Wisconsin’s Department of Health Services teamed up with the Department of Justice and other state agency partners to design and deliver a statewide media campaign to prevent prescription drug misuse.
About the Collaboration
When Attorney General Brad Schimel ran for office in 2014, tackling Wisconsin’s growing opioid crisis was a central platform of his campaign. Once elected, he made creating a statewide media campaign to raise awareness of the dangers of misusing prescription narcotics a top goal for the Department of Justice.
Meanwhile, Wisconsin’s Department of Health Services had long been planning to use Partnerships for Success II grant funding to create its own media campaign, but were struggling to get the campaign off the ground. When they heard that the new Attorney General was planning to develop a prevention campaign, they contacted his office. “When we found out he had his own plans, it came at a very opportune time,” says Christine Niemuth, Prevention Coordinator for the Division of Care and Treatment Services.
Theirs’ was a perfect pairing. Working together with a broad range of stakeholders from across the state, the two agencies developed Dose of Reality, a multi-component media campaign, targeting Wisconsin teens and their families, “millennials,” and the medical community. Campaign messages warn about the dangers of misusing prescription painkillers and highlight the importance of safe use, storage, and disposal of medications. The campaign delivers its promised “dose of reality” with a mixture of edgy, direct, and heartbreaking TV and radio spots, social media, billboards, and high-quality online materials that communities can download and customize.
Since the campaign launched in September 2015, Dose of Reality has caught the attention of Wisconsin residents, boasting over 200,000 page views and approximately 10,000 YouTube views. The campaign has reached residents across the state through thousands of television spots and online/mobile advertisements.
Attorney General Schimel affirmed the critical role that partnership played in designing the campaign at the 2016 National Prescription Drug Abuse and Heroin Summit. He stated, “Everybody—from our state’s Medical Society to our state chamber of commerce to our school administrators—had a voice in developing aspects of our prevention campaign . . . I am proud to share with my colleagues and contemporaries from across the country the importance of building coalitions to fight this epidemic, as we have done in Wisconsin.”
Elements of Success
Find a Champion
Though Attorney General Schimel is now recognized nationally for his work combatting prescription drug misuse, he wasn’t always a strong proponent for prevention. Prior to becoming Attorney General, Schimel was a county district attorney. When the reality and extent of the opioid crisis began playing out in his courtroom, he decided to join several ad hoc committees on alcohol and other drug misuse. “At the time, [Attorney General Schimel] really came from a law enforcement perspective of ‘we need to find these people and arrest them so they can get help and treatment’,” says Niemuth. “Through his committee involvements, he came to understand the nature of addiction and eventually became a great prevention champion.”
Having the Attorney General in their court has significantly strengthened the state’s prevention efforts. His commitment to addressing the state’s opioid crisis initially led him to allocate $1.7 million in funding to develop the Dose of Reality campaign and his office continues to devote resources to enhance and expand it.
Niemuth’s experience working with AG Schimel underscores the importance of making the case for prevention wherever—and whenever—possible. “It all starts with education,” she says. “You never know which partner you’re working with or which person you are educating might be your next Attorney General.”
Learn from Past Mistakes
Dose of Reality replaced an earlier Department of Justice campaign designed to raise awareness about heroin addiction. Like Dose of Reality, the former campaign also included a quality website, videos, and materials. Its theme and messaging, however, missed the mark. According to Niemuth, “People didn’t connect with the message and it didn’t drive them to the website.”
Drawing on lessons learned from this experience, the Departments of Health and Justice made it a priority to engage stakeholders from across sectors to help craft Dose of Reality’smessaging and materials. “It was really important for us to find out from youth, parents, physicians, and prescribers what resonates with them,” says Niemuth.
To collect this input, they hired a marketing firm to conduct a series of focus groups with youth, prescribers, parents, and other consumers. The results were instructive. For example, focus groups with youth revealed that youth didn’t understand what “opioids” were, “And so we started saying ‘prescription pain killers’ instead,” Niemuth explains, “That really helped frame the message.”
Engage the Medical Community
The campaign also took time to connect with representatives from Wisconsin’s Medical Society, Hospital Society, and pain management experts. “We wanted to make sure we were getting the opinions of folks who would be impacted by the campaign, or perhaps changing practices because of the campaign,” says Niemuth.
One loud and clear message they heard was that physicians did not want to be blamed for the opioid problem. “This message was consistent with our priorities, as well,” says Niemuth. “We were committed to creating a campaign that didn’t vilify anybody, but that really looked at things from a prevention standpoint.”
They also learned that patients sometimes became distraught about not being able to obtain a prescription opioid, physicians needed help discussing opioid prescribing with patients, and physicians were concerned about taking opioid medication away from people that really need it.
To address these concerns, the Medical Society had meetings with their members to get feedback and share campaign goals. Based on this feedback, the team developed materials to help physicians discuss alternative pain management strategies with their patients and guidance on how to gradually adjust opioid dosage for patients at risk for misuse until optimal results are reached.
Anticipate Implementation Challenges
Early engagement with the medical community also helped pave the way for a smooth campaign launch. “By bringing in the Medical Society and different associations, we were able to quell some fears before the campaign even launched,” says Niemuth. “We let prescribers know ‘we’re not here to attack you, we’re trying to do better now that we know better.’”
The Medical Society also teamed up with the Hospital Association to send letters to their constituents introducing the campaign and its message and encouraging them to support it. These letters helped to build a sense of ownership for the campaign among the medical community, and lent credibility to the prevention messages.
Now in its third year, Dose of Reality has emerged as a successful tool for raising awareness and providing hope in the midst of the opioid crisis.
“The campaign has been really well received,” says Niemuth. “We have a lot of folks that have signed onto the website, downloaded the materials, printed them, and distributed them widely.”
Wisconsin is currently expanding the campaign’s target audience to include seniors, as well as hospice workers caring for seniors. Materials for these groups focus on ways to properly secure medications and disposing of them safely.
Dose’s success has also drawn strong interest from other states grappling with the opioid crisis. Speaking at a National Attorney General’s meeting, Attorney General Schimel presented the campaign to his colleagues and offered them a chance to use the Dose of Reality campaign materials. Several Attorney Generals jumped at the chance, knowing the campaign had been vigorously message-tested. Currently, Minnesota, Nebraska, and Maine have replicated core components of the campaign.