OFFICE OF NATIONAL 

DRUG CONTROL 

POLICY

Progress toward Some 

National Drug Control 

Strategy Goals, but None 

Have Been Fully Achieved

Statement of Diana C. Maurer, Director, 

Homeland Security and Justice

Testimony 

Before the Committee on Homeland 

Security and Governmental Affairs, 

U. S. Senate

For Release on Delivery 

Expected at 2:30 p.m. ET

Tuesday, May 17, 2016

GAO-16-660T

United States Government Accountability Office
United States Government Accountability Office

Highlights of GAO-16-660T, a testimony before 

the Committee on Homeland Security and 

Governmental Affairs, U.S. Senate

May 17, 2016

OFFICE OF NATIONAL DRUG CONTROL 

POLICY

Progress toward Some National Drug Control 

Strategy Goals, but None Have Been Fully 

Achieved

What GAO Found

The Office of National Drug Control Policy (ONDCP) and federal agencies have 

made mixed progress toward achieving the goals articulated in the 2010 National 

Drug Control Strategy (Strategy) and ONDCP has established a mechanism to 

monitor and assess progress. In the Strategy, ONDCP established seven goals 

related to reducing illicit drug use and its consequences by 2015. As of May 

2016, our analysis indicates that ONDCP and federal agencies have made 

moderate progress toward achieving one goal, limited progress on three goals, 

and no progress on the three other three goals. Overall, none of the goals in the 

Strategy have been fully achieved. In March 2013, GAO reported that ONDCP 

established the Performance Reporting System to monitor and assess progress 

toward meeting Strategy goals and objectives. GAO reported that the system’s 

26 new performance measures were generally consistent with attributes of 

effective performance management. A 2015 ONDCP report on progress towards 

these measures similarly identified some progress towards overall 

achievements—some of the measures had met or exceeded targets, some had 

significant progress underway, and some had limited or no progress.

Federal drug control spending increased from $21.7 billion in fiscal year (FY)

2007 to approximately $30.6 billion in allocated funding in FY 2016 as shown in 

figure 1. Although total federal drug control spending increased from FY 2007 

through FY 2016, spending on supply reduction programs, such as domestic law 

enforcement, interdiction, and international programs remained relatively 

constant at $13.3 billion in FY 2007 and $15.8 billion allocated in FY 2016. 

However, federal spending for—treatment and prevention has steadily increased 

from FY 2007 through FY 2016 and spending in these two programs went from 

$8.4 billion in FY 2007 to $14.7 billion allocated in FY 2016.

Figure 1: Federal Drug Control Spending for Fiscal Years 2007 through 2016

View GAO-16-660T. For more information, 

contact Diana Maurer at (202) 512-8777 or 

maurerd@gao.gov

Why GAO Did This Study

Policymakers, health care providers, 

and the public are concerned about the 

nation’s current drug epidemic and its 

effects, as drug overdose deaths 

surpassed auto accidents as the 

leading cause of death or injury in 

recent years. To help address national 

drug control policy efforts, ONDCP 

coordinates and oversees 

implementation of a National Drug 

Control Strategy to reduce illicit drug 

use, among other things. 

This statement addresses (1) what 

progress has been made toward 

achieving National Drug Control 

Strategy goals and how ONDCP 

monitors progress and (2) trends in 

federal drug control spending. 

This statement is based upon findings 

GAO reported in March 2013 and 

December 2015, analysis of ONDCP’s 

Budget and Performance Summaries

and selected updates in 2016. For the 

updates, GAO analyzed publically 

available data sources that ONDCP 

uses to assess progress on Strategy 

goals, reviewed ONDCP Performance 

Reporting System reports, and 

interviewed ONDCP officials.

What GAO Recommends

GAO made a prior recommendation to 

ONDCP to assess overlap in drug 

prevention and treatment programs. 

ONDCP concurred and has 

implemented it. GAO is not making 

new recommendations in this 

testimony. 
Letter

Page 1 GAO-16-660T 

Chairman Johnson, Ranking Member Carper, and Members of the 

Committee:

I am pleased to be here today to discuss the Office of National Drug 

Control Policy’s (ONDCP) efforts to implement the National Drug Control 

Strategy. In recent years, policy makers, health care providers, and the 

public at large are turning their attention to the current drug epidemic and 

its impact on our nation. Deaths from drug overdose rose steadily over 

the past two decades to become the leading cause of injury or death in 

the United States, surpassing the annual number of traffic crash fatalities 

in recent years. In 2013, approximately 120 people died every day from 

drug overdoses. ONDCP is responsible for, among other things, 

overseeing and coordinating the implementation of national drug control 

policy across the federal government to address illicit drug use.1 In this 

role, the Director of ONDCP is required annually to develop a National 

Drug Control Strategy (the Strategy), which is to set forth a 

comprehensive plan to reduce illicit drug use through programs intended 

to prevent or treat drug use or reduce the availability of illegal drugs.2

ONDCP is also responsible for developing a National Drug Control 

Program Budget proposal for implementing the Strategy.3 In fiscal year 

2017, a total of $31.1 billion was requested to support the Strategy. This 

represents an increase of more than $500 million over the enacted fiscal 

year 2016 level of $30.6 billion.

