1. What Were They Thinking?
1.1. It’s difficult with the perspective of time to see the campaigns of the past as anything but bewildering. Since they clearly didn’t work, reflecting on past campaigns comes with a healthy dose of cynicism. Nancy Reagan3, the Teenage Mutant Ninja Turtles, Rachel Leigh Cook4 and others all variously exhorted us to “just say no,” and queried, “Why do you think they call it dope?” They advised elementary and middle school kids to defiantly rebuke grade school pushers as “turkeys.”5
1.1.1. Name-calling always stops a war, right? It seemed every time you turned the channel, there was another familiar face: Punky Brewster6, McGruff the Crime Dog7, or those cute Diff’rent Strokes kids8 getting in on stopping the action. Even years later, soon after 9/11, one of the most political and memorable Super Bowl ads linked illegal drug purchases to terrorism, which critics called propaganda and taking the war on drugs too far.9
2. Follow The Money
2.1. The government (a.k.a. “we”) allocated billions of dollars for these campaigns. To give you an idea of how much money was spent, from 1977 to 1982 alone, Congress appropriated $1 billion to anti-drug campaigns.10 By the late ‘80s, $1 million in media time was devoted each day to scaring us away from drugs.11
2.1.1. In fact, a single anti-marijuana campaign12 spent $1.4 billion between 1998 and 2005. That’s an average of a half a million dollars per day to deter marijuana use. (Figure 2) These campaigns were mostly intended to scare young viewers away from the temptation of peer pressure and drugs. Whatever their results (we’ll get to that later), the intentions of those who created these media barrages were well meaning, if not well researched or well executed. From a sociological perspective, these historical TV spots and shows provide snapshots in time of our past culture – visually, musically and emotionally.
3. The Best Of The Worse
3.1. From the folks who gave us The Flintstones, Yogi Bear, The Jetsons, Scooby-Doo and other Saturday morning fodder, the team at Hanna-Barbera might have been under the influence of hallucinogens themselves when they created this trippy phantasmagorical journey36 that transports, in 30 seconds (Figure 3), a hapless drug-taker, led by anthropomorphic pills, right into a skeleton-filled crypt.
3.1.1. Another special took a similar approach. McDonald’s financed the anti-drug film, “Cartoon All-Stars to the Rescue,”13 which was simulcast on all four major networks in the early ’90s. Garfield, Muppet Babies, Alvin and the Chipmunks, Bugs Bunny, Daffy Duck and others encourage two siblings to resist the lure of drugs – symbolized by a cloud of smoke. The effectiveness of this television special can best be summed up by YouTube commentator, Phlebas:
4. Rates Of Drug Abuse: Anything But Clear
4.1. Although illegal drug use decreased from the late ‘70s to early ‘90s, overall drug use more than doubled in 1992. Experts referred to this year as a “relapse” in the drug epidemic. This uptick occurred on the heels of the period when the airwaves were saturated with scare campaigns.20 (Figure 4)
4.1.1. Multiple studies have been done over the years on the rates of illegal drug use. From the National Survey on Drug Use and Health21 we learned, in 2012, that illegal drug use in America was again on the rise. That same year, another study22 sponsored by the Partnership for Drug-Free Kids at Drugfree.org, in conjunction with the MetLife Foundation, showed an increase in prescription drug abuse among teens, with 24 percent of high school students claiming to have abused these medications, a 33 percent increase from 2008. Then just two years later, in 2014, the Monitoring the Future Study23 (an ongoing study since 1975) showed a decrease in the use of certain illegal drugs (but not heroin). From the Centers for Disease Control’s National Youth Risk Behavior Survey24 we glean insight into the increases and decreases of misuse of all kinds of drugs between 1991 and 2013: marijuana, cocaine, heroin, steroids, inhalants and more. To borrow a phrase from the end of the memorable fried egg PSA, “Any questions?” One thing is clear: we definitely have a drug abuse problem.
