2.1
There are many different approaches that can be taken to reduce illicit drug use or to mitigate its harmful effects, including law enforcement approaches and drug treatment to reduce addiction. Public communications campaigns can also be useful in achieving both these aims. This chapter will examine the different types of public communications campaigns and evaluate their efficacy.
Introduction
2.2
Public communication campaigns have been used for many years in Australia as a key method in achieving both health and law enforcement objectives. Public communications campaigns can be delivered via many forms of media, including mass media such as television, radio, newspapers and roadside advertising, as well as methods that allow for targeting specific cohorts of people, such as via social media, printed materials distributed in health facilities, or information campaigns that utilise advocacy or service delivery networks.
2.3
The National Drug Strategy 2017–2026 (National Drug Strategy) itself includes 'targeted communication strategies' as a method to achieve its overall aim of reducing drug-related harms. However, the last campaign activity associated with the National Drug Strategy was in 2017–18.
2.4
The Parliamentary Joint Committee on Law Enforcement (committee) was informed by submitters and witnesses that public communications campaigns are effective to raise awareness and provide factual, evidence-based information. Saatchi & Saatchi, an multi-national advertising agency, submitted that:
Mass media campaigns in public health disseminate information about health, or threats to it, to persuade people to adopt a behaviour change. They are commonly used by authorities around the world due to their perceived ability to change the knowledge or attitude of a target audience, reaching large populations at a low cost per capita.
2.5
ACT Policing submitted that media campaigns are important in ‘addressing drug and substance abuse' and that ‘education and public messaging are important components of crime prevention and community safety'.
2.6
The committee heard there are two distinct main aims of public communications campaigns on illicit drug use, and each individual campaign can assign different priorities to either one, or both, of these aims. The first aim is simply information awareness, to increase knowledge in the targeted cohort. The second aim is to effect a desired behaviour change, in this case to reduce the use of illicit drugs.
Effectiveness of public communications campaigns on illicit drug use
2.7
The committee received a great deal of evidence, some of it conflicting, on the effectiveness of public communications campaigns to reduce illicit drug use.
2.8
Most submitters agreed that public communications campaigns can be effective to raise awareness of illicit drug issues and safety, but most submitters from the alcohol and other drugs (AOD) treatment sector questioned whether such campaigns translate into the desired behavioural change of reduced illicit drug use.
2.9
Additionally, questions were raised by submitters as to the effectiveness of communications campaigns depending on the substance being targeted. Multiple submissions to this inquiry cited mass media campaigns as being very effective to reduce tobacco use and alcohol misuse, but stated that such campaigns are not effective for illicit substances without providing an explanation as to why.
2.10
360Edge submitted that while harm reduction messages are suitable for successful mass media campaigns in areas such as drink driving, substance reduction campaigns have little evidence they work. The Drug Education Network suggested there should be further examination of 'why on the whole mass media campaigns of all types work for antismoking messages and not for anti-drug messages'.
2.11
Harm Reduction Australia and the Drug Education Network both cited a 2015 review of communications campaigns that targeted illicit drug use. Harm Reduction Australia submitted the review found that mass media campaigns showed little to no evidence that they were effective in reducing illicit drug consumption. Conversely, the Drug Education Network submitted the review found that while eight studied campaigns had no effect on drug use and intention to use drugs, four had some evidence of beneficial effects in preventing drug use and two provided evidence of 'iatrogenic' effects, that is, where the intervention itself caused an illness.
2.12
Many submitters from the AOD treatment sector told the committee that public information campaigns that seek to reduce drug use are both ineffective and potentially damaging, and the best way to reduce drug use is through behaviour change programs and ‘other activities that for the same investment would definitely have positive results’ such as AOD treatment for individuals. This is discussed further in chapter four.
2.13
However, Dr Vernon White, a Canadian Senator who has led a successful drug use reduction campaign in Canada targeting school children, advised the committee that approaches should be a combination of reducing or delaying young people's first drug use, as well as assisting existing drug users to reduce or cease. Dr White advised that targeting younger people tended to be more successful, because the earlier they are in their addiction the more likely they are not to resume drug use.
