More of the same…

The Rudd government announced another advertising campaign to ‘confront illicit drug use’ last night. Their media release states that:

Too many young Australians donโ€™t understand the very real and dangerous impacts of taking or using illegal drugs

Their ‘new’ campaign will tackle this perceived lack of knowledge by using graphic images that emphasise the damaging effects drugs have. Young people need to ‘face facts’ about the risks involved in drug use.

I have numerous problems with this announcement.

  1. This is not a new campaign. Howard’s Tough on Drugs campaign has been on the go for many years with the same concepts and ideas.
  2. Social marketing campaigns like this are not informed by credible evidence. The National Drug Research Institute’s Prevention Monograph, a report commissioned by the Department of Health and Ageing themselves, found limited evidence to support the effectiveness of social marketing campaigns in reducing or preventing drug use and associated harms. Some studies even find such campaigns may lead to increased drug use through curiosity or reactance. Their most likely outcome is to have little influence on drug use decisions.
  3. These campaigns seem to be designed more for showing the general voting public that the government is ‘doing something’ about drug use. It seems no accident that this announcement and action comes in an election year.
  4. Assuming that young Australians don’t understand the dangers of drug use is unfair. This assumption should be tested. Research suggests that young people do understand and acknowledge the risks they are taking, yet they still choose to use drugs. Until the government can accept that choosing to use drugs can be a logical, informed decision, they will miss their mark in trying to engage young drug users.
  5. The Department of Health and Ageing needs to learn how to interpret statistics accurately!

Two prevalence estimates are compared across time by the Department to support their action in ‘tackling illicit drug use’. They appear to be drawn from the National Drug Strategy Household Survey series. The first read:

The proportion of recent regular ecstasy users who use weekly or more often has risen from 0.8 per cent in 1998 to 17.3 per cent in 2007.

I traced these figures back to their sources in the NDSHS reports and found that these figures refer to teenagers aged 14 to 19, and that the 1998 estimate was based on such small numbers that the estimate should be used with caution. The second reads:

There is also a disturbing trend in the increased ecstasy use by young females aged between 14-19 which is up from 4.7 per cent in 2004 to 6 per cent in 2007.

The table this comparison is taken from in the NDSHS 2007 report shows the increase is not statistically significant. That is, there is no disturbing trend. It is, in fact, hard to find ‘disturbing trends’ in the NDSHS series. Most drug use estimates are decreasing or steady. Whoever was charged with finding these disturbing trends to fit this media release has capitalised on the fact that most people who read it won’t know its source and how to access and interpret the original data.

I recall the Rudd government talking about its plans to use evidence-based policies on drugs and health issues more generally. This campaign is just more of the same. I guess drug policy misses out again when it comes to evidence-based policy.

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13 thoughts on “More of the same…”

  1. But let’s face it, Mon, if there weren’t morons running drugs policy in Australia, we wouldn’t have all the cool stupid headlines to show at international conferences. It seems that the worm is turning in America, with real inroads being made by the DPA; the ‘Drug Industry Elites’ in Australia need to pull together, grow some cojones, and stand up to this rubbish where it’ll hurt the pollies- in the media. Politicians don’t read journals…

  2. Thanks for commenting Dr C. I hope you are enjoying being part of the rest of the world ๐Ÿ˜‰

    You know I agree with you. This blog is the beginning of my attempt to be more public about my views, though I am by no means one of those at the top.

    There is somewhat of a conflict of interest in the world of drug researchers which I bet happens around the world. Our existence, our jobs, our projects, tend to be funded by our governments. In a robust democracy, researchers would be encouraged and supported in critiquing government policy so it could be improved. We are not living in a robust democracy…

    I’m glad to hear things are changing in the US. I was most impressed with Professor Nutt in the UK standing up to his government about drug policy. This kind of action in Australia is well overdue.

