1. Office of National Drug Control Policy Executive Office of the President October 2002 CHART BOOK Illicit Drugs and Drug Control

2. Office of National Drug Control Policy (ONDCP) PRIMARY MISSION: To lead national efforts to reduce illicit drug use and its consequences 7/2002

3. ONDCP u Created by the Anti-Drug Abuse Act of 1988, as amended u Develops the National Drug Control Strategy and coordinates and oversees implementation u Develops Federal Drug Control Budgets u Recommends improvements in management and organization of drug control efforts u Conducts evaluations and performance measurement to improve program effectiveness 7/2002

4. National Drug Control Strategy Priorities u Stopping Use Before It Starts: Education and Community Action u Healing America’s Drug Users: Getting Treatment Resources Where They Are Needed u Disrupting the Market: Attacking the Economic Basis of the Drug Trade 7/2002

5. National Drug Control Strategy Goals Two-Year Goals: u A 10 percent reduction in current use of illegal drugs by the 12-17 age group u A 10 percent reduction in current use of illegal drugs by adults age 18 and older Five-Year Goals: u A 25 percent reduction in current use of illegal drugs by the 12-17 age group u A 25 percent reduction in current use of illegal drugs by adults age 18 and older 2/2002

6. FY 2003 Budget Highlights: Funding by Major Initiatives 7/2002

7. Stopping Use Before It Starts: Education and Community Action FY 2003 Request Safe and Drug-Free Schools Program: $644.3 million ($634.3 million drug-related) National Youth Media Campaign: $180 million Drug-Free Communities Program: $60 million Parents Drug Corps Program: +$5 million Drug-Free Workplace Programs: $3 million 8/2002

8. HHS Drug Abuse Treatment Programs Substance Abuse Mental Health Services Administration: â Targeted Capacity Expansion Program: +$109 million â Substance Abuse Prevention and Treatment Block Grant: +$60 million HHS Drug Abuse Treatment Research â National Institute on Drug Abuse: +$80.5 million (Includes planned transfer from the National Cancer Institute) Healing America’s Drug Users: Getting Treatment Resources Where They Are Needed FY 2003 Request 8/2002

9. DOJ Drug Abuse Treatment Programs Promoting Drug Treatment in the Criminal Justice System â Residential Substance Abuse Treatment: +$7 million ($77 million total) â Drug Courts: +$2 million ($52 million total) Healing America’s Drug Users: Getting Treatment Resources Where They Are Needed (continued) FY 2003 Request 8/2002

10. Disrupting the Market: Attacking the Economic Basis of the Drug Trade FY 2003 Request â Andean Counterdrug Initiative: $731 million â Coast Guard’s Deepwater Project: +$500 million â Border Control and Enforcement: +$76.3 million ($11.4 million drug-related) â Southwest Border Prosecutor Initiative: $50 million 8/2002

11. The Federal Drug Control Budget, 1988-2003 Dollars, in Billions FY 2003: President’s Request FY 2002: Enacted Level FY 2000-2001: Final Budget Authority All Other Years: Final Budget Authority/Actual Obligations 8/2002

12. The Federal Drug Control Budget, 1988-2003 Constant 2002 Dollars, in Billions FY 2003: President’s Request FY 2002: Enacted Level FY 2000-2001: Final Budget Authority All Other Years: Final Budget Authority/Actual Obligations 8/2002

13. Treatment and prevention account for almost half of Federal drug control spending Dollars, in Billions 8/2002 *President’s Request

14. Treatment and prevention account for almost half of Federal drug control spending Constant 2002 Dollars, in Billions 8/2002 *President’s Request

15. Treatment and prevention account for almost half of Federal drug control spending Constant 2002 Dollars, in Billions 8/2002 *President’s Request

16. FY 2003 President’s Request, by Function Total Resources: $11.5 Billion (Dollars in Millions) Domestic Law Enforcement Treatment w/Research Prevention w/Research 25% 29% 17% 8/2002 19% 10% Interdiction International

17. National Drug Control Budget for Research & Development (FY 2002) Total Dollars = $971.1 (in Millions) 9/2002 $554.5 $368.4 $48.2

