The Partnership for a Drug-Free America (PDFA) has long been associated with communicating the nation's most visible drug and alcohol abuse prevention messages through public service announcements. With the help of advertising agencies that provide their services on a pro bono basis, the partnership's work reached iconic status in the 1980s with a simple image of an egg frying and the accompanying tagline “This is your brain on drugs.” This vivid depiction of drug abuse's physiologic effects resonated with a generation of young people and became part of the cultural lexicon, and its effectiveness provided the foothold for future antidrug PSAs.

While duplicating the success of its famous 1980s ad could prove elusive, the PDFA is nonetheless trying to parlay its experience in communicating prevention messages to the addiction treatment field. Through a series of television commercials, radio spots, and newspaper and billboard ads, the PDFA wants to tell Americans with drug and alcohol addiction and their families that addiction is a disease like any other and that treatment should be sought. The Hope, Help and Healing campaign aspires to erase the stigma still associated in some circles with addiction.

The campaign was piloted in early 2005 in Houston and Cincinnati, and all indications are that requests for treatment information have increased in these communities, with a surge in phone calls to hotlines and visits to a dedicated Web site administered by the PDFA. Building on this success, the PDFA is now planning rollouts for other cities.

The Partnership embarked on this effort with the realization that there is a continuum between prevention and treatment, says Paul Costiglio, the PDFA's deputy director of public affairs. The endeavor encompassed several years of research and discussion with addiction treatment professionals, as well as the creative process with the advertising agencies. Five agencies worked with the PDFA to create the ads, and the Robert Wood Johnson Foundation provided financial support.

A synopsis of several of the eight television ads used in the campaign illustrates the diverse creative approaches that were used to emblazon the message that addiction is a disease, that it affects family members as well as the individual, and that help should be sought expeditiously:

• Arguably the most controversial pair of ads in the series addresses the disease concept head-on. In one of the ads, a woman approaching middle age states: “I’d rather have heart disease; that way you wouldn’t look at me with shame. You and I could talk openly about my problem—there would be no stigma…. If I had heart disease, you would understand that I need treatment, not hate.” A similar theme is repeated in the second ad by a young man with a pencil-thin mustache and dark hair reaching the nape of his neck: “It’d be better if I had cancer; then you wouldn’t tell me what I’m going through is just a phase,” he says. “You wouldn’t see my condition as a lack of willpower but the disease that it truly is. There’d be walks, telethons, campaigns to raise funds to end it. If I had cancer, you’d understand I need treatment, not a lecture.” Despite the controversial dialogue in these ads, campaign personnel say very few complaints from the public about the messages were logged in the two pilot cities.

• Another ad uses the message “Choose to help a loved one with a drug or alcohol problem; it could change everything.” This ad uses word substitution to reflect the changing circumstances of someone who receives help: “Your daughter's wasted again; you ignore it/get help; soon she's arrested/promoted; you post bail/congratulate her; one day you get a call; it's bad news/good news; she's gone/expecting; you cry.”

• An ad geared toward the person in need of help portrays a young man waking up in the operating room just as he is about to undergo surgery. “Whoa, I can handle it myself,” he says, as he pulls himself off the surgical table and leaves the room. A voiceover intones: “You wouldn’t face any other disease alone; why face drug addiction alone?”

• An ad entitled “I Waited” shows family members and friends saying how they waited for their troubled love one to reach a certain point, culminating with a mother saying: “I waited for my daughter to die.” The voiceover states: “What are you waiting for—don’t wait for someone with a drug or alcohol problem to hit bottom,” and then directs viewers to a campaign Web site now found at https://www.drugfree.org/Intervention.

• In another ad, a car hurtles around a corner as an impaired man smashes into a van crossing traffic. The ad portrays the actual physical impact not only on the driver, but on his wife, daughter, and father. “Your addiction isn’t just hurting you. It's hurting your family, friends, everyone,” the voiceover intones.

Quantitative impact

The PDFA worked with the Coalition for a Drug-Free Greater Cincinnati and the Alcoholism Council of the Cincinnati Area, an affiliate of the National Council on Alcoholism and Drug Dependence (NCADD), as local partners for the Cincinnati pilot. The Alcoholism Council already had hotlines in place to handle incoming calls emanating from the campaign advertising, and the ads also furnished a new local phone number to call. Interestingly, while phone call volume to the new dedicated line was significant, the existing hotlines experienced an astronomical increase in calls after the start of the campaign.