2.14
The State and Territory Alcohol and Other Drug Peaks Network submitted that national mass media campaigns for alcohol and other drug demand have stigmatised drug users which reduces treatment seeking and are expensive and ‘should not be considered a viable alternative to place-based demand reduction (treatment and prevention). The issue of stigma is discussed in greater detail later in this chapter.
2.15
Conversely, Drug Free Australia (Queensland) submitted evidence on the effectiveness of communications campaigns in reducing drug use, citing a 2006 Australian Government illicit drug campaign that 'produced a confronting, but potentially effective media and community communication campaign designed for television' complemented by every Australian household receiving a booklet about the harms of illicit drugs. Drug Free Australia (Queensland) noted that '[i]nterestingly the 2007 National Household Survey showed a decrease in illicit drug use'.
Awareness raising versus drug use reduction
2.16
As outlined above, the committee heard general agreement from submitters and witnesses that communications campaigns targeting illicit drug use are effective in raising awareness and providing information. Opinion differed as to whether that raised awareness resulted in the behaviour change of reduced drug use.
2.17
The Drug Education Network submitted that even where no significant change in drug use or intention to use is demonstrated, 'studies show that recall of campaigns is high and that they can have an impact on knowledge, attitudes and beliefs about substance use'.
2.18
Dalgarno Institute submitted that information itself can influence drug-taking behaviours and that '[i]gnorance of fundamental drug facts is also suggested from data showing 65 per cent of first-time users begin from curiosity and 50 per cent are influenced by friends or family'.
2.19
Dalgarno Institute further argued:
[In a] free democratic society, the continued right to choose well rests on access to all necessary information in order to rationally assess the benefits and risks associated with those choices. As no individual can fully consent to what they have no conscious understanding and awareness [of].
2.20
The Victorian Alcohol and Drug Association argued the opposite, and submitted that communications campaigns on illicit drugs 'rarely achieve any substantive change in either perceptions or levels of drug use’ and referred to such campaigns as 'virtue-signalling'. Drug Free Australia (Queensland) similarly submitted that '[g]iving knowledge about a behaviour may not, on its own, produce significant behaviour changes'.
2.21
The committee was told by public communications experts that the lack of appropriate evaluations of such campaigns targeting means the question of efficacy cannot be conclusively answered by either side of the debate. Saatchi & Saatchi submitted that despite the many campaigns that have targeted illicit drugs and substance abuse, 'there are few available conclusive peer reviewed studies on the efficacy of mass media campaigns targeting the prevention of illicit drug use'. Research and evaluation of campaigns is discussed in chapter three.
2.22
The committee was told, however, that public communications campaigns are more effective in changing behaviours where they are complemented by a broader group of interventions. The Drug Education Network cited an Icelandic model which focuses on risk reduction and enhancement of protective factors at various levels of prevention, which was later reviewed and found to have reduced drug use from one of highest in Europe 20 years ago to one of lowest.
2.23
Similarly, Dr Vernon White informed the committee of a highly successful program being run for many years in Canada, which coupled a communications campaign with a schools-based education program that included social workers, mental health workers and addiction counsellors. This program is discussed in further detail in chapter four.
Unintended consequences
2.24
The committee heard that communications campaigns on drug use can have unintended negative consequences. The Drug Education Network submitted information from a European Monitoring Centre for Drugs and Drug Addiction meta-analysis of 14 illicit drug campaign studies which found 'no effect on the reduction of use and a weak effect on the intention to use illicit substances’ as well as ‘possible unwanted effects in terms of young people declaring that they would like to try drugs… after having watched a media campaign'.
2.25
The Victorian Alcohol and Drug Association similarly submitted information from a study of Phase Two of the Australian Government’s National Drugs Campaign, which targeted youth aged from 13 to 24, which found 'rather than having the intended outcome of preventing the use of drugs, the campaign failed to garner any significant change to existing rates of illicit drug use'.
2.26
The negative impacts of campaigns are discussed in greater detail later in this chapter.
Cross-portfolio approach
2.27
The committee heard that a cross portfolio approach, where law enforcement and health agencies collaborate on the task of reducing illicit drug use, was the most successful approach.
2.28
The Department of Health emphasised to the committee that the 'balanced approach between health and law enforcement is key to achieving excellent outcomes in relation to [the National Drug Strategy].'