18. Restructuring the National Drug Control Budget u In the past, the budget has partly been based on imperfect estimation techniques that gauge the portion of a program related to drug control. Under the new approach, all drug programs will tie directly to actual line items in agency budgets – establishing clearer lines of authority and accountability for results. Principles: u All funding items displayed in the drug budget should be readily identifiable line items in the Budget of the President or agency budget justifications; and u The budget presentation will be simplified by eliminating several supporting agencies from the drug tabulation. Only agencies with a primary demand reduction or supply reduction mission would be displayed in the drug budget. 7/2002

19. Restructuring the National Drug Control Budget u Department of Defense u Department of Education Safe and Drug-Free Schools u Health and Human Services SAMHSA NIDA u Department of Justice BOP DEA OCDETF INS OJP u ONDCP u Department of State u Department of Transportation Coast Guard u Department of Treasury Customs Service OCDETF u Department of Veterans Affairs u Other Presidential Initiatives Drug-Free Workplace Programs Parents Drug Corps Program Agencies Included Under Budget Restructuring: 8/2002

20. FY 2001 FY 2002 FY 2003 FY 02-03% Final BA Enacted Request Change Change Treatment (w/ Research)$2,939.0$3,135.5$3,325.6$190.16.1% Prevention (w/ Research)1,889.82,030.41,988.6(41.9)(2.1%) Domestic Law Enforcement2,464.52,781.92,859.577.62.8% Interdiction1,895.31,968.02,155.8187.99.5% International617.81,086.01,113.227.22.5% Total$9,806.32$11,001.74$11,442.67$440.94.0% Federal drug control funding by function ($ in millions) (Detail may not add to totals due to rounding ) Restructuring the National Drug Control Budget Modified Pro Forma Drug Control Budget

21. The Current Drug Situation

22. Summary of Current Situation: The 2001 National Household Survey n Overall drug use increased from 2000. The rate of current (past month) illicit drug use rose from 2000, up from 6.3 percent of the population 12 years and older to 7.1 percent in 2001. This represents an estimated 15.9 million current users in 2001. n Marijuana is the most commonly used illicit drug--77 percent of current illicit drug users used marijuana, and approximately 56 percent consumed only marijuana. There were 12.2 million current users of marijuana in 2001. n The highest rate of use was found among young adults (ages 18-25) with 18.8 percent reporting current use, and among youth (ages 12-17) with 10.8 percent. n Current use of cocaine in the household population is down from its peak of 3.0 percent of the population in 1985 to 0.7 percent, or 1.7 million, in 2001. n There were 4.8 million nonmedical users of a psychotherapeutic drug (2.1 percent). Current stimulant users accounted for 1.0 million users (0.6 percent), with methamphetamine users comprising a subset of 576,000 (0.5 percent). n There were 1.3 million current users of hallucinogens (0.6 percent), including 320,000 users of LSD (0.1 percent). Also included are 786,000 current users of MDMA/ecstasy (0.3 percent). 9/2002

23. Summary of Current Situation: (Continued) Estimates of substance abuse initiation in the 2001 NHSDA are: n There were 2.4 million new marijuana users in 2000, relatively unchanged from 2.3 million in 1999 and 2.5 million in 1998. The average age at first use was 17.5 years. n Youths aged 12 to 17 have constituted about two-thirds of the new users of marijuana in recent years, with young adults aged 18 to 25 constituting most of the remaining third. n New cocaine users in 2000 numbered about 926,000, slightly up from 1999 (851,000). n First-time users of hallucinogen (including LSD and PCP) were estimated at 1.5 million, the highest estimate since 1965. 9/2002

24. n Among youth (ages 12-17), the rate of any illicit drug use in the past month is higher by a statistically significant amount, from 9.7 percent in 2000 to 10.8 percent in 2001. n The increase in current use of any drug was fueled by a significant increase in marijuana use, from 7.2 percent to 8.0 percent. n Past year increases were found in the use of any illicit drug (9.7 percent to 10.8 percent), for marijuana (13.4 percent to 15.2 percent) and for nonmedical use of any psychotherapeutic (7.1 percent to 7.9 percent). n The percentage of youth reporting “great risk” in smoking marijuana once or twice a week declined from 56.0 percent to 53.5 percent. Summary of Current Situation: (Continued) 9/2002

25. Percent Reporting Past Month Use of Any Illicit Drug Source: SAMHSA, National Household Survey on Drug Abuse. New survey series* *The survey methodology was changed in 1999. Estimates based on the new survey series are not comparable to previous years. 9/2002 For the total population ages 12 or older, there was a statistically significant increase in 2001.

