Pictures of a young woman's overdose death from heroin are shocking but they are not likely to stop others from following in her footsteps ...
In the pictures Rachel's body is curled into a tight ball next to a chest of drawers. A syringe is still grasped in her hand, although it's been three days since the heroin it once contained killed her. Her arms and face are mottled purple and in a second photograph a dark stain can be seen on the plain beige carpet, apparently blood from a cut on her knee.
These pictures are of Englishwoman Rachel Whitear, who died in May 2000, aged 21. Last week her mother and stepfather, Pauline and Mick Holcroft, released the graphic images as part of a video to be used in English schools to warn students of the dangers of drugs. Instead of a young life and early death cut short and rendered meaningless by drugs, they have found a way to create something positive from their loss.
Education authorities in Herefordshire, which will make the video part of their regular curriculum, said they were aware some people would find the image distasteful. Mrs Holcroft described them as "horrific", but said the decision to release them publicly would help send a powerful anti-heroin message to young people. She told the BBC she hoped no child would use the drug after seeing its terrible effect on her daughter.
"We believe that the answer to drug abuse is in education, especially of young people and showing the effects that it will have on them." She said school children who had already seen the film felt it had a big impact on them. "They think seeing this film has changed their viewpoint on drugs and we're hoping it will have a far-reaching effect."
Many psychologists and drug experts say shock tactics can actually reduce the behavioural impact of a message. In other words, shocking people might get their attention but it won't make them change their behaviour.
Social issues director at the Australian Psychological Society, Professor Graham Davidson, said the human mind tends to block out information it finds too distressing or confronting. "Sometimes when you receive images of disfigurement, or very threatening information, you suppress it," he said yesterday. "We tend to suppress information that we don't want to see or hear."
While a certain degree of shock can emotionally arouse people and make them more susceptible to information, finding the correct balance between scaring and teaching is a difficult and complex exercise. "You need to get people to look at their coping mechanisms, then deal with the emotions associated with this particular health risk behaviour, then get them to examine strategies to get them to avoid or stop it."
Prof Davidson hasn't seen the UK program based on Rachel's death, but he said Australian psychologists are generally moving away from supporting shock tactics. However there are some situations where such techniques appear to be having some success, such as a program in the US where young offenders are shown around a jail to realise what life is like inside. But he emphasised these findings had not yet been scientifically tested: "there's anecdotal evidence these things are effective but I don't know of any sound scientific evidence".
Despite the state of research, the state and federal governments in Australia have consistently used scare tactics in campaigns against health dangers like smoking, HIV/AIDS and drink-driving.
The state road toll in 2000 was the highest in four years, despite the use of graphic car-crash advertisements. A year later a series of advertisements aimed particularly at combating fatigue – shown by statistics to be a serious risk factor in accidents – used a mixture of medical explanation and graphic imagery.
The road toll dropped.
There's no way of proving whether the two were causally linked, but the "microsleep" advertisement does illustrate the way shock and education can be used to complement each other.
Young people are notoriously invulnerable to death, at least in their own eyes. Many will look at the picture of Rachel's body and no doubt be shocked by the graphic nature of it, but that was what happened to one woman. It's not what will happen to them.
Prof Davidson said the most effective way to persuade children to steer clear of risky health behaviour like taking drugs is to give them good, non-preachy information as part of a co-ordinated long-term strategy. "I just don't think it works these days to show pictures of dead and maimed individuals. "I say that with great respect to the families which might have suffered the grief of losing a child and with great respect for their willingness to be part of an anti-drugs campaign."
As well as the brutal pictures of Rachel's body, the UK video includes poetry and letters written by her as she struggled to overcome addiction. The 22-minute tape tells the story of a bright, happy and talented girl from a happy home who ended up living, then dying, in a bedsit apartment.
Last week Mr and Mrs Holcroft blamed their daughter's boyfriend Luke Fitzgerald, 27, for Rachel's descent into addiction. Friends of the university dropout revealed to British newspaper The Mail on Sunday that she was injected with heroin by her boyfriend and said she saw it as an act of love. The drug sessions took place in a squalid communal room in a house occupied by other junkies.
They watched as Mr Fitzgerald plunged a syringe into the arm of a compliant Rachel. Her friend Michelle Hill, also a heroin addict, said she believed Rachel would probably not have died had it not been for Mr Fitzgerald.
But it is not as simple as that: they both, it appears, egged each other on. Rachel was already a habitual user of marijuana and ecstasy when they met, and Ms Hill said Mr Fitzgerald tried to kick heroin. At one point, while Mr Fitzgerald was trying to wean himself off heroin through a methadone programme, Rachel seemed determined to continue using the drug. Her habit saw her drop out of uni, lose touch with her family and eventually die. She'd told her parents she wanted to donate her organs if she died young, but because her body wasn't found until three days after she died, that wasn't possible. Instead her parents have donated her life to the public in the hope it will help someone.
"This donation is more than simply the pictures of her death; it is the entire story of how she lived and why she died. "To us, those photos [of her death] are not that shocking," Mr Holcroft said. "This photo of Rachel [innocent and smiling in her school uniform] probably causes us more upset."