Today, I will discuss (1) what progress has been made toward achieving 

National Drug Control Strategy goals and how ONDCP monitors progress 

and (2) trends in federal drug control spending. My remarks today are 

based on findings from our March 2013 report on progress toward 

Strategy goals and ONDCP mechanisms to monitor progress, our 

 1

Illicit drug use includes the use of marijuana (including hashish), cocaine (including 

crack), heroin, hallucinogens, and inhalants, as well as the nonmedical use of prescription 

drugs, such as pain relievers and sedatives.

2

For the purposes of this statement we refer to the National Drug Control Strategy as ‘the 

Strategy’ mirroring the reference commonly used by ONDCP.

3

21 U.S.C. §§ 1703(b)-(c), 1705(a). Under 21 U.S.C. § 1701(7), the term “National Drug

Control Program agency” means any agency that is responsible for implementing any 

aspect of the National Drug Control Strategy, including any agency that receives federal 

funds to implement any aspect of the National Drug Control Strategy, subject to certain 

exceptions regarding intelligence agencies.

Letter
Page 2 GAO-16-660T 

December 2015 testimony statement on these areas, updates to our 

analysis and findings in the report and testimony statement, and our 

analysis of ONDCP’s Budget and Performance summaries.4

In performing the work for our March 2013 report, we analyzed the 2010 

National Drug Control Strategy; available data on progress toward 

achieving Strategy goals, and documents about ONDCP’s monitoring 

mechanisms. In March 2013 we made a recommendation to ONDCP to 

assess overlap in drug prevention and treatment programs. ONDCP 

concurred and has implemented it. For our December 2015 testimony 

statement, we analyzed ONDCP’s reported progress on Strategy goals in 

its 2015 Strategy and performance report. More detail on our scope and 

methodologies can be found in our March 2013 report and December 

2015 statement. For updates to these reports, we analyzed publically 

available data sources, ONDCP reports on progress toward the 

Strategy’s goals and objectives, and reviewed ONDCP’s Fiscal Year 2015 

and Fiscal Year 2016 Budget and Performance reports, and interviewed 

ONDCP officials.5 We previously reported on progress toward meeting 

Strategy goals in our December 2015 testimony based on results 

provided in ONDCP’s 2015 Strategy and performance report, which were 

issued in November 2015. To assess progress on Strategy goals, we 

updated results for the goals using publically available data sources as of 

May 2016. The data sources for the goals were determined by ONDCP 

when developing the 2010 Strategy, based on their availability and 

quality. We used the same data sources that ONDCP uses to assess 

progress on Strategy goals to update results and did not independently 

assess the reliability of these data.

This statement is based on our prior work issued from July 2012 through 

December 2015, with select updates as of May 2016. The work upon 

which this testimony is based was conducted in accordance with 

generally accepted government auditing standards. Those standards 

 4

See GAO, Office of National Drug Control Policy: Office Could Better Identify 

Opportunities to Increase Program Coordination, GAO-13-333 (Washington, D.C.: Mar. 

26, 2013) and Office of National Drug Control Policy: Lack of Progress on Achieving 

National Strategy Goals, GAO-16-257T (Washington, D.C.: Dec. 2, 2015).

5

Office of National Drug Control Policy FY 2015 and FY 2016 Budget and Performance 

Summaries Companion to the National Drug Control Strategy, July 2014 and November 

2015; and National Drug Control Budget FY 2017 Funding Highlights, February 2016. 
Page 3 GAO-16-660T 

require that we plan and perform the audit to obtain sufficient, appropriate 

evidence to provide a reasonable basis for our findings and conclusions 

based on our audit objectives. We believe that the evidence obtained 

provides a reasonable basis for our findings and conclusions based on 

our audit objectives.

ONDCP was established by the Anti-Drug Abuse Act of 1988 to, among 

other things, enhance national drug control planning and coordination and 

represent the drug policies of the executive branch before Congress.6 In 

this role, the office is responsible for (1) developing a national drug 

control policy, (2) developing and applying specific goals and 

performance measurements to evaluate the effectiveness of national drug 

control policy and National Drug Control Program agencies’ programs,7

(3) overseeing and coordinating the implementation of the national drug 

control policy, and (4) assessing and certifying the adequacy of the 

budget for National Drug Control Programs.

The 2010 National Drug Control Strategy is the inaugural strategy guiding 

drug policy under President Obama’s administration. According to 

ONDCP officials, it sought a comprehensive approach to drug policy, 

including an emphasis on drug abuse prevention and treatment efforts 

and the use of evidence-based practices—approaches to prevention or 

treatments that are based in theory and have undergone scientific 

evaluation. Drug abuse prevention includes activities focused on 

discouraging the first-time use of controlled substances and efforts to 

encourage those who have begun to use illicit drugs to cease their use. 

Treatment includes activities focused on assisting regular users of 

 6

See 21 U.S.C. § 1702. ONDCP was created and authorized through January 21, 1994, 

by the National Narcotics Leadership Act of 1988, which was enacted as title 1 of the AntiDrug Abuse Act of 1988. Pub. L. No. 100-690, 102 Stat. 4181 (1988). ONDCP has 

continued to operate since the conclusion of its first authorization through multiple 

reauthorizations or as a result of legislation providing continued funding.

7

Department of Agriculture; Court Services and Offender Supervision Agency for the 

District of Columbia; Department of Defense; Department of Education; Federal Judiciary; 

Department of Health and Human Services; Department of Homeland Security; 

Department of Housing and Urban Development; Department of the Interior; Department 

of Justice; Department of Labor; Office of National Drug Control Policy; Department of 

State; Department of Transportation; Department of the Treasury; and Department of 

Veterans Affairs.