26. Current Drug Use, Population 12 and Older Percent Reporting Past Month Use Source: SAMHSA, National Household Survey on Drug Abuse. DATA BREAK* *The survey methodology was changed in 1999. Estimates based on the new survey series are not comparable to previous years. 9/2002

27. Past Month Use of Any Illicit Drug, Marijuana, Cigarettes, and Alcohol Among Those Aged 12 and Older Percent Reporting Past Month Use Source: SAMHSA, National Household Survey on Drug Abuse. DATA BREAK* *The survey methodology was changed in 1999. Estimates based on the new survey series are not comparable to previous years. 9/2002

28. 15.9 million were current (past month) users of an illicit drug in 2001. (other than marijuana ) (incl. crack) Past Month Users (in Millions) Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

29. New survey series* Among youth and young adults, current use of any illicit drug increased from 2000 to 2001. Percent Reporting Past Month Use of Any Illicit Drug Source: SAMHSA, National Household Survey on Drug Abuse. *The survey methodology was changed in 1999. Estimates based on the new survey series are not comparable to previous years. 9/2002 18-25 12-17

30. Marijuana only Marijuana and some other drug Only a drug other than marijuana Among current drug users, marijuana is the most commonly used illicit drug. Total Current Users: 15.9 million Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

31. Among youth (aged 12 to 17), current use of any illicit drug in 2001 increased significantly from 2000 for any illicit drug and for marijuana specifically. Percent Reporting Past Month Use Source: SAMHSA, National Household Survey on Drug Abuse. 9/2002

32. Percent Reporting Past Month Use Source: SAMHSA, 2001 National Household Survey on Drug Abuse. Young adults have the highest drug use rates. 9/2002

33. Percent Reporting Past Month Use Overall drug use rates peak at age 19, with almost one in four reporting current use of an illicit drug. Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

34. Males consistently have higher rates of illicit drug use. Percent Using Any Illicit Drug in the Past Month Source: 2001 National Household Survey on Drug Abuse 9/2002

35. Persons of multiple race have the highest rate of current use of any illicit drug. Percent Using in Past Month (12 and older) Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

36. Current use of any illicit drug is lowest in rural areas. Percent Using in Past Month Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

37. Marijuana accounts for the largest proportion of drug use, both among youth and in the general population. Percent Reporting Use Age 12 or Older Youth (12 -17) Source: 2001 National Household Survey on Drug Abuse 9/2002

38. Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002 Example of an aging cohort of drug users -- this group began use in the late 1970s. Current drug use varies widely by age, but the cohort effect lasts a lifetime. Percent Reporting Past Month Use of an Illicit Drug

39. While methamphetamine use is low, it continues to be a major concern due to the potential for rapid spread. u ADAM data and the 1999 NHSDA State-level data both indicate that methamphetamine use is primarily a problem in Western and Southwestern states, especially in certain key cities. u There are valid concerns about the potential impact and spread of methamphetamine use, especially into the Midwest. u Using treatment admission rates as a proxy for the spread of methamphetamine use shows a dramatic shift over the last five years. u The following slide illustrates clearly the pattern of the spread and the full extent of the problem. 9/2002

40. Source: SAMHSA, Treatment Episode Data Set. Methamphetamine Admission Rates (per 100,000) Since 1994, methamphetamine problems have spread from the Far West to States along the Mississippi. > 55 < 3 No data 3-27 28-54 1994 MAI NE 1996 MAI NE 1998 MAI NE 1999

41. Drug Use Among Youth

42. Data sources: u National Household Survey on Drug Abuse (NHSDA) u Monitoring the Future study (MTF) u Youth Risk Behavior Survey (YRBS)

