Public-Health Experts Are Skeptical of the CDC’s New Anti-Opioid Campaign – Pacific Standard – Oct 2017
Last month, the Centers for Disease Control and Prevention (CDC) launched an advertising campaign aimed at reducing addictions and deaths that are linked to prescription opioids.
The campaign suggests the government wants Americans to eschew opioid prescriptions altogether. Its tagline is, “It only takes a little to lose a lot.”
In his featured ad, Duggan says, “One prescription can be all it takes to lose everything.“
This is the biggest lie of all because addiction is in the person, not the drug.
The videos are incredibly moving—and yet, according to nearly every public-health researcher Pacific Standard consulted, they probably won’t do much. Why not?
Everyone pointed to the same fatal flaw: The ads tell viewers that prescription opioids are a big problem, but don’t tell them what steps to take.
“What were they asking people to do?” clinical psychologist Craig LeFebvre asks me, rhetorically, when I interview him.
As LeFebvre and others point out, telling Americans to avoid prescription opioids altogether just isn’t feasible.
The drugs may, in many cases, be a good choice to treat pain.
I’m heartened to see the truth stated so clearly. Now, if only the rest of the media would catch on.
In fact, advising people not to use opioids at all contradicts the CDC’s own “Guideline for Prescribing Opioids for Chronic Pain,” which was published last year.
The guideline recommends caution, not abstinence.
This has been the problem all along: doctors are being told (ordered, if they are employees) to stop prescribing opioids without any alternatives for their patients.
All other methods of pain control are either much less effective or too expensive for insurances to cover.
Alternative medicine usually involves on-going treatments, often weekly, for the rest of the patient’s life.
The video ads do show a URL at the end, cdc.gov/RxAwareness, but it disappears quickly and there’s no indication of what the site offers.
In addition, campaigns that tell people to just not do something, without offering alternatives, don’t typically work, argues Bill DeJong, a professor of community health sciences at Boston University.
DeJong offers the example of efforts in the United States to reduce drunk driving, which got off to a slow start until a suite of changes in the late 1980s, including the invention of the idea of a designated driver. “It wasn’t until there were changes in policy and enforcement, changes in the law, coupled with offering steps you could take to avoid it, like the designated driver, that we got some real change,” DeJong says.
Psychological theory explains why “Just say no” doesn’t work.
It’s thought that, before they’ll change their behavior, most people need to feel empowered to do so. The technical name for the feeling is self-efficacy.
Without that self-confidence, the CDC’s opioid campaign just makes viewers sad and afraid, emotions they may deal with unproductively.
Some of the experts Pacific Standard talked with took the stance that the CDC ads would be at least somewhat effective,
DeJong, however, has a harsher opinion. “The campaign isn’t going to make a damn bit of difference,” he says.
I’m relieved to hear this and, for all our sakes, hope he’s right.
The CDC is one of America’s major science agencies. It employs scientists of many stripes, including epidemiologists who do crucial work in tracking drug use in America, which helps doctors and officials stay on top of a fast-changing epidemic.
Why, then, would it sponsor an ad campaign that health psychologists don’t think will work?
The agency’s press office didn’t fulfill requests for a phone interview about the campaign, nor did it answer questions sent over email.
This is because the CDC’s missteps on the opioid epidemic are indefensible.
DeJong speculates the problem might be the federal government approaching public service announcements as advertising problems, rather than health-behavior ones.
This is because PROP and the recovery industry *are* using overdose deaths as advertising for their ineffective “recovery” programs, trying to scare us all by telling us that opioids can turn anyone into an addict instantly.
In the past, the government has hired (or received pro bono services from) ad firms to try to discourage Americans from drunk driving and drug use.
America’s ad men can indeed be effective at persuading people to change their behaviors—for example, to use body wash instead of soap, or to spritz the toilet before sitting on it.
But getting people to be healthier is different.
As DeJong puts it: “We don’t tell people that you’re going to die if you don’t use Crest toothpaste.”