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A New White House Tell-All Illustrates Trump's Views on How to Keep Teens From Abusing Opioids

Yet another tell-all Trump administration book came out Tuesday, this time by a former White House staffer named Cliff Sims. The book is called Team of Vipers. Of particular interest to us here at Pacific Standard is Team of Vipers' recounting of what President Donald Trump wanted for White House-sponsored ads intended to discourage young Americans from abusing opioid painkillers, such as OxyContin and Percocet. "We need people dying in a ditch. I want bodies stacked on top of bodies," Sims writes that Trump told adviser Kellyanne Conway, who leads the White House's anti-addiction efforts. Trump wanted "the most horrifying ads you've ever seen."

Trump has also publicly hinted at his belief in scare-'em-straight tactics, though not as vividly. In a speeches dedicated to America's opioid overdose epidemic in 2017, he promised to show the "devastation and ruination" addiction causes, and said that the "best way to prevent drug addiction and overdose" is by "talking to youth and telling them: 'No good. Really bad for you in every way.'"

In June of 2018, the White House did indeed launch a uniquely horrifying ad campaign, showing young people deliberately crashing a vehicle, slamming an arm inside a door, and getting under a car, jacked up as if for repairs, and then kicking out the jack—all in order to injure themselves seriously enough that a doctor would prescribe them the opioids they were addicted to. Ads like these have not been shown to actually improve the choices people make, as a slew of public-health experts told me at the time:

Ads like this work well to capture viewers' attention, experts say. In focus groups, teens and young adults—the stated targets of these spots—will often say they like dramatic, scary ads, says Craig Lefebvre, who studies public-health marketing at RTI International. Unfortunately, such ads have been documented to have unintended consequences.

By themselves, they haven't been shown to create long-lasting behavioral change. They elicit revulsion and fear, feelings that people often don't deal with productively if they're not immediately shown what steps they can take to avoid a bad fate. They may simply avoid the ad, or the feelings, instead of dealing with the issue.

The most effective public-health ads tell viewers what to do, like the Designated Driver ads that gave Americans a concrete solution for how to avoid driving drunk, researchers say. "If the goal of a campaign is to change behaviors and actually improve behaviors, as I believe all government-funded health campaigns should be," Jay Bernhardt, former director of the National Center for Health Marketing at the Centers for Disease Control and Prevention, told me last year, "then clear action steps are critical."