Background
Page 4 GAO-16-660T 

controlled substances to become drug free through such means as 

counseling services, inpatient and outpatient care, and the demonstration 

and provision of effective treatment methods.

ONDCP established two overarching policy goals in the 2010 Strategy for 

(1) curtailing illicit drug consumption and (2) improving public health by 

reducing the consequences of drug abuse, and seven subgoals under 

them that delineate specific quantitative outcomes to be achieved by 

2015, such as reducing drug-induced deaths by 15 percent. To support 

the achievement of these two policy goals and seven subgoals 

(collectively referred to as goals), the Strategy included seven strategic 

objectives and multiple action items under each objective, with lead and 

participating agencies designated for each action item. Strategy 

objectives include, for example, Strengthen Efforts to Prevent Drug Use in 

Communities and Disrupt Domestic Drug Trafficking and Production. 

Subsequent annual Strategies provided updates on the implementation of 

action items, included new action items intended to help address 

emerging drug-related problems, and highlighted initiatives and efforts 

that support the Strategy’s objectives.

ONDCP is required annually to develop the National Drug Control 

Strategy, which sets forth a plan to reduce illicit drug use through 

prevention, treatment, and law enforcement programs, and to develop a 

Drug Control Budget for implementing the strategy.8 National Drug 

Control Program agencies follow a detailed process in developing their 

annual budget submissions for inclusion in the Drug Control Budget, 

which provides information on the funding that the executive branch 

requested for drug control to implement the strategy.9 Agencies submit to 

ONDCP the portion of their annual budget requests dedicated to drug 

control, which they prepare as part of their overall budget submission to

the Office of Management and Budget for inclusion in the President’s 

 8

In 2008, the National Academy of Public Administration’s report entitled Building the 

Capacity to Address the Nation’s Drug Problem recommended that ONDCP develop a 

comprehensive budget to ensure policymakers and the public have a full understanding of 

the federal drug control expenditures. In response to this recommendation, ONDCP 

undertook a review of the National Drug Control Budget to determine which agencies and 

programs should constitute the National Drug Control Budget. As a result, it decided to 

restructure the budget.

9

See 21 U.S.C. § 1703(c).
Page 5 GAO-16-660T 

annual budget request. ONDCP reviews the budget requests of the drug 

control agencies to determine if the agencies have acceptable 

methodologies for estimating their drug control budgets, and includes 

those that do in the Drug Control Budget.10 In FY 2016, the budget 

contains 38 federal agencies or programs.

There are five priorities for which resources are requested across 

agencies: substance abuse prevention and substance abuse treatment

(both of which are considered demand-reduction areas), and drug 

interdiction, domestic law enforcement, and international partnerships 

(the three of which are considered supply-reduction areas) as shown in 

figure 1. ONDCP manages and oversees two primary program accounts: 

the High Intensity Drug Trafficking Areas (HIDTA) Program and the Other 

Federal Drug Control Programs. ONDCP previously managed the 

National Youth Anti-Drug Media Campaign which last received 

appropriations in fiscal year 2011.

 10An acceptable methodology relies on availability of empirical data at the agencies for 

estimating their drug control budgets. These data include determining which portion of an 

agency’s funding is for drug control programs or activities versus non-drug control 

programs. See GAO, Office of National Drug Control Policy: Agencies View the Budget 

Process as Useful for Identifying Priorities, but Challenges Exist, GAO-11-261R 

(Washington, D.C.: May 2, 2011). Agencies may administer programs that include drug 

abuse prevention and treatment activities but do not meet ONDCP’s standards for having 

an acceptable budget estimation methodology. Such programs are not represented in the 

Drug Control Budget.
Page 6 GAO-16-660T 

Figure 1: Federal Drug Control Program Priority Areas
Page 7 GAO-16-660T 

In the 2010 National Drug Control Strategy, ONDCP established seven 

goals related to reducing illicit drug use and its consequences to be 

achieved by 2015. As of May 2016, our analysis indicates that ONDCP 

and federal agencies have made moderate progress toward achieving 

one goal, limited progress on three goals, and no demonstrated progress 

on the remaining three goals.11 ONDCP officials stated that they intend to 

report on updated progress toward meeting the strategic goals in summer 

2016. As of May 2016, overall, none of the goals in the Strategy have 

been fully achieved. Table 1 shows the 2010 Strategy goals and progress 

toward meeting them.

 11Three of the Strategy’s goals have multiple sub-measures. Limited progress indicates 

that progress has been made toward goals on at least one of these measures but not all. 

We previously reported on progress toward meeting Strategy goals in our December 2016 

testimony based on results provided in ONDCP’s 2015 Strategy and performance system 

report, which were issued in November 2015. See GAO-16-257T. We updated results for 

five of the seven goals based on available data sources as of May 2016.

