Target Not Met

(2009)

NSDUH

Measure 1.5: Average age of initiation 

for alcohol use**

(2009)
21

Table 2-1, continued: Objective 1 Measures, Baselines, Progress-to-date, Targets, and 

Assessment – Measure 1.6

See Appendix C for information about data sources.

Assessment of Progress

The following sections discusses the data sources, targets, progress made to date, and if future is action 

required to achieve each of the measures comprising Objective 1: Strengthen Efforts to Prevent Drug 

Use in Our Communities.

Measure 1.1: Percent of respondents, ages 12 – 17, who perceive a great risk in smoking

marijuana once or twice a week

The data for this measure are from SAMHSA’s NSDUH. Due to the NSDUH re-design the most 

recent data are from 2014. It is unlikely that in the absence of the re-design the data would suggest 

that the Nation made up the needed deficit in one year and achieved the 2015 target. Consequently, 

this measure is assessed as “target not met”. The percentage of youth, 12 to 17, perceiving great risk

in smoking marijuana once or twice a week has trended downward from 49.0 percent in 2009 to 37.4 

percent in 2014. Additionally, the rate of those reporting great risk in smoking marijuana once a month 

has declined from 30.3 percent in 2009 to 22.9 percent in 2014. Perceived risk is an important variable

and has been a leading indicator of use. 

Objective 1 Measure Progress-todate

Assessment

17.5 years 2015: 17.9 18.0 years**

2014: 18.6

2013: 17.8

2012: 17.8

2011: 17.2

2010: 17.3

20.7 years 2015: 20.9 18.0 years**

2014: 20.4

2013: 21.6

2012: 20.5

2011: 19.6

2010: 20.5

18.9 years 2015: NC*** 18.0 years**

2014: 19.0

2013: 18.4

2012: 18.8

2011: 19.8

2010: 19.3

* Since NSDUH reports data according to tobacco product, the assessment is made separately for cigarettes, cigars, and smokeless tobacco. 

** Target consistent with legal of age of tobacco sales set forth in Family Smoking Prevention and Tobacco Control Act of 2009.

*** 2015 values are not comparable due to methodological changes in NSDUH.

Target Met or Exceeded 

(2009)

 - Cigarettes

Baseline

NSDUH

NSDUH

 - Cigars Target Met or Exceeded 

(2009)

 - Smokeless tobacco

(2009)

Target Not Met

2015 Target

NSDUH

Measure 1.6: Average age of initiation for tobacco use*
22

Measure 1.2: Percent of respondents, ages 12 – 17, who perceive a great risk in consumption

of one or more packs of cigarettes per day

The data for this measure are from SAMHSA’s NSDUH. Cigarette use in adolescence not only 

negatively affects physical health and development, but also is associated with (though not sufficient 

on its own) future illicit substance use (U.S. Department of Health and Human Services, 2012). Thus, 

perception of risk of cigarette use is an important indicator of youth drug use behavior. Due to the 

NSDUH re-design the most recent data are from 2014. It is unlikely that in the absence of the redesign the data would suggest that the Nation made up the needed deficit in one year and achieved 

the 2015 target. According to the 2014 NSDUH, the percentage of youth aged 12 to 17 who reported 

great risk in smoking one or more packs of cigarettes per day increased from 65.5 percent in 2009 to 

66.3 percent in 2014.

Measure 1.3: Percent of respondents, ages 12 –17, who perceive a great risk in consuming

four or five drinks once or twice a week.

The data for this measure are from SAMHSA’s NSDUH. Binge drinking and heavy drinking are 

associated with a range of adverse consequences including alcohol poisoning, traffic crash injuries and 

fatalities, risky behavior, violent behavior, and an increased risk for alcohol use disorders. In the 

NSDUH, binge drinking is defined as having five or more drinks on the same occasion on at least 1 

day in the 30 days prior to the survey. Heavy alcohol use is defined as five or more drinks on the same 

occasion on each of 5 or more days in the past 30 days.9 According to the 2014 NSDUH, 39.2 percent 

of youth ages 12‐17 perceived great risk in having 4 or 5 or more drinks of an alcoholic beverage once 

or twice a week as compared to 39.6 percent in 2009. Due to the NSDUH re-design the most recent 

data are from 2014. It is unlikely that in the absence of the re-design the data would suggest that the 

Nation made up the needed deficit in one year and achieved the 2015 target of 41.4 percent. 

Measure 1.4: Average age of initiation for all illicit drugs

According to the NSDUH, about 3.0 million persons aged 12 or older used an illicit drug for the first 

time in 2014, averaging about 8,200 new users per day; this is similar to the number in 2013. Over half 

(51.5 percent) of those who reported first time illicit drug use were younger than age 18. The average 

age of initiation among persons aged 12 to 49 was 19.0 years; this is the same as the 2013 estimate and 

represents an increase over the 2009 baseline age of 17.6 years. Movement toward the target of 19.5 

years is in the right direction. Given the data available at this time, progress is sufficient to meet the

target.

Measure 1.5: Average age of initiation for alcohol use

The 2014 NSDUH estimates that approximately 4.7 million persons aged 12 or older used alcohol for 

the first time within the past 12 months; averaging approximately 12,700 initiates per day. Most (81.1%) 

were younger than age 21 at the time of initiation, and over one half (56.2%) initiated use prior to age 

18. The average age of first alcohol use among recent initiates aged 12 to 49 years is 18.0 years. There 

has been some progress, however, based on 2015 NSDUH data the target has not been met. The age

of 21 is a “stretch target” and was selected with the awareness it would be a challenge to achieve by

 

9 These levels are not mutually exclusive categories of use; heavy use is included in estimates of binge and current use, and binge use is

included in estimates of current use.
23

2015. The measure was selected in the context of the legal age for alcohol use, a target that is consistent

with the standard set forth in the National Minimum Drinking Age Act of 1984.

Measure 1.6: Average age of initiation for tobacco use

The 2014 NSDUH reported that there were approximately 2.2 million persons aged 12 or older who 

smoked cigarettes for the first time within the past 12 months, which was similar to the 2013 estimate 

(2.1 million). This averages to about 5,900 new cigarette smokers per day. Less than half of them 

(44.1%) began smoking before they were 18 years old. The NSDUH provides data for specific tobacco 

products ‐ cigarettes, cigars, and smokeless tobacco. Therefore, the PRS considers each as a separate 

measure; assessments for each measure are as follows:

Cigarettes ‐ the 2015 target age of 18.0 (which was selected in the context of the legal age for

tobacco use). According to the 2015 NSDUH, among past‐year initiates aged 12 to 49, the average

age of first cigarette use was 17.9 years. While the measure was not met, it was nearly met being only 0.1 

years shy of the target.

Cigars ‐ the 2015 target of 18.0 years has been exceeded. Among past year cigar initiates aged 12 to 49,

the average age at first use was 20.7 years in 2009 and 20.4 years in 2014. The 2014 NSDUH estimates

that 2.6 million persons, aged 12 or older, used cigars for the first time in the past 12 months, which is

similar to the 2013 estimate (2.8 million).

Smokeless Tobacco ‐ the 2015 target of 18.0 years has been exceeded. According to the 2014

NSDUH, the average age of first use among 12‐49 year olds was 19.0 years, similar to the 2009 (18.9

years) and 2013 (18.4 years) averages. The numbers of persons who initiated the use of smokeless

tobacco in the past year were estimated at 1.3 million in 2011, 1.0 million in 2012, 1.1 million in 2013, 

and 1.0 million in 2014.

Objective 2 ‐ Seek Early Intervention Opportunities in Health Care

Full implementation of the health care reforms under the Affordable Care Act and parity

10

will extend 

access to substance use disorder treatment services for an estimated 62 million Americans and help

integrate treatment into mainstream health care (Berino, K. et al., 2013). To meet the anticipated

increase in demand for health care services, the number of specially trained professionals should be

increased; the health care system should adopt and integrate evidence‐based approaches; and tools to

enable the detection and treatment of substance use disorders should be fully utilized, such as

Screening, Brief Intervention, and Referral to Treatment (SBIRT). The treatment provided must be

effective to achieve desired outcomes. Hence, assessment of progress toward achieving this Objective

concentrates on the availability of SBIRT and the effectiveness of treatment for the non‐medical

use of prescription drugs, fatalities from which have reached epidemic proportions according to

the CDC (Centers for Disease Control and Prevention, 2011). Table 2‐2 below outlines the

measures, targets, and progress‐to‐date for this Objective.

 10The Affordable Care Act builds on the Mental Health Parity and Addiction Equity Act of 2008 to extend Federal parity protections. 

The parity law aims to ensure that when coverage for mental health and substance use conditions is provided, it is generally

comparable to coverage for surgical and other medical care.
24

Table 2-2: Objective 2 Measures, Baselines, Progress-to-date, Targets, and Assessment

 See Appendix C for information about data sources.

Assessment of Progress

The following sections discuss the data sources, targets, progress made to date, and if future action is 

required to achieve each of the measures comprising Objective 2: Seek Early Intervention 

Opportunities in Health Care.

Measure 2.1: Percent of Health Center grantees providing Screening, Brief Intervention, and

Referral to Treatment services

This measure tracks the expansion of SBIRT services among HRSA Health Center Program grantees. 

SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and 

treatment services for persons with, or at risk for developing, substance use disorders. HRSA’s health 

center grantees provide services to over 24 million people, many of whom are medically underserved, 

and report data annually on the services they provide for monitoring within HRSA’s Uniform Data 

System (UDS). HRSA’s UDS warehouses service provider data on its grantees; however, no national 

source of data is available for all health care providers. In the absence of data on the aggregate 

performance of all health care providers and facilities nationwide, this HRSA grantee measure is used 

as a proxy for the greater expansion of screening services in primary care settings.

