Drug Treatment and Crime Reduction Act of 1991

Drug Treatment and Crime Reduction Act of 1991 - Adds a new title XXI to the Social Security Act: Addiction Treatment Services. Directs the Secretary of Health and Human Services to make no fewer than ten five-year grants to organizations for establishing and operating a comprehensive drug and alcohol addiction treatment program (CDAAT Program). Requires that no less than 50 percent of a CDAAT Program's participants be individuals whose family gross income does not exceed 200 percent of the Federal poverty line and that any charges for services be based upon an individual's ability to pay for such services. Directs grantees to arrange for a participant's receipt of a preliminary needs assessment, case management services, and treatment which is designed to reduce or eliminate physical or psychological dependence on controlled substances, alcohol, or prescription drugs and includes psychotherapy or counseling as an integral part of the treatment. Requires that family or marriage counseling and training in social or vocational skills be included as Program services where available on a reasonable cost basis and essential to the achievement or maintenance of successful treatment. Requires an evaluation unit to compile information on CDAAT Program participants and treatment services provided to such participants and transfer such information each quarter to the grantee and the Secretary at the grantee's expense. Provides payments to grantees on the basis of their actual costs during the first two years of the Program and pursuant to a prospective payment system during the three remaining years of the Program. Creates the Addiction Treatment Services Trust Fund and appropriates to it amounts which are attributable to this Act's increase of excise taxes on alcohol and certain tobacco products. Requires an annual estimate of the fund's surplus or deficit. Provides for the use of copayment and reductions in payment limits and the use of the annual or cumulative surpluses to eliminate any deficits. Establishes in the fund a separate cumulative account of surpluses and deficits. Provides for confidentiality of records of patients under this title. Prohibits the use of records for criminal investigative or prosecutorial purposes except under court order. Makes special provision for coordination of regulations regarding records of veterans suffering from alcohol abuse or alcoholism. Requires grantees to submit annual reports on the effectiveness of their CDAAT Programs. Amends the Internal Revenue Code to increase alcohol and tobacco excise taxes. Directs the Secretary to contract with the National Academy of Sciences to conduct a study of the clinical and cost effectiveness of various drug and alcohol addiction treatment methods and services. Requires a study and report to the Congress on the costs and benefits of expanding CDAAT Programs to provide funding for treatment services for nicotine addiction. Directs the Secretary to establish a national uniform drug and alcohol abuse data collection system within one year of this Act's enactment.