Entry Category
Single Entry – Social Media Marketing in a social marketing program
Name of Intervention/ Program
Looks Legit, Might Be Fentanyl: Youth Opioid Overdose Prevention
Background and Situation Analysis
The U.S. is experiencing the most significant substance use and overdose epidemic it has ever faced, driven by the proliferation of highly potent synthetic opioids like fentanyl. Opioid overdose deaths have dramatically increased over the past 10-15 years, and while overall death rates are beginning to come down, opioid risk to youth populations has grown. Counterfeit prescription pills containing fentanyl have become prevalent and are increasingly marketed for sale to teens on social media. Teenagers understand the danger of fentanyl but are less aware of their personal risk of exposure, particularly when taking pills from friends and in party situations. Youth are also lacking information about how and where to access naloxone, a life-saving overdose treatment medication. Starting in late 2024 and extending through Spring 2026, we worked on a statewide youth overdose prevention campaign with a goal of increasing awareness of fentanyl exposure from counterfeit prescription pills and illicit drugs among teens age 14-18 in Washington State.
Priority Audiences(s)
Youth in Washington state ages 14-18 who may have access to counterfeit prescription pills and other drugs that could contain fentanyl.
Behavioral Objectives
A recent DEA study showed that more than 50% of counterfeit pills sold in the U.S. contained fentanyl. Yet youth believe that an overdose is something that happens to others, not themselves. The campaign needed to both educate youth about the risks and motivate them to change their behaviors to keep themselves – and critically, their friends – safer. The team used secondary research and conducted interviews with subject matter experts to assess the baseline with the youth audience, understanding attitudes and beliefs regarding the current opioid landscape. Among youth, there was mixed awareness about contamination of drugs and counterfeit pills, an understanding of what naloxone is but not how to use or acquire it, and a belief that an overdose happens to others, not themselves. We also found significant number of high school and college students have purchased drugs and pills on social media or the dark web believing them to be authentic oxycodone, Adderall, Xanax or other medicines. The campaign sought to interrupt teens’ assumptions about prescription pills like Adderall and Xanax being safe to get from friends or buy online. Purpose: Reduce overdose deaths caused by opioids in the state of Washington Goal: Increase knowledge among youth ages 14 – 18 about how to reduce fentanyl risk Primary Behavioral Objectives: Help youth avoid fentanyl exposure by being ready to refuse pills or other drugs that are not prescribed to them.
Description of Strategy/Intervention
Primary and secondary research were leveraged to underpin the campaign strategy. The team began with secondary research and conducted interviews with subject matter experts in substance use and behavioral health to assess the baseline with the youth audience around awareness, attitudes, and beliefs regarding opioids and personal risk. We found: 1. Among youth audiences, there was mixed awareness about fentanyl contamination in illicit drugs and counterfeit prescription pills 2. A significant number of high school and college students purchase pills on social media or the dark web believing them to be authentic oxycodone, Adderall, Xanax or other medicines. 3. Optimistic bias is prevalent among teens; they believe they are less likely to experience negative events like an overdose, compared to peers with the same behaviors. Strategic Framework The team used the social marketing process to arrive at a four-part strategy framework: Problem: Teens don’t realize the drugs or fake pills they or their friends use may be contaminated with a deadly dose of fentanyl. Insight: They see an overdose as something that happens to others, not them. Advantage: Keeping themselves and their friends safe from fentanyl. Strategy: Show them that the risk associated with fentanyl is too high to take chances with pills not prescribed to them, and empower them to be informed and plan ahead. Creative Strategy With a strategy in place, creative concepts were developed, focusing on breaking through to teens in the crowded, often chaotic online environments they’re used to. The “Might Be Fentanyl” concept centered bright colors and collage-style graphics as well as a short, catchy jingle that conveyed core messages about the risk of fentanyl showing up in drugs and fake prescription pills, leveraging a bizarre style to align with the humor of online memes popular with teens. The concept was also tested with teens who found the designs compelling and the jingle memorable. Main Message: No one knows if fentanyl will be present in the drugs or counterfeit pills you are taking. Know the risks of taking pills that aren’t prescribed to you, learn the signs of an overdose, and carry naloxone to help save someone in need.
Implementation
Implementation focused on delivering key messages in quick, compelling ways, and delivering the ads natively on the online channels that teens use most. Media communications were deployed statewide with ads placed on TikTok, Snapchat, and Instagram, as well as streaming video and audio channels. All video, audio, and static graphics included the phrase “Might be fentanyl,” along with common scenarios teens could face, underscoring how it’s impossible to confirm the absence of fentanyl in drugs obtained without a prescription: “Buy it on social? Might be fentanyl”; “Got it from a friend? Might be fentanyl”; “Looks legit? Might be fentanyl”. The campaign first ran in Spring and Summer 2025, with video and static graphics on Facebook, Instagram, TikTok, and Snapchat; video on digital TV / pre-roll; and a :30 audio spot on radio and digital audio streaming. To increase impact, ads were bolstered and out-of-home billboards were placed in the ten counties with the highest rates of opioid overdose deaths at the time of the campaign, delivering the messages to more rural areas of the state. In 2026, the campaign ran again, using many of the existing assets and added in a new audio jingle. Billboard designs were also tweaked and ran again, this time placed in counties with the highest overall numbers of opioid overdoses, in more populated areas of the state. Website: While the campaign was designed to work well natively, some ads also drove users to a new landing page just for teens that was added to the existing PreventOverdoseWA website. The webpage included more details about fentanyl and the risk of exposure through fake pills, as well as information about reversing an overdose with naloxone, and tips and resources to keep teens and their friends safer. Community Partnerships & Social Diffusion: as part of campaign dissemination, a new asset aimed at parents of teens as influencers was created. A parent-facing flyer encouraging parents to talk to their teens about fentanyl was designed and transcreated in English and Spanish, and sent to parents through high schools across Washington State. In addition, the flyer was shared with organizations including community centers, libraries, YMCAs, 4H clubs and Boys and Girls Clubs to post and share with teens.
Evaluation Methods and Results
Campaign outcomes were measured through a post-campaign survey with youth to test ad recall, attitude shifts, and progress toward the campaign’s behavioral objectives. Output metrics included digital analytics for digital ad channels and website as well as OOH media evaluation for billboards. Outputs: 2025: In 2025, the campaign reached 88% of all youth ages 14 – 18 in Washington based on a calculation of combined impressions and statewide audience population. Reach and impressions were strong, with more than 5 million completed video views, 8 million audio listens, and 72,000 unique visitors to the website. Of Washington youth surveyed after the campaign, 31% correctly recalled at least one of the campaign main messages and 16% recalled the campaign creative. 2026: In 2026, the campaign budget was reduced by around 40%, but results were still strong. The campaign reached 76% of all youth ages 14 – 18 in Washington based on a calculation of combined impressions and statewide audience population. The campaign saw more than 4 million completed video views, 3 million audio listens, and 43,000 unique visitors to the website. Outcomes: 2025: Of Washington youth surveyed after the campaign, 31% correctly recalled at least one of the campaign main messages and 16% recalled the campaign creative. 2026: Of Washington youth surveyed after the 2026 campaign, 41% of youth recalled seeing the “Might Be Fentanyl” ads, with awareness more than doubling since the 2025 campaign evaluation. This increase over the two-year period shows that consistent public messaging and good design deliver strong awareness and behavior change over the course of time.
Entry Number: 19