“We saw a huge increase in phone calls coming in,” says council CEO Nan Franks Richardson, referring to the first six months of the campaign from January to June 2005. “The only thing we had differently in that six-month period was to be part of the campaign.” The council's 60-year presence in the community apparently resonated with Cincinnati denizens who dialed the hotline numbers.

In January 2004, the council had received 1,450 incoming phone calls, says Ginna Marston, the PDFA's executive vice-president and director of program development. For the same month in 2005, the number of calls shot up to 2,931. The PDFA attributes the marked increase to a heightened public awareness of the opportunity to inquire about interventions and treatment options.

“This was the big referral agency in the community. They’re well established, so if people didn’t get the exact phone number when they saw the story in the press or the ad on television or on a billboard, they would still find their way there in great numbers,” says Marston. She adds that the campaign uses local agencies as the contacts for referral purposes so that people do not feel they are working with a more impersonal national entity.

In Cincinnati, about two-thirds of the hotline calls came from family members, with the remainder coming from people with substance abuse problems, says Marston.

The PDFA also was able to track traffic to the Web site it promoted exclusively during the two-city pilot: https://www.intervenenow.org (users are now directed from that Web address to https://www.drugfree.org). For the first half of 2006, the site had about 478,000 visits, says Marston, with average visit times of 13 minutes during the first half of the campaign and 11 minutes during the second half.

“The length of stay says they’re getting engaged and using it,” says Marston. The PDFA surveyed individuals about the site: 60% of respondents said it was excellent; 46% said they used it to find help for someone. The PDFA did not conduct formal evaluations of public response to individual ad messages in the campaign.

The PDFA created the site, which includes real stories about recovery, because it found nothing else online that provided the breadth of resources and information that people need, says Costiglio. “Sometimes people aren’t ready to pick up the phone, but they need information—they want a Web site that has screening tools, personal stories, and lots of great information,” he says.

In Houston, the NCADD-affiliated Council on Alcohol and Drugs Houston, which has worked in the community for about 60 years, was tabbed as the PDFA's local partner. The effort received incredible media support in the form of $2 million worth of donated time, says Becky Vance, a Houston antidrug leader and a regional manager for the PDFA.

The Houston community was very responsive to the ads and used them in creative ways, such as treatment centers using them in family groups and schools using them to introduce the topic of addiction, says Vance.

Working with local partners in a variety of ways has constituted an integral part of the Hope, Help and Healing campaign. In addition to the advertising spots, public relations efforts included placing real stories of recovery in local newspapers and holding press events to boost the campaign's profile. The local partners were critical to identifying local success stories.

Future rollouts

Working with NCADD, the PDFA plans to roll out Hope, Help and Healing in Kansas City, Mo., Detroit, St. Louis, Santa Barbara, Calif., and the Tampa Bay area of Florida. In addition, the PDFA will be working with its own affiliates for statewide rollouts in Washington, New Jersey, and Iowa and city efforts that include one in Baltimore.

The campaign's overall goal is to bring the problem of addiction out of the closet and into the light, says Marston. “We think the time is right for that—we’re reaching a tipping point in the culture because so many people have direct experience with this; most people in the public know someone who is addicted.”

The campaign has proven to be a positive experience for the PDFA in that it has allowed the organization to become more involved in local efforts, Marston adds. Also, it has brought together treatment and prevention professionals who for so long have worked separately, she says.

Lessons learned from the campaign thus far, Marston believes, are that barriers such as shame and stigma don’t have to obstruct getting help; promoting interventions by families and friends should be the top priority; and multiple messages are more effective than one.

The PDFA plans to infuse the messages from the Hope, Help and Healing campaign into all of its other national campaigns as it moves forward, including its comprehensive effort on methamphetamine, says Costiglio.

“We have creative efforts in the pipeline now that address methamphetamine treatment, overcoming the misconception that methamphetamine addiction is untreatable and trying to provide hope for people,” he says. “There are prevention messages related to methamphetamine; there's also going to be this strong treatment message.”