Social Media and Other Health Risk Behaviors

Similar to alcohol, many celebrities use their reach and power to harness passive social influence to promote their use of drugs.

• Wiz Khalifa, Diplo, Rihanna, and Nicki Minaj have posted hundreds of pictures with drugs and alcohol.
• Celebrities, such as Seth Rogen, are starting their own cannabis companies and are actively promoting them on social media.
• More than 7% of Snoop Dogg’s Instagram photos involve drugs, most notably marijuana.
• A quick search for the hashtag #marijuana on Twitter reveals almost 2.8 million posts.

Based on what you read in Module 5, it shouldn’t be a surprise that research shows that exposure to substance use on social media is associated with increased likelihood of actually using those substances. 

In addition to just being exposed to images of drug use (i.e., passive social influence), drug sales (i.e., active social influence) are rampant on social media.

• Social media has emerged as a marketplace made up of thousands of dealers who sell small amounts of drugs to individual users.
• Snapchat in particular has become a popular avenue for buying drugs on social media.
• So how does it work? Dealers post pictures of their products and use certain emojis and hashtags to advertise what they have in stock, which makes it easily searchable.
• Although social media companies do not endorse this behavior and it is illegal in the US, most platforms aren’t able to stop this activity.

How frequently is your teen seeing drug sales on social media?

• One in four young people have been advertised drugs on social media.
• 56% saw drugs being advertised on Snapchat, 55% on Instagram, and 47% on Facebook.
• Of teens who reported seeing drug sales on social media:
  • 63% saw marijuana being advertised – making it the most commonly seen drug advertised for sale. Cocaine was the second drug most commonly seen advertised (26%), followed by MDMA/Ecstasy (24%), Xanax (20%), Nitrous Oxide (17%), and Codeine (16%).
  • 72% said that they see illegal drugs advertised for sale on social media sites or apps once a month or more.
  • 48% were not concerned by seeing drugs advertised for sale on social media.

Why does this matter?

• Similar to alcohol use, your teen doesn’t have to be an active drug user, actively searching for drug use, or participating in drug sales to be influenced by what they see online.
• Seeing drugs advertised for sale on social media is yet another form of social influence that is likely to normalize drug use which in turn may make teens more willing and open to eventually try drugs themselves.

So what should you do about this as a parent?

• Thankfully, the same basic tips and strategies we provided in Module 5 are still applicable here. The information presented in Module 5 specifically about starting conversations and what to do if you think your teen has posted about alcohol on social media or may be using alcohol can be easily adapted for concerns related to other substances.
• One thing to consider when framing conversations about substances other than alcohol is that the health, legal, and social consequences of posting about, viewing, or using alcohol may be quite different than posting about, viewing, or using marijuana or other substances.
• As always, feel free to revisit Module 1 to refresh yourselves on communication best practices.

Social media’s role on teen mental health has been gaining increasing attention in recent years and we have heard from many other parents that this is one of their primary concerns. In this section, we want to highlight both potential mental health benefits and consequences of social media use among teens.

Mental Health Benefits

What are potentially positive mental health benefits of using social media?

• Having more and higher quality social relationships has positive impacts on mental health, and for many teens, social media can serve as both a channel through which to maintain existing social relationships and to form new ones.
• Nearly 25% of teens report that using social media makes them feel less lonely.
• Research indicates that teens who report higher levels of social media connectedness (feelings of belonging) report lower levels of depression and anxiety and higher levels of subjective well-being (life satisfaction).
• Social media provides a space for teens to explore identities, disclose experiences, and share ways to cope and get support. This may be particularly true for teens who are a part of a minoritized population.

What kind of conversations about the mental health benefits of social media should I be having with my teen?

• When discussing mental health with your teen, be sure to ask about the positives they experience as a result of being on social media. Teens report that they wish their parents understood the many good things they perceive about social media and being open to hearing them will set the stage for positive conversations as well as allow for opportunities to talk about less positive things they may experience related to their mental health.
• We suggest having open and honest conversations with your teens about these issues. Some sample questions you might want to ask are:
  • How does using social media make you feel?
  • How might social media make some people feel happier and more connected?
  • How can you use social media in a way that makes you feel happier and more connected?
  • What do you I wish I knew about the good things about social media?