43. n Among youth (ages 12-17), the rate of any illicit drug use in the past month is significantly higher, from 9.7 percent in 2000 to 10.8 percent in 2001. n The increase in current use of any drug was fueled by a significant increase in marijuana use, from 7.2 percent to 8.0 percent. n Past year increases were found in the use of any illicit drug (9.7 percent to 10.8 percent), for marijuana (13.4 percent to 15.2 percent) and for nonmedical use of any psychotherapeutic (7.1 percent to 7.9 percent), specifically pain relievers (5.4 percent to 6.4. n Lifetime increases were found for any illicit drug (26.9 percent to 28.4 percent) and for marijuana (18.3 percent to 19.7 percent), ecstasy (from 2.6 percent to 3.2 percent), and pain relievers (8.4 percent to 9.4 percent). n A significant decrease in the rate of lifetime use of LSD was noted, from 3.6 percent to 3.1 percent. This is likely due to the movement of some who have tried LSD into the next older cohort of young adults. n Several measures of youth perception of risks of drug use declined significantly from 2000 to 2001. The percentage of youth reporting great risk in smoking marijuana once or twice a week declined from 56.0 percent to 53.5 percent, as did those reporting great risk of using cocaine once a month (from 55.4 percent to 54.1 percent), and those reporting great risk of trying heroin once or twice a week (from 84.1 to 83.1 percent). 9/2002 Summary of Current Youth Situation 2001 National Household Survey

44. Among youth, 2.6 million were current (past month) users of an illicit drug in 2001. (other than marijuana ) (incl. crack) Past Month Users (in Millions, ages 12-17) Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

45. ILLICIT DRUG USE AND OTHER RISK BEHAVIORS

46. Among youth, there is a clear relationship between the amount of alcohol consumed and current use of an illicit drug other than alcohol. 9/2002 Source: 2001 National Household Survey on Drug Abuse Percent Using Any Illicit Drug in the Past Month (Age 12-17)

47. Source: 2001 National Household Survey on Drug Abuse 9/2002 Among youth, there is also a clear relationship between smoking cigarettes and current illicit drug use. Percent Using Any Illicit Drug in the Past Month (Age 12-17)

48. Percentage of those ages 12 to 17 who reported aggressive behavior in the past 6 months, by frequency of marijuana use Aggressive anti-social behavior among youth is clearly linked to frequency of marijuana use Source: NHSDA Household Survey Data, 1994-1996 Percent Who Destroyed Other's PropertyPercent Who Physically Attacked People Number of days used marijuana in the past year 4/2002

49. Percentage of those ages 12 to 17 who reported delinquent behavior in the past 6 months, by frequency of marijuana use Marijuana use is also related to other delinquent behaviors Source: NHSDA Household Survey Data, 1994-1996 Number of days used marijuana in the past year Percent Who Cut ClassesPercent Who Stole

50. Percent Reporting Driving Under the Influence of an Illicit Drug Source: 2001 National Household Survey on Drug Abuse 9/2002 Drugged driving is highest among young adults.

51. Source: SAMHSA, 1999 and 2000 National Household Survey on Drug Abuse (Initiation of Marijuana Use: Trends, Patterns, and Implications). Percent with Illicit Drug Dependence or Abuse (Past Year) (Dependence Based on DSM-IV Diagnostic Criteria, Age 26 or older) Drug dependence as an adult is clearly related to the age at which a person starts using marijuana. The younger the age at first use, the higher the rate of adult drug dependency. Age at First Use of Marijuana 9/2002

52. Demand Reduction Strategy n Drug use is a preventable behavior Ô Stop initiation n Drug use is responsive to deterrence Ô Intervene with users n Drug dependence is treatable Ô Improve treatment Targets: Ô those who have not initiated Ô those who have initiated Ô those who are dependent 9/2002

53. Role and Objectives of Drug Prevention n Deter new use and encourage existing users to stop using n Take steps to deter progression into more serious use n Break intergenerational cycle n Reduce risk factors and increase protective factors n Improve knowledge and attitudes n Reduce drug and alcohol problem behaviors 4/2002

54. Number of new users (1,000s) Marijuana initiation appears flat, but alcohol is trending upwards while new cigarette users is down. Source: SAMHSA, National Household Survey on Drug Abuse, 1991-2001. 9/2002 *2000 data on alcohol and cigarettes not available.

