It may seem like a bizarre claim, but bear with us: Anti-drug campaigns are as American as apple pie, baseball and Budweiser.
Much of that has to do with our Puritanical roots, and the role faith played in shaping every aspect of early American society, but consider what sociologist Carl Reinarman wrote in his 1994 paper  “The Social Construction of Drug Scares”:
“What I have called drug scares have been a recurring feature of U.S. society for 200 years. They are relatively autonomous from whatever drug-related problems exist or are said to exist. I call them ‘scares’ because, like Red Scares, they are a form of moral panic ideologically constructed so as to construe one or another chemical bogeyman, á la ‘communists,’ as the core cause of a wide army of pre-existing public problems.”
Moral authorities, whether they come from government or religion, love to gin up public concern over various and sundry chemical epidemics, and they’re still going on today. But are these anti-drug campaigns effective? Do they actually make a difference? And perhaps most importantly, do they distract from difficult conversations about the biological nature of the effects these substances have on the brain?
These aren’t easy questions to answer, but they deserve consideration in any discussion involving the use of drugs and alcohol among young adults in the United States.
Anti-Drug Campaigns: Temperance
The definition of temperance, according to Merriam-Webster : “moderation in action, thought or feeling; restraint.” During the 19th century, however, few Americans demonstrated it, according to the Social Welfare History Project by Virginia Commonwealth University : “By 1830, the average American over 15 years old consumed nearly seven gallons of pure alcohol a year — three times as much as we drink today. Among urban factory workers, this level of intoxication created unreliability in the labor force, dismaying employers. At home, women and children often suffered, for they had few legal rights and were utterly dependent on husbands and fathers for support.”
Over the next two decades, the temperance movement took root in America’s Protestant churches, piggybacking on abolitionist efforts to rid the nation of slavery. The two came to be seen as America’s greatest sins, and the movement, according to the Ken Burns PBS documentary “Prohibition,”  “first urged moderation, then encouraged drinkers to help each other to resist temptation, and ultimately demanded that local, state, and national governments prohibit alcohol outright.”
One of the most influential anti-alcohol organizations in U.S. history — the Women’s Christian Temperance Union (WCTU) — was established in 1874 in Cleveland, and after Frances Willard took over as the group’s leader in 1879, according to the website History.com , the organization expanded its platform to advocate for labor laws, prison reform and suffrage as well. The connection between suffrage and temperance, Dr. Julia Guarneri, senior lecturer in US history at the University of Cambridge, told the BBC in 2020 , was a union of common interests. The WCTU, Guarneri said, “thought alcohol was one way that money went from the employer to the employee to the saloon, and never reached the family,” and as a result, the organization’s efforts “were vital in bringing about prohibition,” enacted by the 1919 passage of the 18th Amendment of the Constitution, which made it illegal for Americans to sell, make, import or transport alcohol.
However noble the goals of Prohibition might have been, however, its passage had unintended consequences, as Sean Billings reported for Newsweek  in 2019: “The onus of enforcement fell largely on the shoulders of the Federal government, to ensure nationwide adherence to the law. As a result, the Bureau of Prohibition assumed the role of chief law enforcement agency for Prohibition. However, funds allocated to the bureau only allowed for approximately 1,500 agents to serve the entire country.” Speaking with Professor Maria Iacullo-Bird, a clinical associate professor of history at Case University, Billings says “the uneven acceptance and enforcement of Prohibition policy, coupled with widely documented corruption among police and government officials, enabled a lack of regard for the law and steady consumption of alcohol.” And as Iacullo-Bird pointed out: “What’s very clear, is that, people want alcohol, and they’re going to get it.”
Anti-Drug Campaigns: Narcotics
Shortly after the 20th century dawned, other substances began to draw the ire of American politicians, driven in large part by the rise of opium use in the aftermath of the Civil War, according to The Washington Post : “Anguished veterans were hooked on morphine. Genteel ‘society ladies’ dosed up with Laudanum — a tincture of alcohol and opium. The wonder drug was widely used as a cough suppressant and it proved very effective at treating diarrhea in children.”
As a result, in 1908 President Theodore Roosevelt appointed Hamilton Wright as the nation’s first Opium Commissioner. Wright, the Post reports, didn’t beat around the bush: “Americans, Wright warned, ‘have become the greatest drug fiends in the world.’” In a 1911 interview with The New York Times , he took it a step further: “The habit has this Nation in its grip to an astonishing extent. Our prisons and our hospitals are full of victims of it, it has robbed ten thousand business men of moral sense and made them beasts who prey upon their fellows, unidentified it has become one of the most fertile causes of unhappiness and sin in the United States, if not the cause which can be charged with more of both than any other.”
