An ad campaign against opioid addiction is drawing criticism

One of the #ResistTheRisk public awareness campaign ads.
One of the #ResistTheRisk public awareness campaign ads.US attorney’s office for the District of Massachusetts

Federal officials in Boston unveiled a multimedia ad campaign Wednesday about the risks of using opioids — and immediately ran into controversy as addiction specialists assailed the ads as stigmatizing and counterproductive.

The awareness campaign, #ResistTheRisk, features four striking images in black, red, and white warning of the dangers of opioids that will appear on public transit and in social media. They include a drawing of tombstones of overdose victims and a picture of a newborn purportedly withdrawing from opioids the mother took while pregnant.

“We hope this campaign will help people make the right choices, that it will help them to resist the risk of selling and sharing prescription painkillers and illegal drugs,” acting US Attorney William D. Weinreb said at the campaign’s launch at the Moakley Federal Courthouse.


But Dr. Richard Saitz, a physician specializing in addiction at Boston Medical Center’s Grayken Center for Addiction, said the campaign employs scare tactics long known to be ineffective and resembles the failed “Just Say No” campaign of the 1980s. And the ads, Saitz and others said, portray addiction as a bad choice rather than an illness, potentially discouraging people from seeking treatment.

“This is a classic example that will be used for years to come in classrooms as how not to do it,” said Saitz, who started a flurry of criticisms on Twitter after someone sent him a photo of an ad on Tuesday.

Weinreb, in a phone interview after the announcement, said the ads are not directed at people who are already addicted. Instead, he said, they are intended to educate young people who may not know, for example, that many pills sold on the street are contaminated or that it’s illegal and dangerous to take a drug prescribed for someone else.

The messages appear on MBTA Red and Orange line trains and on buses operated by the MBTA, Southeastern Regional Transit Authority, and Greater Attleboro Taunton Regional Transit Authority.


The $60,000 campaign, cosponsored by the US attorney’s office and the Drug Enforcement Administration’s New England Field Division, will expand in the coming weeks to billboards and across social media platforms, including Snapchat, Facebook, and Instagram.

MBTA spokesman Joe Pesaturo said Wednesday that the T had received only one complaint, via Twitter, and that the ads meet the transit authority’s advertising guidelines.

One of the ads depicts three tombstones, with epitaphs saying a 24-year-old and 19-year-old had died of overdoses. The middle stone reads: “Keep your name off the next headstone.”

Saitz called that a “classic scare tactic. It’s one that we definitely know doesn’t work for youths.” Youngsters know people who took pain pills and didn’t die. “They see right through it,” Saitz said.

Of particular concern is the ad showing a baby with an intravenous line in the arm and a feeding tube into the nose. “The first weeks of my life were spent in detox,” it states, listing symptoms babies experience when withdrawing from opioids their mothers took while pregnant. It then repeats the #ResistTheRisk slogan.

Dr. Munish Gupta, a newborn specialist at Beth Israel Deaconess Medical Center, said it’s dangerous to suggest that pregnant women should “resist” the drugs they are addicted to. A pregnant woman addicted to opioids can harm herself and her fetus if she suddenly stops using.

Instead, Gupta said, women who are addicted and seeking recovery are prescribed methadone or buprenorphine throughout their pregnancies — and their babies are still at risk of undergoing withdrawal.


But that is not a terrible thing, Gupta said. Babies in withdrawal receive comfort and breast-feeding as their primary treatments.

“The terrible thing is a pregnant woman who is not seeking treatment for an opioid use disorder,” he said, and the ad might discourage women from doing so.

The picture also contains several inaccuracies, noted Dr. Jonathan M. Davis, chief of newborn medicine at Tufts Medical Center. Rarely do babies withdrawing from opioids need feeding tubes, and almost never do they get IVs, he said.

The symptoms list mentions seizures, which happen rarely and only outside medical care, and vomiting, also almost never seen, Davis said. (The US attorney’s office said the text about symptoms came from Stanford Children’s Hospital.)

Davis said he would have been happier if the ad had encouraged pregnant women to seek treatment for their addiction. But otherwise he was not critical of the campaign.

“Anything we can try to do to discourage people from using opioids is not necessarily a bad thing,” he said. “If it gets even one kid to think, maybe we should do it.”

The ads were developed in consultation “with people both inside and outside the law enforcement community,” including public health officials, Weinreb said.

They were intended to be an attention-grabbing way to educate people, many of whom don’t even know what opioids are, he said.


“We were looking for messages that would resonate with the groups that are most vulnerable,” he said. “We’re trying to address the problem by stopping people from getting addicted in the first place.”

The campaign is another effort to combat the epidemic of opioid addiction, which claimed more than 2,000 lives in Massachusetts last year.

Felice J. Freyer can be reached at felice.freyer@Globe.com, Ben Thompson at ben.thompson@globe.com.