55. Number of new users (1,000s) Heroin initiation rates are lower than for any other major drug. Cocaine initiation is on a rising trajectory since the early 1990s. Source: SAMHSA, National Household Survey on Drug Abuse, 1991-2001. 9/2002

56. Consequences of Drug Use The Social Costs of illicit drug abuse were projected to cost $161 billion in 2000 U.S. drug users spend about $64 billion in 2000 to purchase drugs Cocaine and heroin problems seriously impact our hospital emergency departments: cocaine continues to be the most frequently mentioned illicit drug, followed by heroin and marijuana Half of all arrestees test positive for illicit drug use There is a high correlation between drug use and gang behavior, violence, threats, and carrying a gun to school There is a high incidence of property crime among drug users 8/2002

57. Money Spent on Drugs U.S. Users Spend $64 Billion in 2000 Billions of Dollars (Projection) Source: ONDCP, What America’s Users Spend on Illegal Drugs (December 2001). 8/2002

58. Dollars, in Millions “Direct” costs include health care costs, costs of goods and services lost to crime, and social welfare costs. Source: ONDCP (2001)The Economic Costs of Drug Abuse in the United States, 1992-1998. Direct economic costs of drug abuse in constant 2000 dollars *Projections 9/2002

59. Indirect economic costs of drug abuse in constant 2000 dollars Source: ONDCP (2001)The Economic Costs of Drug Abuse in the United States, 1992-1998. “Indirect” costs are from lost productivity attributable to drug abuse. *Projections 9/2002 Dollars, in Millions

60. The economic costs of drug abuse in constant 2000 dollars (direct vs. indirect) Source: ONDCP (2001)The Economic Costs of Drug Abuse in the United States, 1992-1998. “Direct” costs include health care costs, costs of goods and services lost to crime, and social welfare costs. “Indirect” costs are due to lost productivity. *Projections 9/2002 Dollars, in Millions

61. Police protection and corrections account for almost half (47%) of direct costs. 2000 Direct Costs $50.2 Billion (Millions of dollars) Source: ONDCP, The Economic Costs of Drug Abuse in the United States, 1992-1998. “Direct” costs include health care costs, costs of goods and services lost to crime, and social welfare costs. 9/2002

62. Direct Cost Components u Health Care Costs u Goods and Services Lost to Crime u Social Welfare Costs 9/2002

63. Health Care Cost Components u Community-based specialty treatment u Federally provided specialty treatment u Support for drug abuse related services u Medical consequences of drug abuse è hospital and ambulatory care è special disease costs è crime victim health care costs è health administration costs 8/2002

64. Goods and services lost to crime u Criminal justice system and other public costs ! police protection ! legal adjudication ! state and federal corrections ! local corrections ! federal spending to reduce drug supply u Private costs ! private legal defense ! property damage for victims of crime 9/2002

65. Indirect Cost Components u Lost productivity from: è Premature death è Drug abuse related illness è Institutionalization/hospitalization è Victims of crime è Incarceration è Crime careers 9/2002

66. Drug-related murders have declined substantially over the past 10 years. Source: FBI, Uniform Crime Reports Murders Related to Narcotic Drug Laws Number of Deaths

67. In 2001, more than 600,000 drug-related ED episodes were reported in DAWN -- cocaine is the most often mentioned drug. Number of Drug Emergency Mentions Source: SAMHSA, 2001 Drug Abuse Warning Network. 8/2002

68. Since 1990 marijuana ED mentions have been rising. In 2001 they exceeded the number of heroin mentions. Source: SAMHSA, 2001 Drug Abuse Warning Network. Number of Drug Emergency Mentions 8/2002

69. Since 1990, ED mentions of marijuana/hashish have increased by more than 500 percent. Source: SAMHSA, 2001 Drug Abuse Warning Network. Number of Emergency Mentions of Marijuana/Hashish 8/2002

70. Among youth, ED mentions of marijuana/hashish have shown a seven-fold increase since 1990. Number of Marijuana/Hashish Mentions (Ages 12-17) Source: SAMHSA, Drug Abuse Warning Network.