Mental Health Consequences

What are potentially negative mental health outcomes of using social media?

• An estimated 27% of children who spend 3 or more hours a day on social media exhibit symptoms of poor mental health.
• Teens who are depressed or suffer from anxiety (both of which are often exacerbated by social media use) may then attempt to use alcohol or other drugs to counteract or lessen these feelings.
• Research shows that spent on social media is correlated with depression and anxiety, but that doesn’t necessarily mean that social media causes these problems.
  • It is unclear whether using social media leads to depression and anxiety symptoms, or if people who are already more depressed or more anxious use social media more than their peers do.
  • However, recent research indicates that teens who deactivated and/or limited their Facebook account for a month reported lower depression and anxiety, as well as increases in happiness and life satisfaction.

Why are social media and poorer mental health connected?

• Culture of Comparison
  • Many teens are concerned about their self-image and who they are as well as have anxiety about fitting in or what other people think about them.
  • These concerns generally will lead teens to compare themselves to the number of likes, friends, or followers other people have when they go on social media.
  • These comparisons and feelings of “not being good enough” lead to them thinking that everyone is happier or better off than they are, which in turn can turn into depression, loneliness, and anxiety.

• The Role of Sleep
  • Many teens report that they use social media at night, even when it affects their sleep. They worry that if they do not use their phone at night, they will miss out on potential social interactions online, which they believe would have a negative effect on their in-person social relationships.
  • There is a social norm to respond to messages quickly, and they don’t want to violate that norm by sleeping through their messages.
  • Many adolescents (29%) report sleeping with their phone and checking it constantly at night.
  • Poor sleep has routinely been found to be associated with poorer mental health outcomes among adolescents.

What kind of conversations about potential mental health consequences of social media should I be having with my teen?

• As always, we suggest having open and honest conversations with your teens about these issues. Some sample questions you might want to ask are:
  • How does using social media make you feel?
  • How might social media make some people feel sad and lonely?
  • What can you do to help avoid feeling sad, lonely, or anxious when using social media?
• Set a good example
  • Many parents may also use their phones and check social media late at night or frequently throughout the day. Setting a good example that it is ok to step away from your phone is a way to model healthy behavior.
• Help your teen set boundaries
  • Instead of making hard and fast rules without your teen’s input, it might be more helpful for parents to teach teens how to create healthy boundaries related to social media.
  • Develop a plan that your teen agrees with to set limits on social media use. For example, mealtimes are a great time to put the phones away. If you ask your teen to set boundaries, this is another good opportunity to lead by example. This also may be a good time for a parent to disclose their own struggles with setting phone-related boundaries and to work on tandem-goal setting with your teen.
  • Another healthy habit is to encourage your teen to set a time each night when they will put all the screens away to give them enough time to wind down before going to sleep.

How are sexual behavior and social media linked?

• Teens are growing up with many new ways to communicate. And, yes, this can include communicating about sex.
• While social media is a central way teens build and maintain relationships as we discussed related to mental health benefits, this level of social connectedness may lead to potentially troubling and nonconsensual exchanges.
• One-quarter of teens say they have been sent explicit images they didn’t ask for, while 7% say someone has shared explicit images of them without their consent.
• Studies show it is common for adolescents to self-report high-risk sexual behavior on personal social media profiles, with references to sex displayed on approximately 24% of profiles.

Why does this matter?

• Research shows that teens who view social media profiles with minimal or no sexually suggestive content perceived that their peers were participating in safer sex practices, such as condom use, and reported that it would influence their future behavior to do the same.
• However, teens who view sexually-suggestive content on social media perceived that their peers were having sex without protection or with strangers, and they were more likely to report personal engagement in these same high-risk behaviors.
• Not dissimilar from the findings related to alcohol and other substance use, research shows that high-risk behavior, including sexually suggestive content, displayed on social media may normalize and encourage similar high-risk behavior. This is yet another example of the power of passive social influence!

So what can I do about this as a parent?

