Keeping Score 1998

Drug Strategies

Keeping Score 1998

Introduction

Drug Strategies prepares Keeping Score annually to capture the dimensions of the nation's drug problems as well as to assess the impact of Federal drug control spending. It is intended to help Americans understand the priorities reflected in the Federal drug budget so that they can judge for themselves the effectiveness of Federal policy. Keeping Score also identifies strategies and programs that are making a difference in communities across the country.

This annual review, supported by a grant from Carnegie Corporation of New York, is guided by our Board of Directors as well as a distinguished national advisory panel of experts from a wide range of disciplines, including law, medicine, criminal justice, public health and education. We are grateful for their insights and their wisdom; however, Drug Strategies is solely responsible for the content of this report.

Each year, Keeping Score examines how Federal anti-drug initiatives affect four areas that are at the heart of public concern about drugs: illicit drug use, drug-related crime, drugs in the workplace and the impact of drugs on health and health care costs. These measures provide a starting point for better public understanding of how pervasive the effects of drugs are in our society. Directly or indirectly, Americans all pay a price for this problem.

Federal Drug Control Spending (chart)

Federal drug control spending has grown ten-fold since 1981, when the total anti-drug budget was $1.6 billion compared to $17 billion today.(1) Under both Republican and Democratic administrations, the need for more vigorous efforts to combat drugs has been a central theme. However, for two decades,the direction of these efforts has not changed. Enforcement, interdiction and overseas programs to cut off foreign drug supplies continue to dominate spending, accounting for two-thirds of the Federal drug budget. Although the current national drug control strategy articulates the need for much greater emphasis on demand reduction, funding priorities remain the same. In 1998, prevention, education, treatment and research account for only one-third of the total drug budget, the same proportion as in 1991.(2) Although occasional cocaine and marijuana use among adults has declined substantially during the past decade, chronic, compulsive use of both drugs is increasing. Heroin continues to grow in popularity, as does methamphetamine. All these drugs are cheaper and more readily available than ever before.

Last year, Keeping Score concentrated on children and adolescents, the group most vulnerable to drugs. Since 1991, drug use among young teens has more than doubled, and attitudes towards drug use among both teens and adults have become more accepting. The most recent National Household Survey (August 1998) reported that illicit drug use in the past year among children ages 12 to 17 increased by almost two-thirds from 1992 to 1997.(3) If these trends continue, by the year 2002, teen drug use will reach the peak levels of the late 1970s.(4)

Despite widespread public concern about rising teen drug use, prevention remains the lowest priority of the Federal drug control budget. The new $195 million anti-drug advertising campaign, launched by President Clinton in 1998 to change attitudes towards drugs, represents slightly more than one percent of total Federal anti-drug spending.

This year, Keeping Score assesses Federal drug control spending with a special focus on women. We look at alcohol, tobacco and other drug use among women from many different perspectives: public health, criminal justice, impact on children, treatment and prevention. Although the number of women and girls who use illegal drugs has risen sharply in recent years, they still represent a much smaller percentage of the nation's addicts than do men. However, if binge drinking, smoking, and abuse of prescription drugs are also considered, millions more women are affected. Several recent studies have documented this silent epidemic of alcohol and other drug abuse that afflicts an estimated 31 million American women.

Substance abuse among women has adverse effects not only on the individuals involved but also on their children, their families and their communities, creating a host of health and social problems. Pregnant women who use alcohol and other drugs risk the safe and healthy development of their unborn children. Research continues to document the effects of neonatal drug exposure, which may include increased vulnerability to drug abuse as drug-exposed infants grow to adolescence. Modern economic realities have also created unprecedented changes for women as parents, employees and community members. In 1998, nearly 60 percent of adult women are employed, and their added responsibilities in the workplace have reduced their availability to participate in school and volunteer activities.

Women are still largely responsible for raising children. Alcohol and other drugs can exacerbate domestic violence, lead to child abuse and neglect and result in foster care placement. The General Accounting Office (GAO) estimates that substance abuse is a critical factor in at least three-quarters(5)of the nation's 502,000 foster care cases.(6) Millions more children are cared for by relatives under protective custody of the court because their parentsoften single mothershave serious alcohol and other drug problems.

In the past decade, arrests of girls for drug offenses have more than tripled.(7) Women have been incarcerated in unprecedented numbers, largely for drug offenses. Many women have been implicated in drug crimes through spouses or boyfriends. They are more likely than their male counterparts to be nonviolent with no criminal history or involvement in high-level drug trafficking. The majority of women behind bars leave children under age18 at home, according to a Department of Justice analysis of 1991 data (the most recent available).(8) Most of their children are taken in by relatives; about 9 percent are placed in foster care.(9) More than half of the incarcerated women are never visited by their children, often because they are imprisoned a great distance from their communities.(10) And the children of women in prison are at increased risk for alcohol and other drug use.

Keeping Score 1998 explores the dimensions of alcohol and other drug use among women and the myriad effects this problem has on families and society. The crack cocaine epidemic that erupted in the mid-1980s riveted public attention on women addicts, largely because the drug hooked them in record numbers. Thousands of "crack babies," born premature, underweight, and drug addicted, created new burdens on public hospitals and outraged public opinion. Crack also destroyed many already fragile families, increased violent, erratic behavior which often led to child abuse and neglect, and turned inner-city neighborhoods into war zones. By the late 1980s, Federal drug policy began to focus on women addicts as a distinct group. Public concern about crack babies led to new prevention and treatment initiatives designed specifically for women and their children. However, as crack abuse has slowly declined in recent years, funding for women's programs has also declined.

Yet significant problems remain. Smoking, drinking, and other drug use among adolescent girls is climbing. If current trends continue, rates of drinking among 10th grade girls will surpass rates among boys of the same age by the year 2000.(11) Girls are closing the gender gap, too, with regard to smoking. In 1997, one in five 8th grade girls reported smoking regularly, the same rate reported by 8th grade boys.(12) By 12th grade, more than one in three boys and girls are regular smokers.(13)

Marijuana use has more than doubled among young teens since 1992; however, increases among girls have been particularly rapid. In 1992, for example, only one in seven 10th grade girls reported using marijuana in the past year, compared to one in three in 1997.(14) Alcohol, tobacco and other drug use will follow many of these girls into adulthood, creating myriad problems for themselves, their families, their children and their communities.

Keeping Score 1998 brings together the latest research on women and alcohol, tobacco and other drugs. We hope that this focus will help Americans understand the need to concentrate resources where they will have maximum effect in reducing substance use and abuse among girls and women. Keeping Score also highlights a number of promising programs for girls, women and their families in communities across the country. Only a few have been rigorously evaluated; when services are scarce, as they have traditionally been for women, funds for research and evaluation are rarely available. However, we believe that the experience of the past decade suggests that the programs we describe point the way for future efforts.

Next Section

Spotlight | Methadone Maintenance Treatment | Welfare Reform and Drug Abuse
Women and Drug Abuse: Court Innovations

Programs | Prevention Programs | Pregnant and Parenting Women's Programs
Family Treatment Programs| Criminal Justice Programs

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