Drug Misuse: Agencies Have Not Fully Identified How Grants That Can Support Drug Prevention Education Programs Contribute to National Goals
Fast Facts
The Departments of Education and Health and Human Services and the Office of National Drug Control Policy manage federal grant programs that can support drug prevention activities in schools.
The agencies haven't clearly defined how their grant programs support the National Drug Control Strategy's goals. Although the agencies have performance measures for their programs, some of the measures:
Didn't relate to drug prevention
Didn't link directly to the Strategy's goals
Weren't reported at all in the Strategy
Our recommendations help the agencies clarify how grant programs support the prevention-related goals of the Strategy.
Highlights
What GAO Found
The Department of Education (Education), the Department of Health and Human Services (HHS), and the Office of National Drug Control Policy (ONDCP) manage six key federal grant programs that can support drug prevention activities in schools. The flexibility of these grants supports a variety of drug prevention education programs. The agencies generally monitor grantees' compliance with grant requirements through periodic reporting.
The aim of the National Drug Control Strategy (Strategy) is to reduce drug misuse, but HHS, and ONDCP have not fully defined how several key grant programs support the Strategy. ONDCP's guidance directs agencies to report, for each grant program, performance measures that relate to the Strategy's goals. However, some performance measures for several programs did not relate to drug prevention, did not link directly to the Strategy's prevention goals, or were not reported at all. For example:
- A $372 million set-aside for HHS's Substance Abuse Prevention and Treatment Block Grant program must be used on drug prevention, but HHS did not link the program's performance measures to the Strategy's prevention education goal.
- ONDCP did not report on any performance measures in the Strategy or document how its $100 million Drug-Free Communities Support program contributes to achieving specific goals in the Strategy.
GAO also found that the approximately $10 million grants to states component of Education's School Climate Transformation Grant program could more fully provide performance information related to the Strategy's prevention education goal.
Fully understanding these programs' contributions to the goals of the National Drug Control Strategy could help Congress and the public better understand and assess how the nation's significant investments in drug prevention education programs help address the drug crisis.
Why GAO Did This Study
Most people who develop a substance use disorder begin using substances as adolescents. To reach adolescents, drug prevention programs are frequently provided in schools. Education, HHS, and ONDCP manage most federal programs that support school-based drug prevention activities.
This report (1) describes how Education, HHS, and ONDCP support drug prevention activities in schools, and monitor those efforts and (2) examines the extent to which these agencies identify how their prevention activities support the National Drug Control Strategy.
GAO reviewed agency documentation, the 2019 and 2020 National Drug Control Strategy documents which ONDCP identified as being most relevant to our review including the fiscal year 2019 drug control budget, ONDCP guidance, relevant federal laws, and GAO's prior work on attributes of successful performance measures that can help achieve agency goals. GAO also interviewed federal and state officials.
Recommendations
GAO is making four recommendations, including that Education, HHS, and ONDCP clarify how grants that can include drug prevention education programs support related goals of the National Drug Control Strategy. HHS and ONCP agreed with the recommendation and Education partially concurred, saying it would explore collecting and reporting related performance data.
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Education | The Secretary of Education should work with grantees to collect and report performance information for the grants to state educational agencies component of the School Climate program that relate to achieving the prevention education goal of the National Drug Control Strategy. (Recommendation 1) |
Education worked with state grantees to collect performance information on opioid abuse prevention and mitigation as part of their annual performance reports. The agency hoped to share information about its progress and conclusions in 2022. As of September 2022, Education had collected information on opioid abuse prevention and mitigation strategies that state grantees had incorporated into their grant activities in 2019, 2020, and 2021. For example, the number of state grantees that were implementing technical assistance events to assist school districts with implementing opioid abuse prevention and mitigation strategies had increased from 3 state grantees in 2019 to 10 state grantees in 2021. Generally, all state grantees had increased their opioid abuse prevention and mitigation strategies since 2019.
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| Department of Health and Human Services | The Secretary of Health and Human Services should clarify how the Substance Abuse Prevention and Treatment Block Grant (SABG) prevention set-aside contributes to the goals of the National Drug Control Strategy, including considering how the performance measures relate to the prevention education goal. (Recommendation 2) |
HHS agreed with this recommendation. In May 2021, HHS said it will continue working with Office of National Drug Control Policy on performance measures for the SABG prevention set-aside and better document how they relate to the prevention education goal of the National Drug Control Strategy. In August 2023, HHS clarified how the SABG prevention set-aside contributes to Goal 2 of the 2022 National Drug Control Strategy, which is "Prevention efforts are increased in the United States" and both of the goal's objectives: (1) Past 30-day alcohol use among young people aged 12-17 is reduced by 10 percent by 2025 and (2) Past 30-day use of any vaping among youth 12-17 is reduced by 15 percent by 2025. HHS also established performance measures for these objectives, including the percent of states showing a decrease in state level estimates of the percentage of survey respondents who reported 30-day use of alcohol (age 12-17) and the percent of clients receiving services who reported vaping any substances at intake and abstained from vaping at 6-month follow-up (age 12-17).
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| Department of Health and Human Services | The Secretary of Health and Human Services should determine how the State Opioid Response program contributes to the prevention goals of the National Drug Control Strategy and develop performance measures that relate to achieving those goals including the prevention education goal. (Recommendation 3) |
In August 2023, HHS confirmed that the State Opioid Response program no longer contributes to the prevention goals of the National Drug Control Strategy because the Office of National Drug Control Policy revised these goals when it issued the 2022 National Drug Control Strategy. The National Drug Control Strategy Performance Review System Report issued in March 2022, which helps assess HHS' progress to achieving the National Drug Control Strategy's goals, also clarifies that prevention goals are now focused on reducing alcohol and tobacco misuse among youth rather than opioid misuse among youth. HHS provided documentation that the State Opioid Response program now contributes to the 2022 National Drug Control Strategy's new harm reduction goal and related performance measures were identified to achieving that goal. With the revision of the prevention goals, this recommendation is no longer applicable.
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| Office of National Drug Control Policy | The Director of ONDCP should report performance measures for the Drug-Free Communities Support program and clarify how those measures are being used to assess the program's contributions to achieving specific goals of the National Drug Control Strategy, in the relevant Strategy documents. (Recommendation 4) |
ONDCP agreed with this recommendation and stated that it would develop performance measures for the Drug-Free Communities Support program that can be used to assess the program's contributions to future iterations of the National Drug Control Strategy. As of June 2023, ONDCP included two performance measures in the National Drug Control Assessment for the Drug-Free Communities Support program. These performance measures relate to reducing past 30-day alcohol use among young people aged 12-17 by 10 percent by 2025 and reducing past 30-day use of an e-cigarette among middle and high school students by 15 percent by 2025. ONDCP clarified that these performance measures were being used to assess the program's contributions to achieving Goal 2 of the National Drug Control Strategy: "Prevention efforts are increased in the United States."
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