Treatment and Recovery Messaging is Personal

Winter is a peak period for substance use. Driven by a desire to escape the isolation, fatigue, and low levels of energy common during the season, many individuals turn to substances as a form of emotional support.

With spring now in sight, it’s a good time to reflect on the patterns of the season behind us. Understanding the complex roots of substance use disorder will help us reach and encourage individuals who need help.

Beyond nature versus nurture

During the past two decades, the Gene-by-Environment (GxE) theory has changed how we understand behavioral health, addiction, and other chronic medical conditions. Our own primary research with those who have lived experience has also deepened our understanding.

The GxE approach examines how our genes and environment interact to shape our health and behavior. It suggests that having a genetic risk for addiction may lead to problems only for people who face specific environmental triggers, while also suggesting that a stressful environment might cause issues only for people who have a specific genetic vulnerability.

Addictions are moderately to highly heritable. Stress, grief, isolation, illness, and difficult childhood experiences like trauma or family problems increase the risk. Substance use often rises seasonally (as we noted earlier) and during big life changes, such as moving out, divorce, losing a job, or retiring.

Each person and situation is different. Understanding how these genetic and environmental factors connect helps us see that someone’s struggle comes from both their body and their surroundings — and helps us create more effective communication strategies and programs. 

Move away from one-size-fits-all slogans

The “Just Say No” era is over. It’s important to reach people in the specific environments and situations where they are most vulnerable, and to offer support instead of a lecture.

By applying GxE logic, we move away from one-size-fits-all slogans toward targeted prevention. This means identifying the unique environmental keys that might trigger a biological predisposition for substance use.

• Adolescence: At a stage where risk-taking is high and social belonging is a primary motivator, messaging should reinforce healthy social norms. Highlight relatable, positive role models and healthy peer connections that make wellness feel like the standard, not the exception.

• Emerging adulthood: For many, a college drinking culture or happy hour scene makes heavy use seem standard. Combined with academic and work pressures, substances can become a coping mechanism. Leverage campus media and early-career workplaces to shift norms. 

• Middle adulthood: For those in the “sandwich generation,” chronic stress from work-life imbalance and caregiving responsibilities can become overwhelming. Messaging must address burnout and de-stigmatize seeking mental health support. Paid media is often a good way to reach this weary and escapist audience. 

• Older adulthood: Retirement can bring a loss of professional identity and social connection. Combined with chronic physical pain, this isolation often leads to increased alcohol use or the overuse of medications. Support here requires a focus on social reconnection and safe medication management.

What messaging works to address substance use?

One of the more empathic counseling approaches is Motivational Interviewing (MI), now considered the “gold standard” for substance use. MI is highly effective. Instead of telling a person why they should change, the approach guides the person to discover their own internal reasons for change and to overcome any ambivalence that has them stuck.

Most people using substances are in a “tug-of-war”: One part of them wants to quit (for health, family, or money), while another part wants to continue (for stress relief or social connection).

MI prompts the individual to voice their own “change talk” (e.g., “I’m tired of feeling foggy every morning.”). Once a person hears themselves say they want to change, they are statistically much more likely to follow through.

How to adapt MI for effective communication

By adopting the principles of MI, we can craft campaigns that mirror the internal dialogue someone experiences when they are on the fence about making a change.

• Develop discrepancy: Rather than highlighting the “wrongness” of a behavior, messaging should help individuals see the gap between where they are and where they want to be (e.g., “Is your current habit getting in the way of the person you want to become?”).

• Support autonomy and self-efficacy: In MI, the individual is the expert on their own life. Messaging that reinforces a person’s power to choose reduces the natural urge to push back against being told what to do.

• Roll with resistance: In some cases, such as communicating the dangers of fentanyl and accidental poisoning, it is vital to warn and educate about the risks. Messages attempting to inspire change toward treatment and recovery, however, should acknowledge and affirm rather than use fear-based tactics that cause people to tune out.

• Evoke “change talk”: The most effective campaigns don’t give the answers; they ask the right questions. By using open-ended prompts about the need and reasons to change, we invite the audience to voice their own motivations for a healthier life (e.g., “How would your life look different if you decided to make a change?”).

By weaving these MI strategies into our communications, we transform public health advertising into a powerful catalyst for internal change.

A top public health priority

Addressing society’s persistent struggle with substance use is one of our highest public health priorities. It is among the most important and impactful work that we do.

To really move the needle, we need to understand the complex human factors at play. If you would like to discuss this approach further, reach out to us today.