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Introduction

Background

Initiatives that address the major goals of U.S. drug control policy have commonly been conceptualized as either supply-control or demand-control activities. Supply-control activities include disruption of production in source countries, interdiction of drug shipments from source countries, and domestic law enforcement activities that aim to disrupt the marketing of drugs within the United States. Demand-control activities include prevention, treatment, and law enforcement activities that seek to reduce the prevalence, intensity, or harmful consequences of drug use among Americans.

Current drug control policy includes both supply-control and demand-control activities. The appropriate mix of such activities is the subject of a continuing debate, with both normative and empirical components. On the normative side, Americans vary in their moral judgment of drug use and in their concern with the collateral consequences of drug-control activities. On the empirical side, Americans vary in their assessment of the effectiveness of prevention, treatment, domestic enforcement, and foreign interdiction activities in reducing the availability of drugs. The continuing debate about drug control policy manifests itself in many ways, among which is an annual battle within the federal government on the allocation of funding across different drug control activities.

The lack of a strong body of data and research to inform policy on illegal drugs has long impeded the development of well-grounded judg-



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1 Introduction Background Initiatives that address the major goals of U.S. drug control policy have commonly been conceptualized as either supply-control or demand-control activities. Supply-control activities include disruption of production in source countries, interdiction of drug shipments from source countries, and domestic law enforcement activities that aim to disrupt the marketing of drugs within the United States. Demand-control activities include prevention, treatment, and law enforcement activities that seek to reduce the prevalence, intensity, or harmful consequences of drug use among Americans. Current drug control policy includes both supply-control and demand-control activities. The appropriate mix of such activities is the subject of a continuing debate, with both normative and empirical components. On the normative side, Americans vary in their moral judgment of drug use and in their concern with the collateral consequences of drug-control activities. On the empirical side, Americans vary in their assessment of the effectiveness of prevention, treatment, domestic enforcement, and foreign interdiction activities in reducing the availability of drugs. The continuing debate about drug control policy manifests itself in many ways, among which is an annual battle within the federal government on the allocation of funding across different drug control activities. The lack of a strong body of data and research to inform policy on illegal drugs has long impeded the development of well-grounded judg-

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ments about the effectiveness of alternative drug control activities (Moore, 1990). Against this background, a body of scientific work on the operation of drug markets began to take form during the 1990s. Researchers sought to understand the empirical relationship between drug use, drug production, and the street price of drugs. Some studies sought to compare the effect of alternative cocaine control strategies, including source country eradication and enforcement programs, interdiction efforts, local criminal justice programs, sentencing schemes, and treatment programs (Crane, Rivolo, and Comfort, 1997; Caulkins et al., 1997; Everingham and Rydell, 1994; Rydell and Everingham, 1994). Other studies sought to evaluate alternative heroin control strategies (e.g., Weatherburn and Lind, 1996; Caulkins, 1995b; White and Luksetich, 1983). The RAND And IDA Studies Of the limited research to date, the studies of cocaine control policy performed at RAND by Rydell and Everingham (1994) and at the Institute for Defense Analyses (IDA) by Crane, Rivolo, and Comfort (1997) have drawn unique attention in the ongoing struggle over federal funding of drug control activities. The RAND study has been used to argue that funding should be shifted toward drug treatment programs and away from activities to reduce drug production or to interdict drug shipments. For example, in a 1995 statement to the Subcommittee on National Security, International Affairs, and Criminal Justice, Committee on Government Reform and Oversight, U.S. House of Representatives (1996:61), Lee Brown, then director of the Office of National Drug Control Policy (ONDCP), stated: Let me now talk about what we know works in addressing the drug problem. There is compelling evidence that treatment is cost-effective and provides significant benefits to public safety. In June 1994, a RAND Corporation study concluded that drug treatment is the most cost-effective drug control intervention. The subsequent IDA study, which was undertaken in part as a reanalysis of the RAND findings, has been used to argue that interdiction activities should be funded at present levels or higher. In a 1996 hearing specifically devoted to the IDA study, ''Review of the Internal Administration's Study Critical of Clinton Drug Policy and White House Suppression of the Study," chair William H. Zeliff began this way (Subcommittee on National Security, International Affairs, and Criminal Justice, Committee on Government Reform and Oversight, U.S. House of Representatives, 1998:1):