HRSA is working with health centers to integrate SBIRT services into primary care through the 

SAMHSA/HRSA Center for Integrated Health Solutions, , and state and national trainings and 

Objective 2 Measure Assessment

10.3% 2015: 29.5% Target Met or Exceeded 

2014: 21.1%

2013: 16.9%

2012: 13.8%

2011: 11.3%

2010: 11.3%

2015: NC*

2014: 6.2%

2013: 5.8%

2012: 6.6%

2011: 7.0%

2010: 7.4%

2015: NC*

2014: 11.8%

2013: 12.2%

2012: 13.7%

2011: 12.7%

2010: 14.3%

2015: NC*

2014: 4.5%

2013: 4.8%

2012: 5.1%

2011: 4.3%

2010: 4.8%

* 2015 values are not comparable due to methodological changes in NSDUH.

Target Met or Exceeded 

(2009)

UDS

Baseline Progressto-date 2015 Target

Measure 2.1: Percent of Health Center 

grantees providing SBIRT services

15.0%

(2009)

NSDUH

Measure 2.2: Percent of respondents in 

the past year using prescription-type 

drugs non-medically, age 12 - 17

7.7% 6.5%

Progress Required to Meet 

Target 

(2009)

NSDUH

Measure 2.3: Percent of respondents in 

the past year using prescription-type 

drugs non-medically, age 18 - 25

15.0% 12.8% Target Met or Exceeded 

(2009)

NSDUH

Measure 2.4: Percent of respondents in 

the past year using prescription-type 

drugs non-medically, age 26+

4.7% 4.0%
25

meetings. Based on 2015 UDS data, the 2015 target of having 15 percent of health centers providing 

SBIRT services has been exceeded , with 29.5 percent of them having done so.

Measure 2.2: Percent of respondents in the past year using prescription‐type drugs non‐

medically, ages 12 – 17

The illicit or non‐therapeutic use of any substance by young people is cause for concern, especially 

because substance use at a young age increases the likelihood of a chronic substance use disorder at a 

later age. (McCabe, S. et al, 2007; DeWit, D. et al, 2000) Given the data available at this time, the

2015 target of 6.5 percent has been exceeded. The 2014 NSDUH reported that the percentage of

youth aged 12‐17 who used prescription drugs non‐medically in the past year was 7.7 percent in

2009, dropping to 6.2 percent in 2014.

Measure 2.3: Percent of respondents in the past year using prescription‐type drugs non‐

medically, ages 18‐25

Data from the 2014 NSDUH indicate that this age group (18‐25) had the highest rate of past year non‐

medical use of prescription drugs (11.8%), as compared to the other two age groups (6.2%for 12‐17

year olds and 4.5%for those aged 26 and over). Non‐medical use of prescription drugs ranked second

only to marijuana use among 18‐25 year olds. While past- year non‐medical use of prescription drugs

remains a persistent risk to young adults, the 2014 estimate of 11.8 percent exceeded the 2015

target of 12.8 percent. Of note, 18‐25 years is the primary age group for initiating use of all classes

of prescription drugs. Among 12‐49 year olds, the average ages of those initiating non‐therapeutic

use of prescription drugs were 21 years for pain relievers, stimulants, and sedatives and 23 years for 

tranquilizers.

Measure 2.4: Percent of respondents in the past year using prescription‐type drugs non‐

medically, ages 26 and over.

Prescription drugs that present particular risk for non‐therapeutic use typically fall into one of four

categories: pain relievers, tranquilizers, stimulants, and sedatives. According to the 2014 NSDUH,

opioid pain relievers were the primary type of prescription drugs that were used non‐medically by

those ages 26 and over, followed by tranquilizers. The 2014 data indicate non‐medical use of

prescription drugs by those 26 and older decreased to 4.5 percent compared to 4.7 percent in 2009. 

While movement is in the right direction, additional efforts are required to meet the target. Of note,

with a 4.5 percent rate of non‐medical use of prescription drugs in 2014, this 26‐and‐older group

amounted to nearly 9.3 million people. Of those, 3.3 million were aged 26‐34 and 5.9 million were 35

and older. Of those aged 26‐34 who used prescription drugs non‐medically in 2014, nearly 2.3

million used pain relievers and about 1.3 million used tranquilizers. Additionally, of the 5.9 million

people age 35 and older who used prescription drugs in 2014, nearly 4.2 million used pain relievers and

2.0 million used tranquilizers.
26

Objective 3 ‐ Increasing Access to Treatment and Supporting Long-term 

Recovery

Substance use disorder is a chronic disorder associated with relapse, where outcomes are greatly 

improved with augmentation by recovery support services. Treatment helps people achieve stable, 

long‐term recovery and become productive members of society, reducing the public health, public 

safety, and economic consequences associated with substance use disorders. The Administration is 

working with states, tribes, local governments, treatment and recovery support services providers, and 

other stakeholders to develop systems and services that support sustained recovery. An essential 

component of this effort is promoting the use of recovery support services, non‐clinical services that 

assist people who are in or seeking recovery. Table 2‐3 outlines the measures, targets, and progress‐

to‐date for this Objective.

Table 2-3: Objective 3 Measures, Baselines, Progress-to-date, Targets, and Assessment

See Appendix C for information about data sources

Assessment of Progress

The following sections discuss the data sources, targets, progress made to date, and if future action is 

required to achieve each of the measures comprising the Objective 3: Increasing Access to Treatment 

and Supporting Long-term Recovery.

Measure 3.1: Percent of treatment plans completed

In the absence of nationwide data on treatment effectiveness—specifically, multi‐year national data

tracking clinical outcomes for individuals—the percentage of those discharged for having completed

treatment was used as a proxy measure. Data for this measure are drawn from SAMHSA’s

Objective 3 Measure Assessment

45.1% 2013: 44.3%

2012: 44.8%

2011: 43.7%

2010: 44.1%

2009: 46.7%

2008: 46.6%

2015: 21.0% Target Not Met

2014: 20.5%

2013: 20.0%

2012: 20.2%

2011: 22.1%

2010: 22.6%

2013: 41.0%

2012: 40.0%

2011: 39.0%

2010: 36.0%

2009: 36.0%

(2007)

TEDS-D

Baseline Progressto-date 2015 Target

Measure 3.1: Percent of treatment 

plans completed

50.0% No Progress to Date

(2009)

UDS

Measure 3.2: Percent of Health Center 

grantees providing substance abuse 

counseling and treatment services

21.6% 23.0%

(2008)

N-SSATS

Measure 3.3: Percent of treatment 

facilities offering at least 4 of the 

standard spectrum of recovery services 

(child care, transportation assistance, 

employment assistance, housing 

assistance, discharge planning, and 

after-care counseling)

35.5% 39.0% Target Met or Exceeded 
27

Treatment Episode Data Set on Discharges (TEDS‐D), an administrative dataset on discharges of

individuals aged 12 and older from alcohol or drug treatment in facilities that reported to Single

State Agencies. Based on the data available at this time, progress is stalled, and accelerated progress is 

required to meet the 2015 target of 50 percent. In 2008, 46.6 percent of those discharged had

completed treatment plans; this rate was 46.7 percent in 2009 before trending generally downward

to 44.1 percent in 2010, 43.7 percent in 2011, 44.8 percent in 2012, and 44.3 percent in 2013.

Measure 3.2: Percent of Health Center grantees providing substance use counseling and

treatment services

This measure focuses on the integration of counseling and treatment for substance use disorders into 

mainstream health care. Since there are no national records on available health care services, this 

measure focuses on HRSA’s Health Center Program grantees and the over 24 million individuals they 

serve. This measure is a proxy for assessing the extent of counseling and treatment services for 

substance use disorders provided in primary care settings. Providing these services would show that 

services for substance use disorders are integrated and expansive, which would be a reasonable 

conclusion, because HRSA Health Center Program grantees are major providers of primary care for 

the Nation’s medically underserved and vulnerable populations. Data for this measure are drawn from 

HRSA’s UDS and are collected annually from HRSA grantees.

There has been progress over the past two years. According to UDS data, the percent of grantees that 

provide substance use disorder counseling and treatment services has remained relatively stable since 

2009, with a rate of 21 percent reported in both 2014 and 2015. Progress has been impacted by the 

rapid growth of the Health Center Program. While the target was not met, the number of health centers 

providing these services has increased by 20 percent as the program has grown by 173 new grantees 

over the two-year period. 

Measure 3.3: Percent of treatment facilities offering at least 4 of the standard spectrum of

recovery services

Recovery from a substance use disorder is a lifelong process, and research has documented that 

treatment success is greatly improved by programs that facilitate recovery (Fisher 2014; McLellan, et

al.1998; Polcin et al 2010; Reif et al. 2014). Based on the data available through SAMHSA’s National 

Survey of Substance Abuse Treatment Services (N‐SSATS), the following six services are included in 

the measure’s definition of the standard spectrum of recovery support services: child care, 

transportation assistance, employment assistance, housing assistance, discharge planning, and after‐care 

counseling. An increase in the percentage of substance use disorder treatment facilities that provide at 

least four of these services would indicate that the number of recovery support services is expanding. 

Based on data available at this time, the 2015 target of 39 percent of treatment facilities offering at least 

four of the standard spectrum of recovery services was achieved, with 41 percent of facilities offering 

this spectrum of services. 

