The push for evidence-based drug policy is clashing head-on with a drug war rooted in fear-mongering and racism.
Per a landmark 2018 bipartisan drug policy reform, the Office of National Drug Control Policy (ONDCP) is tasked with creating an Emerging Drug Threat Committee to identify and designate new trends in drug-related harms. Thereafter, James Carrol, ONDCP’s director, will be required to launch explicitly prohibitionist National Anti-Drug Media Campaigns, if deemed necessary, to “address” them.
Campaigns are still a ways off: The tentative criteria to define an Emerging Drug Threat were only just proposed on May 15. The public can comment until June 30. Given the statutory section on permissible use of funds, a Campaign may involve news and entertainment media, advertising, outreach to cops, patient education resources, and drug curricula for students.
An Anti-Drug Campaign will be in an bit of an oxymoronic bind: tasked with, above all, discouraging drug use while being “evidence-based and accurate, meet[ing] accepted standards for public awareness campaigns, and use[ing] effective strategies.”
Precedent for this particular combination is lacking, explained Daniel Raymond, deputy policy director for the Harm Reduction Coalition. “We’ve seen a lot of anti-drug campaigns in the past that aren’t anchored in evidence,” he told Filter.
For example, in the 1980s, Black people, and particularly Black women, were caught in the cross-hairs of dehumanizing cultural portrayals, like 48 Hours on Crack Street—rooted in since-debunked myths that maternal crack use irrevocably hurts a child. Or more recently, a 2019 video series (see video above) by Substance Abuse and Mental Health Services Administration, a supposedly science-based federal agency, depicted meth as an animated monster that leaves its opponent with “meth mouth,” a hyperbolized issue that is more related to hygiene and self-care than the actual drug itself.
The supposed convergence of scientific evidence with a drug-warrior mentality was conceived at a key political moment: the 2018 midterms and a peaking overdose crisis. The Support for Patients and Communities Act (SUPPORT) Act was passed through Republican and Democratic collaboration. Its provisions tinkered with regulations to make opioid use disorder medications and naloxone more accessible and available, while not fully tackling issues of funding and other intersecting areas.
“It was a bipartisan effort that allowed a lot of lawmakers to burnish their credentials with voters; that’s not to say it didn’t include some valuable provisions, but there was a clear mandate to get something passed,” said Raymond. “As with the Comprehensive Addiction and Recovery Act, it steered clear of any substantive questioning or revamping of the overarching criminal justice framework that shapes how drug issues play out. Congress’s work on the opioid overdose crisis has never been meaningfully coupled or integrated with criminal justice reform efforts such as the First Step Act.”
One of the Campaign’s statutorily required objectives is strikingly awkward: to be “supporting evidence-based prevention programs targeting the attitudes, perception, and beliefs of persons concerning substance use and intentions to initiate or continue such use.”
One education program originating in the ’80s had a similar goal and failed miserably at following evidence. DARE, the infamous anti-drug-user youth education program that wanted students to “Just Say No,” was resoundingly ineffective at preventing adolescent drug use, the National Institute of Justice has determined. A little over a decade ago, DARE was redesigned to incorporate strategies that have been shown to be more effective at changing some students’ use patterns.
But even with a little tweaking, abstinence-only messaging is not among the evidence-based best practices prescribed by the Centers for Disease Control and Prevention for preventing overdoses—the national crisis that precipitated the Emerging Drug Threat Committee in the first place.
It doesn’t provide the “tools [audiences] need to make safe decisions or to get help if problems with alcohol and other drugs do occur,” the Drug Policy Alliance* explains. In fact, such messaging seems to be implicitly banned, or at least marginalized, by the SUPPORT Act. The statute prohibits use of funds for Campaign “advertising that does not contain a primary message intended to reduce or prevent substance use.”
“Rather than finding new drug threats to scare people about, one drug at a time,” said Raymond, “effective media campaigns should aim to build on general resilience and protective factors that apply across a range of substances.”
*The Drug Policy Alliance previously provided a restricted grant to The Influence Foundation, which operates Filter, to support a Drug War Journalism Diversity Fellowship.
Video of SAMHSA’s 2019 “meth monster” campaign.