71. Mentions per 100,000 population for Marijuana Rates for ED mentions of marijuana are highest for young adults and are increasing. Source: SAMHSA, Drug Abuse Warning Network.

72. Cocaine emergency episodes by location Source: SAMHSA, Drug Abuse Warning Network.

73. ILLICIT DRUGS AND THE CRIMINAL JUSTICE SYSTEM

74. Drug-related criminal activity is still a serious problem Source: NIDA, Drug Procurement Study. l NIDA study of drug users not in treatment found: -- 46 percent report legal-only sources of income -- 10 percent report illegal-only sources of income -- 42 percent report both legal and illegal sources -- 2 percent report no income -- 30 percent of illegal income was generated from property crimes; 42 percent was from prostitution

75. Number of Arrests Total Arrests and Drug-Related Arrests, 1980-2000 Source: Uniform Crime Reports, Federal Bureau of Investigation. 8/2002

76. All other offenses Drug violation arrests Drug violation arrests accounted for 11% of all arrests in 2000. Total Arrests: 13.98 million Source: Uniform Crime Reports, Federal Bureau of Investigation. 9/2002

77. Adults on parole or supervised release and those on probation have substantially higher rates of current drug use compared to adults not under criminal justice system (CJS) supervision Percent Reporting Past Month Use of Any Illicit Drug Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 10/2002

78. The total number of inmates in State or Federal prisons or local jails reached more than two million in 2000. State Prisons 1,236,476 Local Jails 621,149 Federal Prisons 145,416 Number of inmates (millions) Source: Bureau of Justice Statistics, 2001.

79. Total State and Federal Prisoners: 1.4 million Source: Bureau of Justice Statistics, 1999. 10/2002 The majority of state and federal prisoners are not incarcerated for drug offenses.

80. State Prisons Federal prisons Estimated drug offenders in custody, 1999 Total Estimated Drug Offenders: 336,400 Source: Bureau of Justice Statistics. 4/2002

81. Drug Treatment

82. Clients in Specialty Treatment for Drugs and Alcohol (one-day census of active clients) More than 1 million persons are in treatment, every day Source: Uniform Facility Data Set, DHHS/SAMHSA, 1995-98

83. DSM-IV checklist for substance abuse Substance Abuse A definite diagnosis of abuse is made when any one of A and both B and C are “Yes.” A. Has the client experienced the following?NoYes 1. Recurrent failure to meet important responsibilities due to use? 2. Recurrent use in situations when this is likely to be physically dangerous? 3. Recurrent legal problems arising from use 4. Continued use despite recurrent problems aggravated by the substance use B. These symptoms have occurred within a 12-month period C. Client had never met the criteria for dependence 8/2002

84. DSM-IV checklist for substance dependence Substance Dependence A definite diagnosis of dependence is made when any three of A and both B are “Yes.” A. Has the client experienced the following?NoYes 1. Tolerance (needing more to become intoxicated or discovering less effect with the same amount) 2. Withdrawal* (characteristic withdrawal associated with type of drug) 3. Using more or for longer periods than intended 4. Desire to or unsuccessful efforts to cut down 5. Considerable time spent in obtaining the substance or using, or recovering from its effects 6. Important social, work, or recreational activities given up because of use 7. Continued use despite knowledge of problems caused by or aggravated by use B. Have these positive items been present during the same 12 month period? Are three or more of the above positive? *A clear cut withdrawal syndrome is not present with some classes of drugs: caffeine, marijuana, phencyclidine, or hallucinogens. 8/2002

85. More than half those in treatment are being treated in outpatient settings Percentage of Clients in Treatment, by Facility Setting Source: Uniform Facility Data Set, DHHS/SAMHSA, Dec 97

86. Referral source for treatment admissions, by primary substance SOURCE: SAMHSA, Treatment Episode Data Set, 1999 8/2002

87. Criminal justice treatment referrals, by primary substance SOURCE: SAMHSA, Treatment Episode Data Set, 1999 8/2002

88. Presenting problems can include both alcohol and other drugs, but illicit drug use is present for 73 percent of those in treatment SOURCE: SAMHSA, Treatment Episode Data Set, 1999 8/2002