2.29
Dr John Coyne, a former officer working on transnational serious organised crime with the Australian Federal Police, agreed that a cross-portfolio approach was necessary:
I want to see us target those people who are producing and making millions of dollars off the misery of our country, but I don't want to see our young people injected into the criminal justice system and I do want to see as many off ramps as we can possibly offer them.
2.30
The Western Australia Network of Alcohol and other Drug Agencies noted that previous inquiries of this committee on methamphetamine use highlighted the 'need for a balance of approaches across demand, harm and supply reduction'.
2.31
The Police Federation of Australia supported this view, telling the committee that while they advocate for 'strong law enforcement strategies to be an integral element of any anti-drugs campaign, we also strongly support a comprehensive communications arm, with specific focus on younger people'.
2.32
ACT Policing submitted that while its 'key focus is on targeting sale and supply of illicit drugs' it also 'supports a whole-of-government response to reduce the social harm caused by drugs' which is operationalised by ACT Policing's 'focus on diverting lower level drug offenders from the criminal justice process' in accordance with the National Drug Strategy.
2.33
ACT Policing further submitted that it 'acknowledges that education and public messaging are important components of crime prevention and community safety' and engages in 'effective safety messaging' using a range of platforms that include social media, face to face engagement, media releases and transient advertising. A case study of ACT Policing's most recent communications campaign is included below.
Box 2.1: What Would They Think? campaign
In December 2019, ACT Policing launched the What Would They Think? campaign to enable ACT Policing to continually educate and engage with the Canberra community on alcohol and drug safety, to encourage members of the community to think about their decisions and consequences, and the potential impacts on family members, friends and colleagues.
Policing along with ACT Ambulance, Transport Canberra, Canberra Metro and CBR NightCrew were at City Walk on Saturday 14 December 2019 and reminded members of the community that their decisions, while alcohol or drug impaired, can have devastating and long lasting effects.
A display was also set up featuring vehicle wreckage recovered from a fatal single vehicle collision in 2014 where the driver was found to have a combination of drugs and alcohol in his system. The display promoted awareness of alcohol and drug safety, and to reinforce the fact that there are potentially life-altering consequences of the decisions people make when they consume alcohol or illicit drugs.
What Would They Think? incorporates a variety of different approaches to educate and raise awareness in the community including merchandise, strategic social media messaging and web content. The Territory Targeting Team also used the tagline to brand their drug and alcohol presentations which are delivered to high schools and tertiary institutions across Canberra, to assist in the approach to drug demand reduction through early intervention strategies.
Source: ACT Policing, Submission 8, pp. 9–10.
2.34
ACT Policing submitted that it will continue to support 'public communication campaigns that focus on early intervention and drug harm minimisation strategies' and will continue to 'work collaboratively with partner agencies to reduce the social harm caused by drugs and other harmful substances'.
2.35
The Department of Health informed the committee that 'continuing to invest in all of those [cross-portfolio] services is important for reducing the prevalence of illicit drug use into the future'.
Social marketing
2.36
The committee received evidence from communications experts on the use of social marketing methods for public communications campaigns. The Australian Association of Social Marketing provided a definition of social marketing to the committee:
Social marketing is an interdisciplinary and strategic approach to behaviour and social change. It seeks to develop and integrate marketing concepts with other approaches to influence behaviour that benefit individuals and communities for the greater social good.
2.37
Advertising agency Saatchi & Saatchi similarly submitted that social marketing seeks outcomes that benefit both society and the target audience, and further submitted it is 'that intent to change the behaviour for the individual and society that makes social marketing distinguishable from information campaigns, that focus on simply raising awareness'.
2.38
The Department of Health submitted that social marketing methods can exert influence on behaviour by stimulating discussions, increasing knowledge and modifying attitudes. The Department of Health further submitted that social marketing is different to broader health communication in that it is based on a ‘strongly research-driven framework’ that seeks to understand the ‘knowledge, attitudes and behaviour of the target audience’ and frames the ‘promoted behaviour in a way which reflects and meets the needs of this audience'.
Efficacy of social marketing
2.39
The committee heard differing views on the efficacy of social marketing in reducing illicit drug use.
2.40
The Australian Association of Social Marketing submitted that there is 'consistent evidence supporting a strategic and multi-faceted social marketing approach as being effective in changing behaviour' including 'drug and substance abuse behaviours'.
