Misusing social media can have various physical, psychological, and social consequences, especially for young people. This can include addiction, not only to drugs but also to the internet, alcohol, and tobacco. Additionally, social media use can have negative impacts on mental health, raise privacy concerns (e.g., in the realm of targeted advertising), and allow for exposure to illegal content such as CSAM (child sexual abuse material). Illicit fentanyl use has become increasingly concerning with steadily rising overdose rates in recent years. Advertising on social media is one way drug sellers are marketing fentanyl and other drugs, with transactions facilitated by users’ ability to remain anonymous. Adolescents are especially at risk of encountering opportunities to purchase illicit drugs through their use of social media. Other factors, such as living in a larger city, having lower educational attainment, and risk-taking behaviors are all positively associated with the purchase of drugs via social media.

While there are risks associated with social media use, there are also opportunities to use social media as a valuable tool for raising awareness and countering misinformation about the dangers of substance use. Social media can also be a valuable tool for continuous monitoring of dynamic changes in drug consumption patterns and outcomes, as well as evaluating drug policies.

Implications of Fentanyl Sales

• Fentanyl is a synthetic drug 100 times stronger than heroin that is both easy and cheap to make and smuggle into America. The ease of supply is driving the demand.
• After more than a decade of holding relatively steady, overdose deaths among adolescents aged 14 to 18 more than doubled between August 2019 and March 2020. Since then, the crisis further intensified, with 5.2 deaths due to overdose per 100,000 adolescents in 2022.
  • Overdose deaths related to heroin and prescription opioids (e.g., Oxycontin) remained flat through 2022 while deaths involving fentanyl use continued to rise.
  • Provisional data from the CDC’s National Center for Health Statistics showed the first annual decrease in 2023 in drug overdose deaths since 2018. However, the data is currently incomplete and there were significant increases in overdose deaths observed in some states.
• Fentanyl is often put into other drugs like methamphetamine or illicit pills that are sold online as Adderall or Ritalin, which increases the overdose risk. Around 4 out of 10 fake prescription pills seized by the DEA are now laced with fentanyl.[i]

Role of Social Media

• Social media platforms have been used by drug sellers to promote fentanyl sales and exchange contact information with buyers for transactions, making it easier for drug users to learn who they can buy from.
• Common platforms used in illicit drug sales include Instagram, Facebook, Twitter, Discord, Snapchat, TikTok and Pinterest.
• Drug sellers often use covert strategies to evade law enforcement detection and to exclude potential buyers who are not using the latest terminology. For example, sellers frequently modify code names, symbols, and emojis associated with illicit substances when advertising on social media platforms.
• The ability to remain anonymous across social media platforms allows buyers and sellers to embrace the privacy it affords them and simplifies transactions.[ii]
• During the COVID-19 pandemic the use of social media increased due to lockdowns and stay-at-home orders. Pandemic-induced stress may have led to additional purchases of fake prescription pills online.

Policy Considerations 

Social media threats for youth, including access to illicit drugs, are a global concern. Policymakers can consider various strategies to prevent sales of illicit drugs via social media. A multipronged approach characterized by the strategies described below can reduce risk in multiple areas and empower youth with the social and digital skills necessary to protect them in the online environment.

Supporting youth health and wellness:

• Invest in mental healthcare and effective prevention programs in schools that educate youth on the dangers of opioids and reduce the risk of drug use.
  • The Results First Clearinghouse Database provides information on the effectiveness of social policy programs, including those related to substance use and school settings.

Increasing education and awareness:

• Create targeted public health messaging and educational content on social media.
  • Public health bodies, charities, schools, celebrities, and/or influencers may have greater success in leading to changes in young people’s behaviors.
  • Educate parents, caregivers, and minors on safe social media practices.
  • Online prevention campaigns on social media were the most cited types of interventions recommended across 56 studies.
  • Living the Example (LTE) is a program that trains adolescent youth ambassadors to develop and disseminate prevention messages within their own social media networks and through in-school activities. LTE is a promising strategy that can lead to reductions in adolescent behaviors revolving around the use, distribution, and sale of drugs.

Reducing supply:

• Implement drug supply reduction measures. The ease of supply is driving the demand for illicit drugs. Access to drugs (physical access and their affordability) is one of the most critical factors for the initiation and continuation of drug use among young people.
  • It is essential to target social networks and the dark net to reduce youth’s access to drugs, including both illicit drugs and prescription drugs.
  • Artificial intelligence software, machine learning, and web forensics can be leveraged to detect online illicit drug sales. [iii]

• Create training and develop capacity among law enforcement to improve social media surveillance efforts. Participate in cross-sector collaboration to develop solutions that address the sale of illicit drugs, while taking into account private companies’ concerns around censorship, cost of monitoring, and public relations challenges.
• Increasing the pressure for social media companies to moderate their content to disrupt online sales of illicit substances has been proposed, but can raise issues related to freedom of speech. [iv]

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[i] In 2023, three teenagers in Arkansas overdosed on fentanyl, unaware that their THC vape had been laced. In this case, they were able to be revived with naloxone.

[ii] The Stored Communications Act restricts social media platforms from disclosing the contents of users’ communications, metadata, or their personally identifying information unless an enumerated exception applies. It also prohibits the treatment of social media sites as the publisher or speaker of any information provided by another information content provider. As such, this law facilitates the ease of access to selling drugs through social media sites where anonymity and personally-identifying information is protected.

[iii] Example: Tim Mackey at UCSD runs a federally funded start-up that developed artificial intelligence software to detect illicit online drug sales.

[iv] Also, enforcing age restrictions on social media platforms can raise concerns with reliability, inclusivity, and privacy. This can also lead to missed opportunities to use social media for protective interventions.