Entry Category
Best Health & Wellness
Name of Intervention/ Program
Opioid overdose continues to be one of Washington state’s most urgent public health challenges. Although opioid overdose deaths have begun to stabilize after years of dramatic increases, Washington state still lost nearly 2,500 people from opioid-related overdoses in 2024. Research shows that many overdose deaths are preventable when people carry naloxone, recognize the signs of an overdose, and use opioids around other people who can respond in an emergency. Despite growing awareness of these harm reduction behaviors, many people who use opioids do not consistently plan ahead to reduce their risk.
To help address this challenge, we extended the statewide Prevent Overdose WA campaign with the goal of increasing safer opioid use behaviors among people who use opioids.
The campaign followed a social marketing planning process grounded in primary and secondary research to help uncover audience insights that could drive the campaign strategy and messaging. Initial research assessed awareness of harm reduction behaviors, evaluated audience perceptions of overdose prevention messages, and reviewed comparable campaigns across the country. Findings demonstrated that messaging emphasizing preparation—specifically carrying naloxone and using around others when possible—was more motivating than messages focused solely on overdose risk. This research informed a campaign that empowered people who use opioids to take care of themselves and others by planning ahead for lifesaving harm reduction behaviors.
Additional research conducted for the campaign extension revealed an important gap. While many people who use opioids understood the value of using with others, a significant segment routinely used alone and were unlikely to change that behavior, whether due to stigma, privacy concerns, or fear of others discovering their opioid use. Veterans and blue-collar workers were identified as important priority populations within this audience.
Following the campaign’s successful first year, 2025-26 efforts expanded focus to reach this particularly high-risk audience: People who use opioids alone. Rather than relying on a single message for all audiences, the campaign expanded its strategy to acknowledge the realities these audiences face and promote practical harm reduction behaviors that could reduce overdose risk even when someone uses alone.
Priority Audiences(s)
The primary audience included adults who use opioids, particularly males ages 25–64, with strategic emphasis on Hispanic/Latino people, veterans and blue-collar workers.:
Behavioral Objectives
The campaign established the following framework:
Purpose: Reduce opioid overdose deaths in Washington state.
Goal: Increase adoption of harm reduction behaviors that reduce the likelihood of opioid overdose.
Campaign Objectives:
- Increase the number of people carrying naloxone.
- Encourage people who use opioids to use around others whenever possible.
- Increase awareness of practical harm reduction behaviors for people who use alone, including telling someone before using and using where others could find them in an emergency.
- Increase familiarity with harm reduction messaging among priority populations disproportionately impacted by opioid overdose deaths.
Description of Strategy/Intervention
The campaign was built around social marketing principles, using audience research to understand the barriers and motivators to increase adoption of harm reduction behaviors in order to reduce the likelihood of an opioid overdose.
Barriers
Research identified several barriers:
- There were high levels of stigma associated with opioid use among the general public and people who use opioids (self-stigma).
- Although some people indicated they use opioids with others, many people prefer to use opioids alone so that they do not have to tell others that they are using.
- People who use opioids know how to reverse an overdose but might not always be prepared to act.
Benefits and Motivators
The campaign emphasized benefits and motivators that directly addressed these concerns:
- Focused on a compassionate and non-judgmental approach to start addressing stigma.
- Two campaign messaging tracks provided steps to stay safe whether using alone or with others.
- Emphasizing thinking ahead can help you stay safe.
Strategic Framework
Problem:
People who use opioids often understand overdose risks but do not consistently prepare for emergencies. Those who use alone may believe using with others is unrealistic or undesirable because of stigma or privacy concerns.
Advantage:
People can reduce their overdose risk by preparing before they use—carrying naloxone, recognizing overdose symptoms, using around others whenever possible, or taking practical harm reduction steps when using alone.
Strategy:
Demonstrate that overdose prevention is achievable through realistic preparation rather than perfect behavior.
Insight:
Planning ahead provides confidence and peace of mind. Even small actions can make a life-saving difference if an overdose occurs.