2.41
The Drug Education Network submitted that as social marketing seeks to influence people as people in subtle and complex ways through a 'combination of cognitive processes and attitude changes that are not fully understood… we are a long way from developing a reliable method for delivering infallible social marketing campaigns'. The Drug Education Network further submitted that reviews of social marketing campaigns found the effects tended to be small and 'evidence for social marketing campaigns for harmful substance use is unclear, as studies often only examine their impact on short-term outcomes'. The Drug Education Network recommended that instead, more funding should be given to harm reduction, not because of existing evidence that approach would work, but because such finding 'could result in sufficient funding to build a substantial evidence base for what works'.
Social media
2.42
The committee was informed that social media can be an effective tool in public communications campaigns, noting that social media is a medium like television or radio, as opposed to a type of campaign such as social marketing.
2.43
Social media usage has increased significantly in recent years, with current statistics showing that worldwide, 2271 million people use Facebook, 326 million people use Twitter, 1000 million people use Instagram, and 287 million people use Snapchat. In Australia, 60 per cent of the population are active Facebook users and 50 per cent of Australians log onto Facebook at least once a day.
2.44
ACT Policing uses social media as a communication tool, with a presence on Facebook, Twitter and Instagram and conducts ongoing social media messaging on a range of crime prevention and community safety issues, including illicit drug use and alcohol-fuelled violence. ACT Policing advised it ‘supports and amplifies illicit drug campaigns generated by partnering agencies such as the ACT Justice and Community Safety Directorate and ACT Crime Stoppers'.
2.45
ACT Policing agreed with that social media can significantly reduce communication costs, and told the committee that:
Having a broad ranging campaign doesn't necessarily have to be expensive and come with a significant price tag. As we all know, the way society works now is that social media platforms are the way that people get their news and their information. It's quite an accessible platform and quite a reasonably priced, cheap platform to advertise on and get through to people.
2.46
Other submitters agreed that using social media channels can significantly reduce the costs of a communications campaign. The Drug Education Network submitted that social media has both a lower cost than traditional mass media and the ability to personalise communications to the target audience, but must also adapt to trends such as current use of Snapchat and Instagram. The Alcohol and Drug Foundation agreed that while mass media campaigns can be a powerful tool, they can be expensive, and further submitted that 'costs can be controlled through better targeting of "at risk" populations through online marketing campaigns'.
2.47
A key advantage of social media was seen to be its ability to deliver communications that are targeted at different audiences or cohorts. The Australian Association of Social Marketing told the committee that while social media can change the way to reach and engage with an audience 'it doesn't fundamentally change what drives human behaviour and what can influence it to change'.
2.48
The Advertising Council of Australia concurred with the view that social media changes the way in which communications can be delivered, but doesn’t fundamentally change the underlying behavioural motivations that the communication is attempting to target:
What's fascinating to me is that it [social media] doesn't really change what people do, it changes how people do it. What people do—the behaviour, the motivation, the reactions and the responses—are the same; they're wired into human beings. It's the ability to do it in a different way. We used to talk about advertising…in a one-channel universe. People can now talk in a very different way; they're still talking, but in a very different way.
2.49
As with other media formats, communication campaigns delivered via social media can have both positive and negative outcomes. The Drug Education Network contrasted the NSW 'Stoner sloth' anti-marijuana social media campaign, which was mocked by young people and criticised by health experts, with a United States of America (USA) campaign using digital and social media campaigns which showed evidence of exposed teens being less likely to use the target illicit drug. The Drug Education Network advised the effectiveness of the USA campaign may be due to the avoidance of a lecturing approach.
Shock advertising
2.50
Shock advertising is a method that seeks to penetrate through a cluttered media environment by intentionally shocking or startling audiences via 'graphic, disturbing, explicit, provocative or offensive content'.
2.51
Advertising agency UM submitted that this shock is intended to generate a surprised response, which has been 'documented as a catalyst for the processing of information, attracting attention, encouraging additional processing/comprehension'. UM further submitted that while this 'improves the memorability of content its impact on behaviour, is weaker and less documented'. Drug Free Australia, however, argued that shock advertising tactics have been used successfully in campaigns to reduce tobacco use, and should therefore be considered for a campaign to reduce drug demand.
