Reducing Substance Abuse in America: Building the Nation's Demand Reduction Infrastructure A Framework for Discussion

The Vision: A Life in the Community for Everyone
The Challenge: Stopping Drug use Before It Starts…Healing America’s Drug Users
The Commitment: Meeting the Challenges Through National Leadership
The Charge: Building the Nation’s Demand Reduction Infrastructure
The Programs: Building Resilience
The Programs: Facilitating Recovery
The Programs: Building Treatment Capacity
Cross-Cutting Infrastructure and Services
Making It Count: Ensuring Accountability Through Data-Driven Decision-making
Cross-Cutting Infrastructure and Services

One thing is clear: Substance abuse is a local, community-based issue. In order to make a meaningful impact to combat our Nation’s issues with drug and alcohol abuse, we must provide community-based solutions. Through grants and contracts, states and communities are given the means to build the nation’s capacity to address substance abuse and mental health problems. SAMHSA's principal responsibility—as reflected in its three strategic goals—is to provide resources and disseminate knowledge. The three goals are reflected in all of SAMHSA's activities, including discretionary grants, technical assistance, and dissemination of effective programs, policies, and practices, that enable states and communities to develop the local means to address local substance abuse problems.

The Substance Abuse Prevention and Treatment Block Grant: Cornerstone of Demand Reduction

Initiated in 1993, the Substance Abuse Prevention and Treatment (SAPT) Block Grant is the cornerstone of the Nation’s Substance Abuse Demand Reduction Infrastructure. Based on a congressionally-mandated formula, the SAPT Block Grant funds States to support a wide range of activities related to the abuse of alcohol, the use or abuse of drugs, and the use or abuse of tobacco products. The SAPT serves as the foundation on which states build a stable infrastructure that includes service delivery and training capacity. This foundation is increasingly important, in light of recent research that shows an increase in the percentage of substance abuse services paid for with public funding and a decrease in private spending for substance abuse services. Within the SAPT grant framework, states have the flexibility to plan, carry out, and evaluate substance abuse prevention and treatment services provided to individuals and families. The grant also affords a minimum 20 percent set-aside for support of substance abuse prevention that allows for infrastructure development, as well as specific programs and activities.

The National Clearinghouse for Alcohol and Drug Information: Disseminating Knowledge to the Public

The National Clearinghouse for Alcohol and Drug Information is the Nation's one-stop resource for information about substance abuse prevention and addiction treatment.

NCADI staffs both English- and Spanish-speaking information specialists 24 hours a day, 7 days a week, who:

  • Refer people seeking help for substance abuse problems to local treatment providers

  • Recommend appropriate publications, posters, and videocassettes

  • Conduct customized searches in the form of annotated bibliographies from alcohol and drug databases

  • Provide grant and funding information.

NCADI offers information and resources to the public, many of which are free of charge, and distributes the latest studies and surveys, guides, videocassettes, and other types of information and materials on substance abuse. For more information, call 1 (800) 729-6686 (English and Espanol) or 1 (800) 487-4889 (TDD).

Science to Services: Evidence-Based Practices

SAMHSA's Science to Services Agenda was born from SAMHSA's ongoing commitment to build on the effectiveness of programs, practices and policies delivered in communities and reduce the time lag between the development of scientific interventions and their application in service settings.

Through its partnerships with the National Institutes of Health—including the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Mental Health—SAMHSA developed and implemented the National Registry of Evidence-Based Programs and Practices (NREPP). NREPP is a comprehensive system to screen, select, and disseminate evidence-based prevention and treatment programs, policies and practices.

Protecting the Nation's Youth

Despite significant success at reducing illicit drug and tobacco use among adolescents, underage drinking remains a serious, persistent, and stubborn problem. Under the leadership of Secretary Leavitt and SAMHSA Administrator Curie, the U.S. Department of Health and Human Services created the Interagency Committee on the Prevention of Underage Drinking. The Committee includes representatives from the Departments of Health and Human Services, Education, Justice, Transportation, the Office of National Drug Control Policy, the Department of Defense, the Department of Treasury, and ex-officio representation from the Federal Trade Commission. This unprecedented collaboration is fully consistent and in response to the Institute of Medicine Report: Reducing Underage Drinking—A Collective Responsibility. The preeminent goal of the IOM strategy is to create and sustain a broad societal commitment to reduce underage drinking. Such a commitment requires participation by multiple individuals and organizations at the national, state and local community levels that are in a position to affect youth decisions.

In addition to activities designed to prevent underage drinking, SAMHSA has also developed materials to help communities support children with addicted parents.

SAMHSA's goal is to lessen the heavy burden of substance abuse from the children of individuals in treatment. Based on SAMHSA's Household Survey, an estimated 6 million children live with at least one parent who abused or was dependent on alcohol or drugs. In partnership with the National Association of Children of Alcoholics, SAMHSA developed a Children's Program Kit to help prevention and treatment professionals develop appropriate programs to reach youth with addicted parents.

Partnering with the Criminal Justice Community

SAMHSA shares common goals with the criminal justice community and is committed to improving both public health and public safety. To address the inescapable link between mental illness, substance abuse, and crime, SAMHSA is focused on leveraging partnerships and building infrastructure. SAMHSA has developed a Criminal and Juvenile Justice Framework that focuses squarely on the needs of consumers who are involved or are at risk of becoming involved in the criminal and juvenile justice systems. Through the Framework, SAMHSA is determined to develop effective reentry efforts, reduce recidivism, and increase the coordination of treatment between providers in prison and in the community. SAMHSA continues to strengthen partnerships with criminal justice organizations such as the Association of State Corrections Administrators, the American Correctional Association, and the National District Attorney’s Association. Additionally, SAMHSA supports Family, Juvenile and Adult Treatment Drug Courts, as well as the Youth Offender Reentry Program, which funds community partnerships that plan, develop, and provide services in the community to promote recovery, and prevent recidivism. SAMHSA also supports a jail diversion grant program to develop model jail diversion programs at 26 sites across the country. Preliminary results of a SAMHSA study on jail diversion for non-violent offenders indicate reduced rates of re-arrest, decreased incidence of substance abuse and psychiatric symptoms, and increased quality of life among people who are diverted from the justice system.

Enhancing the Use of Data

SAMHSA is committed to moving away from simply collecting data, including outcomes, to using it to inform management and policy decisions. Survey data, as well as data from other information systems must be managed in the spirit of the old adage: "One's judgment is no better than one's information." SAMHSA will continue to improve the quality of management decisions by emphasizing the need for research-based data, as well as developing data management strategies to identify emerging drug threats such as trends in the use of methamphetamine and the abuse of prescription drugs.