89. Treatment Admissions by Primary Substance of Abuse (Ages 12 and Older) SOURCE: SAMHSA, Treatment Episode Data Set, 1999 8/2002

90. Treatment Admissions by Primary Substance of Abuse (Ages 12 - 17) SOURCE: SAMHSA, Treatment Episode Data Set, 1999 9/2002

91. A total of 16.6 million persons were drug or alcohol dependent or abusers in the past year. Number of Dependents or Abusers (in 1000s) Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

92. 5.6 million persons reported substance abuse or dependence on an illicit drug in 2001. Past year substance abuse or dependence (in Millions) Source: SAMHSA, 2001 National Household Survey on Drug Abuse. (Nonmedical use) 9/2002 Dependence or abuse is based on the definition found in the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

93. Of those diagnosed with drug dependence or abuse, two out of three are drug dependent. Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 9/2002

94. Among current users, about one in three are considered to be in need of treatment; less than one- fifth received treatment in the past year. Number in Millions (12 or Older). Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 10/2002

95. Most of those in need of drug treatment did not seek specialty treatment. Total in need of treatment = 6.1 million. Source: SAMHSA, 2001 National Household Survey on Drug Abuse. 10/2002

96. One year after treatment Illicit drug use decreased 50 percent Illegal activity decreased 60 percent Drug selling fell by nearly 80 percent Arrests by down more than 60 percent Trading sex for money or drugs down by nearly 60 percent Homelessness dropped by 43 percent and receipt of welfare by 11 percent Employment increased 20 percent Source: Drug Abuse Treatment Outcome Study (DATOS) National Treatment Improvement Evaluation Study (NTIES) THE EFFECTS OF DRUG TREATMENT LAST

97. FIVE YEARS AFTER TREATMENT Users of any illicit drugs reduced by 21 percent Cocaine users by 45 percent Marijuana users by 28 percent Crack users by 17 percent Heroin users by 14 percent Numbers engaging in illegal activity significantly reduced 56 percent fewer stealing cars 38 percent fewer breaking and entering 30 percent fewer selling drugs 23 percent fewer victimizing others 38 percent fewer injecting drugs 34 percent fewer homeless THE EFFECTS OF DRUG TREATMENT LAST (continued) Source: Services Research Outcome Study (SROS)

98. In summary Drug dependent people who participate in drug treatment decrease their drug use decrease their criminal activity increase their employment improve their social and intrapersonal functioning improve their physical health Drug use and criminal activity decrease for virtually all who enter treatment, with increasingly better results the longer they stay in treatment.

99. Supply Reduction

100. Interdiction must be included as a key element in a comprehensive approach n Interdiction alone cannot greatly impact the drug flow. It must be supported by other programs and approaches, if it is to have the desired impact. n Without production control at the source, with every interdiction the producers can simply increase production. We must focus attention on destroying the source of drugs in the prime source countries. n Targeted interdiction based on solid intelligence data will have the greatest longterm impact.

101. The Source Country Focus n Provides for better intelligence, so interdiction assets can be strategically placed and efficiently used n Focuses attention close to where drugs are produced, increasing the leverage from each action n Limits production to maximize the impact from interdiction and eradication n Interdiction is most effective when it occurs closest to the source because alternative supplies of coca leaf and base are limited n Thus, stopping the flow before the drugs can be moved into the broader expanse of the transit zone is the most effective strategy

102. Breaking Up the Delivery System n Our strategy also focuses on breaking up the delivery system, at all levels n The air bridge between Peru and Colombia has historically been seen as the weakest link, and, over the years, there has been some success there n Peru and Colombia end game participation is key to success n Successfully attacking the air bridge and other key supply routes can cause backups all the way back to the sources of coca leaf, depress the price, and impact profits

103. The Worldwide Cocaine Threat A Hemispheric Perspective U.S. Portion of Worldwide Consumption Declining 1990 = 350 MT 2000 = 250 MT Worldwide Consumption Increasing 1990 = 200 MT 2000 = 400 MT All coca is grown in the Andean Region 8/2002