Objective 4 ‐ Criminal Justice Reform: Making the System More Effective and 

Fair

At the end of 2014, about 6.85 million people were under some form of adult correctional supervision

(Kaeble, D. et al, 2014.) Various studies have examined the prevalence of illicit drug use and drug use
28

disorder among thisspecial population. According to the most recent information available, 45 percent

of Federal prisoners met the criteria for substance use disorder (Mumola et al 2004). Nearly three‐

quarters of state prison inmates are in need of some substance use intervention with over 31 percent

of men in prison and over 52 percent of female inmates requiring intensive treatment services,

including residential treatment programming (Belenko et al 2005). However, only 25 percent of male

ex‐offenders returning to the community from prison and 14 percent of women ex‐ offenders

returning to the community from prison report participating in a formal drug or alcohol treatment

program while incarcerated (Belenko et al, 2005). A 2004 survey showed that 40 percent of State

and 49 percent of Federal inmates took part in some kind of drug program, which, for the most part 

were self‐help or peer counseling groups; only 15 percent of State prisoners and 17 percent of Federal

prisoners took part in drug treatment programs with a trained professional (Mumola et al, 2004).

Over the past few years, the Obama Administration has sought to reform the criminal justice system

to more effectively address substance use disorders and reduce recidivism. When individuals

become involved with the criminal justice system, it may be their first opportunity to obtain substance

use disorder treatment. Placing non‐violent individuals with substance use disorders on community

supervision—and providing treatment and other services—has gained wide acceptance among

policymakers, academics, and practitioners. However, more can be done to incorporate appropriate

supervision and services throughout the criminal justice system continuum. In addition, providing

evidence‐based treatment and wrap‐around services to young people who have had contact with law

enforcement or the justice system could prevent them from spiraling further into the system and

reduce intergenerational substance use disorders.

Table 2-4: Objective 4 Measures, Baselines, Progress-to-date, Targets, and Assessment

See Appendix C for information about data sources

Assessment of Progress

The following sections discuss the data sources, targets, progress made to date, and if future action is 

required to achieve each of the measures comprising Objective 4: Criminal Justice Reform: Making the 

System More Effective and Fair.

Measure 4.1: Percent of residential facilities in the juvenile justice system offering treatment

for substance use disorders

This measure focuses on treatment available to youth in the juvenile justice system and the

Objective 4 Measure Assessment

2014: 43.4%

(2008) 2012: 45.3%

2010: 40.5%

2013: 47.5%

2012: 47.7%

2011: 47.5%

2010: 47.9%

2009: 49.6%

2008: 48.4%

(2007)

TEDS-D

Target Met or Exceeded 

JRFC

48.8% 51.0%

38.8% 42.7%

Measure 4.2: Percent of treatment No Progress to Date

plans completed by those referred by 

the Criminal Justice System

Baseline Progressto-date 2015 Target

Measure 4.1: Percent of residential 

facilities in the Juvenile Justice System 

offering substance abuse treatment
29

importance of breaking the cycle of drugs and crime in this population at an early stage. The data are

provided by the Office of Juvenile Justice and Delinquency Prevention’s Juvenile Residential Facility

Census (JRFC). The JRFC reports biennially on a variety of information on facility operations and

services, including substance use disorder treatment.

For the initial PRS design report, the baseline was established based on the percentage of residential

juvenile facilities that offered treatment for substance use disorder services in 2006, the most recent

year for which data from the JRFC were then available. In the 2014 PRS report, the data were corrected

from reporting on the number of juvenile facilities that provided substance use “screening” to the

number of juvenile facilities that provided “treatment” for substance use disorders. As a result, the

baseline was recalculated to reflect the rate of juvenile facilities that provided treatment for substance 

use disorders. The revised value for 2006 is 40.4 percent. With 2008 data available, the baseline year

was revised to 2008 with a value of 38.8 percent. With the same degree of change--an increase of 5

percent, as reported in the PRS design report--the 2015 target also was revised, to 42.7 percent.

The target for this measure has been exceeded. In 2014, the data showed that 803 out of 1 , 852

(43.4%) juvenile facilities reported providing treatment for a substance use disorder. Of the facilities

in the juvenile justice system offering treatment for substance use disorders, 40.2 percent were public

residential facilities and 47.2 percent were private facilities providing substance use disorder services,

either on‐site or off‐site. While this measure exceeds the 42.7 percent target for 2015, there has been a

reduction from the total number of facilities from 2,450 in 2008 to 1,852 in 2014, and a reduction in

the number of facilities providing treatment services from 950 in 2008 to 803 in 2014. A complete

breakout of past availability of facilities providing treatment for substance use disorders by facility

type can be found in Table 2‐5 below.

Table 2-5: Office of Juvenile Justice and Delinquency 

Prevention's

Juvenile Residential Facility Census (JRFC)

Availability of substance use 

disorder treatment

JRFC JRFC JRFC JRFC JRFC JRFC JRFC JRFC

2000 2002 2004 2006 2008 2010 2012 2014

Total number of reporting 

facilities 3,047 2,955 2,799 2,649 2,450 2,111 1,985 1,852

N facilities providing

treatment 1,147 1,252 1,149 1,071 950 854 900 803

% of total 37.6% 42.4% 41.1% 40.4% 38.8% 40.5% 45.3% 43.4%

Availability of substance use disorder treatment by facility operation

Facility operation 2000 2002 2004 2006 2008 2010 2012 2014

Public

Total facilities 1,200 1,182 1,187 1,166 1,150 1,074 1,007 1,008

% providing service 40.7% 45.3% 42.7% 45.4% 42.3% 42.5% 44.0% 40.2%

Private

Total facilities 1,847 1,773 1,612 1,483 1,300 1,037 978 844

% providing service 35.7% 40.4% 39.8% 36.5% 35.6% 38.4% 46.7% 47.2%
30

Measure 4.2: Percent of treatment plans completed by those referred by the criminal justice

system11

Research indicates that increased completion of treatment plans is correlated with improved treatment 

outcomes and is also a predictor of reduced drug use (Gerstein and Harwood, 1999). This measure is 

a proxy, as there are no nationwide data on the outcomes of treatment effectiveness in the criminal 

justice population. SAMHSA’s TEDS‐D data set covers areas such as treatment completion,

12 length 

of stay in treatment, substance use disorder characteristics, and client demographics. Based on the data 

available at this time, progress is stalled and accelerated progress is required to meet the target of 51 

percent for 2015. According to the latest 2013 TEDS‐D, the data showed that 47.5 percent (251,777 

of 530,374) of those who entered treatment from criminal justice referrals completed their drug use 

treatment plans.

Objective 5 ‐ Disrupt Domestic Drug Trafficking and Production

The Strategy focuses on disrupting domestic drug trafficking and production within the United States 

through the implementation of a range of counterdrug efforts. The measures listed in Table 2‐6 below 

collectively assess the progress for Chapter 5 of the Strategy toward limiting the availability of illicit drugs 

by targeting the organizations that produce and distribute them.

The output measures for this objective are related to increasing the number of Drug Trafficking 

Organizations (DTOs) disrupted or dismantled, and decreasing the number of methamphetamine lab 

incidents. The number of DTOs reported are further delineated by their criminal associations, or 

“linkages” to Consolidated Priority Organization Targets (CPOTs) or Regional Priority Organization 

Targets (RPOTs). 

CPOT designation identifies heads of drug or money laundering organizations, clandestine 

manufacturers or producers, and major transporters and distributors – all of whom play significant 

roles in the supply of illicit drugs to the United States. RPOTs are those individuals, organizations, and 

facilitators, whose drug trafficking and/or money laundering activities have a significant impact in the 

nine designated Organized Crime Drug Enforcement Task Forces (OCDETF) regions13 as determined 

by the U.S. Department of Justice (DOJ) and its partner agencies. Reduction of methamphetamine labs 

is used as a positive outcome for law enforcement, since seizure rates are assumed to be fairly constant; 

therefore, fewer lab seizure incidents suggest reductions in methamphetamine lab activity.

 

11 TEDS-D defines “criminal justice referral” as a referral by any police official, judge, prosecutor, probation officer, or other person

affiliated with a Federal, State, or county judicial system. This includes referral by a court for DWI/DUI, clients referred in lieu of or

for deferred prosecution, or during pretrial release, or before or after official adjudication. 

12 “Treatment Completed” is defined as “All parts of the treatment plan or program were completed.”

13 The nine OCDETF regions are the Florida Caribbean, Great Lakes, Mid‐Atlantic, New England, New York/New Jersey, Pacific,

Southeast, Southwest, and West Central.
31

Table 2-6: Objective 5 Measures, Baselines, Progress-to-date, Targets, and Assessment

See Appendix C for information about data sources

Assessment of Progress

The following sections discuss the data sources, targets, progress made to date, and if future action is 

required to achieve each of the measures comprising Objective 5: Disrupt Domestic Drug Trafficking 

and Production.

Measure 5.1: Number of Domestic CPOT‐linked Organizations Disrupted or Dismantled

U.S. law enforcement agencies and their partners focus on the CPOT list with the intent of having the 

greatest effect in disrupting drug production and trafficking. The data source used for this measure is 

the Priority Target Activity and Resource Reporting System (PTARRS) maintained by DEA. PTARRS 

is used to capture and report domestic and international CPOT‐linked Priority Target Organizations 

(PTO) investigative activities and dispositions (disruptions and dismantlements, including disrupted 

pending dismantlement). In 2009, 296 domestic CPOT‐linked organizations were disrupted or 

dismantled. In FY 2012, FY 2013, FY 2014, and FY 2015 PTARRS reported 455, 475, 550, and 491 

domestic CPOT-linked disruptions and dismantlements, respectively. The fluctuations in the data from 

2009 through 2015 reflect the natural and temporal variabilities that occur when reporting investigative 

or enforcement-based data. The target for this measure (380 disruptions or dismantlements) was 

exceeded.

Measure 5.2: Number of RPOT‐linked Organizations Disrupted or Dismantled

Similar to CPOT‐linked organizations, RPOTs are drug trafficking organizations that are primarily 

responsible for a specific region’s drug threat. The RPOT list enables a coordinated regional focus for 

Federal, state, local, and tribal law enforcement efforts.

The primary data source for the number of RPOT‐linked organizations disrupted or dismantled is the 

OCDETF database to which OCDETF regions report data concerning disruptions or dismantlements. 