As the New York Academy of Medicine (NYAM) points out, there was good reason for alarm : “By 1900, use of narcotics was at its peak for both medical and non-medical purposes. Advertisements promoting opium- and cocaine-laden drugs saturated the newspapers; morphine seemed more easily obtainable than alcohol; and widespread sale of drugs and drug paraphernalia gained the attention of medical professionals and private citizens alike. State regulations failed to effectively curb distribution and use.” In 1901, the American Pharmaceutical Association organized a committee that, upon studying the issue, recommended a ban on the non-medical use of drugs. The American Medical Association offered a quick second and urged federal legislation to do so.
And so began Wright’s campaign, which bore little fruit at first, according to the NYAM: A 1910 bill “banning the non-medical use of opiates, cocaine, chloral hydrate, and cannabis” faced stiff opposition from manufacturers and druggists and died in Congress, but Wright’s ideas had begun to gain traction — and not necessarily for honorable reasons, according to David Courtwright, who detailed “A Century of American Narcotic Policy” for the Institute of Medicine : “Wright also played up the prevalence of lower-class and criminal use … (but) Wright’s research was highly unsystematic and hardly merited numerical expression … he was, however, magnifying an epidemiological reality: by 1910 criminals and prostitutes did have much higher rates of use than the general adult population and possibly (although this is not certain) higher rates than medical personnel, who historically had a serious addiction problem. Wright was, moreover, believed. His statements and statistics were given wide circulation in the popular press, medical journals, congressional committee reports, and other official documents.”
The end result was the passage of the Harrison Act in 1914, which restricted the sale of “potentially addictive narcotics,” according to the Library of Economics and Liberty : “In essence, the Act required anyone engaged in the importation, production, manufacture, or sale of cocaine and opium-based products to register with internal revenue collectors for the purpose of imposing a special tax on the distribution of these products. This did not make cocaine and opiates illegal; rather it restricted their distribution to those firms and individuals who could afford the onerous registration fees and high taxes. While the underlying purpose of the Harrison Act was to impose transaction costs so high that the distribution of cocaine and opiates disappeared, and enforcement on physicians and other providers could be harsh.”
Anti-Drug Campaigns: Weed
It’s important to note that morality had as much, or perhaps more, to do with the Harrison Act’s passage than public health concerns. As Reinarman points out , a number of different forces combined their efforts to advocate for it: “State Department diplomats seeking a drug treaty as a means of expanding trade with China, trade which they felt was crucial for pulling the economy out of recession; the medical and pharmaceutical professions whose interests were threatened by self-medication with unregulated proprietary tonics, many of which contained cocaine or opiates; reformers seeking to control what they saw as the deviance of immigrants and Southern African Americans who were migrating off the farms; and a pliant press which routinely linked drug use with prostitutes, criminals, transient workers (e.g., the Wobblies), and African Americans. In order to gain the support of Southern Congressmen for a new federal law that might infringe on ‘states’ rights,’ State Department officials and other crusaders repeatedly spread unsubstantiated suspicions, repeated in the press, that, e.g., cocaine induced African American men to rape white women.”
These racial motivations fueled the next great American anti-drug campaign in 1937, this time against marijuana. According to Jeffrey Ramos, writing for Medium , “Towards the end of alcohol prohibition, in 1930, Harry J. Anslinger became the commissioner of the Federal Bureau of Narcotics … after alcohol prohibition ended, the FBN’s funding was falling and the department was on the brink of being shut down. Anslinger needed something to help him hold on.” He found it in weed, and while cannabis had been used in tinctures and medicines for a century, it was “a drug that was still unknown to most Americans in its recreational form.” Anslinger changed that.
Although he was on record as agreeing that the idea Americans could get addicted to marijuana was an “absurd fallacy,” according to CBS News , he nevertheless took aim at the substance once he ascended to the highest rank in the FBN. He seized on several tabloid-ish newspaper stories from the 1920s that trumpeted the dangers of weed, and in a radio address said that untold numbers of American youth were “slaves to this narcotic, continuing addiction until they deteriorate mentally, become insane, turn to violent crime and murder.”
As writers for the peer-reviewed journal Cannabis and Cannabinoid Research  pointed out, Anslinger did not attempt to disguise the racist overtones to his push for prohibition and is on record as saying, “There are 100,000 total marijuana smokers in the US, and most are Negroes, Hispanics, Filipinos, and entertainers. Their Satanic music, jazz and swing, results from marijuana use. This marijuana causes white women to seek sexual relations with Negroes, entertainers, and others.”
