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What GAO Found Federal drug control efforts span a range of activities including prevention, treatment, interdiction, international operations, and law enforcement. These efforts represent a considerable federal investment. The federal drug control budget for fiscal year 2022 was over $39 billion and the federal government has enlisted more than a dozen agencies to address drug misuse and its effects. Our preliminary review of the available documents suggests that ONDCP included some but not all of the types of information in the strategy that is required by federal law. More information may be in the additional documents ONDCP plans to release later this year.

To better guide neuromodulation therapies, we need to know which brain regions are causally involved in addiction remission in human patients. A unique source of information that can help answer this question is cases where brain damage such as a stroke results in remission of addiction in a patient. These cases are valuable because they provide a causal link between therapeutic benefit and human neuroanatomy. For example, lesions involving the insula are more likely to disrupt nicotine addiction than lesions that spare the insula. However, lesions disrupting addiction have been reported outside the insula in many different brain locations, leaving localization unclear. Recently, it has been possible to link lesions in different brain locations to a common neuroanatomical substrate using the human connectome, a map of human brain connectivity. When lesions result in therapeutic benefit, this approach can identify effective therapeutic targets.