Results Show Lack of Progress on Strategy Goals, although Implementation of Most Action Items Is Complete or On Track; ONDCP Established a New Mechanism to Monitor Progress

Our analysis indicates that ONDCP and federal agencies have not made  progress toward achieving four of five goals established in the 2010  Strategy for which primary data are available. However, ONDCP reported  strong progress in implementing most of the action items in the Strategy  intended to support achievement of these goals. ONDCP officials stated  that implementing these action items is necessary but may not be  sufficient to achieve Strategy goals. ONDCP’s Performance Reporting  System (PRS) is a new monitoring mechanism intended to provide more  specific, routine information on progress and help identify causal factors  for performance gaps and options for improvement. According to ONDCP  officials, the office plans to report on PRS results for the first time in 2013  and assess the system’s reliability and effectiveness, which could help  increase accountability for improving results and identify ways to bridge  the gap between the lack of progress toward Strategy goals and the  strong progress on implementing actions in the Strategy. However, 29 of  76 (about 40 percent) surveyed programs reported no coordination with  other federal agencies on drug abuse prevention or treatment activities. Drug Abuse Programs Are Fragmented across 15 Federal Agencies, and Many Are Overlapping, Which May Result in Inefficiencies

Federal drug abuse prevention and treatment programs are fragmented  across 15 federal agencies that administered 76 programs in fiscal year  2011. However, overlapping programs are not  necessarily duplicative, if the services provided and the populations   Of the programs we reviewed, 59 of  served differ in meaningful ways.the 76 programs (nearly 80 percent) are overlapping because they can  provide or fund at least one drug abuse prevention or treatment service  that at least one other program can provide or fund, either to similar  population groups or to reach similar program goals. Many Programs Reported That They Do Not Coordinate, and ONDCP Has Not Assessed the Extent of Overlap and Identified Coordination Opportunities to Help Improve Efficiencies

			Coordination Efforts in Two Areas with Overlap Helped Minimize Risk of Duplication, but Not All Programs Reported Such Efforts

Agency officials who administer programs in two areas that we reviewed  in more detail—specifically, programs for youth and programs for  offenders—reported making various efforts to coordinate overlapping  program activities or services, which can serve to minimize the risk of  duplication. While ONDCP has identified activities related to the development and  implementation of the Strategy and Drug Control Budget that promote  coordination, it has not systematically assessed all drug abuse prevention  or treatment programs to examine the extent of overlap and potential for  duplication and identified opportunities for coordination among programs  to more efficiently use limited resources. ONDCP has developed a 5-year  Strategy to reduce illicit drug use and its consequences, but our analysis  shows lack of progress toward achieving four of the Strategy’s five goals  for which primary data are available. Recommendation for Executive Action

To identify opportunities to increase efficiencies and therefore better  leverage agency prevention and treatment resources, we recommend  that the Director of ONDCP assess the extent of overlap and potential for  duplication across federal programs engaged in drug abuse prevention  and treatment activities and identify opportunities for increased  coordination. With regard to progress toward achieving Strategy goals, ONDCP stated  that it is important to analyze trends for each drug category separately  and noted that we recognized this in our discussion of ONDCP’s goal to  reduce drug use among 12- to 17-year-olds by 15 percent by 2015. As  the report states, marijuana accounts for almost 80 percent of drug use in  this age group, and the lack of progress on this goal is due primarily to an  increase in the rate of reported marijuana use, offset by decreases in the  rates of other drug use. To what extent does fragmentation, overlap, and duplication exist  across drug abuse prevention and treatment programs, and do  ONDCP and federal agencies coordinate efforts to reduce the  potential for unnecessary overlap or duplication? Assessing Progress toward Strategy Goals and Mechanisms to Monitor Progress

To assess progress toward Strategy goals and the extent to which  ONDCP has mechanisms in place to monitor progress, we analyzed the  2010 Strategy and 2011 and 2012 annual updates, the National Drug  Control Budget, and ONDCP documentation about its Performance  Reporting System and associated performance measures. Assessing Fragmentation, Overlap, and Duplication across Drug Abuse Prevention and Treatment Programs and Agency Coordination Efforts