By 1931, according to the Saturday Evening Post , 29 states had outlawed marijuana, and it was effectively made illegal by the Marihuana Tax Act of 1937, which was passed at the behest of Anslinger: “This act would require marijuana users, growers, distributors, or anyone planning ‘to acquire or otherwise obtain any marihuana,’ to purchase a tax stamp … essentially anyone wishing to purchase a marihuana tax stamp would have to submit all of their personal information for government records. The law taxed marijuana at around $1 per ounce, or $17.95 today. The price, in addition to the forced self-reporting of anyone with a connection to the drug, discouraged its sale and use.”
The Nixon-Era War on Drugs
By the 1960s, however, the counterculture revolution openly flaunted anti-drug laws, and a decade of civil unrest led to a growing concern — again, among America’s political ruling class — that America was under siege by a drug menace. In fact, President Richard Nixon used those exact words in a 1971 address to Congress : “If we cannot destroy the drug menace in America, then it will surely in time destroy us. I am not prepared to accept this alternative.”
As a result, writes German Lopez for the online publication Vox, “over the next couple decades, particularly under the Reagan administration, what followed was the escalation of global military and police efforts against drugs. But in that process, the drug war led to unintended consequences that have proliferated violence around the world and contributed to mass incarceration in the US, even if it has made drugs less accessible and reduced potential levels of drug abuse.”
Consider the numbers compiled in 2017 by the libertarian think tank the Cato Institute :
- “In 1980, for example, 580,900 people were arrested on drug‐related charges in the United States. By 2014, that number had increased to 1,561,231. More than 700,000 of these arrests in 2014 were related to marijuana. In fact, nearly half of the 186,000 people serving time in federal prisons in the United States are incarcerated on drug‐related charges.”
- Even more astonishing for the purposes of a piece dedicated to the history of anti-drug campaigns that target younger Americans: “Approximately 50,000–60,000 students are denied financial aid every year due to past drug convictions. In addition, those who violate drug laws are penalized throughout their working careers in terms of limited job opportunities.”
- “Since the War on Drugs began more than 40 years ago, the U.S. government has spent more than $1 trillion on interdiction policies. Spending on the war continues to cost U.S. taxpayers more than $51 billion annually.”
In recent years, the War on Drugs has been studied extensively, and like most anti-drug campaigns, the evidence demonstrates that it served as a psychological operation as much as it did a legitimate crusade to benefit American health and well-being. For example, in a groundbreaking interview with John Ehrlichman, Nixon’s domestic policy advisor, Harper’s Magazine quotes Ehrlichman  on the record as describing the gist of the War on Drugs: ““The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
In addition, a four-part History Channel documentary that aired in 2017, “America’s War on Drugs,” interviewed former operatives and historians to demonstrate that the Central Intelligence Agency was a critical component of the drug trade in the 1970s and 1980s. As New York University professor Christian Parenti told the camera, “The CIA is from its very beginning collaborating with mafiosas who are involved in the drug trade because these mafiosas will serve the larger agenda of fighting communism.”
In summarizing the series, Intercept writer Jon Schwarz cuts straight to the point : “The war on drugs has always been a pointless sham. For decades the federal government has engaged in a shifting series of alliances of convenience with some of the world’s largest drug cartels. So while the U.S. incarceration rate has quintupled since President Richard Nixon first declared the war on drugs in 1971, top narcotics dealers have simultaneously enjoyed protection at the highest levels of power in America.”
The Power of Popular Culture
Few media sources revolutionized popular culture more so than the advent of MTV on Aug. 1, 1981. Then President Ronald Reagan had vowed to crack down on drugs and revitalize the drug war, and he made good on his word, according to History.com : “In 1986, Reagan signed the Anti-Drug Abuse Act. This law allotted $1.7 billion to continue fighting the War on Drugs, and established mandatory minimum prison sentences for specific drug offenses. During the Reagan years, prison penalties for drug crimes skyrocketed, and this trend continued for many years. In fact, the number of people incarcerated for nonviolent drug offenses increased from 50,000 in 1980 to more than 400,000 by 1997.”
At the same time, his wife, First Landy Nancy Reagan, embarked on one of the most visible anti-drug campaigns in recent memory: Just Say No. It began, according to the Reagan Foundation , during a visit with schoolchildren in Oakland, California. “A little girl raised her hand and said, ’Mrs. Reagan, what do you do if somebody offers you drugs?’ And I said, ’well, you just say no.’ And there it was born. I think people thought we had an advertising agency over who dreamed that up — not true,” the foundation quotes her as saying. And it was effective: “By 1988 more than 12,000 ‘Just Say No’ clubs had been formed across the country and around the world. The results were encouraging: cocaine use by high-school seniors dropped by one-third, the lowest rate in a decade,” the foundation goes on to add.