5. The New Approach
5.1. This approach to the Above the Influence (ATI) campaign continues previous efforts with an effort to reach teens with a highly visible and effective national messaging presence while supporting and funding local participation. The White House identifies some of these organizations: Drug-Free Community grantees, Boys and Girls Clubs of America, SADD Chapters, Girl’s Inc., Girl Scouts, Community Anti-Drug Coalitions of America (CADCA), the National Organization for Youth Safety (NOYS), ASPIRA, and YMCAs.
6. The Anti-Drug Campaign didn’t work.
6.1. igure 1 – Heroin StudyIn fact, numerous researchers cited in a Scientific American article titled “Why ‘Just Say No’ Doesn’t Work” concluded that the programs had little impact on teen drug use. These campaigns now act as a different type of cautionary tale – what not to do to fight teen drug use. The ads and Public Service Announcements hold a special place in our collective cultural conscious – more nostalgic wry amusement and a sadness that this country wasted so much time and money.
6.1.1. What – if anything – does work? While we’ve made significant scientific advances in understanding the science of how drugs affect our brain and the damage they can do to the developing brain, we have little hard science about how to use this information in drug abuse prevention efforts. We can all agree that fear mongering associated with misinformation and hyperbole doesn’t work, but we haven’t yet figured out what does. What we do know is that community engagement and close interaction between mentors and teens through programs like Above the Influence (ATI) have predicted decreases in marijuana use. So, we keep trying to do something to make a dent, regardless of the astronomical costs and strain on resources.
6.1.1.1. As Michael Botticelli, director of the National Drug Control Policy recently stated, “This issue touches every family and every community in one way or another. There are millions of Americans – including myself – who are in successful long-term recovery from a substance use disorder. The (newest) policy supports each and every one of us and demonstrates a real commitment to a smarter, more humane approach to drug policy in the 21st century.”[1]
7. How It All Began
7.1. President Richard Nixon, learning in 1971 that 10 to 15 percent of servicemen in Vietnam were addicted to heroin, declared drug abuse “public enemy No. 1” and the War on Drugs was born (Figure 1). Every administration since Nixon’s has had comprehensive initiatives to fight drug use, which go far beyond prevention into border control and drug treatment programs. These efforts cost us a whopping $51 billion annually.2 In 1988, the Drug Czar, as the head of the Office of National Drug Control Policy (ONDCP) became known, mandated a national anti-drug campaign directed at youth and funded the Partnership for a Drug-Free America. The heavens opened, and money poured forth.
7.1.1. It’s easy to resist drugs. All you have to do is “just say no.” “Just Say No.” That’s what Nancy Reagan replied in 1982 when a student in Oakland, California asked what to do if she was offered drugs. The rest is history.
8. Scared Much?
8.1. Did the advertising campaigns and after school television specials work? Not that well. When you think about it, how could anyone seriously think that commercials and television specials could have a fighting chance against the thrill-seeking, undeveloped teenage-or-younger brain or the various cartels of the world using their own tactics to hook kids. There are just too many other variables at play to think these anti-drug media campaigns could work: family history, parental involvement, the international drug trade, geography, availability, socioeconomics and even trends in favored drugs. As a result, it’s almost impossible to draw a cause-and-effect line between watching a few PSAs and TV specials and preventing teens from using drugs.
8.1.1. A handful of studies indicated a possible correlation, but even the government’s own research found little evidence that the media campaigns worked. The study “Effects of the National Youth Anti-Drug Media Campaign on Youths,” funded by the National Institutes of Health concluded: “The campaign is unlikely to have had favorable effects on youths and may have had delayed unfavorable effects.” In other words, the results revealed a behavioral reaction in the opposite direction, or a “boomerang effect,” where greater exposure to the campaign resulted in increased drug use.17 The scare campaigns crossed borders. Even though there was and is meager evidence to show their veracity, according to BBC writer Brian Wheeler, “a surprising number of anti-drug campaign around the world still fall back on scare tactics and, in particular, the drug-fuelled ‘descent into hell’.”18 Want more proof of failure? A 2011 Canadian review and meta-analysis took a broad and deep look at the “effectiveness” of these campaigns and concluded: “Existing evidence suggests that the dissemination of anti-illicit-drug PSAs may have a limited impact on the intention to use illicit drugs or the patterns of illicit-drug use among target populations.”19