ONDCP and Other 

Federal Agencies 

Have Not Fully 

Achieved 2010 

Strategy Goals; 

ONDCP Has 

Established a 

Mechanism to 

Monitor Progress

Although Limited Progress 

Has Been Made for Some 

Goals, None of the 

National Drug Control 

Strategy Goals Have Been 

Fully Achieved
Page 8 GAO-16-660T 

Table 1: 2010 National Drug Control Strategy Goals and Progress toward Meeting Them, as of May 2016

2010 Strategy goals

2009 

(baseline) Progress to datea 2015 (goal)

Curtail illicit drug consumption in America

1. Decrease the 30-day prevalence of drug use among 12- to 17-yearolds by 15 percentb 10.1 percent 9.4 percent (2014) 8.6 percent

2. Decrease the lifetime prevalence of eighth graders who have used 

drugs, alcohol, or tobacco by 15 percent

Illicit drugsc 19.9 percent 20.5 percent(2015) 16.9 percent

Alcohol 36.6 percent 26.1 percent (2015) 31.1 percent

Tobacco 20.1 percent 13.3 percent (2015) 17.1 percent

3. Decrease the 30-day prevalence of drug use among young adults 

aged 18-25 by 10 percentd 21.4 percent 22.0 percent (2014) 19.3 percent

4. Reduce the number of chronic drug users by 15 percente

Cocaine 2.7 million 2.5 million (2010) 2.3 million

Heroin 1.5 million 1.5 million (2010) 1.3 million

Marijuana 16.2 million 17.6 million (2010) 13.8 million

Methamphetamine 1.8 million 1.6 million (2010) 1.5 million

Improve the public health and public safety of the American people by reducing the consequences of drug abuse

5. Reduce drug-induced deaths by 15 percent 39,147 49,714 (2014) 33,275

6. Reduce drug-related morbidity by 15 percent

Emergency room visits for drug misuse and abusef 2,070,452 2,462,948 (2011) 1,759,884 

HIV infections attributable to drug use 5,799 3,852 (2014) 4,929

7. Reduce the prevalence of drugged driving by 10 percentg 16.3 percent 

(2007) 20.0 percent (2013) 14.7 percent

Source: GAO analysis of ONDCP’s 2015 Performance Reporting System report and data from (1) Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use 

and Health (NSDUH); (2) National Institute on Drug Abuse’s Monitoring the Future; (3) What America’s Users Spend on Illegal Drugs; (4) Centers for Disease Control and Prevention’s (CDC) National 

Vital Statistics System; (5) SAMHSA’s Drug Abuse Warning Network drug-related emergency room visits; (6) CDC’s HIV Surveillance Report‐Diagnoses of HIV Infection in the United States; and (7) 

National Highway Traffic Safety Administration’s National Roadside Survey. | GAO-16-660T

a

Year for which the most recent data were available is in parenthesis.

b

According to the 2014 NSDUH, 7.4 percent of 12- to 17-year-olds reporting having used marijuana in 

the past month and 3.6 percent reported having used illicit drugs other than marijuana.

c

According to the 2015 Monitoring the Future survey, 15.5 percent of eighth graders reported having 

used marijuana in their lifetimes and 10.3 percent reported having used any illicit drug other than 

marijuana.

d

According to the 2014 NSDUH, 19.6 percent of 18- to 25-year-olds reported having used marijuana 

in the past month and 6.4 percent reported having used illicit drugs other than marijuana.

e

The data source for this measure is a report entitled What America’s Users Spend on Illegal Drugs, 

which is sponsored by ONDCP and prepared by RAND Corporation. As of May 2016, the most recent 

report had been released in February 2014 and provided data from 2000 through 2010.

f

According to ONDCP’s 2015 Performance Reporting System report, the data source for this 

measure—the Drug Abuse Warning System—was discontinued by SAMHSA in 2011, and SAMHSA 

and CDC are currently working to implement a replacement system to provide data on drug‐related 

emergency department visits.
Page 9 GAO-16-660T 

g

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

Highway Traffic Safety Administration. The baseline survey was conducted in 2007. The NSDUH, 

which also measures the prevalence of drugged driving, serves as a secondary data source to the 

National Roadside Survey. ONDCP reported that the drugged driving goal was met when 2013 data 

from the NSDUH source is used.

ONDCP and federal drug control agencies have made mixed progress 

but have not fully achieved any of the four Strategy goals associated with 

curtailing illicit drug consumption. For example, progress has been made 

on the goal to decrease the 30-day prevalence of drug use among 12- to 

17-year-olds by 15 percent. The data source for this measure—

SAMHSA’s National Survey on Drug Use and Health (NSDUH)—

indicates that in 2014, 9.4 percent of 12- to 17-year-olds reported having 

used illicit drugs in the past month. This represents a 7 percent decrease 

from the 2009 baseline for this measure. However, progress has not been 

made on the goal to decrease the 30-day prevalence of drug use among 

young adults aged 18 to 25 by 10 percent. Specifically, the rate of drug 

use for young adults increased from 21.4 percent in 2009 to 22 percent in 

2014, moving in the opposite direction of the goal. This increase was 

primarily driven by marijuana use. According to the 2014 NSDUH, 19.6 

percent of young adults reported having used marijuana in the past month 

and 6.4 percent reported having used illicit drugs other than marijuana.12

The rates of reported marijuana use for this measure increased by 8 

percent from 2009 to 2014 while the rates of reported use of illicit drugs 

other than marijuana decreased by 24 percent.

