The Philadelphia Department of Public Health is launching a new installment of an awareness campaign warning people to avoid prescription painkillers, even when they get them legally from their doctor.
“Don’t take the risk,” urge the ads appearing on television and social media.
They tell a familiar story about how the public health crisis came to be, featuring real people from Philadelphia who turned to heroin after becoming addicted to prescription opioids — pills that some got from their doctors to treat pain.
“It started with three painkillers,” says one woman at the beginning of a 30-second television spot.
Then the ad cuts to others who describe the ravages of heroin addiction, some speaking from the streets of the city’s drug-plagued Kensington neighborhood.
“It led me to prostituting myself,” says another woman.
Words on the screen declare that prescription painkillers are quote “heroin in pill form.” Viewers are left with the closing image of an orange prescription bottle with pills spilling out of it alongside a syringe.
But are these drugs truly “heroin in pill form?”
Some scientists have challenged the narrative that the opioid crisis has been driven by people becoming addicted after a prescription from their doctor.
The research is complicated, but some studies have found that even people who use prescription painkillers long-term to treat chronic medical conditions have rates of addiction around 10 percent, while others have reported even lower rates.
Still, Philadelphia Health Commissioner Dr. Tom Farley defended the phrase “heroin in pill form.”
“We think it is entirely appropriate,” he said. “[Both drugs] work in the same way in the body, and we thought that that analogy would help people recognize how dangerous these pills are.”
The Department of Public Health ran similar ads with the same slogan last year, and is spending around $150,000 on the new round of advertising.
Far too many Philadelphians are taking unnecessary prescription opioids that were prescribed by a doctor, Farley said, citing a report the department released last year, which found that one in three people in the city reported taking a prescription painkiller in the past year. More than 80 percent of them were prescribed by a doctor, the survey found. The ad campaign seeks to challenge a false sense of security people may have when they get these pills from a physician, Farley said.
“To let them know that there is a risk from these pills is new information, and something which we hope will help them have a healthy fear of these pills,” he said.
Awareness campaigns designed to put the fear of drugs in people are, of course, not a new thing. Beginning in the 1980s, television ads told Americans to “just say no” and famously used an egg sizzling in a frying pan as an illustration of “your brain on drugs.”
But research on those campaigns has shown them to be mostly ineffective.
Philip Massey, an assistant professor of public health at Drexel University, said anti-drug campaigns work better when they empower people to make healthy decisions, rather than just scaring them.
Massey praised Philadelphia’s anti-opioid campaign for building awareness about the risks associated with prescription painkillers. But he said its message of “don’t take the risk” may overemphasize the individual agency of patients who put trust in their doctors and find themselves in a health care system that makes a variety of opioid pills readily available.
“When you’re in the doctor’s office, there’s a lot going on,” Massey said. “You may not be able to draw upon these messages in times when your priority isn’t exactly not becoming addicted to heroin, but your priority may be managing acute pain.”
Massey said the campaign might be more effective if its message were paired with tools and information to help people navigate these situations and advocate for alternatives to opioids. If future installments of the campaign evolve in this way, he said, the “don’t take the risk” ads could be a promising start.