In a TV ad from the 2000s, a teenager stood at a mirror before the camera panned down to show her mother panicking. She had attempted suicide after using meth.
It was one commercial in a memorable and often frightening campaign that came from the Montana Meth Project, which is now shifting its messaging to fentanyl.
$21 million in opioid settlement money is flowing into Montana communities, and the Meth Project is getting some of that funding. But, drug prevention experts say the program isn’t backed by evidence.
The Meth Project is asking 14 local opioid boards for nearly half a million dollars. So far, it’s received a little more than $100,000.
Researchers are wary of that investment. Amanda Latimore is the Director of the Center for Addiction Research and Effective Solutions.
“The first question I have when I see investments in public health campaigns like this is, ‘Where’s the evidence to support it?’” Latimore said.
The Meth Project declined MTPR’s interview request. In its application, the nonprofit said it will evaluate its fentanyl program based on impressions on social media and by asking kids about their perceptions of fentanyl.
Latimore said that’s common for messaging campaigns.
“Few follow all the way through: Did people hear the message? Did it land in a way that will change behavior?” Latimore said.
She said studying whether campaigns change behavior takes years of follow-up research.
The Meth Project claims its past work is based on rigorous research. It also takes credit for large reductions in first-time teen meth use found in a federal survey. The nonprofit didn’t provide MTPR with any evidence to support either claim.
Montana State University professor of economics Mark Anderson studied the Meth Project in 2010.
“My conclusion is it appears to have had no effect on self-reported teen meth use in the state,” Anderson told MTPR.
Anderson said teen meth use declined similarly in states without messaging campaigns. Because of that, you can’t say the Meth Project was responsible for the decline in Montana.
Experts are also skeptical of the Meth Project’s new fentanyl messaging, which is based on the U.S. Drug Enforcement Agency’s “One Pill Can Kill” campaign. They say it’s a scare tactic, and research suggests it doesn't work.
Stanford researcher Bonnie Halpern-Felsher said it is true that one pill can kill.
“This is based on our research on adolescent decision making. If we say, ‘If you do X, Y could happen,’ and that doesn’t happen, teens completely lose trust in us,” Halpern-Felsher said.
Halpern-Felsher said the One Pill Can Kill slogan might drown out Meth Project messaging on spotting overdoses and what to do. She said it’s important to tell kids not using drugs is the safest but messaging also needs to address kids who will try drugs.
“If you are using, let’s keep you safe, and in the case of fentanyl and other drugs, let’s keep you alive,” Halpern-Felsher said.
That means talking honestly about ways to test drugs for fentanyl and other practices that can reduce overdose deaths.
Researchers acknowledge opioid boards deciding how to spend their funding have a tough job sorting out what’s effective as they are bombarded with applications.
Opioid boards like Yellowstone County are investing in programs like the Boys and Girls Club, which works directly with at-risk youth. Yellowstone County Public Health Department COO Eric Owen chairs the county opioid board. He also voted to fund the Meth Project.
“I do think they have some evidence base behind their stuff that they put together,” Owen said.
But that decision was based on limited information.
“That application was it, and a 10-minute live presentation,” Owen added.
The Meth Project’s application made the same claims about its efficacy without evidence. It also didn’t say director Amy Rue is the only employee. Experts interviewed for this story question whether one person could effectively run a statewide campaign.
Owen didn’t comment when MTPR told him the Meth Project couldn’t provide evidence to support its claims about the efficacy of its past work.
Researchers say campaigns like the Meth Project can seem powerful to adults. Flathead County opioid abatement board member Ron Catlett remembers those vivid Meth Project commercials.
“There’s some shock value they go for, certainly with the Meth Project,” Catlett said. “But I think that does create more attention to the issue, which leads to more opportunities for conversation and education, certainly.”
Linda Richer with the Partnership to End Addiction said that sentiment is why abstinence-based drug prevention programs like the Meth Project or DARE get funding. But kids’ brains don’t evaluate risk in the same way as adults.
“We can have really strong intentions not to do something that’s bad for us, but especially kids — you put them in the situation where they’re most vulnerable around their peers and all those intentions go out the window,” Richer said.
Richter said these programs are cheap and easy to put together. She worries they’ll out-compete others that get at the root cause of why some kids try dangerous drugs, like poverty or parents who are using. She said it’s much harder for those kids to just say “no.”
