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Starts with One

“Starts with One”

Washington State prescription opioid misuse prevention campaign (US-WA) launched January 2018 by the Department of Social and Health Services with a federal SAMHSA grant, later run by the Health Care Authority. It asks young adults, parents and older adults to take one step: talk about pain options, never share pills, lock up and dispose of medications. Later waves added Spanish, tribal and culturally co-created spots (2021), a pharmacy safe-storage program and a Washington State Hospital Association provider partnership (2022-23), and a 2025-26 pain-management phase ("Healing starts with one conversation") at GetTheFactsRx.com.

Years
2018–now
Reach
8M impressions as reported
“WSHA partnership reached 130+ hospitals with 8 million+ impressions.”
Country
United States
Topic
DrugsOpioids
Asks people to
StartTalk to someone
Strategy
Simple instruction
Channel
Clinical settingOutdoorPoint of saleRadioSocial (organic)Social (paid)TVWebsite
Audience
CliniciansOlder adultsParentsYoung adults
Young adults, parents/caregivers and older adults; Spanish speakers and tribal communities (separate sites and spots); Black/African American, Latinx and LGBTQIA+ communities via co-created videos; hospital prescribers through WSHA; pharmacy patients.

Evidence

Self-reportedUnknown

HCA reports 2022-23 outcomes: 86 million ad impressions, 96,401 website users, 3,025 material downloads, 14,899 lbs of medication collected on National Take Back Days, and a post-campaign survey finding a 50% increase in Washingtonians locking up medication versus the previous year; pharmacy program in 17 pharmacies (615 locking bags, 855 pharmacist conversations). WSHA partnership reached 130+ hospitals with 8 million+ impressions. No independent outcome evaluation found.

Sponsor (who paid)

Credits (who made it)

Executions (individual ads)

Related campaigns

Sources

  1. DSHS continues work to combat opioid crisis with launch of Starts with One campaign sponsor · 2018
  2. HCA fact sheet: prescription drug and opioid misuse prevention sponsor
  3. Spokane Public Radio: Opioids media campaign targets young people in Washington news · 2020
  4. DH case study: Empowering everyone to prevent opioid misuse (Starts with One, for WA State Health Care Authority) archive
  5. HCA: Preventing opioid misuse and overdose (SURSAC campaign overview, 2022-23 outcomes) sponsor · 2024
  6. Starts with One campaign site (GetTheFactsRx.com) sponsor
  7. Heley K et al. Reducing Health-Related Stigma Through Narrative Messages. Health Commun reference · 2019 · DOI 10.1080/10410236.2019.1598614 · PMID 31014112
  8. Ledford VA et al. Don't Call Them "Unclean" Or "Unkempt": Analyzing the Harmful Direct and Indirect Effects of Opioid Stigma Marks on Stigmatizing Attitudes and Behavioral Intentions. J Health Commun reference · 2025 · DOI 10.1080/10810730.2025.2552949 · PMID 40898421
  9. Ledford V et al. The Influence of Stigmatizing Messages on Danger Appraisal: Examining the Model of Stigma Communication for Opioid-Related Stigma, Policy Support, and Related Outcomes. Health Commun reference · 2021 · DOI 10.1080/10410236.2021.1920710 · PMID 33941010
  10. Hom JK et al. The impact of news photographs on drug-related stigma: A randomized message testing experiment in a National Sample of US Adults. Prev Med reference · 2025 · DOI 10.1016/j.ypmed.2025.108293 · PMID 40311941
  11. Krendl AC et al. Addiction onset and offset characteristics and public stigma toward people with common substance dependencies: A large national survey experiment. Drug Alcohol Depend reference · 2022 · DOI 10.1016/j.drugalcdep.2022.109503 · PMID 35644088
  12. Frkovich J et al. Opioid-Related Public Health Communication Campaigns: An Environmental Scan. Am J Health Promot reference · 2022 · DOI 10.1177/08901171221082471 · PMID 35365055

Research notes

US-WA. Department of Health helped produce some PSAs (TRACTION youth group). Credits checked 2026-10-22 against fetched pages: DH's own case page ("For WA State Health Care Authority") says HCA came to DH in 2016 and that DH named the campaign, built the brand, websites, toolkits, videos and the Pharmacy Safe Storage and WSHA programs; HCA and tribal spots are hosted on DH's Vimeo account. WSHA credited as partner from HCA's SURSAC overview. Extended 2026-10-22 for #17: 2021+ waves, executions (years are YouTube/Vimeo upload dates), 2022-23 outcomes. The 2021 tribal spots (We Know You, Treatment Works) still sit in the For Our Lives toolkit; see wa-for-our-lives. No source found that opioid settlement money paid for Starts with One. Ad library search: "Starts with One", "Washington State Health Care Authority", "Washington State DSHS". Evaluation links reviewed 2026-10-22: six general opioid-stigma message studies (Heley 2019, Ledford 2021, Ledford 2025, Hom 2025, Krendl 2022, Frkovich 2022 environmental scan) set to reference; none evaluates this campaign. Site status 2026-10-22: the DSHS launch release (dshs.wa.gov/node/29645) now returns 404; Wayback copy: https://web.archive.org/web/20250401213712/https://www.dshs.wa.gov/node/29645. Campaign site https://www.getthefactsrx.com/ ('Home | Starts With One') is live.

Record cases/wa-starts-with-one.json, updated 2026-10-22· Link to this campaign