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U.S. Drug Misuse Rates Continue to Climb

National rates of drug misuse—using illicit drugs or misusing prescription drugs—in the United States rose from 15 percent of the population in 2003 to 19 percent in 2018. To encourage progress in this area, the U.S. Government Accountability Office (GAO) will add drug misuse to its High Risk List in 2021.

The list covers areas in need of transformation or at high risk from fraud, waste, abuse, and mismanagement. Other topics on the High Risk List include governmentwide personnel security clearance processes, the U.S. Department of Defense’s contract management, tax law enforcement, ensuring national cybersecurity, the national flood insurance program, and the management of federal oil and gas reserves, among dozens of other risk areas.

According to a GAO report issued in March 2020, Drug Misuse: Sustained National Efforts Are Necessary for Prevention, Response, and Recovery, drug misuse rates have increased in the United States since 2002, and the U.S. Substance Abuse and Mental Health Services Administration reported that more than 53 million people misused or abused drugs in 2018.

Current events may exacerbate the crisis still further. “The severe public health and economic effects of the coronavirus disease 2019 (COVID-19) pandemic could fuel some of the contributing factors of drug misuse, such as unemployment—highlighting the need to sustain and build upon ongoing efforts,” the GAO report said.

National estimates from 2018 showed that 34.6 percent of unemployed people reported drug misuse, compared to 21.3 percent of full-time employees and 24.1 percent of part-time employees.

The effects of drug misuse stretch across society, including increased healthcare needs and costs, special education needs, increased crime, increased childhood trauma, reduced workforce productivity, and loss of life. Rates of drug overdose deaths have increased nationwide since the early 2000s, the report said. In 2018, more than 67,000 people died as a result of a drug overdose in the United States.

While the GAO found that the federal government is making some progress in addressing drug misuse, “a strategic, coordinated, and effective national response—with key sustained leadership from federal agencies—is needed.”

Since fiscal year 2015, GAO has made more than 80 recommendations to multiple agencies for addressing drug misuse, but more than 60 of those recommendations have yet to be implemented.

The latest report outlined opportunities to address challenges in providing sustained leadership and coordination, including sustained implementation of the 2020 Strategy by the Office of National Drug Control Policy; guidance to states from the U.S. Department of Health and Human Services for the safe care of infants born with prenatal drug exposure; better analysis and use of drug transaction data by the Drug Enforcement Agency to prevent prescription opioid drug diversion or illicit sale; and the development and implementation of a U.S. State Department data management system for Caribbean Basin Security Initiative activities to reduce illicit drug trafficking and track trends.

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