Crashing cars into walls, breaking hands with hammers: How the White House is warning against opioids

WASHINGTON — One commercial ends with a young woman unbuckling her seat belt, flooring her gas pedal, and ramming her car into a dumpster. Another shows a young man opening his garage door, sifting through a toolbox, and forcefully slamming a hammer down on his left hand.

Both are part of a new White House campaign aimed at educating adults ages 18 to 24 about the perils of opioid misuse and illustrating the lengths to which some go to obtain prescriptions for the highly addictive painkillers. The effort, White House adviser Kellyanne Conway told reporters on Thursday, will use four “hyper-realistic” narratives based on real events from young adults around the country.

While the circumstances in each ad vary, all four aim for a visceral reaction — to scare viewers away from opioid use given the associated dangers.

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That is an approach that has been tried previously in public health awareness campaigns, including the infamous “This Is Your Brain on Drugs” ad campaign from the 1980s. Numerous studies have found that ad campaigns that aim to produce an emotional reaction, instead of producing a change in behavior, often fail to achieve their desired effect.

Still, contacted by STAT on Thursday, two former “drug czars” — one from a Democratic administration and another from a Republican administration — were largely supportive of the new ad campaign.

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“I actually think scare tactics — that are relevant to the target you’re going after — do work,” said Gen. Barry McCaffrey, a former four-star general who ran the Office of National Drug Control Policy under President Bill Clinton.

McCaffrey, who expressed broader frustration with how the Trump administration has responded to the opioid crisis, said he was heartened by the announcement of the marketing campaign.

“I think the ads are powerful, there’s no question in my mind they’ll help,” said John Walters, who served as drug czar to President George W. Bush. “There’s a lot of cynicism about ‘Just Say No.’ The basic principle here is to give people the information and to give them the support to not start self-destructive behavior. That’s what a free people wants.”

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A White House commission empaneled last year by President Trump included a sweeping media campaign in its recommendations, a suggestion the president revisited when he announced his administration would declare the crisis a national public health emergency in October.

Conway said on Thursday that the ads being unveiled were one of many outreach steps to come.

Rafael Lemaitre, who worked at ONDCP during the Clinton, W. Bush, and Obama administrations, said that public awareness campaigns were generally a force for good, regardless of how effective the ads themselves are.

“I’m not advocating for a ‘Just Say No’-style campaign,” he said. “But what you saw during the mid-’80s was everyone in government standing up and saying: There’s a big problem and we need to do something about it, and the issue was elevated.”

Drug policy experts applauded the collaboration with two nonprofit organizations on message-testing, and said the organizations tested roughly 150 messages before settling on a theme for the ads.

One of the organizations is the Truth Initiative, which has long engaged in similar outreach efforts regarding tobacco use. The other, the Ad Council, partners with advertising agencies to fund public service announcements, and worked with former First Lady Nancy Reagan on the “Just Say No” campaign.

The campaign will largely rely on donated airtime and media resources, said Jim Carroll, the White House’s nominee to lead the Office of National Drug Control Policy.

Representatives for the Ad Council and Truth Initiative said campaigns like the one rolled out Thursday were typically worth roughly $30 million in ad buys.

The 18-24 demographic, however, is not among those most impacted by opioid addiction and overdose deaths. The White House said the campaign was a preventative tool aimed at breaking a cycle of prescription painkillers serving as a gateway to heroin and illicit fentanyl.

Roughly 60,000 Americans died from drug overdoses in 2016, and 42,000 of those deaths involved opioids.