Objective 5 Measure Assessment

2015: 491

2014: 550

2013: 475

2012: 455

2011: 488

2010: 429

2015: 162

2014: 153

2013: 170

2012: 156

2011: 164

2010: 116

2015: 7,635

2014: 9,384

2013: 12,057

2012: 13,442

2011: 13,423

2010: 15,217

(2009)

NSS

Target Met or Exceeded 

Target Met or Exceeded 

Target Met or Exceeded 

Measure 5.3 Number of 

methamphetamine lab incidents

12,858

(2009)

OCDETF MIS

Measure 5.2: Number of RPOT-linked 

organizations disrupted or dismantled

119 156

Baseline Progressto-date 2015 Target

Measure 5.1: Number of domestic 

CPOT-linked organizations disrupted 

or dismantled

296 

(2009)

PTARRS (DEA)

380

9,639
32

The number of RPOT‐linked organizations that law enforcement identifies fluctuates each year, greatly 

influencing the number of disruptions and dismantlements. The 2009 baseline for this measure is 119 

and the 2015 target is 156. 

The most recent data show that the target was exceeded, ending the fiscal year with 162 RPOT 

disruptions and dismantlements. OCDETF will continue to focus available resources on only the 

highest level organizations engaged in regional, national, or international organized activities related to 

the importation, manufacture, distribution, crop cultivation, diversion, sale, financial support, and/or 

money laundering associated with the illicit trafficking of any illegal drug or narcotic substance; 

including pharmaceuticals trafficking and the diversion, purchase, and use of precursor chemicals.

Measure 5.3: Methamphetamine Laboratory Activity

An actual measure of methamphetamine laboratory activity is unknown. A proxy measure for this

activity is the number of methamphetamine lab seizure incidents.

14 The underlying logic for this proxy 

measure it that as laboratory activity increases, more are seized; as laboratory activity decreases, the 

number of them seized decreases (assuming law enforcement resources and priorities are stable). This 

measure assesses progress in reducing domestic methamphetamine lab seizure activity and associated 

consequences, such as methamphetamine laboratory and dumpsite clean‐up costs. Methamphetamine 

laboratory seizure incident data are compiled by the National Seizure System (NSS), an intelligence 

database maintained by the El Paso Intelligence Center (EPIC).

Since this measure was established a number of activities have occurred that may have affected the 

laboratory seizure trends. In 2005, with the enactment of the Combat Methamphetamine Epidemic 

Act, precursor chemicals for domestic labs were restricted and the number of methamphetamine 

laboratory seizures declined dramatically. In 2007, Mexico banned the primary precursor chemicals 

used in the illicit manufacture of methamphetamine: pseudo ephedrine and ephedrine. This altered the 

amount and quality of Mexican-produced methamphetamine sent to U.S. markets. Federal funding for 

methamphetamine laboratory clean-up ended in early 2011, but was restored later that year. There also

was an adjustment to the accounting of domestic methamphetamine laboratory seizure incidents. Prior 

to 2011 two Federal data systems tracked methamphetamine laboratory seizure incidents. The 

Hazardous Waste Disposal System (HWDS), which accounted for Federal funding to 

methamphetamine clean‐ups, was maintained by DEA. The NSS, collected detailed methamphetamine 

laboratory seizure reporting from each state. In 2011, the HWDS non-duplicative incidents were 

integrated into the NSS for all previous years. Subsequent methamphetamine laboratory clean‐up 

incident reporting was tabulated in the NSS to avoid future NSS under‐reporting. Since the initial PRS 

report, the number of methamphetamine laboratory incidents, as tabulated by the NSS, increased for 

all years when data from the HWDS was integrated into the existing NSS. As states and localities 

continue to provide updated data to NSS, the laboratory seizure incident data also are updated. The 

data in this report reflect updated data.

Figure 2‐4 compares the number of methamphetamine lab seizure incidents before and after the 

adjustment. Taking the updated NSS data, the 2009 baseline has been revised to 12,858. Since 2010, 

there has been an overall downward trend from 15,217 to 7,635 in 2015. The 2015 target of 9,639 

 14 Lab seizure incidents can be categorized as: 1) pre-labs (equipment and glassware seized), operating labs, 2) active labs, or 

3) post-operation labs (dumpsites). Various state reporting may define each of these categories differently, therefore, for this 

report a sum of all three types is used as the measure of activity and are called methamphetamine lab seizure incidents”. 
33

represents a revised target identified in the 2015 PRS report.

Figure 2‐4: Number of Methamphetamine Lab Seizure Incidents

While progress has been made on the part of U.S. law enforcement in reducing the number of 

domestic methamphetamine laboratories, other factors likely have contributed to this decrease. Since 

2010, other data on methamphetamine indicates that the quality and quantity of methamphetamine

from Mexican production has been increasing. Methamphetamine seizures at the Southwest border 

have increased 215 percent from 2010 to 2015, indicative of increased flow of the drug into the United 

States (DOJ 2016a; DOJ 2016b). Purity also rose from 83 percent to 93 percent over the same period

(DOJ 2015). Drug overdoses involving psychostimulants (which are primarily due to 

methamphetamine) increased 132 percent from 2010 to 2014. In addition, restrictions of precursor 

chemicals in the United States contributed to reduced domestic production (DOJ 2016a). The target 

of 9,639 was met. 

Objective 6 ‐ Strengthen Law Enforcement and International Partnerships to

Reduce the Availability of Foreign Produced Drugs in the United States

Partnering with foreign nations to disrupt and dismantle violent criminal enterprises that traffic illicit

drugs into the United States is key to reducing the supply of drugs and promoting the rule of law.

There is global recognition that addressing the use, production, and trafficking of drugs is a shared

responsibility among all nations. In the Strategy, strengthening international partnerships is an

instrumental part of helping to reduce the production and trafficking of drugs smuggled into the 

United States.

This objective focuses on a range of international drug control efforts supported by U.S. Federal

agencies. This includes initiatives to curb the amount of drugs that enter the United States by

developing criminal cases, capturing major kingpins, and seizing drugs and the illicit proceeds from

their sale. The emphasis on supporting drug transit and producing countries in their supply reduction

efforts is intended to substantially reduce the flow of foreign-produced drugs into the United States.
34

There also is a focus on building institutional capability, supporting economic alternatives to drug

production, and promoting collaborative efforts in prevention, treatment, and research, thereby

assisting global partners in acquiring the capabilities to overcome the consequences of drug use.

The effort assists host nations in building their capacity to addressthe full range of drug threatsthey

face. For measures 6.1 and 6.2, the progress ofselected countriesis presented in aggregate and does not

compare countries’ effortsin curbing drug supply or demand. This objective’s measures listed in Table

2‐7 below collectively assess the progress in strengthening international partnerships and reducing the

availability of foreign‐produced drugs in the United States.

Table 2-7: Objective 6 Measures, Baselines, Progress-to-date, Targets, and Assessment

See Appendix C for information about data sources.

Assessment of Progress

The following discusses the data sources, targets, progress made to date, and if future action is 

required to achieve each of the measures comprising Objective 6: Strengthen Domestic Law 

Enforcement and International Partnerships to Reduce the Availability of Foreign Produced Drugs 

in the United States.

Measure 6.1: Percent of selected countries on the Majors list that increased their

commitment to supply reduction

An assessment of a particular country’s commitment to addressing its unique supply reduction

challenges is based on the data available from that country and includes information on budget,

programs, and policies. Supply reduction efforts include financial resources dedicated to drug crop

eradication, drug interdiction, judicial and law enforcement programs and institutional

strengthening focused on drug trafficking. The countries selected for assessment during the PRS

design process were Afghanistan, Bolivia, Colombia, Guatemala, Mexico, Pakistan, Peru and the

Objective 6 Measure Assessment

100% (progress to

 date)

100% (progress to

 date)

 2015: 0.0%

 2014: 43.0%

2015: 78

2014: 72

2013: 77

2012: 69

2011: 51

2010: 66

** The available data varies among countries; countries selected for this measure are: Afghanistan, Burma, Laos, Mexico, Bolivia, Colombia, and Peru.

*The countries selected for this measure are: Afghanistan, Mexico, Colombia and Peru.

State Dept

Target Met or Exceeded 

State Dept

Measure 6.2: Percent of selected 

countries on the Majors List* that 

increased their commitment to 

demand reduction

2009 100%

Measure 6.1: Percent of selected 

countries on the Majors List* that 

increased their commitment to supply 

reduction

2009 100%

Target Met or Exceeded 

ONDCP

Measure 6.4: Number of international 

CPOT-linked organizations disrupted 

or dismantled

65 60

Measure 6.3: Percent of Majors List 

countries** showing progress since 

2009 in reducing either cultivation or 

drug production potential

2009 100% Target Not Met 

Target Met or Exceeded 

(2009)

PTARRS

Baseline Progressto-date 2015 Target
35

Dominican Republic. ONDCP and the State Department decided that a pilot project was needed 

to determine whether it was feasible to obtain the required information. The results of the 

pilot indicated that data for Bolivia, Guatemala, Pakistan and the Dominican Republic were more

challenging to collect on a systematic and yearly basis at this time. The State Department has been

able to systematically collect data from Afghanistan, Mexico, Colombia and Peru. These countries

are central to collaboration with the United States in reducing the supply of illicit drugs and are 

therefore used for the purposes of this report.