• Talk with your teen!
  • Using the general tips and strategies in Module 1, find a time to sit down with your teen and discuss sexual content they may have viewed or sent on social media.
  • If they shared content, you could discuss reasons why they may have sent this type of content? What were their motivations? What led them to share photos of themselves or someone else?  What made them curious to engage in this type of communication? Is this something you might not want someone to have in the future? If so, how hard might it be to get that content back? This is another good opportunity to discuss that once something is shared online, it may not be possible to ever fully delete or remove it.
  • If your teen viewed or received sexual content, ask them why someone else might send a sexual image or text? How did they feel when they saw the sexual image?
  • Regardless of whether your teen shared or viewed sexual content, it might be a good idea to bring up legal consequences of having these sort of sexually suggestive images on their phone or computer. Any type of nude photograph, taken or shared with sexual intent, of a child under the age of 18 is illegal and considered child pornography. Even if your teen shared a picture of themselves to someone else, that could be considered distributing child pornography. If the pictures on your teen’s phone are of another teen, that can also be considered being in possession of child pornography. Talk with your teens about immediately deleting this type of content from their phone if they were to receive it.
• Keep your teen involved.
  • While it’s important to handle these situations as a parent, keep your teen informed. If you talk with other parents or with your teen’s school, let them know. It’s important for your teen to have a voice. This experience can affect your teen’s social life and emotional wellbeing. Staying involved can help them feel more empowered. As your teen grows into an adult, they should know that they have choices regarding their sexuality.

Another potentially harmful aspect of social media is cyberbullying, which is bullying that occurs online. Unlike bullying that takes place in-person, victims of cyberbullying cannot get away from it, it stays online, and it often happens out of sight of teachers and parents.

In this module, we are focusing specifically on cyberbullying, so it is important as a parent that you are able to discern what is cyberbullying and what is not.

Cyberbullying is:

• Generalized abuse, largely towards the appearance, interests, intelligence, or previous posts of the bullying target.
• Not a separate issue from traditional bullying, but is rather an expansion of the platforms (i.e., social media) on which it exists.

Hate Speech is:

• Abuse directed specifically toward a unique, non-controllable attribute of a group of people, most typically race, ethnicity, sexuality, and gender identity.

How common is cyberbullying?

• As many as 72% of teens say that they have been cyberbullied at some point in their lives and 23% report being cyberbullied in the past month.
• The most common type of harassment teens encounter online is name-calling. Approximately 42% of teens say they have been called offensive names online or via their cellphone. Additionally, about a third (32%) of teens say someone has spread false rumors about them on the internet, while smaller shares have had someone other than a parent constantly ask where they are, who they’re with or what they’re doing (21%), or have been the target of physical threats online (16%).
• The vast majority of teens (90%) believe cyberbullying is a problem that affects people their age, and 63% say this is a major problem.

How to know if your teen might be the target of cyberbullying?

• Being emotionally upset during or after using the Internet or the phone
• Being very secretive or protective of one’s digital life
• Withdrawal from family members, friends, and activitiesAvoiding school or group gatherings
• Slipping grades and “acting out” in anger at homeChanges in mood, behavior, sleep, or appetite
• Wanting to stop using the computer or cellphone
• Being nervous or jumpy when getting an instant message, text, or email
• Avoiding discussions about computer or cellphone activities

What are negative effects of cyberbullying?

• Cyberbullying has been associated with anxiety, depression, issues concentrating in school, trouble getting along with peers, and may even lead to physical symptoms such as frequent headaches and stomach pain.
• Cyberbullying is more strongly correlated with suicide attempts than is face-to-face bullying.

What can parents do about it?

• Each case is individual, but there is some general, tried-and-true advice that you could consider sharing with your teen:
  • Know that it’s not your fault. No one deserves to be treated cruelly.
  • Don’t respond or retaliate. Sometimes a reaction is exactly what bullies are looking for because they think it gives them power over you, and you don’t want to empower a bully.
  • Save the evidence. The only good news about bullying online or on phones is that it can usually be captured, saved, and shown to someone who can help. You can save that evidence in case things escalate.
  • Reach out for help – Especially if the behavior’s really getting to you. You deserve backup. See if there’s someone who can listen, help you process what’s going on and work through it – a friend, relative or maybe an adult you trust.
  • If someone you know is being bullied, take action. Just standing by can empower an aggressor and does nothing to help. The best thing you can do is try to stop the bullying by taking a stand against it. If you can’t stop it, support the person being bullied.