Highlights of a Forum: Preventing Illicit Drug Use

What Forum Participants Said

In individual presentations and group discussion, participants in a forum that GAO convened identified the common factors related to illicit drug use--the use of illicit drugs and the misuse of prescription drugs. According to forum participants, illicit drug use typically occurs for the first time in adolescence and involves marijuana. Forum participants also discussed how legal prescriptions for opioid-based pain relievers are increasingly a pathway to illicit drug use. Several participants noted that the number of prescriptions for opioids has increased in recent years, and two forum participants reported that there has been an increase in the number of people who start illicit drug use with pain relievers.

Forum participants discussed strategies available in the education, health care, and law enforcement sectors for preventing illicit drug use.

• Education. Forum participants championed the use of three school-or community-based prevention programs that research has shown to be successful in preventing illicit drug use and other behaviors: Life Skills, Strengthening Families Program: For Parents and Youth 10-14, and Communities That Care. These programs focus generally on combatting a range of risky behaviors and strengthening family and community ties.

• Health care. Forum participants identified and discussed three principle health care strategies for preventing illicit drug use: 1) having providers adhere to the Centers for Disease Control and Prevention's guideline for prescribing opioids for chronic pain, 2) having providers use prescription drug monitoring programs (PDMP)--state-run electronic databases used to track the prescribing and dispensing of prescriptions for controlled substances--and 3) having primary care providers screen and intervene with patients at risk for illicit drug use. 

• Law Enforcement. Forum participants identified four law enforcement strategies for preventing illicit drug use: 1) enforcing laws prohibiting underage consumption of alcohol and tobacco, 2) building trust between law enforcement and local communities, 3) using peers to promote drug-free lifestyles, and 4) closing prescription drug "pill mills" -- medical practices that prescribe controlled substances without a legitimate medical purpose--and other efforts to reduce the supply of illicit drugs. 

Forum participants identified several high priority areas for future action to prevent illicit drug use. These included supporting community coalitions for preventing illicit drug use that comprise the health care, education, and law enforcement sectors; consolidating federal funding streams for prevention programs; increasing the use of prevention programs that research has shown to be effective; supporting prevention efforts in primary care settings; and reducing the number of opioid prescriptions. For example, to reduce the number of opioid prescriptions, one forum participant said that physicians who receive Medicare reimbursement should be required to 1) check a PDMP to determine whether patients are trying to obtain prescriptions from multiple providers and 2) receive training on CDC's guideline for prescribing opioids for chronic pain.

Why GAO Convened This Forum

Illicit drug use is a burgeoning problem that adversely affects individuals as well as their families, their communities, and the nation. According to the latest Centers for Disease Control and Prevention data, 47,055 people died of drug overdoses in the United States in 2014--more than any previous year on record. The use of opioids--in particular, heroin and prescription pain relievers--has driven a significant increase in drug overdose deaths. According to the Office of National Drug Control Policy, the most effective way to mitigate the costs associated with illicit drug use is through prevention.

GAO convened and moderated a panel of education, health care, and law enforcement officials on June 22, 2016 to discuss: 1) common factors related to illicit drug use; 2) strategies in the education, health care, and law enforcement sectors to prevent illicit drug use; and 3) high priority areas for future action to prevent illicit drug use. With assistance from the National Academy of Sciences, GAO selected the participants, including federal officials, public health and drug policy experts, physicians, law enforcement representatives, and educators. The viewpoints summarized in the report do not necessarily represent the views of all participants, their organizations, or GAO. GAO provided participants the opportunity to review a summary of key points from the forum and incorporated their comments as appropriate prior to publishing this report.

For more information, contact Elizabeth Curda at (202) 512-7114 or curdaE@gao.gov.