Creative Strategy
Two creative platforms were implemented:
Teamwork reinforced the importance of carrying naloxone and using with others whenever possible, and Build extended the campaign to audiences who typically use alone. Both campaigns normalized practical harm reduction behaviors to fit their lived experiences.
The Teamwork campaign continued to encourage people who were willing to use around others to view overdose prevention as something they could prepare for together. Messaging emphasized carrying naloxone, recognizing overdose symptoms, and having someone nearby who could respond during an emergency.
Recognizing that many individuals would continue to use alone regardless of campaign messaging, the Build campaign introduced an alternative harm reduction strategy. Rather than asking audiences to change behaviors they were unlikely to adopt, Build promoted small, realistic actions that could still reduce overdose risk, including telling someone before using and using where others could find them.
Implementation
The implementation strategy focused on the development of two complementary campaigns: Teamwork & Build. Together, they recognized that effective overdose prevention requires meeting people where they are.
Media communications were deployed statewide in English and Spanish using the following channels: television, connected TV, digital video, YouTube, Facebook, Instagram, TikTok, radio, and digital audio. Paid media investments were strategically concentrated within the ten Washington counties experiencing the highest opioid overdose death rates while using audience targeting to efficiently reach priority populations statewide.
Websites: A new Safety Tips page was added to the PreventOverdoseWA.org and NoMassSobredosisWA.org websites to allow campaign audiences to learn more about being more prepared and thinking ahead about safer use of opioids and reversing an overdose.
Social Diffusion: Trusted organizations played an essential role in reinforcing campaign messages. Partnerships with community and veteran services, supportive housing organizations and labor unions extended the campaign through posters. In addition, a partnership with rest areas across Washington helped spread messaging statewide to normalize practicing harm reduction behaviors.
Evaluation Methods and Results
Campaign outcomes were evaluated through annual statewide tracking research measuring campaign awareness, message recall, and self-reported harm reduction behaviors among the general public and people who use opioids.
Objective: Increase the number of people carrying naloxone.
Result: Objective exceeded. Carrying naloxone remains more than twice the 2023 level, with 28% of people saying they carry naloxone (versus 13% in 2023).
Objective: Encourage people who use opioids to use around others whenever possible.
Result: Objective exceeded. Survey findings indicated using with others was the top harm reduction behavior stated by people who use opioids, with 46% saying they always or often use with others.
Objective: Increase awareness of practical harm reduction behaviors for people who use alone, including using low and slow, telling someone before using and using where others could find them in an emergency.
Result: Objective exceeded. Survey findings indicated that using low and slow was the second highest harm reduction behavior stated by people who use opioids with 40% saying they always or often go low and slow using one drug at a time.
Objective: Increase familiarity with harm reduction messaging among priority populations disproportionately impacted by opioid overdose deaths.
Result: Objective exceeded. The campaign successfully increased familiarity and visibility among the intended audience. Nearly half (49%) of people who use opioids recalled seeing the campaign, an increase from 42% during the previous year. Recall was also strong among Spanish-speaking respondents (38%) and exceeded recall among the general English-speaking population (25%). In addition, 36% of veterans recalled seeing the campaign.
Among audiences reached by the new Build creative, respondents also demonstrated strong recall of the campaign’s key messages encouraging people who use alone to tell others before using (48% of English speakers and 32% of Spanish speakers) and to use where someone could find them if an overdose occurred (47% of English speakers and 23% of Spanish speakers).
Campaign outputs were measured through reach and engagement:
- More than 89 million impressions
- More than 40 million completed video views
- More than 14 million completed audio listens
- More than 42,000 website clicks
- More than 34,000 unique campaign website visitors
By combining audience research, behavioral science, targeted creative development, and efficient media delivery, the Prevent Overdose WA campaign successfully evolved beyond awareness-building to encourage practical harm reduction behaviors among people at greatest risk of opioid overdose, including audiences traditionally underserved by overdose prevention campaigns.
Entry Number: 33