Progress has also been mixed on the remaining three Strategy goals 

associated with reducing the consequences of drug use. For example, the 

goal to reduce drug-related morbidity by 15 percent has two measures, 

and progress has been made on one but not the other. Specifically, HIV 

infections attributable to drug use decreased by 34 percent from 2009 to 

2014, exceeding the established target. However, the number of 

emergency room visits for substance use disorders increased by 19 

percent from 2009 to 2011. The data source for this measure—

SAMHSA’s Drug Abuse Warning Network—indicates that 

pharmaceuticals alone were involved in 34 percent of these visits and 

 12Marijuana includes marijuana and hashish. Illicit drugs other than marijuana include 

cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type 

psychotherapeutics used nonmedically.
Page 10 GAO-16-660T 

illicit drugs alone were involved in 27 percent of them.13 According to the 

2013 Drug Abuse Warning Network report, the increase in emergency 

room visits for drug misuse and abuse from 2009 to 2011 was largely 

driven by a 38 percent increase in visits involving illicit drugs only. In 

addition, progress has not been made on the goal to reduce drug-induced 

deaths by 15 percent. According to the CDC’s National Vital Statistics 

System, 49,714 deaths were from drug-induced causes in 2014, an 

increase of 27 percent compared to 2009. This represents a significant 

departure from the 2015 goal. The CDC’s January 2016 Morbidity and 

Mortality Weekly Report stated that 47,055 of these deaths were from 

drug overdoses, the majority of which (61 percent) involved opioids.

In March 2013, we reported that ONDCP established the Performance 

Reporting System (PRS) to monitor and assess progress toward meeting 

Strategy goals and objectives and issued a report describing the system 

with its 2012 Strategy.14 The PRS includes interagency performance 

measures and targets under each of the Strategy’s seven objectives, 

which collectively support the overarching goals discussed above. For 

example, one of the six performance measures under the Strategy’s first 

objective—Strengthen Efforts to Prevent Drug Use in Our Communities—

is the average age of initiation for all illicit drug use, which has a 2009 

baseline of 17.6 years of age and a 2015 target of 19.5 years of age. 

These PRS measures were established to help assess progress towards 

each objective. According to ONDCP, they are a tool to help indicate 

where the Strategy is on track, and when and where further attention, 

assessment, evaluation, and problem‐solving are needed.

As part of our review for our March 2013 report, we assessed the PRS 

measures for the Strategy’s seven objectives and found them to be 

generally consistent with attributes of effective performance management 

identified in our prior work as important for ensuring performance 

measures demonstrate results and are useful for decision making.15 For 

 13These numbers do not include visits that involved a combination of illicit drugs, 

pharmaceuticals, and/or alcohol, which accounted for 35 percent of emergency room visits 

for substance use disorders.

14See GAO-13-333.

15See GAO, Tax Administration: IRS Needs to Further Refine Its Tax Season 

Performance Measures, GAO-03-143 (Washington, D.C.: Nov. 22, 2002).

ONDCP Established a 

System to Monitor 

Progress toward Strategy 

Goals
Page 11 GAO-16-660T 

example, we found that the PRS measures for the objectives were clearly 

stated, with descriptions included in the 2012 PRS report, and all 26 of 

them had or were to have measurable numerical targets. In addition, the 

measures were developed with input from stakeholders through an 

interagency working group process, which included participation by the 

Departments of Education, Justice, and Health and Human Services, 

among others. The groups assessed the validity of the measures and 

evaluated data sources, among other things. At the time of our review, 

the PRS was in its early stages and ONDCP had not issued its first report 

on the results of the system’s performance measures.

ONDCP released its most recent annual PRS report in November 2015. 

The 2015 report assesses progress on the Strategy’s goals and the 28 

performance measures and submeasures related to each of the 

Strategy’s seven objectives, which support the achievement of the 

goals.16 For each objective, the report classifies results on performance 

measures into five categories and identifies areas of progress on and 

challenges with achieving objectives.17 For example:

• Objective 1—Strengthen Efforts to Prevent Drug Use in Our 

Communities. The report indicates that sufficient progress has been 

made on reducing the average age of initiation for all illicit drugs to 

enable meeting the 2015 target. However, it notes that accelerated 

effort is needed to prevent youth marijuana use and counter youth 

perceptions that marijuana (including synthetic marijuana) use is not 

harmful. The report shows that the percent of respondents aged 12 to 

17 who perceive a great risk in smoking marijuana once or twice a 

week decreased from 2009 to 2013, moving in the opposite direction 

of the 2015 target.

• Objective 3—Integrate Treatment for Substance Use Disorders into 

Health Care and Expand Support for Recovery. The report shows that 

 16ONDCP included new submeasures for one of the performance measures in the 2015 

PRS report, which accounts for the difference in the number of measures between the 

2012 and 2015 reports. 

17The categories are (1) target met or exceeded, progress should be maintained through 

2015; (2) progress sufficient to enable meeting 2015 target; (3) progressing, accelerated 

progress required to meet 2015 target; (4) no progress to date, accelerated progress 

required to meet 2015 target; and (5) significant (or considerable) progress required to 

meet 2015 target.
Page 12 GAO-16-660T 

the percent of treatment facilities offering at least four specified 

recovery support services, such as child care, employment 

assistance, and housing assistance, increased from 2008 to 2013 and 

exceeded the 2015 target. However, the report states that challenges 

persist in the integration of substance abuse treatment services into 

mainstream health care. For instance, the percent of the Health 

Resources and Services Administration’s Health Center Program 

grantees providing substance use counseling and treatment services 

decreased from 2009 to 2013. According to the report, implementation 

of the Affordable Care Act presents opportunities to provide greater 

access to treatment for substance use disorders by, for example, 

efficiently integrating such treatment into the health care system and 

providing non-discrimination for coverage for preexisting conditions.

• Objective 5—Disrupt Domestic Drug Trafficking and Production. 

