Challenging Dogma


...Using social sciences to improve the practice of public health

Wednesday, April 25, 2007

The Partnership for a Drug-Free America’s® Media Campaign Fails to Incite a Positive Change - Molly O’Brien

Prescription medications are being abused by teenagers at alarming rates. In its 17th annual national study of adolescent drug abuse released in April 2005, The Partnership for a Drug-Free America® reports that one in five teenagers has abused a prescription painkiller to get high. The study found that 4.3 million teenagers (one in five) nationwide report abusing Vicodin® while 2.3 million teens (one in ten) reports abusing Oxycontin®. Both medications are powerful prescription painkillers and both are highly addictive (1). It must be noted that these figures represent adolescent abuse in 2004. The numbers today may be significantly higher. In addition, the study conducted by The Partnership depends on teens answering questionnaires honestly. The nature of the survey can lead to underestimates in total teenage drug abuse due to under-reporting and dishonest answers.

Prescription (or Rx) medications are known to be safe when used according to a doctor’s orders. Yet, when used without a prescription or in excess these same medications, particularly painkillers, can cause serious harm. "Teenagers abuse narcotic pain relievers more than any other prescription medication"(2). These medications are opiate drugs which make them extremely addictive and dangerous when used improperly. Tolerance develops quickly among abusers as well as physical dependence (3). Due to these aspects, withdrawal symptoms are strongly felt when teens attempt to stop using. Adolescents may experience intense restlessness, insomnia, severe muscle and bone pains, vomiting, diarrhea, and cold flashes. When taken in overdose these medications can slow breathing and even lead to death (2).

The study conducted by The Partnership depicts a new trend in substance abuse among teenagers. In order to gain further insight into this growing epidemic The Partnership is in the midst of conducting additional research. It is aiming to better understand teens’ knowledge, awareness, and attitudes in regards to Rx medication abuse. Researchers plan to look into access to drugs, reasons for abuse, and in particular, the degrees of risk teens correlate with certain medications (1). Yet, research itself will not be enough to decrease the numbers of teenagers abusing drugs. President and CEO of The Partnership Steve Pasierb believes “educating parents and teenagers about the risks of abusing medications will be exceptionally challenging, but it clearly must be done (1).” This education is a pertinent factor in preventing Rx abuse among adolescents. To date, The Partnership for a Drug-Free America® has produced and released a small media campaign consisting of three separate commercials to address this growing problem. While a media campaign is a proactive attempt to confront and, in return, decrease abuse, the campaign has been unsuccessful. The television campaign produced by The Partnership to combat prescription medication abuse by teenagers unfortunately fails to effectively incite a positive change in behavior.

The Commercials
The Partnership for Drug-Free America’s® campaign to counter Rx medication abuse consists of three different television commercials. The television messages are entitled “The Hood,” “Rx Label,” and “Pharmtown” and were created in collaboration with Grey Advertising. “The Hood” depicts a car with tinted windows driving through a suburban neighborhood. A narrator explains that there is a new drug dealer in town. “So who’s supplying your kids?" the narrator asks, “You are.” The car window rolls down to reveal a mother coming home to her children after grocery shopping. As she unpacks her groceries her teenage daughter steals a bottle of prescription medication. The “Rx Label” video shows a prescription bottle label that warns parents about the more than two million teens who abused a prescription medicine last year to get high. The third commercial “Pharmtown” displays a carload of adolescents driving through their neighborhood. As they drive, they point out neon signs hanging above each house that read "Free Drugs," "Pharmacy," and "Open 7 Days." The narrator states that teens can access prescription medications any day from any home across America for free. All three commercials are addressed to parents of teenagers. Each advises parents to talk to their children regarding prescription drug abuse and offers The Partnership for Drug-Free America website as a reference for help.

Missing the Target Audience
The commercials created by The Partnership for a Drug-Free America® to address the issue of prescription medication abuse among teenagers fails to reach the masses of adolescents and parents across America. The commercials are shown infrequently and inappropriately. Many parents and teens have not even seen the campaign spots. The commercials are not being placed on appropriate networks or at appropriate times.

The Partnership created the commercials to address parents of teenagers; however, these adults are never getting the message. In order for positive change to occur as a result of these three video spots, they need to be repeatedly viewed by parents. The commercials need to grab the attention of parents and they must be a constant presence. This entails frequent airings during times when most adults are watching television. The commercials need to be aired on networks with large adult audiences. To be successful, a public health campaign needs to be loud and strong. The Partnership’s commercials fail to accurately reach parents across America rendering them ineffective.

Wrong Audience
The television commercials are intended for parents of teenagers abusing prescription medications. The blame and the responsibility are placed solely on the shoulders of the adults. The teenagers, the population actually abusing the Rx drugs, are never directly addressed in The Partnership’s media campaign. This aspect derails the campaign from the start.

There are many barriers in place that can stop a parent from successfully talking to his or her teen about drug abuse. In the United States in 2002, thirty-one percent of children were living in single-parent households (4). Single moms and dads must serve as the sole income producers for their families and therefore they have less one on one time with their teens. Both single parents and married parents in America spend most of their day out of the house either working or doing errands to keep the household running smoothly. Teenagers in turn spend most of their days in school, playing sports, or with friends. Due to the limited alone time that occurs between parents and adolescents, parents are often completely unaware of their child’s drug abuse.

Creating commercials intended for parents will not work in the case of Rx medication abuse because the majority of parents are oblivious to this new trend among teens. If and when a parent views The Partnership’s commercials it is very likely he or she will simply ignore it. It will not draw adults in if parents do not believe it pertains to them. An effective parent-focused commercial must connect with all parents. Adults must view the advertisement and instantly relate to what they are seeing on television. They need to be reminded of their own teenagers and they must be equipped with appropriate tools to use to address the issue. Parents must believe their child is susceptible to drug abuse and they must feel empowered to fight this vulnerability for a media campaign to be effective.

