Drug Policy

GAO: Federal Funds for Drug Rehab Are Going to Programs That Don't Work

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The tagline of the Office of National Drug Control Policy is "Relying on science, research and evidence to improve public health and safety in America." A review of the ONDCP's drug control strategy report released this week by the Government Accountability Office, however, suggests there's a lack of evidence in at least one area of the agency's program. 

"While agencies make efforts to ensure that grantees implement interventions that have proven to be effective," the report reads, "we found that HHS, DOJ, and Education agency officials and the other experts we spoke with reported various challenges in identifying interventions that are proven effective."  

More from that particular section: 

Agency officials and experts told us that local-level data for assessing the effectiveness of interventions often are limited. For example, local data are often not available because of the high cost and intensive resources necessary for collection. If they are available, there are often gaps in the data—for example, data that are collected only every other year. Further, limited population-level information exits for smaller populations that may bear a disproportionate burden of drug abuse-related morbidity and mortality (i.e., American Indian and Alaska Native populations). In addition, officials said that determining the impact of a prevention intervention can be a challenge because it is often difficult to quantify something that did not happen—such as a youth's decision not to use illicit drugs—because of a preventive measure

The report also states the DOJ in particular "give[s] preference to applicants that adopt interventions for their programs that include features that have been determined to be effective." Gives preference? Shouldn't the disbursement of grants and other funds be 100 percent dependent on a firm's ability to show that it can, you know, actually help drug users? 

If there's one industry the DOJ is quite confident about shoveling money to it's drug courts:

DOJ gives Drug Court Program grant applicants greater consideration during review of grant applications when they demonstrate that a program's design is consistent with seven evidence-based program design features, which OJP considers to be indicators of an effective program. For example, evidence-based program design features include screening and assessment as well as monitoring activities. More specifically, the screening and assessment feature requires that applicants demonstrate an ability to screen promptly and systematically for all offenders potentially eligible for the drug court, identify the agency that will conduct this screening, and detail the procedures that will be used for screening. Monitoring involves the inclusion of a comprehensive plan to monitor drug court participants using random drug testing and community supervision, disseminate results efficiently to the drug court team, and immediately respond to noncompliance according to established program requirements. 

Fun fact: The only way a drug court can receive federal funding is if it locks up people who fail their piss tests or miss appointments. Courts that use other means for encouraging compliance–like San Francisco, which requires people who test dirty their first time to write essays–aren't eligible for federal funds. 

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  1. Yeah, I’m not for giving my hard-earned tax dollars to those touchy-feely programs that coddle drug users. They’re drug users. They use drugs. I want the hardcore, zero tolerance systems that give our corrections officers employment security.

    1. Apparently that’s because you hate blacks, Fist. If you don’t support giving money to people, you’re racist. Tony said so.

  2. determining the impact of a prevention intervention can be a challenge because it is often difficult to quantify something that did not happen

    I have to call bullshit on this. Remember all the numbers about jobs saved or created?

  3. I’m still trying to wrap my head around getting mad at a hot blonde who gets drunk a lot.

    1. It’s like Mitch Hedberg said. Alcoholism is a disease, but it’s the only disease you can get yelled at for having.

  4. I actually had a discussion about this with someone connected to the rehab industry.

    Let’s leave to one side the entire issue of how you measure the success of compulsory rehab in the first place, and only talk about voluntary rehab.

    Voluntary rehab is essentially a category of therapy. If we aren’t talking about a chemical treatment or pill, you’re essentially measuring the success of a series of individual relationships between therapists and addicts. And whatever measurements you make can’t really be scaled, can’t be applied to different situations, and aren’t scientifically meaningful.

    A charismatic personality passionately committed to helping someone will probably attain success in “helping” an addict, no matter what stupid approach they take. (Call this the “Tyler Durden” theory of therapy.) But you can’t tape record everything that therapist does, have Uncharismatic Uncommitted Clockwatching Therapist try to go through the motions of doing it, and expect them to be successful. The success of a relationship-driven event is entirely based on the personalities involved in the relationship, and lessons from it can’t be generalized to other situations involving different people. Not at a level any more sophisticated than what you see in Dating Advice columns.

    And that means that measuring the success of different programs isn’t really giving you any information you can productively use.

  5. Fun fact: The only way a drug court can receive federal funding is if it locks up people who fail their piss tests or miss appointments.

    And right there is the hard truth about federal drug policy, no matter what Kerlikowske says. There is nothing the government craves more than criminalizing human behavior, since that gives it more power.

  6. Alt text: “Fuck you, lamp!”

  7. writing essays?

    oh, i get it now, you have no control over your body because we’re all 6th graders without rights! It was so obvious.

    1. San Francisco, which requires people who test dirty their first time to write essays

      “”5 Drugs I Did This Summer, by Jonas Herndorf

      This summer, I did a lot of drugs. I enjoyed some of them, some were OK, and one really failed to please me. I especially liked one drug, which I keep doing now all the time, and which I recommend to people who also like doing drugs.

      The first drug I tried was crack. It was OK. It was cheap, and it got me really high, but it didn’t last very long, and people kept saying I smelled like a black person.

