By Sara Polley, MD

It is undeniable that social media plays a large role in the lives of most teenagers. Websites like YouTube, Discord, TikTok, and Snapchat are used by over 95% teens. With 75% of them reporting daily use and 25% describing use as almost constant. In addition to frequent social media use being connected with poor youth mental wellbeing, it is also a risk factor for substance use in teens and the development of addiction. In our work to prevent the development of substance use disorders from becoming chronic conditions, social media use is a modifiable risk factor we can address in office with our patients.

The Role of Social Media in Teen Substance Use

Many teens report that social media helps them feel connected, provides them with current events information, and serves as a coping skill when they are upset. Unfortunately, these platforms also expose young people to normalized and glorified substance use, health misinformation, and carefully crafted substance advertising. Research shows that youth who spend more time on social media have higher rates of tobacco, nicotine and cannabis use. Youth on social media are more likely to view substances as low risk and “normal”.

Several factors contribute to the link between social media and substance use in teens:

• Glorification and Misinformation: Studies looking at the types of substance related content online conclude that the majority show use as safe, fun, normal and even helpful. The only substance where this is not the case is fentanyl. Continuous exposure to substance-related content can desensitize teens to the dangers associated with these behaviors. When drinking or smoking is portrayed as “cool” or harmless, it may encourage imitation.
• Normalization: Social media makes it seem like everyone, especially celebrities, use substances to have fun and cope with stress. I work with many teens to tell me they learned about why they should use marijuana for their anxiety through social media. Even parents can be swayed by these convincing social media wellness influencers and ask me if this is a good idea. Adolescent brains are wired to relate with and try what they see other youth and mentors doing. This places them at risk of use of substances because they don’t want to miss out.
• Mental Health Struggles: High levels of social media use can cause and worsen anxiety, depression, and suicidal thoughts.

What Primary Care Physicians Can Do

I encourage all of us seeing youth in to ask about and address incorporate an open ended question about social media use into our evaluations and follow-up appointments. There are evidence based screening tools for social media use, however they are developed for research and are usually long. In the absence of a short screener. As frontline providers, it’s essential to incorporate discussions about social media into routine adolescent health assessments. Questions about screen time, favorite platforms, and any changes in behavior related to social media use can help identify risk factors for substance use. It’s also crucial to educate both teenagers and families about the potential risks of excessive social media engagement and its connection to substance use.

By promoting healthy coping mechanisms and open communication, we can help teens navigate the pressures of the digital world while reducing the likelihood of substance use.

Conclusion

Social media’s influence on adolescent behavior is undeniable, and its potential role in substance use is an emerging concern. By staying proactive in recognizing this connection, primary care providers can play an important role in preventing substance use disorders in teens and guiding them toward healthier, more balanced online and offline lives.

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