LETTER: Scare tactics less effective in overdose crisis

B.C. Chief Coroner Lisa Lapointe

Image Credit: THE CANADIAN PRESS

December 03, 2017 - 12:00 PM

OPINION

The illicit drug overdose crisis has taken over 2,000 lives in British Columbia since January 2016, and the province is likely to surpass the 1,500 mark for deaths in 2017 alone.

Too many valued lives are being lost, and that's why the B.C. Coroners Service is working collaboratively with a number of partners across the province and the country to find meaningful ways to reduce the tragic number of deaths in our communities.

Recent media coverage has indicated that a B.C. funeral-services company has developed a public-awareness campaign to highlight the danger of opioids, targeting youth and teens, with an event planned to include a "more visceral, emotional experience". The coverage indicated that coroners would be participating.

While we acknowledge the importance of public education and awareness, the B.C. Coroners Service does not endorse, and will not be participating in, fear-based initiatives. Evidence suggests that the reasons for drug use are complex and multifaceted, and programs focused on scaring people from using drugs, are not effective in saving lives. Additionally, they tend to increase the stigma surrounding drug use and actually discourage people from seeking help - an obsolete approach that has led to the loss of countless lives.

The B.C. Centre on Substance Use recently provided some research on universal substance use prevention, pulling together a number of different academic studies. Among key findings was that mass media campaigns and public service announcements showed no evidence of effectiveness while interactive, skills-based approaches showed positive results, with targeted approaches being especially effective. This is why timely, accurate data from coroners' investigations is so important; allowing our health partners to inform evidence-based initiatives. With data showing that most of those dying from overdoses are using alone, health authorities and service providers can innovate targeted strategies aimed at saving lives.

We also know that image-use needs to be very strategic in awareness campaigns. For example, those with lived experience tell us that images featuring drug paraphernalia can act as a trigger, resulting in the desire to use and causing more harm. We also know that periods of abstinence result in reduced tolerance; putting drug users at higher risk for death.

In the United States, the 'Just Say No' and D.A.R.E. campaigns produced poor results. It has many people in that country worried about a massive advertising campaign promised as part of their federal government's response to what is being described as at the worst drug crisis in American history and the deaths of almost 100 people every day. According to the Associated Press, between 1998 and 2004, the U.S. government spent nearly $1 billion on a national campaign designed to discourage the use of illegal drugs among young people. However, a 2008 follow-up study funded by the National Institutes of Health found the campaign to have no positive effects on youth behaviour and may have, in fact, prompted some to actually experiment with using substances.

A 2004 Canadian Transportation Research Forum study recommended that policy-makers and advertisers focus more on providing their target audiences with a number of strategies to cope with the threat they are trying to address, rather than increasing the level of threat or fear arousal in the advertisements.

The experiences and life situations of people who use drugs, as well as the physiological changes they experience, means they might not be ready or able to engage with the overdose prevention strategies suggested in the some of the ads that currently exist. We need to be aware of peoples' realities and be realistic about what change they are capable of for the stage they are at in their lives. In the long run, compassion and support, including prescribed medical treatment where appropriate, will be much more effective in turning this crisis around than fear and shame.

Let's have the courage to step out of our comfort zones to save lives.

— Lisa Lapointe is the Chief Coroner with the B.C. Coroners Service