The Government Accountability Office directed the federal government to boost national efforts to curb and recover from drug misuse, adding the recommendation to its biennial list of high-risk areas vulnerable to fraud, waste, abuse and mismanagement.
The largest recorded increase of drug overdose deaths occurred from May 2019 to May 2020, with the Centers for Disease Control and Prevention noting a significant increase in overdose deaths from March to May that was likely fueled by the staggering economic impacts of the COVID-19 pandemic, according to the report. The GAO offered several recommendations to better address the drug misuse epidemic.
1. Boost capacity
Capacity and access remain major issues, with nearly one-third of U.S. counties lacking substance use disorder treatment facilities as of May 2020, the Substance Abuse and Mental Health Services Administration found. There should be a five-year projection for the National Drug Control Program that estimates and prioritizes federal funding or other resources needed to achieve long-range quantifiable goals, the GAO said. There should also be clearer direction on the role of states and use of grant funding to address the training needs for those struggling with drug misuse.
2. Improve leadership
The Office of National Drug Control Policy should work with HHS, the Justice Department, Department of Education and Department of Homeland Security to coordinate drug misuse prevention and recovery efforts. That includes fostering partnerships with state, local, and tribal agencies as well as with community groups that are also working on the drug crisis.
3. Round out the action plan
The ONDCP should fill in holes related to its long-term goals, the GAO said. The office did not measure or document how its $100 million drug-free communities support program contributes to achieving specific goals and some programs at SAMHSA did not include adequate metrics to link the programs' activities to the prevention goal. The school climate transformation grant program also lacked metrics related to its impact.
4. Shore up data reporting
The ONDCP and other federal, state and local government officials have criticized the timeliness, accuracy and accessibility of data from law enforcement and public health sources related to fatal and non-fatal overdose cases. The office should lead a review of how to improve data reporting.
5. Continued vigilance
Although the rate of drug overdose deaths in 2018 decreased compared to 2017, that was reversed in 2019 as the overdose death rate increased from 20.7 to 21.6 deaths per 100,000 population—almost reaching 2017's peak. While many agencies responsible for addressing drug misuse are currently engaged in COVID-19 response and relief efforts, the drug epidemic will continue to require their attention.