Last month, the Centers for Disease Control and Prevention (CDC) launched a series of incredibly moving ads in response to America's rising deaths linked to prescription opioids. (Though prescription pills aren't the only opioids killing Americans, this ad campaign targeted scripts in particular.) There was only one problem: Nearly every health-behavior expert that Pacific Standard asked to review the ads thought that they wouldn't work because they didn't include a call to action, such as "Ask your doctor if there are any alternative pain treatments" or "Go here if you're worried a loved one is addicted." Instead, the ads seemed designed to make people sad and scared, which researchers thought wouldn't lead viewers to take productive action.
At the time we wrote about our findings, the CDC didn't fulfill our requests to learn more about how the campaign—called Rx Awareness—was made and the reasoning behind it. Two days after our story published, however, a CDC spokeswoman, Julie Eschelbach, answered our questions over email. After learning from Eschelbach that a firm called ICF had made the CDC's ads, we sought to speak with someone there, but an ICF spokeswoman referred us back to the CDC. Below are further details we learned about the Rx Awareness campaign from the agency.
How much did this campaign cost?
The CDC had $4.2 million to develop, pilot, evaluate, and launch the campaign through our state programs.
I've been talking to researchers who study public-health campaigns and one comment they've all had is that the ads should have included action steps for viewers to take. Without such action steps, the campaign may not be very effective, the researchers say. Why did the CDC decide not to include action steps?
The goals of CDC's Rx Awareness campaign are to increase awareness and knowledge among Americans about the risks of prescription opioids.
The campaign did not include a direct call to action because the prescription opioid issue is a complex one. The campaign's intention is to increase awareness about the risks of prescription opioids—even when they are started under the care of a health-care provider. The results of a pilot of the campaign found, overall, the campaign messages and materials show evidence of contributing to increased awareness, knowledge, and intentions. Findings also suggest that campaign messages have the potential to not only affect awareness and knowledge, but also influence actions.
What I got out of the ads is that I'm not supposed to start taking any prescription opioids at all because one script is enough to get me addicted. Is this the message the CDC intended? If yes, I'm curious because it seems to me that such a message contradicts the 2016 Guideline for Prescribing Opioids for Chronic Pain. The guideline doesn't say opioids are never appropriate for chronic pain. How did the CDC decide on this message of no opioids at all?
Our aim is to prevent prescription opioid overdose deaths since prescription opioids continue to be involved in more overdose deaths than any other drug.
The Rx Awareness campaign focuses on the general public, where the CDC Guideline for Prescribing Opioids for Chronic Pain focuses on health-care providers. Both were produced by the CDC for specific audiences to address their needs and goals. The Rx Awareness campaign highlights the importance of reducing opioid abuse to prevent overdoses, different from the CDC Guideline, which is focused on improving the way opioids are prescribed through clinical practice.
This interview has been edited for length and clarity.