2.52
A seminal shock tactic public health campaign was the 1987 Grim Reaper HIV/AIDS campaign, which pioneered the use of shock tactics for harm minimisation. Advertising agency Saatchi & Saatchi agreed that the campaign was 'ground breaking' in its ability raise awareness of public health issues, but did have some unintended negative consequences. These are discussed in greater detail later in this chapter.
2.53
The Police Federation of Australia noted that while there are some detractors of this campaign, 'it should be noted that over 30 years later, people are still talking about Reynolds’ AIDS ads'. The Police Federation of Australia further quoted Mr Siimon Reynolds, creator of the Grim Reaper campaign:
Most people say fear campaigns don’t work on them. In fact, most people say advertising doesn’t work on them. Neither is true ... That’s why it’s a multi-billion dollar industry. Many countries use fear campaigns with great success, but they have to be cleverly done.
2.54
Submitters and witnesses with expertise in advertising and social marketing agreed that the evidence is both mixed and emerging on the efficacy of shock tactics in health messaging, as well as whether shock and surprise versus fear can best generate behavioural change.
2.55
UM submitted that shock and fear involve different emotional elements, and can therefore have different impacts:
Shock’s impact is attributed to the additional cognitive processing produced by surprise. Whereas fear’s impact is linked to inducing more emotive responses. Surprise, compassion, and interest appear to be the key emotions linked to influencing behavioural intention. Shock, in comparison, tested as largely ineffective.
2.56
Saatchi & Saatchi similarly submitted that the power of shock tactics lies in the element of surprise and how it impacts memory and response, but also argued that:
[S]urprise without shock (startling or offending the audience) can have stronger impacts on behaviour. To improve behavioural influence this surprising element partnered with modelling the intended behaviour in a way that reflects and is relatable to the majority is recommended.
2.57
The Australian Association of Social Marketing agreed with this view and submitted that evidence is mixed as to the achievement of behaviour change from shock tactics, with meta-analysis suggesting that some kinds of strong fear-based messaging are found to be more effective than others in changing behaviour.
2.58
In regards to the efficacy of shock tactics to effect behavioural change, the Drug Education Network cited research from the Murdoch University School of Psychology and Exercise Science which found that using fear as a marketing tool 'has an intuitive appeal, but paradoxically the outcomes are often ineffective or counterproductive rendering it at best an equivocal tool for changing behaviours'.
2.59
The Australian Association of Social Marketing submitted that fear campaigning does not work effectively with people who are engaging in risky behaviours, as they tend to take the view '[t]hat's not going to happen to me. I've taken a calculated risk, and I can push to the side this fear that's being pushed in this campaign'.
2.60
Dalgarno Institute submitted that this should not be used to evaluate the success of ‘scare tactics’, arguing that the failure to sway some people who are already using drugs does not mean it is not effective for reducing uptake in people not yet taking drugs, because 'experience reveals that in every society across all demographics and throughout all civilisations there are always individuals who will defy authority, push against sound advice and ignore best practice'.
2.61
Regardless of whether or not fear or shock campaigns are effective, concerns were raised by submitters regarding the ethical and moral concerns about the impact of fear in shock campaigns.
2.62
The Alcohol and Drug Foundation submitted that shock advertising can result in a form of 'moral disgust', which 'may be accompanied by other negative emotions like anger or contempt for those who are engaging in that "disgusting" behaviour which can inadvertently increase stigma and discrimination'. The Drug Education Network submitted that 'it cannot be said these are appropriate and just interventions if they use disgust, fear and shame, often provoking anger and contempt for those who are portrayed as weak and as "other" for the promotion of public health'.
2.63
However, an American addiction specialist wrote that it is not unethical to place stigma on the 'reckless and harmful behaviours that addicts commit' as opposed to the people themselves, and this does not negate sympathy or a duty to provide care and addiction treatment.
Negative impacts of campaigns
2.64
The committee received evidence around the potential negative impacts of public communications campaigns targeting illicit drug use, largely campaigns where shock tactics are used, with some impacts attributable to all types of campaigns.
2.65
A range of negative impacts of shock tactics were cited, including:
Making people believe drug use is more common than they had thought, triggering an increase rather than decrease of drug use.
Scenarios not being seen as credible or realistic, leading people to reject entire safety message.
People becoming desensitised or avoiding distressing images.
