Addiction is a deeply personal issue for Republican presidential candidate Jeb Bush, whose daughter, Noelle, suffered from addiction and a string of related criminal charges while he was governor of Florida.
Bush offered a glimpse into "the heartbreak of drug abuse" in a post on the website Medium, along with policy proposals to better address addiction based on his gubernatorial tenure.
"As governor of Florida, I used a combination of strategies to help reduce heroin use among youth in Florida by approximately 50 percent," Bush wrote.
We wondered if Bush, who took office in January 1999 and left in January 2007, was right.
His campaign cited the 2006 Florida Youth Substance Abuse Survey conducted by the Florida Department of Children and Families.
For heroin use, the survey offers two measurements — heroin use at any time of one's life, and heroin use during the past 30 days.
For the category of heroin use in one's lifetime, 2.2 percent of respondents ages 11 to 18 had used it in 2000, compared to 1.1 percent in 2006. That's a 50 percent decrease.
For the second category of heroin use in the past 30 days, 0.8 percent reported using it in 2000, compared to 0.4 percent in 2006. That's also down 50 percent.
So numerically, Bush has a point. However, experts said it's worth taking those numbers with a grain of salt. One concern is the percentage of youth using heroin is small, meaning the differences from year to year are small and potentially unreliable.
The report even cautions heroin use in the youth population is "extremely rare," and not just in Florida: "Nationally, no lifetime prevalence rate for heroin has exceeded 2.4 percent in the eighth, 10th or 12th grades in the past decade. . . . Given the extremely low prevalence rates associated with heroin use by Florida students, analyses that attempt to precisely specify or quantify changes over time are subject to error."
In addition, for both measurements, the biggest drop came between 2000 and 2001, with minimal changes between 2002 and 2006. That seemed curious to Lloyd Johnston, a senior research scientist at the University of Michigan's Institute for Social Research and principal investigator of the Monitoring the Future study, which tracks drug use in the United States.
"While that is possible, I don't think it very plausible," Johnston said. "Rates almost always change more gradually."
Among other curiosities, Johnston said he would not expect a one-year decline that steep for lifetime heroin use. From year to year, the pool of respondents is mostly the same. In the first year, the survey includes youth who are 11 through 18 years of age. The following year, the 18-year-olds drop out and a new group of 11-year-olds joins, but all the other groups are included again. With such modest changes from year to year in the makeup of the age groups, one would not expect a large change in heroin use over a lifetime from one year to the next, Johnston said.
"That makes the lifetime improvement in 2001 highly implausible," Johnston said, adding that a sizable change in the 30-day rates would be more plausible.
There's also a separate issue: Did Bush's policies help engineer this decline?
That's hard to say, though drug policy experts in Florida praise Bush for his work on the issue.
James Hall, a drug abuse epidemiologist at Nova Southeastern University, said that Bush gave the issue high priority, including the creation of a drug policy office out of his own office to coordinate law enforcement, treatment, education and prevention. The office — which was later eliminated by Gov. Rick Scott — made a "very significant contribution" to drug policy in the state, Hall said.
In addition, Bush championed community-based anti-drug coalitions that helped consolidate prevention efforts, Hall said. And his wife, Columba, was also active in drug- and alcohol-abuse issues, he added.
Still, such efforts likely had a "marginal influence" on heroin-use rates, Hall said. Often, broader issues such as demographic and social trends have a bigger impact.
Johnston's own study found heroin use among youth was declining nationally between 1999 and 2007, the full extent of Bush's term in office. "For the three grades we study (eighth, 10th, and 12th), the combined prevalence of heroin use during the prior 12 months declined from 1.3 percent in 1999 to 0.8 percent in 2007," he said. That's a drop of about 40 percent — not far from the Florida-only results.
The only statistics for this claim support Bush's statement, but there are legitimate questions about the data. We rate the claim Half True.
Edited for print. Read more at PolitiFact.com/florida. Contact Louis Jacobson at email@example.com. Follow @loujacobson.