		Identifying Programs

To identify federal drug abuse prevention and drug abuse treatment  programs, and programs that include drug abuse prevention or treatment  activities, we developed a preliminary list based on the agencies included  in our previous work in this area and a review of ONDCP and agency  information, such as the fiscal year 2013 National Drug Control Budget,  the 2010 National Drug Control Strategy, and publically available  information on agency websites.
Why GAO Did This Study

ONDCP is responsible for coordinating implementation of drug control policy across the federal government to address illicit drug use. ONDCP developed the 2010 Strategy, which sets forth a 5-year plan to reduce illicit drug use through programs intended to prevent or treat drug abuse or reduce the availability of drugs. GAO was asked to review Strategy implementation and drug abuse prevention and treatment programs. This report assesses, among other things, the extent to which progress has been made toward achieving Strategy goals; ONDCP has mechanisms in place to monitor progress; fragmentation, overlap, and duplication exist across prevention and treatment programs; and ONDCP and federal agencies coordinate efforts to reduce the potential for unnecessary overlap or duplication. GAO analyzed the Strategy and its updates, available data on progress toward achieving Strategy goals, and documents about ONDCP's monitoring mechanisms. GAO also analyzed data from questionnaires sent to the 15 federal agencies that administer prevention and treatment programs that collected information on services provided and coordination efforts.

What GAO Found

The Office of National Drug Control Policy (ONDCP) and federal agencies have not made progress toward achieving most of the goals articulated in the 2010 National Drug Control Strategy (the Strategy), but are reported to be on track to implement most Strategy action items intended to support these goals. ONDCP established seven Strategy goals related to reducing illicit drug use and its consequences by 2015. As of March 2013, GAO's analysis showed that of the five goals for which primary data on results are available, one shows progress and four show no progress. For example, no progress has been made on reducing drug use among 12- to 17-year-olds by 15 percent. This is primarily due to an increase in the rate of reported marijuana use, offset by decreases in the rates of reported use of other drugs. Nevertheless, ONDCP reported that 107 of the 112 action items in the Strategy are complete or on track. ONDCP officials stated that implementing these action items is necessary but may not be sufficient to achieve Strategy goals.
ONDCP primarily intends to address the extent of progress in achieving Strategy goals through its new Performance Reporting System (PRS)--a monitoring mechanism intended to provide specific, routine information on progress toward Strategy goals and help identify factors for performance gaps and options for improvement. ONDCP officials stated that they plan to report on PRS results for the first time in 2013. They also said that they plan to assess the system's reliability and effectiveness. This could help increase accountability for improving results and identify ways to bridge the gap that currently exists between the lack of progress toward Strategy goals and the strong progress made on implementing Strategy actions.
Drug abuse prevention and treatment programs are fragmented across 15 federal agencies and provide some overlapping services, which could increase the risk of duplication. Specifically, GAO identified overlap in 59 of the 76 programs included in its review. These programs could provide or fund one or more drug abuse prevention or treatment service that at least one other program could also provide or fund, either to similar population groups or to reach similar program goals. Such fragmentation and overlap may result in inefficient use of resources among programs providing similar services.
GAO's prior work has found that inefficiencies created by fragmentation and overlap can be minimized through coordination. However, many prevention and treatment programs that GAO surveyed did not report coordination efforts, and ONDCP has not assessed the extent of overlap, duplication, and coordination. Agency officials who administer the 21 programs that GAO reviewed in detail-- programs for youth and offenders--reported making various efforts to coordinate program activities, but 29 of 76 (about 40 percent) surveyed programs reported no coordination with other federal agencies on drug abuse prevention or treatment activities. Moreover, ONDCP has not assessed all drug abuse prevention or treatment programs to identify the extent of overlap and potential duplication and any opportunities for coordination. Such an assessment would better position ONDCP to help ensure that agencies better leverage and more efficiently use limited resources.

What GAO Recommends

GAO recommends that ONDCP assess the extent of overlap and the potential for duplication across federal programs engaged in drug abuse prevention and treatment activities and identify opportunities for increased coordination. ONDCP concurred and stated that it will work with agencies administering these programs to further enhance coordination.