Drug use becomes stigmatised, leading people to avoid drug treatment programs.
2.66
These negative impacts are discussed in greater details below.
Trigger increased drug use
2.67
The committee heard from a number of submitters from the AOD treatment sector that campaigns targeting illicit drug use can sometimes have the opposite effect and inadvertently trigger increased drug use. 360Edge submitted that campaigns which imply illicit drug use is on the rise can make young people more likely to use, as they believe it more commonplace that previously thought. 360Edge further submitted:
Paradoxically, describing drugs as 'deadly' or 'dangerous' can actually make them more appealing. A 2007 study of media reports and public health messages warning of a spike in heroin overdoses, found that for some people who use the message had the effect of encouraging them to seek out the more potent product.
2.68
The Drug Education Network cited a review of a US campaign targeting methamphetamine use, which found that 50 per cent of surveyed teenagers believed the graphic ads exaggerated the drugs risks, and that the campaign caused a threefold increase in percentage of teens who thought using methamphetamine is not risky.
Credible and realistic solutions
2.69
The committee heard that for fear tactics to work, viewers must think they are susceptible to the threat, and then be presented with a solution to the fear that is both attractive and that people believe will work. The Department of Health advised the committee that audiences respond to severe consequences if they are credible and realistic 'which is judged as whether they have experienced this or know or have heard of someone to whom the consequence has happened. Drug Free Australia agreed with this view and submitted that a level of reality needs to be conveyed in messaging if dangerous and unhealthy behaviours are to be prevented.
2.70
The Alcohol and Drug Foundation submitted that the messaging may be ignored by the target audience if ‘people reject the credibility of the message, that suggested threat or their consequences seem unlikely (especially if a person has engaged in the activity and has not experienced a negative outcome), or people becoming desensitised to the intended message'.
2.71
Dr Vernon White informed the committee that even where a negative outcome might be realistic, young people believe it would never happen to them:
I spent 32 years policing in 16 communities across this country for three different police agencies. I have never met a 15 year-old girl who wants to be a drug addict living in a ditch and performing sex acts so they can buy their next hit of crack cocaine or crystal meth, yet I know hundreds of those drug addicts. The challenge you have is that, no matter what you show those young people, they will not believe it's going to be them.
Avoidance and desensitisation
2.72
Another negative consequence of campaigns targeting illicit drug use, particularly where shock tactics are used, is where people either avoid messages they find distressing, or become desensitised to the shock.
2.73
Independent Drug Education Australia said the danger with desensitisation is that young people can get ‘warning fatigue’ where they develop ‘a sense of indifference or apathy towards other, legitimate health warnings'.
2.74
The committee was also told that some studies of such campaigns has suggested they can cause target audiences 'to avoid the confronting messages by responding with perceptual and cognitive defence mechanisms - in effect engaging in avoidance or denial that the risk affects them or a fatalistic acceptance of risk'.
2.75
Conversely, the opposite problem can occur where shock tactics can trigger 'hyper-sensitivity, the complete opposite to desensitisation, whereby individuals become over vigilant with choices they make to avoid risk'. This occurred as a result of a British Government warning in 1995 regarding deep vein thrombosis, which resulted in many women discontinuing or avoiding oral contraceptives.
Stigma
2.76
By far the greatest concern with potential negative outcomes of campaigns against illicit drug use, primarily expressed by submitters from the AOD treatment sector, was that these campaigns can lead to the stigmatisation of drug users, causing them to avoid addiction treatment and disengage from harm minimisation programs. The World Health Organisation has ranked illicit drug dependence as one of the most stigmatised health conditions globally.
2.77
The Department of Health has defined stigma as:
The term 'stigma' means a mark or sign of disgrace or discredit, and 'to stigmatise' means to regard a person as unworthy or disgraceful.
2.78
The Grim Reaper campaign was cited as an example of health messaging that created strong awareness of the targeted health condition, but also created fear and hysteria that resulted in discrimination towards homosexual men.
2.79
The Penington Institute submitted that people who use drugs 'face a stigma that is complex, pervasive and wide-ranging … the effects of stigma are less-safe drug consumption, a reduction in people seeking help and feelings of shame and loss of honour'. The Penington Institute recommended that effective interventions for people who use drugs actively seek to eliminate stigma from the service experience, such as needle and syringe programs.
