Objective

Every day in Washington state, about seven people die of an opioid-related overdose. The dramatic increase in opioid deaths in recent years is largely driven by the growing prevalence of powerful synthetic opioids like fentanyl. In 2025, C+C worked in partnership with the Washington State Department of Health (DOH) to develop a campaign in response to a troubling trend within the opioid crisis. Youth are at increased risk of overdose due to accessing counterfeit prescription pills through social media and from friends, and are largely unaware of fentanyl’s growing inclusion in counterfeit prescription pills and other drugs. A combination of primary and secondary research helped the team narrow the campaign focus to the most immediate intervention that can help save lives – getting more youth to understand that fentanyl could be in a pill that looks just like a familiar prescription medicine and that if it’s not prescribed to you, you can’t know if it’s safe. The team crafted a strategic youth education and outreach campaign around this core message with the following objective: raise awareness among teens ages 14-18 in Washington state about the risk of fentanyl exposure and overdose death when taking pills that are not prescribed to them. The campaign was developed under the umbrella for Washington State’s overdose prevention initiative, Prevent Overdose WA, leveraging an established brand while creating a youth-focused message, look, and feel.

Strategy

Research revealed the following key insights: 

• A recent DEA study showed that more than 50% of counterfeit pills sold in the U.S. contained fentanyl.
• A significant number of youth purchase pills on social media or the dark web believing them to be authentic (e.g. Adderall, Xanax or other medicines).
• Youth have limited awareness about fentanyl’s presence in many counterfeit pills.
• Youth are sharing medication/pills with one another without considering risks.
• Youth believe that an overdose is something that happens to others, not themselves.

The team then conducted listening sessions with youth to test campaign messaging and concepts. Creative insights included:

• A short jingle from one of the concepts was well-received.
• Bright colors and collage-style graphics featured in one of the concepts aligned with trending social media content and youth meme culture.
• Youth preferred the terminology “fake pills” when it came to describing counterfeit pills. 

The core campaign messaging focused on three primary risk factors when it comes to teens consuming pills that weren’t prescribed to them, making these risks explicit while avoiding stigma about taking medications when they’re prescribed to you by a doctor.

• Looks legit: Counterfeit prescription pills look identical to the real versions of drugs like oxycodone, Adderall, and Xanax. There’s no way to tell for sure if a pill is authentic unless it was prescribed to you by a doctor.  
• Got it from a friend: Teens who use drugs often get them from friends or acquaintances. Even if it comes from someone you trust, it’s too risky to take pills that aren’t prescribed.  
• Bought it on social: Illicit drug sellers increasingly use social media to sell counterfeit pills, marketing them as authentic. 

A short jingle and corresponding animations were the cornerstone of the campaign, crafted to match current youth trends and capture attention and shares.

The campaign deployment had four pillars: 

• Website: Campaign materials drove youth to an informational webpage prioritizing short, to-the-point facts to guide them through information about drug safety and overdose awareness. 
• Social Media: Given the widespread nature of online drug sales and youth social media habits, the campaign heavily leveraged social channels where youth access counterfeit pills: TikTok, Snapchat and Instagram. Channel-specific ads were created to feel native to each platform.  
• Audio and Video: Campaign assets were placed on digital TV, radio, and digital audio platforms youth use.
• Billboards: Billboards were placed near high schools in 10 Washington counties that had higher rates of youth mental illness, drug use and overdose deaths.  

A challenge with executing this campaign was balancing feedback from a wide range of stakeholders, including subject matter experts and external partners. Wherever needed, we made sure youth message testing feedback was considered first and foremost because they were the intended audience.

Results

The campaign achieved the primary campaign objective to raise awareness among youth about the risk of fentanyl exposure when taking pills or other drugs that are not prescribed to them. Success was measured using a post-campaign survey of youth across Washington state as well as campaign performance metrics.  

Post campaign survey results:  

• 16% recalled the “Might be Fentanyl” campaign creative 
• 81% of youth that recall seeing fentanyl-related ad(s) recently remember at least one of the main messages from the "Might Be Fentanyl" campaign. This represents approximately 31% of the overall youth respondent population. 
• Among respondents who recall seeing ads related to fentanyl risks, the messages they most commonly recalled were “don't take pills that aren't prescribed to you” and “you should only trust medicine you get from a pharmacy with a prescription”, aligning with the primary campaign messages. 

The media campaign drove 47K social media engagements, 5M+ completed video views, 8M+ audio listens, 93K+ clicks, and 72K+ unique visitors to the campaign website.  

Media