      The next drug I tried was PCP. It was not good at all. I don’t remember getting high and apparently I was found naked in a bush. I also had a headache.

      The next drug I tried was Heroin. Wow! Seriously, this stuff is great. Everyone should try it. I bet it will be very popular in a few years. It was reasonably priced, got me very high, and lasted a long time. The only thing is I feel itchy now and need to go shoot up again.

      The last drugs I tried were Methamphetamine and Ketamine. They were OK but I like heroin better. So, in summation: Heroin is great, crack is cheap, and PCB makes you take your clothes off. Those are the drugs I did this summer. THE END.””

      1. excellent.

        btw, fun fact…

        speaking of PCP and taking clothes off…

        according to the FBI LEJ, calls where officers respond to drug/mental complaints (not streakers) where the persons have stripped off their clothes are statistically amongst the most dangerous of calls an officer can go to.

        iow, nekkid EDP’s can be EXTREMELY dangerous. same behavior is also assocation with excited delirium, a condition some are skeptical of, but i have seen it too many times to doubt it (plus imo the literature/data supports it).

        1. That does make sense.

          My schizophrenic little brother once had a bad episode when he’d not taken his meds for a while…it involved the cops, and he was naked, and he’d cut himself with a knife a bit.

          Fortunately for everyone, they talked him down and he went to the hospital.

          A few months ago, another unarmed mentally shaky guy was killed by police in the same town. Well, he had his pants on, but he was black.

          https://www.commondreams.org/view/2012/04/05-0

          That story was mentioned here @ H+R

      2. “C-, needed more detail. Did not meet page number requirements. Some grammar and syntax was below 6th grade reading standards.”

        1. Jonas: “”I passed! Whee! Now mom won’t make me change the cat litter all the time!””

  8. GAO: Federal Funds for Drug Rehab Are Going to Programs That Don’t Work

    Of course, otherwise they lose sight of their true purpose: To give make-believe jobs to politically-friendly wonks.

  9. needless to say i deal with a lot of addicts.

    as for opioid addicts, some have had success with suboxone. others are currently using methadone.

    many others have tried one or both and they didn’t work for them, and they went back on the hard stuff.

    some others have just quit cold turkey. it only takes about 4-6 days based on literature and the anecdotal reports I hear to break the PHYSICAL addiction, but psychological craving continue.

    any drug that affects the pleasure centers (cocaine, opioids) such as dopamine and serotonin is going to leave at a minimum strong psychological cravings because people want to feel good. period.

    there are also a number of OTC drugs that help with withdrawal, whether or not FDA approved for it – they do help.

    1. as for opioid addicts, some have had success with suboxone. others are currently using methadone.

      “Success” in substituting some shitty synthetic opioid for their preferred drug. Calling coerced substitution “treatment” is just bizarre.

      1. sure, switch heroin addicts to another opioid addiction.

        But pain-patients? Fuck em!

        W.T.F.F.

        1. i have repeatedly criticized the fact that many states make it way too difficult to get opioids for pain relief. in WA, draconian laws passed by our legislature mean many pain patients cannot get the opioids they need

          nobody is a harsher critic of that shit than i am

          fwiw, i have used oxycontin, dilaudid, etc. pursuant to severe trauma, etc. and i am aware of the efficacy of such drugs.

          imo, just because SOME people will abuse the scripts dr’s write, that’s THEIR fucking problem, ditto if they OD and die (and i have been going to a LOT of opioid OD’s ever since the oxycontin heroin craze started. over twice as many as in the past).

          the problem is many doctors are either legitimately afraid to prescribe proper dosages or hampered by draconian state regulations and DEA oversight

          1. nobody is a harsher critic of that shit than i am

            Yet it doesn’t stop you from repeating the same worn-out bullshit talking points.

            Talk, Walk, etc.

            and, if it quacks like prohibitionist, etc

      2. well, yes.

        fwiw, methadone is the preferred opioid for medicaid (or is it medicare, i get those confused) and there has been a lot of controversy because of several OD deaths on it and the argument that it can have longer lasting effects than classic opioids (oxycodone, etc.) such that blood levels are less easy to predict.

        that aside, if somebody is using an illegal opioid (e.g. heroin) and can get on methadone and get off heroin, that’s at least a partial success in that

        1) they are no longer subject to being pummeled by the CJ system for using a C-I controlled substance

        2) while on methadone they can function well (job, etc.). it is true that many heroin addicts can do the same, but many can’t.

        3) they aren’t subject to abscesses, artery injections (leading to necrosis) and other injection related problems

        4) they are far less likely to OD, especially since heroin comes in unknown purity to the consumer

        and of course methadone doesn’t offer the RUSH that heroin does, and that’s why many heroin addicts go “fuck it” and go back on heroin

        regardless, i would thus label it at least a qualified success.

        and granted , many heroin addicts don’t WANT to break the addiction, they just wanna get high which imo should be legally fine, but the reality is – it’s still illegal

        1. most of your justifications for it being a “success” are entirely caused by the prohibition on heroin.