9. What Next?
9.1. 27 Using prevention messaging that promotes alternatives to drug use, ATI is heavily supported by targeted local efforts and the scientific concept that a substance use disorder is not primarily a moral failing – a key message in the media campaigns of the past – “but rather a disease of the brain that can be prevented and treated.”28 This is the cornerstone of the Obama administration’s 2014 National Drug Control Strategy, which focuses on addiction as a disease, based on discoveries about the brain. The driving force behind this stance is Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health, who pioneered the use of brain imaging to investigate the effects and addictive properties of drugs.29
9.1.1. Trying to instill fear does not work.25 According to a 2011 Substance Abuse Risk Factor study,26 drug users tend to be more informed about risks and consequences of drug use than non-users. So, intervention campaigns that focus on disseminating information may be of limited value. One recent effort, called Above the Influence, goes beyond cartoons and preachy TV ads. Above the Influence recently transitioned away from government control and is now under the auspices of the not-for-profit, Partnership for Drug-Free Kids.
9.1.1.1. Currently, the White House’s No. 1 anti-drug priority is indeed community-based programs, not PSAs. Federal resources, totaling $1.3 billion, support education and outreach programs intended to discourage the use of controlled substances, while encouraging community outreach efforts focused on getting those who have begun to use illegal drugs to stop. This is a 4.7 percent increase ($59.9 million) over the FY 2014 level.30 (Figure 5)
9.1.1.1.1. Community-based interactive programs, like Narcotics Overdose Prevention and Education (NOPE), the Robert Crown Center Heroin Prevention Program, Not My Kid and many, many others, focus on educating students face-to-face (sometimes peer-to-peer) about the dangers of drugs. After the hue and cry following the inefficacy of earlier programs, the Office of the National Drug Control Policy is more than a little eager to show the effectiveness of locally-driven campaigns like, Above the Influence. The question remains, though, what is the long-term effect of such campaigns? That “exposure to the ATI campaign predicted reduced marijuana use” is simply not enough.31
10. There’s Always Hope For A Better Tomorrow
10.1. While the focus has shifted from broad-based media campaigns to community-led programs primarily driven by science, government spending hasn’t abated one bit. Federal funding for public health programs that address substance use has increased every year with the portion (43 percent) spent on drug treatment and prevention efforts now at its highest level in over 12 years.32 And even though they downplay it, many programs still use fear to attempt to change behavior. In a recent Reuters article, reporter Laila Kearney describes33 a NOPE program presented to 500 students at a Pennsylvania high school, which started with a recording of a mother’s 911 call about her son’s overdose. The urn containing his ashes sat conspicuously onstage. What’s different from the media campaigns is that these new programs are locally integrated. Kids can relate to tragedy that happens in their neighborhoods and to kids like them. But does that stop kids from using drugs? Although one student commented that it felt personal, he was circumspect about whether or not the NOPE presentation would actually change behavior. That’s frightening when you consider that 46 people die each day in America from prescription painkillers alone.34 Addressing the impact of substance abuse is estimated to cost Americans more than $600 billion each year.
10.1.1. 35 While the community-based programs purport to be scientifically based, what that means is that the information given to the target audience is scientifically factual, not that we have a scientifically verified method to keep people from using drugs. Teenagers are inherently experimental and human nature means that some teens will experiment with drugs – and, sadly, some will become addicts. The hope is that an informational approach that respects their intelligence is more likely to engage young minds and less likely to make them reject the information out of hand.