Meth madness: Montana’s prevention program increases acceptability of abuse

The film “Reefer Madness” became a cult classic more than a generation ago. Originally produced as a graphic warning against the use of marijuana, it was so overwrought it produced the opposite reaction to that intended. The film tells the story of teenagers lured into trying marijuana and, ending up involved in manslaughter, rape, suicide and an eventual descent into “madness.” By the 1970’s, it had become a cult classic, shown to great enjoyment and acclaim across college campuses.

The transformation from dire warning to joke is well known in the world of advertising and prevention campaigns. It is called the “boomerang effect” for obvious reasons. Typically it occurs when warnings are so dire that they are no longer believable. In fact, people take away the opposite message: the disfavored behavior could not possibly be as harmful as depicted, and therefore is probably safer than previous thought.

That phenomenon may be responsible for the paradoxical results of the Montana Meth Project (MMP). The MMP, the largest advertiser in the state of Montana, may not only fail to decrease meth use; it may actually increase it.

The MMP website proudly reports:

The Meth Project is the largest advertiser in Montana, reaching 70-90% of teens three times a week. This is saturation-level advertising.

The research-based messaging campaign—which graphically portrays the ravages of Meth use through television, radio, billboards, and Internet ads—has gained nationwide attention for its uncompromising approach and demonstrated impact. The campaign’s core message, “Not Even Once®,” speaks directly to the highly addictive nature of Meth.

Wikipedia groups the 16 television ads by director:

Tony Kaye’s spots feature themes of meth-addicted teens’ moral compromises and regret, and certain teens’ false confidence that they can use meth without becoming addicted… Just Once, That Guy and Junkie Den feature teens who promise themselves that they will only try meth “once”…

Each of the spots directed by Darren Aronofsky features a voice-over spoken by the teen featured in the spot. In voice-over, each teen talks about how strong their relationships are with their friends and family, and how important those relationships are to them. The action on screen demonstrates that if a person becomes addicted to meth, their addiction will destroy even their strongest relationships.

Each of the spots by Alejandro González Iñárritu features a teen or teens who appear to be normal and healthy in the beginning of the spot, but who appear pockmarked, bleeding, and addicted at the end, despite the fact that time passes normally. As each teen encounters their downfall—prostitution, robbery, or overdose—a narrator intones the simple phrase: “This isn’t normal… but on meth, it is.”

The MMP claims is has produced impressive positive results:

Teen Meth use has declined by 45%

Adult Meth use has declined by 72%

62% decrease in Meth-related crime …

…As a model prevention program for states nationwide, the Meth Project has expanded into Arizona, Idaho, Illinois and Wyoming. Additional states are expected to launch in the coming year.

A new study in the December 2008 issue of the journal Prevention Science takes issue with those claims. According to Drugs, Money and Graphic Ads: A Critical Review of the Montana Meth Project, by David Erceg-Hurn, the campaign has actually resulted in increases in the acceptability of using meth, and decreases in the perceived danger of using drugs. The key finding of the study, though, is that meth use had been declining before implementation of the campaign and there is no evidence that the campaign is responsible for the continued decline. According to Erceg-Hurn:

“Meth use had been declining for at least six years before the ad campaign commenced, which suggests that factors other than the graphic ads cause reductions in meth use. Another issue is that the launch of the ad campaign coincided with restrictions on the sale of cold and flu medicines commonly used in the production of meth. This means that drug use could be declining due to decreased production of meth, rather than being the result of the ad campaign.”

As the paper concludes, after an exhaustive analysis of each of the projects claims that the existing data that support or do not support those claims:

The MMP has successfully portrayed its advertising campaign as a resounding success to the media, politicians, and even some researchers. However, claims that the MMP’s advertisements have been associated with positive changes in attitudes to methamphetamine are, for the most part, not supported by evidence. In some cases, the MMP’s claims of efficacy are directly contradicted by data in their own reports. It is very worrying that the MMP has ignored and misrepresented several negative findings, such as increases in the acceptability of methamphetamine use, and decreases in the perceived dangers of drug use.

The Montana Meth Project has had an impact far beyond Montana. It’s approach to drug abuse is consonant with the beliefs of the Bush administration on preventing drug abuse, and it’s report of positive results has encouraged the government to extend the program to other states. Yet the Government Accounting Office (GAO) has reported that despite $1.5 billion spent since 1998 on large scale programs warning of the dangers of drug abuse, there has been no evidence of any impact on drug use. Indeed, some campaigns appear to have increased the use of drugs after repeated exposure to such campaigns.

Methamphetamine abuse is a serious problem, with widespread ramifications for communities across the country. The government should try to prevent drug abuse through public health campaigns. However, there is a danger that graphic and exaggerated advertising will have precisely the opposite effect of that intended. Instead of reducing meth use, the Montana Meth Project may go the way of “Reefer Madness,” becoming a cult classic for a new generation of teens and young adults.