The political will to sustain counternarcotics efforts with host nation resources has continued, and the 

target for this measure has been met. The selected countries’ commitment to supply reduction have 

all increased since 2009. The progress for each country is described separately below:

Afghanistan’s Ministry of Counternarcotics (MCN) has increased its capacity to plan and implement 

counternarcotic efforts. Afghan President Ashraf Ghani approved a National Drug Action Plan 

(NDAP) in October 2015 that outlines Afghanistan’s strategy to pursue a balanced, comprehensive, 

coordinated, and sustainable approach to combat illegal drug production, trade, and usage over the 

next four years. The NDAP highlights the actions necessary to counter the cultivation, production, 

trafficking, and use of narcotics; the timeframe, goals, and metrics to evaluate progress on the plan; the 

role the Afghan MCN and other ministries will play in executing the plan; and the ways in which the 

international community can support the plan. Furthermore, under the Ministry of Interior, the U.S.‐

mentored Afghan counternarcotics police‐vetted units have successfully initiated, planned, 

coordinated, and executed – without any significant non‐Afghan tactical support – multiple large‐scale 

interdiction operations.

Colombia’s budget from 2009 to 2015 shows significant increases in the drug policy programs of the 

Justice and Interior Ministries and in its Defense spending for supply reduction. The combined total 

of Justice and Interior Ministry spending on drug policy was $2.7 million in 2009 and increased to $6.9 

million in 2015. The Defense budget for drug policy programs was $12.5 million in 2009 and $213.6 

million in 2015. Colombia also has taken fiscal responsibility for the helicopter safety program and 

absorbed the direct cost of the herbicide used in aerial eradication operations, which came to an end 

on October 1, 2015. On January 20, 2014, President Juan Manuel Santos signed a comprehensive 

Asset Forfeiture law (no. 1708) to counter money laundering. Colombia and the United States also 

signed November 21, 2016, a forfeited asset sharing agreement to facilitate the sharing of assets seized 

during criminal investigations in the two countries. Colombia also has increased its commitment to 

state presence in and around coca-growing areas through increases in membership of its Public 

Security Forces, from 429,793 in 2009 to 451,000 in 2015. Colombia also assumed greater 

responsibility for drug interdiction in the region by taking over control of the Air Bridge Denial 

program.

Mexico’s budget from 2009 to 2016 shows a steady increase in funding for drug supply reduction and

security efforts, from $8.0 billion in 2009 to over $9.4 billion in 2016 (U.S. Department of State,

2014a). Funding is used to combat organized crime, expand crime prevention programs, improve

interagency coordination, consolidate police forces, support justice reforms, and encourage citizen

participation in crime control.

Peru’s budget from 2009 to 2015 shows an increase in overall drug supply reduction spending from 

$42.5 million in 2009 to $167.7 million in 2015. Included in the total budget is the drug supply 
36

reduction funding for the National Commission for Development and Life without Drugs 

(DEVIDA), the Public Ministry, Ministry of Defense, Judicial Power, and Ministry of Interior 

Effective Management Program for Drug Supply Control. In 2012, Peru adopted and began 

proactively implementing its billion‐dollar, five‐year counternarcotics strategy. The Peruvian 

counternarcotics strategy is comprehensive – including eradication, interdiction, alternative 

development, precursor controls, and combating money laundering. In 2015, Peru eradicated a record 

high of 35,868 hectares (ha) of coca and the target for 2016 is 30,000 ha. In 2014, DEVIDA, with 

USAID support, created more than 18,000 new jobs and assisted over 31,000 families on over 43,000 

ha of alternative crops, 20,000 ha of which were newly planted. Projected spending for the National 

counter-narcotics strategy decreased from $91.6 million to $70.9 million in 2016.

Measure 6.2: Percent of selected countries that increased their commitment to demand 

reduction efforts

The countries for this measure were selected in the same manner as those for Measure 6.1 to

explore options to refine the data collection process. Budgets and actions taken for demand reduction

efforts conducted by Afghanistan, Mexico, Colombia, and Peru were examined. The political will to

sustain counternarcotics efforts with host nation resources has continued, and the target for this 

measure has been met. The selected countries’ demand reduction budgets and activities have all

increased since 2009. The progress for each country is described below:

Afghanistan has expanded the number of treatment programs, with U.S. support, from zero to over 

100 since 2007, including inpatient, outpatient, home‐based and village‐based programs, as well as 

services tailored specifically to meet the needs of women and children within the Afghan cultural 

context. The Ministry of Public Health independently manages over 30 programs and is working with 

the State Department to implement a transition program to take increasing leadership and 

responsibility for treatment programs within the country. The United States is encouraged by seniorlevel Afghan government support for a public health approach to drug demand reduction. 

Colombia, as a result of overall decreases to its budget due to a decrease in oil prices, reduced its 

spending on demand reduction and prevention in 2015. Funding was $6 million in FY 2009 and $7.2 

million in FY 2013 (the latest year for which budget data are available). However, the government 

also announced a new anti-narcotics strategy in 2015, which declared prevention and treatment to be 

two key pillars of the national response. This change in policy has led to an unprecedented level of 

cooperation between the Ministries of Health and Justice who are now focused on working together

to expand the availability of evidence-based prevention campaigns and treatment programs. 

Mexico’s 2012 budget for Demand Reduction was $84 million, increasing to $95.8 million in 2013, 

and $103.8 million in 2014; this is a significant increase from the $29.2 million funded in 2009 (U.S. 

Department of State, 2014a). The U.S.‐Mexico Drug Abuse Prevention Research Fellowship reflects 

Mexico’s support of demand reduction programs. The program provides 12 months of postdoctoral 

training in the United States for a Mexican citizen or permanent resident. In addition to conducting 

mentored prevention research, fellows participate in professional development activities and learn 

about the U.S. National Institutes of Health (NIH) grant application process. Through this fellowship, 

participants are gaining essential networking contacts and are increasing their professional 

development, which has resulted in published articles in professional medical journals and an increase 

in research funding through grants. Through another NIDA international fellowship and NIDA and 
37

State Department grants, Mexico established a university‐community treatment provider network 

based on the NIDA Clinical Trials Network to conduct treatment clinical trials, and completed the 

first study, Motivational Enhancement Treatment to Improve Treatment Engagement and Outcome 

for Spanish‐Speaking Individuals Seeking Treatment for Substance Use Disorders. Mexico also has 

hosted Demand Reduction conferences focused on research. From 2009 to 2014, NIDA awarded 20 

grants for various projects – most of which were focused on drug‐related HIV – to U.S. principal 

investigators working with partners in Mexico.

Peru’s allocation of funds from 2009 to 2015 shows an increase in its overall demand reduction 

budget from nearly $1 million in 2009 to $11 million in 2016. Included in the total budget is drug 

prevention and treatment funding for DEVIDA, Peru’s Counternarcotics strategy for prevention, 

treatment, and rehabilitation, as well as for the Ministry of Women, Judicial Power, The National 

Penitentiary Institute, Ministry of Education, and Peru’s Health Services Institute. NIDA continues 

to support domestic grants to U.S. principal investigators working with partners in Peru on HIV 

Testing and Treatment to Prevent Onward HIV Transmission among high‐risk men. In January 2014, 

NIDA and the Peruvian Instituto Nacional de Salud signed a bi‐national agreement to facilitate 

scientific exchange activities focused on collaborative drug use research. NIDA and NIH’s Fogarty 

International Center approved the use of funds from a training grant to a U.S. principal investigator 

working with colleagues in Peru to support a workshop for researchers on drug use issues from 

Andean States in conjunction with the 2014 NIDA International Forum, held June 13‐16, 2014 in 

Puerto Rico.

Measure 6.3: Percent of Majors List countries showing progress in reducing either cultivation

or drug production potential

Reducing the cultivation or drug production potential of selected countries represents success in the

international effort to reduce the flow of illicit drugs. The countries selected to track this measure are

Afghanistan, Burma, Laos, Mexico, Bolivia, Colombia, and Peru. For these countries, the cultivation or

production of opium poppy, heroin, coca, and marijuana were estimated using either U.S. data

(ONDCP 2015; for Afghanistan, Mexico, Bolivia, Colombia, and Peru) or data from UNODC (2014; 

Burma and Laos) to determine an improvement in reducing either cultivation or production since

2009. As in previous measures, countries are not compared to one another.

The target calls for 100 percent of the selected countries showing progress by 2015 in reducing drug

cultivation or production from their individual baseline figures in 2009. The target for this measure 

has not been met. Accelerated progress is needed for all the countries to meet the 100 percent target. 

The progress of each country is described below:

Afghanistan experienced an increase in poppy cultivation and a concomitant increase in potential

opium production. Poppy cultivation totaled 131,000 ha in 2009 and increased to an estimated

201,000 ha in 2015. Potential opium production remained relatively stable; it was 4,300 metric tons in

2009 and 4,100 metric tons in 2015, largely because of poor growing conditions in 2015.

Bolivia saw several years of relatively stable coca cultivation and potential pure cocaine production from 

2009-2013, but experienced a rise in both areas in 2014 and 2015. Coca cultivation totaled 29,000 ha

in 2009 and increased to 36,500 ha in 2015. According to the most current estimates, production 
38

potential for pure cocaine increased from 150 metric tons in 2009 to 230 metric tons in 2015.

Burma experienced a significant increase in poppy cultivation and opium production. Due to poor

weather conditions that stunted cultivation in 2009, 2010 was chosen for the baseline. Poppy

cultivation increased from 45,500 ha in 2010 to 52,000 ha in 2014. Potential opium production also 

rose from 530 metric tons in 2010 to 900 metric tons in 2014. Potential heroin production was 29 

metric tons in 2009 and 85 metric tons in 2014.

Colombia, after a notable decline in coca cultivation and potential cocaine production between 2009 

and 2013, experienced a resurgence of coca cultivation and potential production starting in 2014. Coca 

cultivation totaled 116,000 ha in 2009 and rebounded to 159,000 ha in 2015. Potential pure cocaine 

production increased from 265 metric tons in 2009 to 420 metric tons in 2015.