Thirty years later, however, a reevaluation of Just Say No reveals that, like so many other anti-drug campaigns before it, the intentions may have once been noble, but the end result was anything but: “Overall, the … message was simplistic and vague, grouping everything from alcohol to angel dust into one toxic cloud that loomed over our society,” writes Michael McGrath for the publication The Guardian . “The demonization of such substances and those people in their orbit was of a piece with the national public service announcements of the day, which told us that drugs either made you fly or fried your brain like an egg. The end result was that, in the minds of impressionable students like myself and my classmates, drugs were a defect rather than a symptom; a moral rather than societal failure.
“From the perspective of an adult (and recreational drug user), Reagan’s message looks much worse: alarmist and damaging, a child-friendly arm of the continuing campaign to justify and perpetuate a ‘war on drugs’ with racially and economically disproportional targets.”
That messaging found its way into the mainstream when influencers realized just how helpful popular culture could be. Consider, Peter Balonon-Rosen says on the economic news website Marketplace , other memorable anti-drug campaigns of the 1980s: The “this is your brain on drugs” ad by the Partnership for a Drug-Free America, in which a solemn-sounding narrator cracks an egg and drops it into a sizzling frying pan. In addition, Balonon-Rosen adds, “there was McGruff the Crime Dog with a chorus of children singing that drug ‘users are losers.’ There were the Teenage Mutant Ninja Turtles calling drug dealers ‘dorks.’ And Pee Wee Herman creepily advising children to stay away from crack cocaine.”
However, despite peaking by the late 1980s at a cost of $1 million a day spent on airtime, they were often ineffective, he goes on to point out: “‘Money spent in the 80s on those ads was a waste,’ said Keith Humphreys, a professor at Stanford University and former drug policy adviser to presidents Bush and Obama. He says those ads were basically lectures with a singular message. ‘You shouldn’t use drugs because authority figures have told you not to,’ Humphreys said. ‘Now, be a good boy or a good girl and do what you’re told. No adolescent wants to hear that.’”
Anti-Drug Campaigns: The Modern Era
One of the most currently active anti-drug campaigns is one with ties to the 1980s: D.A.R.E., or Drug Abuse Resistance Education. According to the organization’s website , “D.A.R.E. envisions a world in which students everywhere are empowered to respect others and choose to lead lives free from violence, substance use, and other dangerous behaviors,” and while the program traces its roots back to a 1983 partnership between the Los Angeles Police Department and the Los Angeles Unified School District, the methodology has remained largely the same.
From “Take Charge of Your Life” to “keepin’ it REAL,” various D.A.R.E. slogans and efforts have been ineffective, writes Natalie Wolchover for Live Science : “The numbers demonstrating this started rolling in way back in 1992, when a study conducted at Indiana University showed that graduates of the D.A.R.E. program subsequently had significantly higher rates of hallucinogenic drug use than those not exposed to the program … every subsequent study on the effectiveness of D.A.R.E., including a major 10-year investigation by the American Psychological Association, found much the same result. The program doesn’t work, and in fact is counterproductive, leading to higher drug use among high school students who went through it compared to students who did not.”
The “scared straight” approach of Just Say No and D.A.R.E. continues to permeate other efforts, however. As Balonon-Rosen points out , in recent years “the ‘brain on drugs’ egg ad got a violent, destructive update. And even private citizens, like a business man in Montana, began to fund scary ads to show the dark side of meth addiction. In those, teens perform over-the-top violent acts, like hitting their mom, in contrast to laid-back voice-overs which talk about how meth isn’t really that bad.
“That shock-em-away playbook has remained. The Trump White House recently partnered with non-profits to create graphic anti-opioid PSAs that will live online. And Arizona is in the midst of a new $400,000 anti-opioid social media campaign. It includes two horror-movie themed ads, featuring teens trapped inside a pill.”
None of them, he goes on to write, have demonstrated any sort of efficacy in regard to curbing drug use. As a result, Balonon-Rosen adds, “there’s a reason we don’t see too many government-funded national anti-drug campaigns. The media budget for the government office funding those ads was axed in 2012, after years of criticism that its ads were ineffective. This has left non-profits and states to take up the PSA helm, and some of them are reaching for a different playbook.”