2.80
The Victorian Alcohol and Drug Association submitted that stigma may deter people from accessing treatment because doing so means taking on the stigmatised identity of a drug user, which can 'lead to people hiding their drug use from their doctor, not seeking support, and, as a result, they may not receive the appropriate and necessary care that they require'.
2.81
However, it must be noted that addiction treatment engagement is already very low. The Australian Drug Trends 2018 report found that only four per cent of regular drug users of ecstasy and related drugs engaged with drug use treatment across the reporting year, despite 25 per cent reporting a non-fatal stimulant overdose and 20 per cent reporting a non-fatal depressant overdose.
2.82
Stigma has been shown to have positive impacts as well as negative ones. Dalgarno Institute argued that portraying drug use in a negative manner can have positive impacts, citing 'successful outcomes of other campaigns such as tobacco quitting campaigns ‘that are focused on an ideal goal and towards that aim provide accurate, timely and targeted information while still offering compassion and support to those struggling to overcome these behaviours'.
2.83
One study into developing resilience, found that the majority of discussion on stigma focuses on the harmful impacts of stigma and does not acknowledge the many cases of stigmatised individuals who are able to flourish in society. The study found that 'successful individuals view overcoming the adversities associated with stigma as an empowering process, as opposed to a depleting process' and recommended 'adopting a new approach to gain a fuller understanding of the experience of being stigmatized'.
2.84
Another study into the consequences of stigma found positive impacts of stigma in 'three generic categories of positive responses to negative labelling: therapeutic opportunities, personal growth experiences, and interpersonal opportunities'.
2.85
Dr Sally Satel, an American psychiatrist and lecturer at Yale University School of Medicine, has written extensively on the value of stigmatisation in drug policy, stating that there are 'few behaviours more deserving of stigmatisation'. Dr Satel questions the value of insulating people 'from the adverse consequences of their behaviour when those consequences (a) motivate them to seek help and (b) serve as a lesson to others about socially acceptable conduct'.
2.86
Dr Satel argued that negative messaging around drug use can be posed not as victim blaming, but as endorsing an 'optimistic truth that people have the capacity to transform themselves'. Dr Satel further argued that removing stigma would effectively decrease opportunities for treatment as decisions for change 'depend on a cognitive calculus that often includes the desire to minimize shame'.
Committee view
2.87
Evidence received by this inquiry indicates there are deeply held and sometimes contradictory views on both the efficacy of public communications campaigns in targeting drug demand, and tactics those campaigns employ, despite drug use being harmful to the individuals engaging in that behaviour and harmful to their family members and broader society.
2.88
On balance, the committee believes that public communication campaigns are an important tool to lift education levels on risks, support other policing elements and enable better decision making.
2.89
The committee is concerned that there has been no National Drugs Campaign activity since early 2018, particularly with reports of increased problematic drug use during the COVID-19 pandemic. Clearly, the time is ripe for action.
2.90
The committee recommends the Australian Government implement a new public communications campaign via the National Drugs Campaign that will support law enforcement agencies' efforts to reduce current and future illicit drug demand. The campaign should include the targeted use of social media.
2.91
The committee notes that the campaign should consider national and international best practice but also include a combination of shock and fear tactics that target the behaviour of drug use rather than the individuals themselves. These tactics should be grounded in a level of reality that potential users or recreational users can find relatable.
2.92
The potential for media campaigns to stigmatise drug users, possibly reducing the chances those drug users would seek addiction treatment, was of particular concern to organisations who deliver those addiction treatments. However, the committee notes that these organisations are, understandably, primarily focused on the outcomes for their client base. While these organisations advocate very well for that client base, the considerations of the committee are much broader than one segment of the Australian population, particularly when making population-wide policy recommendations.
2.93
The committee also recognises and agrees that stigma, while having some negative impacts, has always been an important tool in regulating behaviour on a societal level. Stigma marks behaviours or characteristics that are seen as negative by society. Without defining behaviours that society does not want, it is impossible to indicate the positive behaviours that are preferred.
2.94
In addition, it is clear from the evidence received, that mass media public communications campaigns alone cannot effect the level of behavioural change required to have a meaningful impact on drug demand. Any media campaign must be coupled with other cross-portfolio interventions in order to be fully effective.