According to the report, progress is being achieved in domestic law 

enforcement and efforts to disrupt or dismantle domestic drug 

trafficking organizations. The 2015 targets for both measures related 

to these efforts have been exceeded. The report also indicates that 

progress has been made on reducing the number of 

methamphetamine lab seizure incidents (a proxy for lab activity) from 

2009 to 2013 but accelerated progress is needed to meet the 2015 

target.

• Objective 6—Strengthen International Partnerships and Reduce the 

Availability of Foreign Produced Drugs in the United States. According 

to the report, key source and transit countries continue to demonstrate 

increased commitment to reducing drug trafficking and use through 

demand and supply reduction efforts. The targets for the two 

measures related to such commitments have both been met. 

However, the report states that accelerated progress is needed in 

working with partner countries to reduce the cultivation of drugs and 

their production potential in Afghanistan, Burma, Laos, Mexico, and 

Peru.

See attachment I for performance measures under each Strategy 

objective, progress toward 2015 targets, and ONDCP’s assessment 

categorizations. ONDCP officials stated that actions taken in response to 

PRS results include Department of Education grants for school-based 

prevention activities to help educate students on the risks of using 

marijuana and increased funding to expand access to treatment to help 

address the rise in drug-induced deaths from opioid use, as discussed 

below.
Page 13 GAO-16-660T 

According to ONDCP, federal drug control spending increased from $21.7 

billion in FY 2007 to approximately $30.6 billion that was allocated for 

drug control programs in FY 2016 as shown in figure 2.18 Though, total 

federal drug control spending increased from FY 2007 through FY 2016, 

spending on supply reduction programs, such as domestic law 

enforcement, interdiction, and international programs remained relatively 

constant at $13.3 billion in FY 2007 and $15.8 billion in FY 2016.19

However, federal spending for demand programs—treatment and 

prevention steadily increased from FY 2007 through FY 2016 and 

spending in these two programs went from $8.4 billion in FY 2007 to 

$14.7 billion in FY 2016. As a result, the proportion of funds spent on 

demand programs increased from 39 percent of total spending in FY 

2007 to 48 percent in FY 2016.

 18We reviewed the fiscal year 2017 National Drug Control Budget Funding Highlights that 

describes fiscal year 2016 allocations. ONDCP refers to these funds as enacted in the 

National Drug Control Budget, while we use the term allocated funding. All FY 2016 

funding is considered allocated funding for purposes of this statement. At the beginning of 

a fiscal year, agencies may allocate certain amounts from available appropriations for 

specific programs. However, to the extent that an appropriation has not identified a 

particular amount for a specific program, an agency may reallocate unobligated funds 

from that program to another during the course of a fiscal year. To the extent other 

statutory authority results in making mandatory funding for programs that may include 

drug abuse prevention and treatment, such as Medicare and Medicaid, we also include 

these as allocated funds.

19All FY 2016 funding is considered allocated funding for purposes of this statement.

Total Federal 

Spending for Drug 

Control Programs 

Has Increased since 

FY 2007

Federal Drug Control 

Spending on Treatment 

and Prevention Increased, 

While Law Enforcement 

and Interdiction Spending 

Remain Relatively 

Constant
Page 14 GAO-16-660T 

Figure 2: Federal Drug Control Spending for Fiscal Years 2007 through 2016

According to ONDCP’s Fiscal Year 2016 Budget and Performance 

Summary, ONDCP has prioritized treatment and recovery support 

services stating that they are essential elements of the Strategy’s efforts 

to support long-term recovery among people with substance use 

disorders. Allocated funding for treatment increased in FY 2016 to 

approximately $13 billion, a 5 percent increase over FY 2015. These 

funds are used for early intervention programs, treatment programs, and 

recovery services. For example, according to ONDCP, approximately 

$8.8 billion was the amount estimated for benefit outlays by the 

Department of Health and Human Services’ (HHS) Centers for Medicare 

and Medicaid Services for substance use disorder treatment in both 

inpatient and outpatient settings for FY 2016. ONDCP also stated that 

preventing drug use before it starts is a fundamental element of the 

Strategy. Funding for prevention increased in FY 2016 to about $1.5 

billion, a 10 percent increase from FY 2015, as shown in figure 3. Funding 

for treatment also increased from $12.5 billion in FY 2015 to $13.2 billion
Page 15 GAO-16-660T 

in FY 2016 in allocated funding. Figure 3 shows the increase in treatment 

and prevention spending for fiscal years 2007 through 2016.

Figure 3: Federal Spending for Drug Treatment and Prevention for Fiscal Years 2007 through 2016

Additionally, in FY 2017, HHS’ Substance Abuse and Mental Health 

Services Administration (SAMHSA) requested $460 million for a new 

program (State Targeted Response Cooperative Agreements) to help 

expand access to treatment for opioid use disorders, as well as $15 

million for evaluating the effectiveness of medication-assisted treatment 

programs to improve service delivery and decrease the incident of opioidrelated overdose and death (Cohort Monitoring and Evaluation of 
Page 16 GAO-16-660T 

Medication Assisted Treatment Outcomes).20 These programs could 

result in increasing SAMHSA’s budget request for treatment programs to 

approximately $3 billion in FY 2017 from $2.5 billion enacted in FY 2016.

