Customize your JAMA Network experience by selecting one or more topics from the list below.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Ayers JW, Nobles AL, Dredze M. Media Trends for the Substance Abuse and Mental Health Services Administration 800-662-HELP Addiction Treatment Referral Services After a Celebrity Overdose. JAMA Intern Med. Published online January 14, 2019179(3):441–442. doi:10.1001/jamainternmed.2018.6562
Despite a substantial investment in evidence-based addiction resources, only 10% of US individuals who need treatment for drug addiction receive it.1 The Substance Abuse and Mental Health Services Administration (SAMHSA) national helpline (800-662-HELP) is the only free, federally managed and endorsed US addiction treatment referral service, helping callers find the best local services that match their needs. We sought to determine awareness of the avialability of this free resource.
On July 24, 2018, singer Demi Lovato was hospitalized for an overdose that on-the-scene investigators linked to heroin.2 Lovato has since recovered. During the week after her overdose (July 24-30, 2018), we assessed public awareness and engagement with 800-662-HELP on Google News (https://news.google.com), Twitter (twitter.com), and Google (https://google.com/trends).3 Given that these analyses were based on public aggregate data, institutional review board approval was not required for this study.
We obtained counts of articles, posts, or searches that mentioned (1) Lovato, (2) opioid or heroin, and (3) 800-662-HELP, including various spellings (eg, 8006624357), from their respective public data feeds with raw Google search volumes estimated using media measurement and analytics from comScore (comscore.com). Furthermore, because internet searchers may not know the SAMHSA helpline number, all searches for opioid or heroin and helpline or help were included in the latter category. We replicated this strategy for the week after Anthony Bourdain’s suicide on June 8, 2018, substituting Bourdain, suicide, and the National Suicide Prevention Lifeline (800-273-TALK) where appropriate (content that also mentioned blast, bomber, doors, or squad [eg, suicide squad] was omitted). Raw counts were computed using Python software (version 3.0; Python Software Foundation), and volumes were compared between the 2 searches.
We located 42 500 news stories, 972 500 tweets, and 14.7 million searches referencing Lovato the week after her overdose (Table). Of these, 25 300 news stories, 342 200 tweets, and 1.2 million searches mentioned opioids or heroin. In contrast, 216 news stories, 258 tweets, and 8000 searches referenced 800-662-HELP; the latter volume was consistent with that of the mean 90 days before Lovato’s overdose (7300; 95% CI, 6200-8200).
In comparison, after Bourdain’s suicide we found 4940 news stories, 20 900 tweets, and 29 000 searches for the National Suicide Lifeline, reflecting 22.9, 81.0, and 3.6 times greater volume. These disparities persist even after factoring in general interest in Bourdain or suicide (eg, Bourdain was cited in fewer news stories [22 400] and suicide was cited in tweets 6.2 times more [2 117 000] than comparative findings after Lovato’s overdose).
800-662-HELP appears to be underappreciated in the media and among the public at large. Additional surveillance is needed to clarify our formative findings, because our keyword-based analyses may have omitted some forms of addiction resource promotion, and our contrasted case studies of Lovato and Bourdain may not be indicative of broader patterns outsider these events. Nevertheless, the dearth of engagement with 800-662-HELP we found can help to motivate strategies for health leaders, news makers, and media companies to promote 800-662-HELP.
The World Health Organization created guidelines around suicide news reporting, standardizing the practice of including suicide helpline numbers, which appears to be effective.4 Similar guidelines for 800-662-HELP are warranted, such as imploring news reporters to include 800-662-HELP in their stories on addiction.
Social media and internet search companies could themselves promote 800-662-HELP. Bing and Google place suicide hotline numbers as the reserved first result for suicide method searches, such as I want to kill myself. Likewise, social media companies have implemented strategies to reach suicidal users who need help.5 Similar efforts could be applied to drug addiction, with industry prioritizing 800-662-HELP within their platforms when their users seek out help.
The managers of 800-662-HELP could use search engine and smartphone-based conversational agent (ie, Siri) optimization to fill existing awareness gaps without relying on media companies themselves.6 Moreover, replicating mass media campaigns, such as how Tips From Former Smokers promotes the smoker’s helpline, might also insert 800-662-HELP into the national conversation, thereby engendering broader free media coverage. The result of these changes will mean more of those who need help know of 800-662-HELP, and tragedies, like that besetting Lovato, could have a positive effect on public health.
Accepted for Publication: September 29, 2018.
Corresponding Author: John W. Ayers, PhD, MA, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Dr, CRSF Room 333, La Jolla, CA 92093 (firstname.lastname@example.org).
Published Online: January 14, 2019. doi:10.1001/jamainternmed.2018.6562
Author Contributions: Dr Ayers had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: All authors.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: All authors.
Critical revision of the manuscript for important intellectual content: Ayers, Dredze.
Statistical analysis: Ayers, Dredze.
Administrative, technical, or material support: Nobles, Dredze.
Conflict of Interest Disclosures: None reported.
Create a personal account or sign in to: