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This Is Your Hand on Opioids: Trump's 'Very Bad Commercials' Rely on Dishonest and Pernicious Scare Tactics

The anti-drug ads exaggerate the risk of addiction and falsely portray pain treatment as a highway to hell.

White HouseWhite HouseThree months ago, Donald Trump promised to spend "a lot of money" on "very, very bad commercials" that would "scare" teenagers away from opioids by depicting "pretty unsavory situations." Today the White House unveiled four of those government-sponsored ads, and they are indeed very, very bad, in the sense that they rely on deceptive tropes and misleading half-truths.

"The first four ads, which are based on real life, tell the graphic stories of four young adults going to extreme lengths to maintain their prescription opioid addiction," says White House Press Secretary Sarah Huckabee Sanders. "These ads show young adults how quickly opioid addiction can occur, and the extreme lengths to which some go to continue use of drugs while in the grips of addiction."

All four ads feature young people who deliberately injure themselves so they can obtain prescription pain medication. Amy crashes her car into a dumpster, Kyle smashes his hand with a hammer, Chris closes his arm in a door, and Joe drops a car on himself by crawling under it and releasing the jack. "I didn't know they'd be this addictive," each of them says in a voice-over narration. "I didn't know how far I'd go to get more."

As is traditional in anti-drug propaganda, these spots present extreme outcomes as common, grossly exaggerating the chances that any given drug user will end up like the pathetic souls they depict. That approach won't be credible to anyone who knows better, and it does a real disservice to people who need opioids to relieve severe pain by portraying medical use of these drugs as a gateway to hellish addiction.

Two of the four self-maimers (Amy and Joe) say they got hooked on pills that were prescribed for pain, suggesting that opioid addiction begins that way something like 50 percent of the time. But that scenario is actually pretty rare. Nonmedical users generally do not get opioids through prescriptions written for them, and people who become addicted to pain pills typically use a variety of drugs and have histories of substance abuse. In a 2007 study of people entering treatment for addiction, 78 percent of the OxyContin users "reported that the drug had not been prescribed to them for any medical reason." Almost all of them used other drugs in addition to OxyContin, and three-quarters of them had previously been treated for substance abuse.

The risk of addiction for bona fide patients is low—something like 1 percent among people treated for acute pain, as Amy and Joe were. The risk of addiction is low even when you include nonmedical users. According to the 2016 National Survey on Drug Use and Health (NSDUH), about 2 percent of the people who used prescription opioids that year, whether legally or illegally, experienced a substance use disorder (SUD). By comparison, the same survey indicates that 9 percent of drinkers experienced an alcohol use disorder in 2016.

The website for the anti-opioid ad campaign nevertheless insists that prescription opioids are "highly addictive," and the ads reinforce that message. That pretense will be hard to maintain, because it is contradicted by everyday experience. According to NSDUH, 92 million Americans used pain pills in 2016, and maybe 2 million qualified for an SUD diagnosis, which includes forms of drug abuse that fall short of addiction. In other words, 98 percent of prescription opioid users did not have experiences anything like the ones portrayed in the government's propaganda. Surely many of the young adults at whom these ads are aimed will have noticed this reality.

Reaching for scientific credibility, the ads warn that "opioid dependence can happen after just five days," implying that prescriptions lasting longer than four days are reckless. But that figure blatantly misrepresents research that shows nothing of the kind.

The ads are alluding to a CDC study that found the likelihood of "continued opioid use"—not "dependence"—rises with the length of the initial prescription. For example, 6 percent of patients who received a one-day prescription were still using opioids a year later, compared to 12 percent of those who received six days of pills and 24 percent of those who initially got a 12-day supply. But continuing to use opioids for a year is not equivalent to addiction, and it stands to reason that patients with longer-lasting pain would tend to get longer initial prescriptions and also be more likely to still need analgesics a year later.

The anti-opioid website bemoans the "nationwide push to take patient pain more seriously," which it blames for causing the "opioid epidemic," and mocks the suffering of people who are unlucky enough to need prescription analgesics: "Unlike something like blood pressure, pain is subjective. One person's IT. IS. A. TEN! is another person's ehhhhsix?, is another person's I'M FINE." This blithe dismissal of the life-warping agony that might lead someone to take opioid pain relievers for longer than a year is of a piece with the pernicious message that patients should avoid such drugs if they don't want to end up like poor Amy and Joe.

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  • Fist of Etiquette||

    "Unlike something like blood pressure, pain is subjective. One person's IT. IS. A. TEN! is another person's ehhhhsix?, is another person's I'M FINE."

    Government only knows one-size-fits-all. Otherwise, central plans would fall completely apart.

  • Libertymike||

    FoE, riddle me this:

    Which army has vanquished kings, eaten sharks, and grounded jets?

  • Leo Kovalensky II||

    Hitler? Is it finally Hitler?

  • Libertymike||

    No, but I'll give you a hint:

    FoE is hoping that the army in question can somehow, someway, overcome the odds and add one more to the list of vanquished kings, eaten sharks, and grounded jets.

  • Fist of Etiquette||

    So much for that.

  • Trollificus||

    I remember Lyndon Johnson seated wrong way on a horse, lance bobbing and charging towards a windmill that had a sign on it that said "Poverty"...or maybe that was just an editorial cartoon in a dream.

  • gormadoc||

    Brazil killed a bunch of dolphins, is that close enough?

  • Libertymike||

    Too close for those dolphins.

  • SQRLSY One||

    The more pain we feel, the more MANLY we are!! Pain killers are for wussies!!!

    If The Donald faces an agonizing death from bone cancer, will He change His Mind?!?!?

    More news at 11:00!!!!

  • Leo Kovalensky II||

    Well I'm hoping that can Cap it off in 7.

  • Leo Kovalensky II||

    *they

  • Robert||

    Oliver's?

  • Libertymike||

    Latest Quinnipiac poll shows favorable at 29% and unfavorable at 44% for President Trump.

  • Chris Cat||

    "I dabbled with stupidity, even read a Mad Magazine, but I had no idea it would lead me to vote for Donald Trump. Now I'm hooked and have to find even dumber politicians and political positions to support my stupid habit. And the magazine stands are still out there pushing Mad. Where is the justice? We need to lock somebody up now, make something illegal, and yet I fear, no matter how stupid it is, it won't be stupid enough."

  • Leo Kovalensky II||

    Look on the bright side, in a generation or two these ads will become cult classics like Reefer Madness.

  • Shirley Knott||

    Or the one that always made me wonder who could prefer raw to fried eggs.
    A classic, of a perverse sort.

  • Cynical Asshole||

    ...who could prefer raw to fried eggs.

    Rocky Balboa?

  • gormadoc||

    So opiates, when taken as and when directed by a medical professional, aren't as addictive as people buying them on the streets to get high? Woah, man.

    How does the White House have any authority to use funds for these ads? It seems wrong to give the most powerful and visible people in the world free ad money.

  • Nardz||

    We're you asking this of the anti-tobacco lobby that's been gov funded for the last 25 fucking years?
    Nope, haven't seen a Reason article on that.
    Fuck off, Progressives

  • BestUsedCarSales||

    What?

  • Agammamon||

    That's because you showed up, like, 6 months ago.

  • Nardz||

    This is true.
    So they have beaten the tobacco rights drum?

    (They're still very crypto-progressive... Or, as others have coined, cosmotarian or woketarian- both great terms)

  • gormadoc||

    Uh, yes. Both for traditional tobacco users and vaping. They've made lots of articles on that. Why don't you try searching using the search bar? That's what it's there for.

  • DajjaI||

    Addiction starts by borrowing or stealing drugs from a friend or neighbor, and this results in a disease that makes you borrow and steal drugs from friends and neighbors. Get it? No? Well that's actually an early symptom of the disease. Now if you'll just come with us.....

  • BYODB||

    The whole idea that addiction itself is a disease seems...tenuous at best but that doesn't stop the government from declaring war on it. Although, obviously, what they're actually declaring war on is individual people who use opioids since you can't go to war with an object. Right?


    Go figure.

  • Jerryskids||

    I'll admit it, I've used prescription pain pills that were prescribed for someone else. If addiction is defined as a regular recurring use* of these drugs, I'll have to admit I'm an addict - every time I get a kidney stone I'm going to use those pills again.

    *I've seen a definition of alcoholism that refers to a regular recurrent use and no reference to the amount or frequency, by which standard if you regularly have a single glass of champagne on New Year's Eve and that's the entirety of your alcohol consumption, you're an alcoholic.

  • gormadoc||

    Normal definitions of addiction include compulsion.

    There are some dumb definitions of alcoholism, though. I saw one back in high school that defined two drinks during the work week as alcoholism.

  • DajjaI||

    It's if you drink despite negative consequences. Like if every time you get drunk you have anonymous sex and have to gnaw your arm off in the morning. Eventually you will have to admit you have a problem.

  • Agammamon||

    Well, not if your arm regrows.