Addressing the drug supply is categorized by three main functions, which 

are Domestic Law Enforcement, Interdiction, and International. For 

Domestic Law Enforcement, ONDCP noted that federal, state, local, and 

tribal law enforcement agencies play a key role in the Administration’s 

approach to reduce drug use and its associate consequences. ONDCP 

also stated that interagency drug task forces, such as the High Intensity 

Drug Trafficking Areas (HIDTA) program, are critical to leveraging limited 

resources among agencies. Allocated funding for domestic law 

enforcement in FY 2016 is approximately $9.7 billion, a 4 percent 

increase from FY 2015 funding. Regarding Interdiction, the United States 

continues to face a serious challenge from the large scale smuggling of 

drugs from abroad which are distributed to every region in the Nation. 

These funds support collaborative activities between federal law 

enforcement agencies, the military, the intelligence community, and 

international allies to interdict or disrupt shipments of illegal drugs, their 

precursors, and their illicit proceeds.

Allocated funding in support of Interdiction for FY 2016 is approximately 

$4.5 billion, an increase of 12 percent from FY 2015. International 

functions place focus on collaborative efforts between the U.S. 

Government and its international partners around the globe. According to 

ONDCP, illicit drug production and trafficking generate huge profits and 

are responsible for the establishment of criminal networks that are 

powerful, corrosive forces that destroy the lives of individuals, tear at the 

social fabric, and weaken the rule of law in affected countries. In FY 2016, 

approximately $1.6 billion was enacted, a 0.4 percent decrease from FY 

2015. Figure 4 shows federal drug spending for Domestic Law 

Enforcement, Interdiction, and International activities.

 20SAMHSA’s FY 2017 request proposed a 2-year $920 million support cooperative 

agreements with states to expand access to treatment for opioid use disorders. In each of 

FY 2017 and 2018, SAMHSA would provide $460 million in new mandatory funding 

toward State Targeted Response Cooperative Agreements.
Page 17 GAO-16-660T 

Figure 4: Federal Spending for Drug related Domestic Law enforcement, Interdiction, and International Activities for Fiscal 

Years 2007 through 2016

In addition to advising the President on drug-control issues and 

coordinating drug-control activities and related funding across the Federal 

government, ONDCP also directly oversees two drug-related functions for 

which it receives federal drug control funding —HITDAs and other federal 

drug control programs, such as the Drug Free Community (DFC) coalition 

grant program. Based on ONDCP’s spending in FY 2012 through its 

allocated funding in FY 2016 for these two functions, ONDCP’s drugrelated spending account for 1 percent of the total federal drug control 

spending in the federal government. ONDCP’s requested funding for FY 

2017 is 1 percent of the total federal drug control request. See figure 5 for 

allocated percentages.

ONDCP Spending 

Account For One Percent 

of Total Federal Drug 

Control Spending
Page 18 GAO-16-660T 

Figure 5: ONDCP Spending Fiscal Years 2012 through 2016

Chairman Johnson, Ranking Member Carper, and Committee members, 

this concludes my prepared statement. I would be happy to respond to 

any questions you may have.

If you or your staff members have any questions about this testimony, 

please contact Diana Maurer at (202) 512-8777 or maurerd@gao.gov. 

Contact points for our Offices of Congressional Relations and Public 

Affairs may be found on the last page of this statement. Other 

contributors included Kevin Heinz, Assistant Director, Aditi Archer, Lyle 

Brittan, Eric Hauswirth, Justin Snover, and Johanna Wong.

GAO Contact and 

Staff 

Acknowledgements
Attachment I: ONDCP 2015 Performance 

Reporting System Report—Performance 

Measures for Strategy Objectives, Progress 

toward 2015 Targets, and Assessment 

Categorizations

Page 19 GAO-16-660T 

Measure Baseline 

Progress to 

date 2015 Target ONDCP assessment 

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.

49.0 percent 

(2009)

39.5 percent 

(2013)

51.2 percent Significant progress required to meet 

2015 target 

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 percent 

(2009) 

64.3 percent 

(2013)

68.0 percent No progress to date, accelerated 

progress required to meet 2015 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 

39.6 percent 

(2009) 

39.0 percent 

(2013)

41.4 percent No progress to date, accelerated 

progress required to meet 2015 target 

Measure 1.4: Average age of initiation for all 

illicit drugs 

17.6 years 

(2009) 

19.0 (2013) 19.5 years Progress sufficient to enable meeting 

2015 target

Measure 1.5: Average age of initiation for 

alcohol use 

16.9 years 

(2009) 

17.3 (2013) 21.0 years Progressing, accelerated progress 

required to meet 2015 target

Measure 1.6: Average age of initiation for 

tobacco use 

Cigarettes 17.5 years 

(2009)

17.8 (2013) 18.0 years Progressing, accelerated progress 

required to meet 2015 target 

Cigars 20.7 years 

(2009)

21.6 (2013) 18.0 years Target met or exceeded, progress 

should be maintained through 2015

Smokeless tobacco 18.9 years 

(2009)

18.4 (2013) 18.0 years Target met or exceeded, progress 

should be maintained through 2015

Objective 2—Seek Early Intervention Opportunities in Health Care

Measure 2.1: Percent of Health Center 

Program grantees providing SBIRT services 

10.3 percent 

(2009)

16.9 percent 

(2013)

15.0 percent Target met or exceeded, progress 

should be maintained through 2015

Measure 2.2: Percent of respondents in the 

past year using prescription-type drugs nonmedically, age 12–17 

7.7 percent 

(2009)

5.8 percent 

(2013)

