2003 Budget Targets Substance Abuse Treatment Gap
President George W. Bush's proposed budget for SAMHSA in Fiscal
Year (FY) 2003 totals $3.2 billion, a net increase of $57 million,
or 2 percent, over the FY 2002 enacted level. The SAMHSA budget
focuses on narrowing the substance abuse treatment gap and maintaining
mental health services.
Reducing the Drug Treatment Gap
In an effort to reduce the treatment gap, an increase of $127
million has been included to fund the President's Drug Treatment
initiative. In total, SAMHSA's budget proposes $2.3 billion for
substance abuse treatment and prevention activities. These additional
funds will allow states and local communities to provide treatment
services to approximately 546,000 individuals, an increase of 52,000
over FY 2002.
Nationwide, there continues to be a great need to expand the capacity
to treat individuals who use and are addicted to illegal drugs.
The drug treatment gap revolves around three issues: accessibility,
affordability, and availability.
The Office of National Drug Control Policy estimates that as many
as 5 million Americans are in need of drug abuse treatment services.
However, fewer than half actually receive services, leaving a treatment
gap of 3.9 million individuals.
SAMHSA's National Household Survey on Drug Abuse from the year
2000 estimates that 14 million Americans used an illicit drug in
the past month. Further, 9.7 percent of youth age 12 to 17 reported
illicit drug use in the past month. Marijuana is the most commonly
used illicit drug; it is used by 76 percent of current illicit drug
users. In 2000, an estimated 6.5 million persons had tried the drug
Ecstasy at least once in their lifetime. This represents an increase
of 1.4 million individuals over the estimated 5.1 million users
in 1999.
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The SAMHSA budget focuses on narrowing the substance abuse treatment gap and maintaining mental health services.
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A total of $1.8 billion is requested for the Substance Abuse Prevention
and Treatment (SAPT) Block Grant, an increase of $60 million over
FY 2002. The SAPT Block Grant is the cornerstone of state substance
abuse programs, providing support for over 10,500 community-based
treatment and prevention organizations.
The budget also includes an increase of $67 million to support
programs that provide direct substance abuse treatment services.
In FY 2003, SAMHSA will begin a new $50 million program for approximately
12 states within the targeted capacity expansion authority. Funds
would be allocated to states based on their commitment to performance
goals and relative need. The results of the National Household Survey
would measure state performance. SAMHSA will also consider factors
such as states leveraging other funds, and the efficiency and effectiveness
of a state's treatment system. This program would require a commitment
to achieving performance goals.
Overall, substance abuse prevention will be reduced by $45 million,
and greater emphasis will be placed on providing treatment services.
In the past several years, many SAMHSA-sponsored projects have
proven to be successful in providing effective treatment services.
For example, a program for youth and families in St. Petersburg,
FL, reported that within 6 months of intake into treatment the percentage
of adolescents with no past-month drug use increased from 4 percent
to 34 percent.
Another success story is an HIV Substance Abuse program in Wilmington,
DE. The goal of this program is to provide a comprehensive array
of substance abuse, mental health, and HIV educational and medical
services to drug dependent women in Wilmington. Of those women in
treatment for 12 months or longer, 75 percent of clients were found
to remain drug-free.
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Mental Health
The budget includes $832 million for mental health activities,
which maintains the FY 2002 funding level. Mental health activities
will continue to work to improve service quality and expand capacity.
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Included is $10 million to assist states in developing solutions to mental health problems from bioterrorism and other traumatic events.
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Of this amount, $47 million is for the Projects for Assistance
in Transition from Homelessness (PATH) program. This is a $7 million
increase over FY 2002. These funds will allow SAMHSA to reach out
to 163,000 homeless individuals in an effort to get them off the
streets and into mental health and substance abuse treatment services
as well as into adequate housing.
Included in the President's request is $10 million to assist states
and local organizations in developing solutions to the mental health
problems that result from bioterrorism and other traumatic events.
In FY 2003, SAMHSA will support the President's New Freedom Commission
on Mental Health. This commission will study and make recommendations
for the mental health delivery system, including recommendations
on the availability and delivery of new treatments and technologies
for people with severe mental illness. The budget also reduces funding
for Programs of Regional and National Significance by $7 million.
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Data Collection
In FY 2003, SAMHSA will continue to engage in an extensive national
data collection effort to evaluate both the prevalence of drug addictions
and the effectiveness of efforts to treat or prevent these problems.
A total of $107 million in FY 2003 will be directed to a wide variety
of national surveys and data efforts.
Of this amount, $11 million is included for the National Treatment
Outcomes Monitoring System (NTOMS). This is an increase of $6 million
over FY 2002. These funds will be used to continue the collection
of data on an ongoing basis and provide drug treatment providers
nationwide with a source of information needed to identify changes
in drug facilities. The purpose of NTOMS is to provide on a continuous
basis the information needed to identify change in drug abuse treatment
outcomes.
In addition to NTOMS, there are three SAMHSA surveys that serve
as the major sources of information to Federal and state officials
in their efforts to fight substance abuse:
- National Household Survey on Drug Abuse
- Drug Abuse Warning Network
- Drug and Alcohol Services Information System.
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Program Management
The FY 2003 budget reflects the Bush Administration's interest
in restructuring and "delayering" the Federal workforce.
The budget includes $80 million for program management, a decrease
of $15 million over FY 2002. 
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