James Carroll, Director of National Drug Control Policy, or “Drug Czar” released the Administration’s National Drug Control Strategy on Thursday, January 31. In announcing the report Mr. Carroll says that the strategy will require “ongoing efforts with a holistic approach. Families, communities, faith organizations, education, and mass media…” in supporting
the process.

The strategy is significant in that, unlike some of the early years of this office, it does include a heavy emphasis on prevention and treatment as well as the traditional tacks of interdiction and enforcement. Another departure is a recognition of the negative impacts past drug use and convictions can have on future employment. This is a departure from efforts in the 1970’s through the turn of this century to penalize people through drug testing and bans from benefits to various government programs and supports.

The Carroll statement says,

“The Strategy emphasizes the importance of preventing drug use before it begins with early intervention and evidence-based programming with a focus on at-risk youth populations. We will also look to improve the effectiveness of prescription drug monitoring plans…Addiction is a chronic disease that affects the brain, and individuals with substance use disorders deserve to be treated with dignity. We know that treatment works and that recovery is possible.”

Several presidents have designated individuals that served as their chief advisor on stopping drug use, but this office was created in 1988 with the first appointment by President George Bush in 1989 with the appointment of William Bennett. Many governors mimicked this office in the late 1980s. Much of the focus was criminal enforcement.

Carroll is the first actual Director for the Trump Administration with an appointment delayed when Congressman Tom Marino (R-PA) pulled out as a result of a controversy last year. Later a temporary administrator resigned in controversy over his education background.

Under the treatment chapter the report says, “…most people who need treatment do not seek it. According to the NSDUH, in 2017 an estimated 20.7 million Americans aged 12 or older needed treatment for a substance use disorder, but only 4 million received any kind of treatment and only 2.5 million received that treatment at a specialty facility—a disparity known as the “treatment gap.”

Under the metrics section the report includes a reference to addressing the restrictions under the Medicaid IMD regulations and limitations by saying,

“Encourage expanded access to evidence-based addiction treatment in every state, particularly Medication-Assisted Treatment for opioid addiction; support legislative changes to allow Medicaid to reimburse certain residential treatment at facilities with more than 16 beds; and encourage states to apply for state Medicaid demonstration projects that address barriers to inpatient treatment as a part of a comprehensive opioid/substance use disorder strategy.”