  • Trollificus||

    +1, strong biology fu

  • Cynical Asshole||

    every time I get a kidney stone I'm going to use those pills again.

    According to the government's propaganda, you should have already given yourself a kidney stone, somehow.

  • Rev. Arthur L. Kirkland||

    Taxpayer funding of nanny-state commercials promoting the authoritarian, stale, immoral drug war?

    Trump fans will love it enough to take a momentary respite from boasting about how much they cherish freedom and hate government spending.

  • SQRLSY One||

    "... promoting the authoritarian, stale, immoral drug war?"

    promoting the authoritarian, STATE, immoral drug war?

    FIXED it fer ye, I did! The State-worshiping liberals will NOT admit that the BIGGEST racist in town is the friggin' Government Almighty!!!! Red or blue, I don't give a flying fig, the drug war is racist ALL the way down!

  • gphx||

    Interesting how America never had an opiate problem until the moment US soldiers took control of the Afghan poppy fields.

  • DajjaI||

    These commercials will actually increase the incidence of self-harm. They really need to run this as a controlled experiment. Wishful thinking I know.

  • Cy||

    As the very accurate joke goes "I wish I was offered half the drugs as a kid that DARE told me to say no to."

  • gphx||

    Yes, Trump is making some bad 'Reefer Madness' style commercials.
    He also commuted the life sentence of a first time drug offender grandmother who had remained imprisoned throughout the Obama era.
    Take what you can get.

  • Cynical Asshole||

    You mean the government lies about drugs?! Help me to my fainting couch, quick!

    The anti-opioid website bemoans the "nationwide push to take patient pain more seriously," which it blames for causing the "opioid epidemic," and mocks the suffering of people who are unlucky enough to need prescription analgesics

    "Take an Aspirin and suck it up."

  • livefree||

    The drug warriors are trying desperately to save the drug war now that cannabis (which has long been the backbone of the drug war) is well on its way to nationwide legalization. That is the whole purpose of this opiod scare campaign.

  • Echospinner||

    Did anyone actually read the CDC article.

    Two points stand out.

    The data indicates that prescription of short term opiods vs longer acting opiod prescriptions in acute pain results in better outcomes. If outcome is measured in later opiod use.

    Tramadol is not benign.

    Have not seen the commercials. This is your brain on drugs...

    Thanks government. So get out of the way and let professionals deal with it.

  • Rich||

    The anti-opioid website bemoans the "nationwide push to take patient pain more seriously"

    'The anti-Congress website bemoans the "nationwide push to take the National Debt more seriously"'

    'The anti-Constitution website bemoans the "nationwide push to take freedom of speech more seriously"'

    ...

  • Dan S.||

    Someone dropped a car on himself, so that he could be prescribed opioids for the pain? Sounds more like a suicide attempt to me. Actually, I have heard of people deliberately causing themselves extreme pain, not as a way to get drugs, but rather as an alternative to them, as a way of inducing mental dissociation from their bodies. That's probably pretty rare too. Anyway, it is good to know that only 1 to 2 percent of people taking opioids actually become addicted. BTW, what, if anything, is the difference between "opioids" and "opiates"?

  • Don't look at me.||

    Opiates come from poppies, opioids are synthetic versions.

  • Robert||

    If enough people hear that such drugs are highly "addictive", they will be. It's a belief system.

  • DajjaI||

    My 80 year old aunt was in the hospital a few years ago and the doctor prescribed vicodin for something. "Can you give me something less addictive?" she asked him. Well I was shocked when she told me this story first of all because she believed in addiction and secondly because it was preposterous for an octogenarian to get 'addicted'. So I thought maybe she was just making up the story for my sake so I asked, "OK so what did he do?"

    "He prescribed narcon," she responded, obviously proud of herself. She's not a medical whiz so no way did she make up the story. I had to look it up, and narcon is pretty much the same as vicodin.

  • Trollificus||

    The drugs themselves are pretty easy for the body to break down, even where tolerance has built up considerably. It is the expense of ever-increasing dosages (illegal ones) that creates crime problems. And the true Enforcer of this whole "addiction" thing is withdrawal.

    If you know the kind of person who might "wait for a tattooed guy in a black Impala to drive into the WalMart parking lot at 3AM", ask them. They'll tell you "Just tryin' to get well, man." It isn't cravings or a desperate desire to trip the stately pleasure domes of laudanum fantasy...it's the willingness to do ANYTHING to avoid the horrific "every cell in your body hates you" experience of kicking that shit. But it can be done.

    Or so I've been told.

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