Some of those include, according to David Heitz writing for Healthline , “NOPE, or Narcotics Overdose Prevention and Education, (which) puts together large assemblies at schools all over the United States. Students watch a multimedia presentation of parents sobbing at the funerals of their children who died from drug overdoses. In addition to its cornerstone video presentation, other stakeholders such as law enforcement come together at middle schools, high schools, and colleges to deliver the message that drug abusers die.”
Another contemporary anti-drug campaign that takes a more measure approach, Heitz added, includes Shatterproof, which “hopes to become the American Cancer Society or American Heart Association of addiction, a massive fundraising machine that brings all stakeholders to the table under one umbrella. The program even holds events where participants rappel down the side of office buildings to help build their self-esteem.”
So … Do They Work?
Put it this way: Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University as well as a former drug policy advisor to both George W. Bush and Barack Obama, told NPR in 2017  that “despite billions of dollars spent from the late ’80s up through the ’90s, the general conclusion is these ads either had no effect or in some cases maybe even a perverse effect that some of the kids who saw the most ads actually said they were more likely to try marijuana rather than less.” Why? A number of likely reasons, primarily that young Americans are much more media savvy, and much more worldly, than the advocates and creators of anti-drug campaigns give them credit for, Humprheys goes on to add:
“I remember watching one of the — I thought the silliest — ad where somebody smashed an egg and smashed up a whole kitchen with a frying pan being shown to a bunch of members of Congress, and they all jumped up and clapped, but America’s youth thought it was ridiculous. And the problem that the ads had was they’re trying to please the congressional audience, a 60-year-old white man or woman in a suit. That’s not what’s going to resonate with kids. In fact, for the kind of kids who are a bit rebellious, it was a signal that, hey, you know, if you really want to irritate your elders, this is the way to do it.”
Humphreys, it should be noted, was part of the team that designed an Obama-era anti-drug campaign, “Above the Influence,” in which the messaging was modeled after anti-smoking campaigns of the previous decade, which told young people, Humphreys said to NPR, “you know, the tobacco industry is run by people your parents age you think you’re a sucker, and they want to addict you. If you want to really, you know, show that you’re free, don’t smoke. And that seems to work a little better. What you’re saying to young people is if you want to be a cool, independent, free kid, you have the power to choose something else. And that resonates more.”
Studies of the “Above the Influence” campaign agreed that it was modestly effective: A 2011 study in the American Journal of Public Health , which examined the messaging and the target audience of the campaign, concluded that “antidrug advertising may be an effective way to dissuade eighth-grade adolescent girls from initiating marijuana use.”
Studies of other anti-drug campaigns, however, haven’t demonstrated the effectiveness originally intended. The American Journal of Public Health, in a five-year study  on “the cognitive and behavioral effects of the National Youth Anti-Drug Media Campaign on youths aged 12.5 to 18 years,” concluded that “ the campaign is unlikely to have had favorable effects on youths and may have had delayed unfavorable effects. The evaluation challenges the usefulness of the campaign.”
It’s of little surprise to recovery advocates who have long pointed out these anti-drug campaigns for what they are: scare tactics that don’t give the “tools [audiences] need to make safe decisions or to get help if problems with alcohol and other drugs do occur,” the Drug Policy Alliance told the online publication Filter . Daniel Raymond, deputy policy director for the Harm Reduction Coalition, took it a step further: “Rather than finding new drug threats to scare people about, one drug at a time, effective media campaigns should aim to build on general resilience and protective factors that apply across a range of substances.”
But, to bring it back full circle to Reinarman, that would defeat the goal of anti-drug campaigns. While they aren’t necessarily Machiavellian in the sense that they’ve been perpetrated by a shadowy cabal of influencers, they do rely on subterfuge, he points out : “In each of these periods more repressive drug laws were passed on the grounds that they would reduce drug use and drug problems. I have found no evidence that any scare actually accomplished those ends, but they did greatly expand the quantity and quality of social control, particularly over subordinate groups perceived as dangerous or threatening.”
Furthermore, Reinarman adds, while it may seem easy to look at the historical patterns of anti-drug campaigns through the lens of moral attitudes of anti-drug crusaders in various time periods, the research, and his expertise, suggest that something more is involved: “I have suggested that these crusaders have benefited in various ways from their crusades. For example, making claims about how a drug is damaging society can help elites increase the social control of groups perceived as threatening, establish one class’s moral code as dominant, bolster a bureaucracy’s sagging fiscal fortunes, or mobilize voter support. However, the recurring character of pharmaco-phobia in U.S. history suggests that there is something about our culture which makes citizens more vulnerable to anti-drug crusaders’ attempts to demonize drugs.”