Laos experienced substantial increases in the production and cultivation of poppy. Poppy cultivation

estimates increased from 2009 to 2014, with nearly 940 ha grown in the region of Phongsaly in

2009 to 6,200 ha grown in three primary growing areas in 2014. Potential opium production for

Phongsaly totaled 11.5 metric tons in 2009 and the primary growing areas surveyed in 2014 (Bokeo,

Houaphan, Louang Namtha, Louangphraband, Oudomxai, Phongsaly, Xiangkhoang, and

Xaignabouri) potentially produced 92 metric tons of opium.15

Mexico experienced an increase in opium poppy cultivation and relatively stable marijuana

cultivation. Poppy cultivation areas totaled 10,500 ha in 2012 and increased to 28,000 ha in 2015,

while marijuana totaled 11,500 ha in 2012 and 11,000 ha in 2014, the most recent year for which data 

are available. A change in the estimation methodology for opium poppy cultivation in 2011

precludes a direct comparison with prior cultivation estimates. Potential pure heroin production 

was 70 metric tons of pure in 2015. There is no marijuana production estimate due to a lack of yield

data for Mexico.

Peru experienced an increase in coca cultivation and potential cocaine production from 2009 to 2015.

Coca cultivation increased from 40,000 ha in 2009 to 53,000 ha in 2015. Potential pure cocaine

production increased from 195 metric tons of cocaine in 2009 to 345metric tons in 2015.

Measure 6.4: Number of CPOT‐linked international organizations disrupted or dismantled

DOJ’s CPOT list represents the most significant international drug trafficking and money laundering 

organizations primarily responsible for the Nation’s drug supply. Disrupting and dismantling CPOTlinked international organizations is thought to have had an impact on the Nation’s illicit drug supply 

and the flow of foreign-produced drugs into the United States on efforts to Combat Transnational 

Organized Crime. 

Internationally, the State Department works closely with DOJ, including DEA, and the Department 

of Homeland Security in disrupting and dismantling foreign CPOT-linked organizations. The data

source for this measure is DOJ’s PTARRS, which captures domestic and international CPOT-linked 

disruptions and dismantlements, including disrupted pending dismantlement, from Federal law 

enforcement. 

 15 The United Nations Office of Drugs and Crime conducted the estimates for Laos. The United States Government conducted all 

other estimates cited in this report. 
39

In FY 2009, PTARRS recorded that 65 international CPOT-linked organizations were disrupted or

dismantled. In FY 2012, FY 2013, FY 2014, and FY 2015, DEA reported 69, 77, 72, and 78 CPOTlinked disruptions and dismantlements, respectively. The fluctuations from 2009 through 2015 reflect 

the natural and temporal fluctuations that occur when reporting investigative or enforcement-based

data. The target of 60 for this measure was exceeded.

Objective 7‐ Improve Information Systems for Analysis, Assessment, and Local

Management

Using data for evidence‐based decision making is the cornerstone of a strategic approach to both 

supply and demand reduction efforts. A range of data is available to inform policy and decision 

making, including national level information on drug use and health behaviors, the criminal justice 

population, the economics of the drug trade and drug use, and the supply of illicit drugs.

Table 2‐8 below outlines the measures, baselines, progress‐to‐date, targets, and assessments for this 

Objective. The measures assess three general performance criteria: (1) timeliness of data release, (2) 

utilization of data, and (3) expansion of the use of feedback mechanisms for data consumers.

Assessment of Measures

The following sections discuss the data sources, targets, progress made to date, and if future action is 

required to achieve each of the measures comprising Objective 7: Improve Information Systems for 

Analysis, Assessments, and Local Management.

Table 2-8: Objective 7 Measures, Baselines, Progress-to-date, Targets, and Assessment

See Appendix C for information about data sources

Objective 7 Measure Assessment

2012: 17.5 15.8

2011: 23.5

2010: 19.5

2014 565,670

2012 356,782

year

2014 113

2012: 148

1

Treatment Episode Data Set (TEDS)a 17.5

Target Met or Exceeded 

per year per year

Measure 7.3: Increase Federal data sets that establish feedback mechanisms to measure usefulness (surveys, focus groups, etc.)

SAMHSA Funded Data Sets 0 1 (progress to 

date)

National Survey on Drug Use and 

Health (NSDUH) (Journal articles 

referencing NSDUH)

37 41

Target Met or Exceeded 

Target Met or Exceeded 

Progress Sufficient to Meet 

Target 

web hits/year web hits/

Measure 7.2: Increase the utilization (number of annual web hits, or number of documents referencing the source) of select Federal data 

sets by 10% from the baseline

Substance Abuse and Mental Health 

Data Archive (SAMHDA)

200,000 220,000

Months Months

(TEDS-A)

Baseline Progressto-date 2015 Target

Measure 7.1: Increase timeliness (year-end to date-of-release) of select Federal data sets above their baseline by 10% 
40

Measure 7.1: Increase timeliness (year‐end to date‐of‐release) of select Federal data sets above 

their baseline by 10%

By improving timeliness and reducing lag times between an event and reporting on it, policy

makers can more quickly address new and emerging threats. The more quickly data are published

post‐collection and available for review, the more actionable and relevant they become. The

Treatment Episode Data Set Admissions (TEDS‐A) was identified as an important data source and

good candidate for reducing lag times between collection and reporting. Two TEDS‐A reports are

published each year. Through calendar year (CY) 2007, the first report presented highlights, and the

second one was the final full report. From CY2008 forward, the first report presented national

measures, and the second report provided information on state measures. For 2012, the baseline for

release of TEDS data from the completion of data collection to release is 17.5 months, with a target

of 15.8 months. Given the data available at this time, there is a reasonable expectation the target will 

be met.

Measure 7.2: Increase the utilization (number of annual web hits, or number of documents

referencing the source) of select Federal data sets by 10% from the baseline

The rate of utilization of Federal data sets is a clear indication of the relevance, utility, and importance

of the data that are being reported. Improved data sets can better inform policy and program 

development and management. The PRS focuses on citations to the NSDUH, the Federal 

government’s primary data system for monitoring drug use and related behaviors. Two key sources of 

data for this measure are information from SAMHSA regarding journal articles referencing NSDUH 

and the Substance Abuse and Mental Health Data Archive (SAMHDA) which houses the NSDUH,

the Behavioral Health Services Information Systems (TEDS‐A and TEDS‐D, the N‐SSATS, and the 

National Mental Health Services Survey), and the DAWN data. SAMHDA promotes the access and

use of the Nation’s preeminent substance use disorder and mental health research data by assuring 

accurate public use data files and documentation. Reports that use NSDUH and other relevant data 

supported through SAMHSA are accessed through SAMHSA’s data page. The NSDUH is a key source 

of data on drug use in the United States. The baseline for SAMHDA web hits per year is based on

current SAMHSA information and sets a target of 220,000 web hits per year by 2015. In 2014, 

SAMHSA received 937,643 hits to its data page and 565,670 hits to the SAMHDA data site. The

baseline for NSDUH journal articles is based on current information and sets a 2015 target of 41 

journal articles/year referencing NSDUH data. SAMHSA identified 113 journal articles using NSDUH 

data published in 2014.16 Both data sets have exceeded their targets as of 2014.

Measure 7.3: Increase Federal data sets that establish feedback mechanisms to measure 

usefulness (surveys, focus groups, etc.)

A key approach to improving the usefulness of data for both Federal partners and the public is

receiving feedback from data users. This information can be helpful in enhancing websites, data 

formats, data reports, etc. Feedback mechanisms can also take a variety of forms, including online 

surveys, conferences, or contact information on agency websites. For this measure SAMHSA sought 

to hold a data users conference by 2015. The target was met for this measure. In August 2012, the

agency held its first Behavioral Health Data Users Conference. The Conference provided 

overviews of what types of data are available and trained attendees on how to access and analyze data.

 16 The most recent year for which data are available is 2014. Updated information will be available with completion of 

contract re-competition.
41

Beyond the measures discussed previously, the Strategy outlines a series of actions focused on sustaining 

and enhancing existing Federal data systems, developing and implementing new data systems and

analytical methods to address gaps, developing data on drug use and its consequences that are useful 

at the community level, and improving data on drugged driving. Progress has been made in all of these

areas.

The DAWN emergency department data system was discontinued at the end of 2011. Efforts are

underway to transition data collection from SAMHSA to the newly consolidated National Hospital Care

Survey by the National Center for Health Statistics. SAMHSA and NCHS are working together on a

range of issues such as, pretesting a revised data collection approach, recruiting the required

number of hospitals, conducting secondary sampling of emergency department visits, and identifying

potential data outcomes to address research questions. With growing public health concerns

surrounding the non‐medical use of prescription drugs, particular emphasis will be placed on this area.

For the NSDUH, a re‐design was implemented in 2015 to improve the quality of the data collected, 

expand the number of prescription drugs covered, and address changing substance use and mental 

health policy and research needs. As a result, a new baseline will be established for certain measures. 

The Behavioral Health Services Information System provides valuable information on treatment

facilities and client outcomes; work is ongoing to ensure the continuing viability of the system. 

Assessing the price and purity of illicit street drugs provides essential information for understanding 

the economics of the drug market. DEA is working to enhance its systems for managing and tracking 

forensic analyses.

Efforts have also been made to develop new data systems and analytical methods to address

knowledge gaps. This includes the transitioning of the Federal‐wide Drug Seizure System to the 

National Seizure System (NSS). Several agencies have also sought to enhance a range of data sources

that can inform a better understanding of global illicit drug markets and facilitate efforts to more

accurately, rapidly, and transparently estimate the cultivation and yield of marijuana, opium, and coca

around the world.