6.5 percent Target met or exceeded, progress 

should be maintained through 2015

Measure 2.3: Percent of respondents in the 

past year using prescription-type drugs nonmedically, age 18–25 

15 percent 

(2009)

12.2 percent 

(2013)

12.8 percent Target met or exceeded, progress 

should be maintained through 2015

Measure 2.4: Percent of respondents in the 

past year using prescription-type drugs nonmedically, age 26+ 

4.7 percent 

(2009)

4.8 percent 

(2013)

4.0 percent No progress to date, accelerated 

progress required to meet 2015 target

Objective 3—Integrate Treatment for Substance Use Disorders into Health Care and Expand Support for Recovery

Measure 3.1: Percent of treatment plans 

completed 

45.1 percent

(2007)

43.7 percent 

(2011)

50.0 percent Significant progress required to meet 

2015 target

Attachment I: ONDCP 2015 Performance 

Reporting System Report—Performance 

Measures for Strategy Objectives, Progress 

toward 2015 Targets, and Assessment 

Categorizations
Attachment I: ONDCP 2015 Performance 

Reporting System Report—Performance 

Measures for Strategy Objectives, Progress 

toward 2015 Targets, and Assessment 

Categorizations

Page 20 GAO-16-660T 

Measure Baseline 

Progress to 

date 2015 Target ONDCP assessment 

Measure 3.2: Percent of Health Center 

Program grantees providing substance use 

counseling and treatment services 

21.6 percent

(2009)

20.0 percent 

(2013)

23.0 percent Significant progress required to meet 

2015 target

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 aftercare counseling) 

35.5 percent

(2008)

41.0 percent 

(2013)

39.0 percent Target met or exceeded, progress 

should be maintained through 2015 

Objective 4—Break the Cycle of Drug Use, Crime, Delinquency, and Incarceration

Measure 4.1: Percent of residential facilities 

in the juvenile justice system offering 

substance abuse treatment 

38.8 percent

(2008)

45.3 percent 

(2012)

42.7 percent Target met or exceeded, progress 

should be maintained

Measure 4.2: Percent of treatment plans 

completed by those referred by the criminal 

justice system 

48.8 percent

(2007)

47.5 percent 

(2011)

51.0 percent Progressing, accelerated progress 

required to meet 2015 target

Objective 5—Disrupt Domestic Drug Trafficking and Production

Measure 5.1: Number of domestic 

Consolidated Priority Organization Targets 

linked organizations disrupted or dismantled* 

296

(2009)

473 (2013) 380 Target met or exceeded, progress 

should be maintained through 2015 

Measure 5.2: Number of Regional Priority 

Organization Targets linked organizations 

disrupted or dismantled 

119

(2009)

153 (2014) 120 Target met or exceeded, progress 

should be maintained through 2015 

Measure 5.3: Methamphetamine lab activity 

(as measured by number of 

methamphetamine lab seizure incidents)

12,852 (2009) 11,329 (2013) 9,639 Progressing, accelerated progress 

required to meet 2015 target

Objective 6—Strengthen International Partnerships and Reduce the Availability of Foreign Produced Drugs in the United 

States

Measure 6.1: Percent of selected countries 

that increased their commitment to supply 

reduction 

2009 or 

earliest 

available

[Baseline not 

provided in 

PRS report]

100 percent 

(progress to 

date)

100 percent Target met or exceeded, progress 

should be maintained through 2015 

Measure 6.2: Percent of selected countries 

that increased their commitment to demand 

reduction 

2009

[Baseline not 

provided in 

PRS report]

100 percent 

(progress to 

date)

100

percent 

Target met or exceeded, progress 

should be maintained through 2015 

Measure 6.3: Percent of selected countries 

showing progress since 2009 in reducing 

either cultivation or drug production potential 

2009

[Baseline not 

provided in 

PRS report]

29 percent

(progress to 

date) 

100 percent No progress to date, accelerated 

progress required to meet 2015 target
Attachment I: ONDCP 2015 Performance 

Reporting System Report—Performance 

Measures for Strategy Objectives, Progress 

toward 2015 Targets, and Assessment 

Categorizations

Page 21 GAO-16-660T 

Measure Baseline 

Progress to 

date 2015 Target ONDCP assessment 

Measure 6.4: Number of international 

Consolidated Priority Organization Targets 

linked organizations disrupted or dismantled 

65

(2009)

72 (2014) 60 Target met or exceeded, progress 

should be maintained through 2015 

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

Measure 7.1: Increase timeliness (year‐end 

to date‐of‐release) of select Federal data sets 

above their baseline by 10percent—

Treatment Episode Data Set(TEDS) 

17.5 Months 23.5 (2011) 16 Months Significant progress required to meet 

2015 target 

Measure 7.2: Increase the utilization (number 

of annual web hits, or number of documents 

referencing the source) of select Federal data 

sets by 10percent from the baseline

Substance Abuse and Mental Health Data 

Archive (SAMHDA) 

200,000 web 

hits/year 

937,643 (2014) 220,000 web 

hits/ year 

Target met or exceeded, progress 

should be maintained through 2015 

National Survey of Drug Use and Health 

(NSDUH) (Journal articles referencing 

NSDUH) 

37 per year 113 (2014) 41 per year Target met or exceeded, progress 

should be maintained through 2015 

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)

1 Target met or exceeded, progress 

should be maintained through 2015 

Source: ONDCP 2015 Performance Reporting System report. | GAO-16-660T

(100835)
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