  3. Nice work Monica. ๐Ÿ™‚
    What concerns me most about the federal government’s $17M advertising campaign is that, besides it appearing to be a rather crude and obvious election year stunt (together with the fact that you cite above re social marketing campaigns being unlikely to influence a young person’s decision to use illicit drugs as well), non-government harm reduction services like QLD RaveSafe are losing funding. Harm reduction services are integral to reducing the potential harms from illicit drug use to the individual and the broader community, as well as reducing demand for drugs and creating pathways/referrals to support/education services and treatment. The (free) services that RaveSafe provide to the festival going public (and not just dance events but also rock events such as Big Day Out and Soundwave) include crowd care (50,000 punters sometimes too!), general first aid, liaison and referrals to St John’s ambos, evidence-based information and education, free water (!), a safe chill out space for all punters (including alcohol-intoxicated people) and particularly young vulnerable women. Trained volunteers provide monitoring and support throughout the course of what is a typically very long day. Police stationed at large events even bring punters who might be in a bit of trouble to the RaveSafe tent for some chill out time and care. I think a mere one per cent (or less) of this budget would be enough to fund services like RaveSafe for an entire year, remembering of course that the 30 or 40 odd team members at any given event are also volunteering their time! A service such as RaveSafe does more to ‘confront’ illicit drug use among young people than any $17M social marketing campaign will – and for a much smaller portion of taxpayers’ dollars. I think I know where I would prefer my tax dollars to go. I’m sure any parent would prefer to know that their child, should they choose to go to an event and use illicit drugs, will almost very definitely be found and taken care of by organisations such as RaveSafe should they find themselves in some trouble. IMHO, the federal government would have been better off funding harm reduction services across all jurisdictions (and RaveSafe provide a great model) and advertising their existence to the public, instead of more same-old same-old campaigns that we’ve all seen before.

  4. Shelley, you make a good point. What is the opportunity cost of spending this large amount of money on an intervention that is not based on evidence of effectiveness? Interventions and programs that have been shown to help drug users face funding cuts while money is spent on ad campaigns like this.

    Peer interventions that engage with drug users should be well funded. Like Joe mentions though, they don’t have the broad support of the electorate. If only drug policy could be a bit less political!

  5. I’m loving your blog, and what it represents… You stretch those wings, hon’ – it’s long overdue!
    I’m actually doing some work with David Nutt at the moment- he has balls the size of Iceland… Think Cameron Duff, crossed with Alex Wodak, on PCP!
    BTW, just LOVE your banner- seriously, who took that photo?!

  6. Thanks David. I’m tentatively flying now. The view is nice and the only way is up ๐Ÿ˜‰ That’s great news you are working with Nutt. This could be an explosion combination!

    The search for the website banner was long – but I’m very pleased with what I found. See the footer for links to its original context – pillreports, of course. No, I didn’t take the picture. My passport is innocent! ๐Ÿ™‚

  7. Absolutely spot on, Monica.

    A regurgitated โ€œTough on Drugsโ€ campaign just to keep parents, anti-drug crusaders and wary voters happy. In reality, it does very little. I wrote about the government “Shock Ads” a while back.

    I too love your efforts but to get the approval of Dr. Caldicott is amazing. David Caldicott is one of my great inspirations and deserves much praise for his brave voice and fearless attempts at getting the truth out in the public arena.

    Keep it up, Monica and maybe Alex Wodak will be along next to sing your praises.

  8. Thanks for your comment Terry. Your blog is fantastic. I’m so happy you are blogging and breaking some stereotypes while you are at it.

    I am also inspired by Dr C.’s fearlessness. It would be great if both David and Alex had their own blogs too!

  9. Love your work also Monica.

    At IHRA this year I heard a presentation from Canada looking at the influence of the media on public opinion about drug use. What stood out to me was that ‘shock’ campaigns that we have all seen many times actually harm young people. They increase the stigma about young people generally, and young drug uers especially. They amplify the community feeling that young people are all on drugs, young drug users (shown as thieving, violent, harrowed and without values) are evil people. So not only do they not reduce drug use (some research has found the opposite) they also increase stigma and harm.
    Our battle is not only to redirect the funds to more useful projects (and I’d be supporting QLD Ravesafe in this) but also to ask them to stop causing damage.

  10. Absolutely Ray! There appears to be a growing body of evidence showing the harmful effects of shock/fear campaigns. Yet there is a popular belief (also held by politicians) that if only people knew the dangers of drug use, they would never try them or quit today! That’s just not true as you already know.

    Looking back on this post two months later, it’s clear that the use of evidence in drug policy is only one of many promises the Rudd government made that has not been kept. I’ve become more and more disillusioned with the Rudd government, however I can’t see Abbott providing a better alternative.

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