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We are holding these hearings today to review a study on drug policy, a study we believe to have significant findings, prepared by an independent group, the Institute for Defense Analyses, at the request of Secretary of Defense Perry in 1994. ... [T]he subcommittee has questioned for some time the administration's strong reliance on treatment as the key to winning our Nation's drug war, and furthermore this subcommittee has questioned the wisdom of drastically cutting to the bone interdiction programs in order to support major increases in hard-core drug addiction treatment programs. The basis for this change in strategy has been the administration's reliance on the 1994 RAND study. The RAND and IDA studies specify similar hypothetical objectives for cocaine control policy, namely reduction in cocaine consumption in the United States by 1 percent. Both studies predict the monetary cost of using certain policies to achieve this objective. Because they focus on the specified objective of a reduction in cocaine consumption, the two studies are called "cost-effectiveness" studies rather than "cost-benefit" studies, which would seek to evaluate the full set of consequences of alternative policies in comparable economic terms. And because both studies focus on real-world interventions rather than on interventions under ideal conditions, they are called "effectiveness" studies rather than "efficacy" studies1 (see also National Research Council, 1979; Rossi and Freeman, 1993; Northridge et al., 1997). The RAND study, which evaluates various demand-control and supply-control policies, reaches this conclusion (Rydell and Everingham 1994:xiii): The analytical goal is to make the discounted sum of cocaine reductions over 15 years equal to 1 percent of current annual consumption. The most cost-effective program is the one that achieves this goal for the least additional control-program expenditure in the first projection year. The additional spending required to achieve the specified consumption reduction is $783 million for source-country control, $366 million for interdiction, $246 million for domestic enforcement, or $34 million for treatment (see Figure S.3). The least costly supply-control program (domestic enforcement) costs 7.3 times as much as treatment to achieve the same consumption reduction. 1   Effectiveness is a measure of the benefit resulting from an intervention for a given health problem under average conditions of use. This form of evaluation considers both the efficacy of an intervention and its acceptance by those to whom it is offered. It answers the questions: Does the practice do more good than harm to people to whom it is offered? Efficacy is a measure of the benefit resulting from an intervention for a given health problem under ideal conditions of use. It answers the question: Does the practice do more good than harm to people who fully comply with the recommendations (National Information Center on Health Services Research and Health Care Technology, 1998a, 1998b)?

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The IDA study, which focuses on source-zone interdiction, reaches an entirely different conclusion (Crane, Rivolo, and Comfort, 1997:3): A rough estimate of cost-effectiveness indicates that the cost of decreasing cocaine use by one percent through the use of source-zone interdiction efforts is on the order of a few tens of millions of dollars per year and not on the order of a billion dollars as reported in previous research [the RAND study]. The differences are primarily attributed to a failure in the earlier research to account for the major costs imposed on traffickers by interdiction operations and overestimation of the costs of conducting interdiction operations. The IDA study, thus, specifically rebuts a key finding of the RAND study. The RAND and IDA studies use very different analytical approaches and data sources to reach their very different conclusions. Both studies were subjected to review before release, but neither was published in a peer reviewed medium. Both studies are unclassified reports available in the open literature. Since their publication, questions have been raised about the validity of the models of the drug market used in both studies. The capacity of even sophisticated analytic approaches to compensate for the limitations of the available data has been questioned by many researchers and policy analysts. Skepticism about the assumptions, data, and methods of one or the other study has been heightened because the two studies reach directly contradictory findings. This Report It is against this background that ONDCP requested the Committee on Data and Research for Policy on Illegal Drugs to assess the two studies. Because the assumptions, data, and methods of the RAND and IDA studies are so different, the committee decided that each study should be assessed in isolation from the other. Thus, the analysis of the RAND study in Chapter 2 makes no reference to the IDA study, and the analysis of the IDA study in Chapter 3 makes no reference to the RAND study. The two chapters have parallel formats, each beginning with a description of the assumptions, data, methods, and findings of the relevant study and then giving the committee's assessment of the study. The committee does not attempt to reconcile the very different findings of the two studies. Nor does the committee attempt to reach its own conclusions about the cost-effectiveness of alternative policies in reducing cocaine consumption. IDA personnel advised that access to classified data is important if the IDA study is to be fully understood. In its work, the committee found that access to classified data would at most be relevant to assessment of one aspect of the IDA study—the selection of interdiction events for

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analysis. Consequently, the committee formed a classified subcommittee to investigate this matter and, more generally, to explore whether access to classified data may be germane to the broader objectives of the committee. See the section "Selection of Interdiction Events" in Chapter 3 for discussion. Although the RAND and IDA studies use different assumptions, data, and methods, the committee can and does apply the same broad criteria in assessing the two studies. Both studies use quantitative methods to draw conclusions from data and assumptions. In assessing each study, the committee evaluates the appropriateness of the data used, the plausibility of the assumptions imposed, and the logic of the methods by which data and assumptions are combined. In each case, the committee does not hold the study to a textbook standard of an ideal scientific analysis. The committee applied a necessarily looser and more pragmatic standard: Are the study's findings sufficiently credible that they should be given weight in the analysis and design of national drug control policy? The Work Ahead The committee is now moving forward on its broad study of data and research to inform drug control policy. The process of scrutinizing the specifics of the RAND and IDA studies has helped the committee to frame the general questions that it will now address. Looking ahead, the committee plans to evaluate the knowledge presently and potentially available about the effectiveness of drug treatment programs, the economics of drug markets (e.g., substitution effects), and the effects of domestic law enforcement activities on drug use. The committee also plans to assess the data presently and potentially available on drug production, use, and prices. The committee's final report will address the broad issue of how data and research can, in the future, serve the objective of informing drug control policy.