As drug use and its consequences vary considerably among localities, developing data that are useful 

at the community level will be helpful in both understanding local problems and identifying approaches

to mitigate the harm to public health and public safety. SAMHSA is currently working to develop a

community early warning and monitoring system to track substance use and problem indicators at the 

local level. Meanwhile, expanding understanding of patterns and risks associated with drugged driving 

will support better public safety efforts. ONDCP has partnered with NHTSA and NIDA to support 

driver simulator research to examine driving impairment as a result of marijuana and combined

marijuana and alcohol use and correlate these findings with the results of oral fluid testing to identify 

behavioral indicators of impairment. 
42

Appendix A: Abbreviations & Acronyms

ADAM Arrestee Drug Abuse Monitoring Program, U.S. Department of Justice

ATR Access to Recovery, Substance Abuse and Mental Health

Services Administration, Center for Substance Abuse Treatment,

U.S. Department of Health and Human Services

ATF Bureau of Alcohol, Tobacco, Firearms, and Explosives

BOP Bureau of Prisons

CBHSQ Center for Behavioral Health Statistics and Quality, Substance Abuse

and Mental Health Services Administration, U.S. Department of

Health and Human Services

CPOT The Consolidated Priority Organization Target (CPOT) List identifies

the most significant international drug trafficking and money

laundering organizations and those primarily responsible for the 

nation’s drug supply.

CPOT‐linked An organization is considered linked to a CPOT if credible evidence

exists (i.e., from corroborated confidential source information, phone

tolls, Title III intercepts, drug ledgers, financial records or other similar

investigative means) of a nexus between the primary investigative target

and a CPOT target, verified associate, or component of the CPOT

organization.

DAWN Drug Abuse Warning Network, U.S. Department of Health and

Human Services

DEA Drug Enforcement Administration, U.S. Department of Justice

DHS U.S. Department of Homeland Security

DOD U.S. Department of Defense

DOI U.S. Department of Interior

DOJ U.S. Department of Justice

DOL U.S. Department of Labor

DOS U.S. Department of State

DOT U.S. Department of Transportation

DUI/DWI Driving Under the Influence/Driving While Intoxicated
DTO Drug Trafficking Organization; complex organization with a highly

defined command‐and‐control structure that produces, transports,

and/or distributes large quantities of one or more illicit drugs.

EPIC El Paso Intelligence Center, U.S. Department of Justice

HHS U.S. Department of Health and Human Services

HRSA Health Resources and Services Administration, U.S. Department of

Health and Human Services

HWDS Hazardous Waste Disposal System

JRFC Office of Juvenile Justice and Delinquency Prevention’s Juvenile

Residential Facility Census, U.S. Department of Justice

MIS OCDETF’s Management Information System

MTF Monitoring the Future. This survey is conducted by researchers at the

University of Michigan's Institute for Social Research, funded by research

grants from the National Institute on Drug Abuse.

NIDA National Institute on Drug Abuse

NMHSS National Mental Health Services Survey

NSS National Seizure System

NSDUH National Household Survey on Drug Use and Health, Substance Abuse

and Mental Health Services Administration, U.S. Department of Health

and Human Services

N‐SSATS National Survey of Substance Abuse Treatment Services, Substance

Abuse and Mental Health Services Administration, U.S. Department of

Health and Human Services

OCDETF Organized Crime Drug Enforcement Task Forces, U.S. Department of

Justice

OJJDP Office of Juvenile Justice and Delinquency Prevention, U.S. Department

of Justice

ONDCP Office of National Drug Control Policy, Executive Office of the President

PTARRS DOJ’s Priority Target Activity and Resource Reporting System; reports

the majority of data concerning the number of CPOT‐linked

organizations collected by the Department of Justice’s Drug

Enforcement Administration (DEA) and the Organized Crime Drug

Enforcement Task Forces (OCDETF).

PTO Priority Target Organization
RPOT The Regional Priority Organization Target (RPOT) Lists identify those

significant regional drug trafficking and money laundering organizations that are 

primarily responsible for regional drug threats.

RPOT‐linked The RPOT Lists consist of those organizations having a significant impact on

the drug supply within the designated OCDETF Regions. OCDETF

participants apply the same standards for establishing a “link” to a RPOT as

they use to establish a credible link to a CPOT.

SAMHSA Substance Abuse and Mental Health Services Administration, U.S.

Department of Health and Human Services

SBIRT Screening, Brief Intervention, and Referral to Treatment, Substance Abuse and

Mental Health Services Administration, U.S. Department of Health and

Human Services

TEDS‐A Treatment Episode Data Set on Admissions, Substance Abuse and Mental

Health Services Administration, U.S. Department of Health and Human

Services

TEDS‐D Treatment Episode Data Set on Discharges, Substance Abuse and Mental

Health Services Administration, U.S. Department of Health and Human

Services

UDS Uniform Data System, Health Resources and Services Administration,

U.S. Department of Health and Human Services
Appendix B: Definitions and Performance Terms

Dismantlement Dismantlement occurs when the identified organization’s

leadership, financial base and drug supply network have

been destroyed to the extent that the organization is

incapable of operating and/or reconstituting itself.

Disruption A disruption occurs when the normal and effective operation

of the organization has been significantly impacted. Evidence 

of “disruption” may be seen in changes in price/purity of the

drug or changes in methods of operation; increases in fees

paid to couriers or transporters; movement of the

organization to a neighboring district; and/or a reduction in

availability of a drug on the streets, even if only temporarily.

A drug seizure, the execution of a search warrant or another

enforcement activity, by itself, does not constitute a

“disruption” unless the action truly results in the alteration of

the organization’s operations or membership.

Impact Target Impact of policies, programs, and initiatives.

Intermediate Outcome Result or event occurring from actions taken by entities

other than the agencies responsible for the joint outcome

and that are likely to lead to the achievement of desired

outcomes. These usually occur between outputs (services or

products delivered) and outcomes reflecting the purpose of

the policy or program.

Majors list Countries that are classified as major drug transit or drug

producing countries for the purpose of the Foreign

Assistance Act of 1961; Currently the following countries

meet the Act’s criteria for illicit drug production or transit:

Afghanistan, the Bahamas, Belize, Bolivia, Brazil, Burma,

Colombia, Costa Rica, the Dominican Republic, Ecuador, El

Salvador, Guatemala, Haiti, Honduras, India, Jamaica, Laos,

Mexico, Nicaragua, Nigeria, Pakistan, Panama, Paraguay,

Peru, and Venezuela.

Performance Measure Represents the specific characteristic or aspect of the

program (or policy) that is used to gauge performance. For

instance, a measure for “drug use” might be the percent of the 

population that used drugs in the past 30 days.
Performance Reporting Performance monitoring and assessment

System (PRS) mechanism for gauging the effectiveness of the Strategy.

Performance Target Desired level of performance to be achieved during a

specified fiscal year for that measure.

PRS Process Collaboration of drug control agencies to identify

performance outcome measures and targets, and an

interagency assessment of progress toward the Strategy’s

Objectives.

PRS Steering Committee Comprised of senior agency officials familiar with drug

control issues, policies, and programs. This Committee’s

primary roles are to advise the Director of ONDCP on the

design and implementation of the PRS, serve as primary

liaisons with their agencies, bring individual agency concerns

to the table for discussion, and to review the

recommendations of the PRS Working Groups.

PRS Working Groups Representatives from the Federal drug control agencies

whose purpose was to address the seven Objectives of the

Strategy; working groups included agency subject matter

experts, policy and program analysts, statisticians,

researchers, line managers, and other drug program or data

experts knowledgeable of drug control programs, policy, and

research. Representatives from the following Federal

agencies participated in the Working Group activities: the

Departments of Defense, Education, Health and Human

Services, Homeland Security, Interior, Justice, Labor,

Transportation, Treasury, State, Veterans Affairs, and the 

Small Business Administration.

Reporting Agency Agency responsible for ensuring that the data are

collected and reported to ONDCP. However, multiple

agencies contribute to achieving the Strategy’s Goals and

Objectives through programs, policies, etc.

SUDs Substance use disorders.

The Strategy—2010 National Guide for the nation in controlling the use and

Drug Control Strategy consequences of the illicit use of drugs.
Appendix C: Data Sources

Strategy Goal 1

NSDUH - Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in 

the United States: Results from the 2014 National Survey on Drug Use and Health (HHS

Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from 

http://www.samhsa.gov/data/

MTF - Monitoring the Future - Johnson, LD, O’Malley, PM, Meich, RA, Bachman, JG, & 

Schulkenberg, JE. (2016). Monitoring the Future national survey results on drug use, 1975-2015: 

Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, the 

University of Michigan

What America’s Users Spend on Illegal Drugs: 2000-2010. February 2014.

Strategy Goal 2

Drug Abuse Warning Network (DAWN). Substance Abuse and Mental Health Services

Administration. (2013). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related 

Emergency Department Visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39. 

SAMHSA, Rockville, MD.

National Roadside Survey. Berning, A, Compton, R, & Wochinger, K. (2015). 2013-2014 National 

Roadside Survey of Alcohol and Drug Use by Drivers: Research Safety Note, National Highway 

Safety Traffic Administration, Washington, DC.: DOT HS 812 118: Retrieved from: 

http://www.nhtsa.gov/Driving+Safety/Research+&+Evaluation/Impaired+driving+(drugrelated)+reports.

Centers for Disease Control and Prevention (CDC). HIV Surveillance Report‐Diagnoses of HIV 

Infection in the United States, 2013. Vol. 25 (February 2015)

Objective 1

NSDUH - Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in 

the United States: Results from the 2014 National Survey on Drug Use and Health (HHS 

Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from 

http://www.samhsa.gov/data/

Objective 2

NSDUH - Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in 

the United States: Results from the 2014 National Survey on Drug Use and Health (HHS 

Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from 

http://www.samhsa.gov/data/

UDS - Health Resources and Services Administration’s (HRSA) Uniform Data System. Information 

available at http://bphc.hrsa.gov/datareporting/.
Objective 3

TEDS-D - Substance Abuse and Mental Health Services Administration's (SAMHSA) Treatment 

Episode Data Set – Discharge. Information available at http://www.samhsa.gov/data/client-leveldata-teds.