          1. i agree.

            and i am agains the prohibition of heroin

            but GIVEN it’s prohibition

            jesus fucking christ. nobody is a stronger critic of the WOD than me

            imo, heroin should not BE illegal

            but it is

            1. nobody is a stronger critic of the WOD than me

              aside from all the WOD critics who don’t repeat the WOD talking points.

              1. what the hell are you talkng about?

                again, is this internetitis, where you feel the need to argue for the sake of arguing?

                i am discussing reality, not how things would be in my perfect world (where heroin would not be illegal)

                the reality is that various rehab programs have varying degree of success. just like diets. because they require discipline, etc. which is not a set quantity

                i have dealt with many many addicts who have had great success with (various) rehab programs and many who did not.

                the reality is, no matter how much you want to wank, suboxone, methadone, and cold turkey as 3 programs (amongst others) for opioid addiction – WORK for some people and don’t work for others.

                1. Your sense of authority on every subject brings out the worst in me.

                  I’m obviously just a wanker, since apparently you actually are an expert in everything under the sun.

  10. GAO: Federal Funds for Drug Rehab Are Going to Programs That Don’t Work

    There are drug rehab programs that “work”?

    1. like most programs involving human psychology and behavior , nothing wil work anywhere near 100%, primarily because JUST LIKE DIETING, it is ultimately up to the end user to have the discipline to be successful, regardless of the method.

      but i can tell you as somebody who routinely deals with addicts and rehab’d addicts, many are VERY thankful for the rehab program they attended and had great success with it

      1. And if their drug of choice wasn’t illegal, jeez, more of them just might seek treatment voluntarily. Go figure.

        1. well, no shit

          that’s partially why im against the WOD

          but i am discussiing reality AS IT IS, not as it SHOULD be

          grok the distinction?

          1. Yeah, I get those two mixed up all the time. Since nobody is interested in transforming the one into the other.

            1. most of us are interested in it, but wanking on reason.com is not going to effect positive change.

              what i CAN do is express my opinion OUTSIDE the echo chamber circle jerk here and maybe change some minds, or at least plant some seeds of doubt amongst pro-wod types. that’s what *i* do.

              as well as vote properly (like for WA’s mj legalization initiative)

              we both wish heroin was legal. but it’s not, so given that, i am speaking about reality

        2. And if their drug of choice wasn’t illegal, jeez, more of them just might seek treatment voluntarily.

          I don’t think so. If the drugs were legal they would keep using or quit.
          There isn’t much of any demand for drug treatment that isn’t coerced. I suppose there would be some small demand created by non-state coercion by employers, spouses, charities etc but, unlike Kerry Howley, I consider that to be “voluntary”

          1. that’s simply rubbish. sorry, but n=metric assloads of addicts who have voluntarily sought treatment/rehab w/o coercion

            when an opioid addict has lost as much as many lose, many DO seek treatment on their own. in fact, i’ve had many ask for resources, which of course i have and provide them. a big problem is w/o $$$$, access is pretty fucking limited.

            1. I, crazily, have to agree with Dunphy on this point.

              If our anti-drug tax dollars were instead spent on subsidizing treatment, and the drug use wasn’t stigmatized and punished from every angle, more people might just look at their habit and say “shit, this isn’t what I want out of life, but I don’t think I can change it without some help.”

              Gov’t subsidized treatment probably isn’t even necessary since there have always been plenty of private organizations in existence who are EAGER to help people who want/need help.

              I’m not clear why drug treatment should cost so much in the first place. Probably because of legal mandates that place treatment programs in hospitals or under the administration of other Health Professional organizations. (It’s good to be a crony.)

              1. I stand by my statement.Who checks into rehab for a tobacco habit?

  11. also, dunphy, STFU about “having experience with addicts”

    You have experience with arresting suspects who are under the influence of substances that they may or may not be addicted to.

    You’re not a fucking addiction counselor, youre an arrestor.

    1. further more, your experience is inherently biased towards people who would be criminals even WITHOUT the WoSD.

      1. no, your bias is entirely towards talking out your ass.

        1. just another of the anti-cop bigoratti, right?

    2. spare me crap. that’s your false reality of what law enforcement is

      first of all, i went to grad school for counseling psychology and dealt with addicts there

      second of all, i deal with (and help) addicts far far far far far more often than i have to arrest them (which sometimes i do)

      you have no idea what the reality of a street cop is, but i deal with addicts all the time, whether assisting paramedics at an OD, talking with them on the street, helping them get medical treatment, etc.

      you are like the typical reasonoid with a 5th grader’s perception of the police as just ARREST ARREST ARREST

      and i didn’t say i was an addiction counselor. i am (rarity amongst cops) an expert witness on drug use testimony, and have immense experience dealing with addicts

      note again that i deal with addicts in all sorts of situations besides drug related. for example, some prostitutes i deal with are addicts and i often deal with them as crime victims.

      1. as I said above, you really are just an authoritative expert on everything. Damn my ultrabiased hyperignorance.

  12. Dude you just never know man, I mean like totally dude. WOw.

    http://www.Gettin-Private.tk

  13. Hey Mike,
    Alt text; Learn it, Know it, live it

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