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Congress Clearly Signals Better Evidence Needed in Setting Drug Control Policy

By Nick Hart, Anand Parekh, MD

Monday, May 21, 2018

More than 100 people died every day in 2016 from opioid-related drug overdoses across the United States. We know this because the National Center for Health Statistics built an infrastructure in partnership with states to analyze mortality data.

Nearly 4 percent of the U.S. population – or 11.5 million people – misused prescription opioids in 2016. For perspective, only six U.S. states have populations with that many people. We know this statistic because the Substance Abuse and Mental Health Services Administration collects data through an annual survey on drug use. 

It turns out, we know quite a bit about certain trends in drug abuse. Some data collection mechanisms have long existed to enable tracking of trends and monitoring broad conditions about government drug policy.

Much of what we do know through intergovernmental coordination can be partially attributed to the role of a little-known government agency attached to the White House called the Office of National Drug Control Policy (ONDCP). This agency is charged with leading the country’s efforts to reduce the supply and use of illicit drugs. In May 2018, the House Committee on Oversight and Government Reform released a bipartisan draft bill aimed at improving how the federal government coordinates drug control policy through ONDCP, including by encouraging stronger data collection and information sharing mechanisms that support evidence-based policymaking.

Some data collection mechanisms have long existed to enable tracking of trends and monitoring broad conditions about government drug policy. 

Here are five signals from the bipartisan authors of the legislation that suggest Congress is considering how to go about receiving and using better evidence for drug control policy:

  • Clearly Articulated Policy Goals. Past program authorizations in law have been criticized for establishing vague goals. In considering how the ONDCP can best implement prescribed policies, the draft legislation includes language that clearly delineates the objectives of a national drug control strategy (see Section 1005(b)). The defined goals indicate congressional intent for project outcomes, which are helpful in evaluating program effectiveness.
  • Expectations for Evidence Use. While requirements to generate new metrics and studies in legislation are never an absolute guarantee that the resulting evidence will be used to shape policy, this draft legislation will likely make the evidence difficult to ignore. In the draft ONDCP reauthorization, Congress outlines expectations that evidence will be used to inform programs and policies. For example, the development of a new drug control strategy must use the “best available medical and scientific evidence” for achieving stated policy goals (see Sections 1005(b) and 1012(c)). The draft bill also includes requirements for identifying challenges for accomplishing actions and for explanations of how measures were developed. In other words, Congress wants to know how ONDCP is using evidence to shape policy and what evidence is being used, thus establishing the feedback to hold ONDCP accountable.
  • Opportunities for Data Coordination and Access. While coordination of data resources is a challenge for government, it is essential for successful evidence-based policymaking across policy domains and jurisdictions. The draft bill encourages increased information sharing and coordination, including through a new National Drug Control Fusion Center (see Section 1012(a)). The center has similarities in design to the National Secure Data Service recommended in 2017 for government by the U.S. Commission on Evidence-Based Policymaking. The proposed unit is suggested as a new statistical agency for the federal government that would be legally obligated to protect confidential data, while enabling new data analyses for generating relevant evidence for policymakers.
  • Standards for Data Quality. Increasingly Congress recognizes the challenges in sharing data across levels of government, where collected data may not have consistent definitions. The draft ONDCP bill follows a recent trend in Congress to require standards for data exchanges, developed collaboratively through intergovernmental processes (see Section 1012(f)).
  • Defining the Unknowns to Encourage Policy-Relevant Research. Identifying what is known in policy discussions, and an honest take on what is not, and then sharing that knowledge with researchers outside of government is a strategy with bipartisan support for encouraging more policy-relevant research. The draft ONDCP bill encourages the establishment of a “learning agenda” to identify policy-relevant questions that new research can address to inform future decisions (see Section 1012(b)). A similar approach was recommended by the Commission on Evidence-Based Policymaking and suggested by the Bipartisan Policy Center as an approach for encouraging the use of evidence in Congress.

While the draft ONDCP bill has a long way to go before becoming law, the initial discussion draft appears to be a productive step toward Congress encouraging more evidence-based policymaking in government. The inclusion of targeted provisions that encourage data infrastructure, information sharing, and expectations for the use of evidence lay the foundation for future progress in drug control policy and addressing this critical issue.