UDS - Health Resources and Services Administration’s (HRSA) Uniform Data System. Information 

available at http://bphc.hrsa.gov/datareporting/. Information available at 

http://bphc.hrsa.gov/datareporting/.

N‐SSATS - Substance Abuse and Mental Health Services Administration's (SAMHSA) National 

Survey of Substance Abuse Treatment Services. Information available at 

http://www.samhsa.gov/data/substance-abuse-facilities-data-nssats.

Objective 4

JRFC – U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention’s

Juvenile Residential Facility Census (Biennial Census);

TEDS-D -- Substance Abuse and Mental Health Services Administration's (SAMHSA) Treatment

Episode Data Set – Discharge

Objective 5

PTARRS -- Priority Target Activity and Resource Reporting System maintained by U.S. Department 

of Justice, Drug Enforcement Administration

OCDETF MIS - Organized Crime and Drug Enforcement Task Forces Management Information 

System maintained by U.S. Department of Justice

NSS - National Seizure System maintained by El Paso Intelligence Center, U.S. Department of 

Justice

Objective 6

U.S Department of State special data collection

Office of National Drug Control Policy

PTARRS -- Priority Target Activity and Resource Reporting System maintained by U.S. Department 

of Justice, Drug Enforcement Administration

Objective 7

TEDS‐A -- Substance Abuse and Mental Health Services Administration's Treatment Episode

Data Set Admissions

SAMHDA -- Substance Abuse and Mental Health Services Administration's Substance Abuse 

and Mental Health Data Archive

NSDUH - Substance Abuse and Mental Health Services Administration National Survey on
Drug Use and Health (NSDUH) special data run on journal articles referencing NSDUH)

Substance Abuse and Mental Health Services Administration - conference generated

recommendations from users of SAMHSA’s data sets.
REFERENCES

Belenko, Steven et al., Estimating drug treatment needs among state prison inmates, Drug &

Alcohol Dependency, Volume 77, Issue 3, Mar. 2005, 269 – 281 pp.

Berino, K., Rosa, P., Skopec, L. & Glied, S. (2013). Affordable Care Act Will Expand Mental Health

and Substance Use Disorder Benefits and Parity Protections for 62 Million Americans. Research Brief.

Assistant Secretary for Planning and Evaluation (ASPE). Washington, DC.

Berning, A., Compton, R., & Wochinger, K. (2015, February). Results of the 2013–2014 National

Roadside Survey of alcohol and drug use by drivers. (Traffic Safety Facts Research Note.

Report No. DOT HS 812 118). Washington, DC: National Highway Traffic Safety

Administration.

Centers for Disease Control and Prevention. HIV Surveillance Report‐Diagnoses of HIV Infection in

the United States, 2013. Vol. 25 (February 2015). Department of Health and Human Services,

Washington, DC.

Centers for Disease Control and Prevention. Diagnoses of HIV Infection in the United States 

and Dependent Areas, 2014. Vol. 26 (November 2015). Department of Health and Human

Services, Washington, DC.

Centers for Disease Control and Prevention. Vital Signs: Overdoses of Prescription Opioid Pain

Relievers ‐‐ United States, 1999‐‐2008, Morbidity and Mortality Weekly Report, November 4,

2011. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm. (Last

accessed on January 6, 2015).

DeWit, David J. et al., First Alcohol Use: A Risk Factor for the Development of Alcohol 

Disorders, J Psychiatry 2000; 157:745–750

Fisher, E, Recovery Supports for Young People: What Do Existing Supports Reveal About the 

Recovery Environment? Peabody J Educ. 2014 January 1; 89(2): 258–270.

Gerstein, D. & Harwood, H. (Eds.). (1990) Treating Drug Problems, vol. 1. Washington, DC:

National Academy Press. Principles of Drug Addiction Treatment: A Research‐Based Guide,

National Institute on Drug Abuse, NIH Publication No. 99‐4180, Printed October 1999.

Glaze, Lauren E. and Herberman, Erin J. Correctional Populations in the United States, 2013.

Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice

Statistics, December 2014. Available at http://www.bjs.gov/content/pub/pdf/cpus13.pdf

(Last accessed on January 15, 2015).

Johnston, L.D. (2003). Alcohol and illicit drugs: The role of risk perceptions. In D. Romer (Ed.),

Reducing adolescent risk: Toward an integrated approach (pp. 56‐74). Thousand Oaks, CA:

Sage. Available at http://www.monitoringthefuture.org/pubs/chapters/ldj2003.pdf.

Johnston, L. D., O'Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Miech, R. A. (2014a).
Monitoring the Future national survey results on drug use, 1975‐2013: Volume I, Secondary school students.

Ann Arbor: Institute for Social Research, The University of Michigan, 630 pp.

Johnston, L. D., O'Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Miech, R. A. (2014b).

Monitoring the Future national survey results on drug use, 1975-2013: Volume II,

College students and adults ages 19-55. Ann Arbor: Institute for Social Research, The University of

Michigan, 424 pp.

McCabe, Sean et al, Does early onset of non-medical use of prescription drugs predict subsequent 

prescription drug abuse and dependence? Results from a national study. Addiction. 2007 

Dec; 102(12): 1920–1930. 

McLellan AT, et al, Supplemental social services improve outcomes in public addiction treatment. 

Addiction. 1998 Oct; 93(10):1489-99.

Mumola, Christopher J. and Karberg, Jennifer C. Drug Use and Dependence, State and Federal Prisoners,

2004. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of

Justice Statistics, 2007. Available at: http://www.bjs.gov/content/pub/pdf/dudsfp04.pdf.

Accessed January 15, 2015.

Office of National Drug Control Policy. (2014). What America’s users spend on illegal drugs: 2000‐2010.

Washington, D.C.: Executive Office of the President.

Office of National Drug Control Policy. (2015). Unpublished U.S. government estimates of coca 

cultivation and cocaine potential production. Available on ONDCP’s website at: 

https://www.whitehouse.gov/ondcp/targeting-cocaine-at-the-source

Polcin, D. et al, Sober Living Houses for Alcohol and Drug Dependence: 18- Month Outcomes. 

J Subst Abuse Treat. 2010 June; 38(4): 356–365.

Reif, S. et al, Recovery Housing: Assessing the Evidence. Psychiatric Services, March 2014, Vol. 

65 No. 3.

United Nations Office on Drugs and Crime. Southeast Asia Opium Survey, 2014. United Nations, 

Vienna Austria, 2014.

U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services

Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of

National Findings, NSDUH Series H‐48, HHS Publication No. (SMA) 14‐4863. Rockville,

MD: Substance Abuse and Mental Health Services Administration, 2014a.

U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services

Administration. Center for Behavioral Health Statistics and Quality. National Survey of

Substance Abuse Treatment Services (N‐SSATS), 2012. ICPSR34968‐v2. Ann Arbor, MI:

Inter‐university Consortium for Political and Social Research [distributor], 2014‐04‐25a.

Unpublished special tabulations (December 2014b).
U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services

Administration. Center for Behavioral Health Statistics and Quality. Treatment Episode

Data Set ‐‐ Discharges (TEDS‐D), 2011. ICPSR35074‐v1. Ann Arbor, MI: Inter‐university

Consortium for Political and Social Research [distributor], May 2014c.

http://doi.org/10.3886/ICPSR35074.v1.

U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young

Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human

Services, Centers for Disease Control and Prevention, National Center for Chronic Disease

Prevention and Health Promotion, Office on Smoking and Health, 2012.

U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services

Administration. Center for Behavioral Health Statistics and Quality. Drug Abuse Warning

Network (DAWN), 2011. ICPSR34565‐v2. Ann Arbor, MI: Inter‐university Consortium for

Political and Social Research [distributor], September 2013.

http://doi.org/10.3886/ICPSR34565.v2.

U.S. Department of Health Resources and Services Administration, Bureau of Primary Health

Care. Uniform Data System Dataset. Unpublished special tabulations (December 2014).

U.S. Department of Justice. Drug Enforcement Administration. National Drug Threat Assessment

2013. DEA‐NWW‐DIR‐017‐13. Washington, D.C.: Office of Intelligence, Warning, Plans

and Programs, (November 2013a).

U.S. Department of Justice. Drug Enforcement Administration. Office of Information Systems. El

Paso Intelligence Center. National Seizure System. Unpublished special tabulations (January 

2013b).

U.S. Department of Justice. Drug Enforcement Administration. Office of Information Systems.

Priority Target Activity Resource and Reporting System Dataset. Unpublished special

tabulations (December 2014a).

U.S. Department of Justice. Drug Enforcement Administration. Special Drug Testing 

Laboratory. Methamphetamine Profile Reports, quarterly through December 2015.

U.S. Department of Justice. Drug Enforcement Administration. National Drug Threat Assessment, 

2016. DEA-DCT-DIR-031-16. Washington, D.C.: Office of Intelligence, Warning Plans 

and Programs, (October 2016a).

U.S. Department of Justice. Drug Enforcement Administration. Office of Information Systems. 

El Paso Intelligence Center. National Seizure System. Unpublished special tabulations 

(extracted February 19, 2016b).

U.S. Department of Justice. Office of Justice Programs. Office of Juvenile Justice and
Delinquency Prevention. Census of Juveniles in Residential Placement [machine‐readable data 

files]. Washington, D.C.: U.S. Census Bureau, August 2014b.

U.S. Department of State. Bureau for International Narcotics and Law Enforcement Affairs. 2014

International Narcotics Control Strategy Report, Volume 1: Drug and Chemical Control. Washington,

D.C, March 2014a. http://go.usa.gov/767w.

U.S. Department of State. Bureau for International Narcotics and Law Enforcement Affairs.

International Narcotics Control Strategy Database. Unpublished special tabulations (December

2014b)