Do Scare tactics Work in Preventing Substance Use?

A readerrecently asked what I thought about a scare tactics campaign initiated by a sheriffin Oregon – see http://www.facesofmeth.us/drugs_to_mugs.html

Theliterature tells us—and has consistently done so now for years—that scaretactics do not work. This, however, does not mean that there is not a place forsuch campaigns in what we do as prevention specialists.

First, whenthe literature tells us that scare tactics do not work, what they report in thediscussion of the findings on which the article is based is that individualswho engage in the high-risk behavior to which the scare tactic refers do not change their behavior as a resultof the scare tactic. So whether it is a “mug shots” campaign referenced above or,my personal favorite, “this is your brain on drugs” (see http://www.youtube.com/watch?v=qyXFN4ocN_o)neither results in someonedoing things differently on Friday night simply because of having watch/seenthe PSA on Thursday.

We knowthat many (most?) high-risk viewers of such PSA find it easy to disconnect.They either mistakenly believe, “Oh, that will never happen to me because…” or “Wellhe/she/they were just stupid and not careful” or “that is just a stupid video.”Interestingly, the key element in such campaigns is their ability to get folkswho watch who are not the subject ofthe PSA in order to get them to react, which is to say, these are the real intended audience for such PSAs…inthe readers note to me, he included the statement, “(It) may bescare tactic – but it sure got my attention sent me.

We, the viewers, are the audience, notthe drug users in society. When parents/concerned citizens/conservatives/lawabiding adults/victims of drug-related crime/etc. view such PSAs, we aregalvanized and tend to demand that something be done. Frequently this “something”is more related to the “supply side” of the drug issue (interdiction) than the “demand”side (prevention and treatment). Yet there is a role for such PSAs to play inthe work that we as prevention specialists and concerned professionals do toaddress the alcohol and other drug problem that exists in our culture.

The literaturealso tells us that people proceed towards change by passing along a continuumof readiness to make that change. When a high-risk user is in the earlierstages of readiness to change—in the literature this is called a pre-contemplative stage—and exposed to suchPSAs, they DO NOT change because of the PSA message. What they may do, however,is take notice and add the information to an archive of stored info on AOD useand perhaps eventually move to thenext stage on the continuum…contemplation.

Ifpre-contemplation is the capital “D” Denial stage, the “I-don’t-have-a-drug-problem-but-a-drug-solution”stage, then contemplation is the small “d” denial stage, a stage where onebegins to question if what I am doing might just be presenting a problem. Fromhere individuals work through the successive stages of change until they reacha point of “action” and it is here that the user essentially says, “The war isover, I lost; give me the articles of surrender and I will sign.” I will notbore you with the details of how to get from “pre-contemplation to action,” butsuffice it to say that scare tactics may,and I emphasize MAY, play a role.

No one hasever moved from pre-contemplation to action and on to maintenance (maintainingthe change once made) without coming to a point of realizing that “to go ondoing what I have been doing is more of a hassle than to change.” Our challengeas prevention specialists is to expedite that movement through these stages…andscare tactics may be able to play a (small) role in this movement. What scaretactics cannot do, however, is move someone from pre-contemplation—or evencontemplation—to action…it is just too easy to find countless examples ofindividuals who are not experiencing the “problem” the PSA rails against and topoint to them as proof of the PSA’s spurious message.

In closing,I am not “against” scare tactics so much a I do not believe they changebehavior. I believe we must first recognize the limitations of scare tacticsPSA before even considering their utility.  Second, we need to accept that they are at least as focused on upsetting you andme as they are in trying to influence the behavior of high-risk users—do theyintend to get users to stop or “everyone else” to be upset? Third, we need to acceptthat no PSA or campaign based on scare tactics is ever going to keep someonewith a substance use disorder, in and of itself,  from using. There is no “silver-bullet” thatwill bring down the werewolf of addiction. There is, however, hope that we canaffect change and help move someone along the continuum of readiness to change.

To learnmore about the stages of readiness to change, visit: http://www.aafp.org/afp/20000301/1409.html

To read more about a comprehensive plan to addresshigh-risk collegiate drinking, which may serve as a model for affecting any high-risk behavior, visit: http://www.robertchapman.net/essays/when_they_drink1.pdf

To read more on my views regarding a more comprehensiveunderstanding of collegiate drinking and my thoughts on what is missing from acomprehensive plan to address such, visit: http://www.robertchapman.net/essays/When_They_Drink2.pdf

What do you think?

Dr. Robert

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