By nature teenagers are rebellious and somewhat distant from their parents. They tend to turn to friends and peers for advice and in times of need more often then their parents. Adolescence is a time of individuality and self-discovery. Teenagers challenge their parents’ limits and bend the rules. They naturally want to rebel against authority.

Adolescents often feel as if they cannot relate to their parents or that their parents do not understand them. The last thing they want to hear is more lecturing and scolding from adults. The Partnership’s media campaign relies solely on parents and their ability to preach to their children which is clearly ineffective.

Parents are advised to “talk to your teens” but methods and insightful information on how to approach the topic are not given. The website for The Partnership for a Drug-Free America® is the only helpful information given during any of the three commercials. Parents are told to log onto www.drugfree.org to learn more. Many parents may not have internet access. Simply referring adults to a website is in no way useful in the fight against teenage drug abuse. Parents may want to discuss this issue with their sons and daughters but are unable to due to the numerous steps needed to require the necessary knowledge.

The Partnership’s media campaign does not take into account self-efficacy and the social cognitive theory. In order for a parent to succeed in addressing drug abuse with his or her child, the adult must feel as though they are capable of doing so. The commercials call attention to the problem but they do not equip parents with the tools to address the issue. A parent must believe that he or she can fully tackle the topic of prescription medication abuse with his or her child. If adults do not feel confident enough or capable enough to talk with their teenagers they won’t even attempt to do so. The Partnership’s campaign does not support parents in believing they are able to execute the needed actions. The commercials actually add more barriers to broaching the subject rendering them completely unsuccessful at inciting a change.

Ignoring the Whole Picture
The Partnership’s campaign fails to address the emotional, social, and psychological elements that can lead to adolescent prescription drug abuse. Simply announcing the problem through broadcasts is not addressing the issue in an effective manner. Substance abuse is a multifaceted problem. Abuse does not stem from one specific character weakness. It cannot be traced to one specific event or time. It is a complicated issue that needs to be viewed and treated as one. The Partnership’s commercials only present the facts and the figures. They do not take into account the coexisting elements that unite and lead to the beginning of adolescent abuse. These include social pressures, personal emotional dilemmas, and psychological problems. A teenager can begin abusing prescription drugs to fit in with friends, to cover up inner turmoil, to rebel, or simply to experience a high. Typically, there is no single, concrete answer. The multiple factors need to be understood and explained before The Partnership for a Drug-Free America can create an influential and worthwhile campaign.

Appropriate Interventions
The Partnership for a Drug-Free America’s® commercial campaign to curb prescription drug abuse amongst teenagers fails to use an appropriate public health model. Maslow’s Hierarchy of Needs is one model that must be understood and followed in order for a public health campaign to be successful at curbing adolescent Rx drug abuse. The campaign has to understand that a teenager must meet ‘basic needs’ before he or she can successfully satisfy ‘higher needs” (5). This means that before a teenager can contemplate stopping abuse of Rx medications, their basic needs including security of body, family, and health must be met. Drug abuse falls into the apex of Maslow’s pyramidal hierarchy. Before an adolescent can confront his or her Rx abuse and successfully tackle the issue, all of his or her needs that form the basis of the pyramid must be met. These needs include physiological ones such as eating and sleeping as well as safety needs like security of body, employment, and health. The next step in the hierarchy requires the fulfillment of love and belonging needs. It is only when all of these ‘basic needs’ are met that a teenager can focus on satisfying his or her needs of esteem. It is in this upper echelon that drug abuse lies (5). A successful campaign will look at solving the basic needs of teens. It is only when these are analyzed and satisfied that a teen can work towards ending his or her Rx abuse.

If the abuse of prescription drugs by adolescents is not halted, there will be severe ramifications in the future. Rx abuse can lead to extreme drug addiction and even death. If not confronted properly, teenagers can start on a path of drug dependency that can last into their adult years, affecting their ability to work, attend school, and excel in the social world. Abuse can divide families and ruin friendships. Rx drug abuse is not a small issue that can easily be fixed with a simple commercial or two. It is an issue that must be viewed from a variety of angles before it can be fully understood. A successful public health campaign must step back and look at the problem as a larger picture. ‘Why do teenagers begin abusing drugs’ is the question The Partnership needs to ask itself. The answer is not easy nor is it universal for all teens. The question is impertinent, however, for the public health field to address and understand before a successful campaign can be created.

References
1. The Partnership for a Drug-Free America. Generation Rx: National Study Reveals New Category of Substance Abuse Emerging: Teens Abusing Rx and OTC
Medications Intentionally to Get High. New York, NY: The Partnership for Drug-Free America, 2005. http://www.drugfree.org/Portal/About/NewsReleases.2. The Partnership for a Drug-Free America. Getting High on Prescription and Over-the-Counter Drugs is Dangerous: A Guide to keeping your teenager safe in a
changing world. New York, NY: The Partnership for a Drug-Free America. www.drugfree.org.
3. National Institute on Drug Abuse. NIDA InfoFacts: Prescription Pain and Other
Medications. Bethesda, MD. National Institutes of Health, 2005.
http://www.nida.nih.gov/infofacts/PainMed.html
4. Assistant Secretary of Planning and Evaluation, US Department of Health and Human
Services. Indicators of Child, Family, and Community Connections: Family Structure.
Washington, D.C.: US Department of Health and Human Services, 2005.
http://aspe.dhhs.gov/hsp/connections-charts04/ch1.htm
5. Wikipedia. Maslow's Hierarchy of Needs. GNU Free Documentation License, April 2007. http://en.wikipedia.org/wiki/Maslow’s_hierarchy_of_needs.

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