How National Campaigns Turn Consensus into Public Health Gains.

Government Messaging Reframes Overdose Prevention as Cultural Responsibility.

The National Overdose Crisis is a Cultural Inflection

The ONDCP report to Congress details how a 31 percent year-over-year increase in overdose deaths by the time President Biden took office forced a historic realignment of national drug policy. The strategy emphasized both public health and public safety, with public communication elevated to the same tier as law enforcement, treatment access, and community prevention. By June 2024, provisional data showed a 14.5 percent decline in overdose deaths, the largest annual reduction ever recorded.

The report attributes part of this reversal to the national media campaign that reframed overdose response as a civic and cultural act, not just a medical one.

Campaign Architecture - Public Health Infrastructure

The ONDCP, working with the Ad Council, launched the Real Deal on Fentanyl campaign in October 2022. Its purpose was clear: target Americans aged 16 to 24, the fastest-growing group of overdose fatalities. Campaign messaging highlighted three levers: the ubiquity of fentanyl in counterfeit pills, the power of naloxone to reverse overdoses, and the agency young people have in carrying and administering it. Delivery channels were engineered to saturate young audiences in their daily environments: college campuses, bars, restaurants, gas stations, digital bus shelters, and subway stations.

Campaign assets were produced in English and Spanish, ensuring equitable access and compliance with federal equity mandates. A parallel campaign, Drop the F*Bomb, targeted parents with the same urgency.

Reach, Scale, and Digital Penetration

By December 2024, the Real Deal on Fentanyl campaign had achieved 2.7 billion impressions across platforms. Its website attracted 6.9 million users with 8.2 million sessions and 1.3 million conversions. Engagement rates were significant: 15.5 percent of sessions showed active interaction. Drop the F*Bomb generated an additional 636 million impressions and 103,000 conversions. The campaigns collectively drew over $62.5 million in donated media value. Paid media outlays, $150,000 for six weeks in 2023 and $75,000 for five weeks in 2024, outperformed industry benchmarks, achieving lower cost-per-mille and higher-than-forecast impressions.

The report shows that public health messaging, when deployed through consumer marketing infrastructure, can achieve commercial-grade reach at federal scale.

Behavioral Shifts are Measured Outcomes

Campaign evaluation relied on continuous survey tracking of 1,500 respondents aged 13 to 24. The ONDCP measured ad awareness, attitudes toward fentanyl, and behavioral intent. By 2024, 69 percent of respondents rated fentanyl “extremely dangerous,” with spikes up to 78 percent in late summer, the highest recorded levels of campaign awareness. Among ad-aware respondents, 53 percent reported seeking additional information in the past 30 days compared to 20 percent of the unaware. Thirty percent discussed fentanyl with peers in the past month compared to 20 percent of those without exposure.

These numbers demonstrate a direct correlation between exposure and action: knowledge translated into information-seeking and peer dialogue, two precursors to cultural normalization of safety behaviors.

Equity and Educational Penetration

The report emphasizes inclusivity. Spanish-language websites, influencers, and instructional videos expanded reach to underserved communities. Young Minds Inspired transformed campaign content into classroom lesson plans distributed to 30,000 high schools in overdose-prone states. Ninety-eight percent of teachers rated the material “good–excellent,” while 79 percent of digital recipients reported using or planning to use the curriculum.

The integration of public health content into the education system reflects a strategic shift: overdose prevention is treated as a mainstream subject alongside civics or science.

Influencer and Cultural Channel Activation

The ONDCP report outlines the role of 39 influencers in the first year and 17 more in the second. Their content delivered millions of impressions with engagement rates 62 percent above Instagram benchmarks, a sign that creator-driven distribution can exceed conventional paid media efficiency. Vetting was strict: every influencer underwent background checks, online content audits, and social media reviews to ensure federal compliance.

Creator fees totaled $111,000 in year one and $75,000 in year two, modest sums compared to the cultural reach secured.

By 2024, additional creators were enlisted specifically to normalize naloxone, with engagement rates surpassing 4 percent, triple the industry average.

Federal Funding Discipline and Oversight

Contracts totaled $500,000 in the first year, $1 million in the second, and $600,000 in the third, drawn from ONDCP’s Evolving and Emerging Drug Threats account. The Ad Council’s remit was limited to media buying, influencer contracting, and distribution. Creative development costs were largely covered pro-bono by partners such as R/GA and Versus.

The ONDCP required monthly reports, bi-weekly coordination meetings, and pre-release review of all assets. Prohibitions were explicit: no partisan messaging, no covert propaganda, no supplanting community-based programs.

One funding request was denied in 2023 for failing compliance. The report frames fiscal discipline as essential to sustaining bipartisan support for future campaigns.

Outcomes Beyond Awareness

The campaign’s outcomes cannot be separated from the national trend line: seven consecutive months of reduced overdose deaths culminating in the largest decline in history. The ONDCP does not claim sole causality but presents the campaign as part of a multi-pronged national response, law enforcement, treatment access, prevention coalitions, and recovery services.

The report underscores that awareness is a precondition for all other interventions: without cultural understanding of fentanyl’s risk and naloxone’s utility, structural investments in treatment or policing cannot reach full effectiveness.

Recommendations

• Treat Messaging as Infrastructure. National communication should be resourced like roads or hospitals, not episodic campaigns.

• Mandate Equity as Default. Spanish-language assets, inclusive influencers, and classroom curricula prove reach is not optional but fundamental.

• Anchor to Measured Outcomes. Impression counts are not enough; link campaigns to attitudinal and behavioral shifts.

• Institutionalize Influencer Vetting. Public health credibility depends on cultural messengers who are both resonant and compliant.

• Sustain Investment Cycles. Multi-year contracts, strict oversight, and cross-sector coalitions prevent waste and accelerate adoption.

Bottom Line Public Messaging Is Now Public Health Infrastructure

The ONDCP’s national media campaign proves that consensus-based messaging can cut through polarization and save lives. A 14.5 percent decline in overdose deaths is not just a data point; it is evidence that when government speaks with cultural fluency, national behavior changes.

The report’s consequence is unmistakable: media strategy is no longer a supplement to drug policy, it is drug policy.