104. Source: Performance Assessment Review, US Interdiction Coordinator, June 2000

109. Andean Region Coca & Poppy Cultivation 1995-2000 Success and Displacement BOLIVIA Coca cultivation decreased 70% to 15K hectares Alternative development and forced eradication Sound economic policies but slow growth PERU Coca cultivation decreased 70% to 34K hectares Air-bridge denial and abandonment Alternative development and forced eradication Democratic transition, economy slow COLOMBIA Coca cultivation increased 166% to 136K hectares Cocaine yield per hectare increased 250% Opium poppy cultivation reached 2500 hectares Displaced cultivation from Peru and Bolivia Violence increasing as peace process falters and economy lags

110. Nature of the Problem and the Interdiction Response 19902000 CHANGES IN THREAT World consumption dominated by US Transit movement via aircraft Cultivation primarily from Peru and Bolivia Increasing European consumption Transit movement via maritime vessels Cultivation primarily from Colombia TRANSIT ZONE SOURCE ZONE ARRIVAL ZONE 50% 3% direct 16% 21% 10% SOURCE: Annual Interagency Assessment of Cocaine Movement, April 2001 ONDCP/DEC 01

111. METRIC TONS HCl 930 950875 825782847 ANDEAN POTENTIAL COCAINE PRODUCTION 1995 - 2001 8/2002 930 TOTALS Source: U.S. Department of State. Interagency Narcotics Control Strategy Report, (1998-2001)

112. 72 % Mexico/Central American Corridor 2001 Estimate of Cocaine Flow from South America 26 % Caribbean Corridor 2 % Direct to U.S. Source: Interagency Assessment of Cocaine Movement, ONDCP, 22nd edition, March 2002 8/2002

113. EUROPE 97% AFRICA < 1% CANADA <1% ASIA < 1% 2000 COCAINE FLOW DIRECT TO NON-U.S. MARKETS -- 104 MT TOTAL UNKNOWN 2% Source: Interagency Assessment of Cocaine Movement, ONDCP, 21st edition, February 2001 8/2002

114. Colombia - Crisis in 1999 DRUGS Colombia producing 74% of world coca leaf -- and 90% of all cocaine HCl shipped to U.S. Cultivation exploding and concentrating in isolated, guerrilla-dominated areas east of Andes GUERRILLAS Especially FARC, moving heavily into Colombia’s expanding drug production Becoming stronger and more capable of attacking government PARAMILITARIES Maintaining some links with COMIL, at least at local level Challenging FARC in the south, and vying for access to drug revenue ECONOMY Going into deep recession, first in 50 years Foreign investment drying up Domestic capital fleeing World bank seeking austerity budget PEACE PROCESS Began in 1998 DMZ established Process moving slowly FARC unwilling to make concessions

115. Widespread Effects of Narcotrafficking Adversely impacts democracy and social development Destabilizes governments Undermines rule of law Exacerbates corruption Distorts legitimate economies Inhibits investment and economic growth

116. 0 1,000 2,000 3,000 4,000 5,000 6,000 199119931995199719992001 METRIC TONS OPIUM GUM Mexico Colombia Vietnam Thailand Laos Burma Pakistan Afghanistan World Potential Opium Production 1991-2001

117. 0 1,000 2,000 3,000 4,000 5,000 6,000 1992199319941995199619971998199920002001 METRIC TONS OPIUM GUM Rest of World Afghanistan Afghanistan vs. the World Opium Production 1992-2001

118. FEDERAL-WIDE DRUG SEIZURE SYSTEM ANNUAL SEIZURES, BY FISCAL YEAR Source: DEA's Federal Drug Seizure System

119. Marijuana seizures along Southwest Border rising dramatically Note: 1. Prior to Oct. 1995, EPIC used a 100 kg. seizure threshold. 2. Investigation seizures are within 150 mi of US/Mx border 3. Effective Oct. 2001, 25 kg minimum threshold *Calendar year estimates based on data thru June 2002 Data source: El Paso Intelligence Center (EPIC) Presented by: ONDCP, OPB, Aug 2002 9/2002