Limiting teens’ exposure to drugs online

Parents have understood the importance of keeping an eye on kids’ and teens’ social media activity for years. There are concerns about the platforms being used for online bullying and inappropriate sexual messaging, as well as used by adult predators to contact youths.

However, new concerns have come up regarding social media also becoming a way to sell and purchase drugs. And the Drug Enforcement Administration (DEA) is advising parents about an alarming trend of colorful fentanyl pills being available for purchase online and in person.

“Rainbow fentanyl” — fentanyl pills, powder and blocks that come in a variety of bright colors — is a deliberate effort by drug traffickers to drive addiction among kids and young adults, the DEA reports. The Centers for Disease Control and Prevention (CDC) found that fentanyl, a synthetic opioid that is 50 times stronger than heroin and 100 times stronger than morphine, was responsible for more than 74,000 overdose deaths in 2022.

Why drug use and overdoses have risen
According to a report in the Journal of Substance Abuse Treatment, the COVID-19 pandemic intensified the risk factors for adolescent substance use — which include early life stress, social isolation and boredom — during a time when kids have also been experiencing natural physical, cognitive and social-emotional changes. During this same period, the CDC found the rate of overdose deaths involving synthetic opioids increased over 56%.

Throughout the pandemic, more kids turned to social media to connect with others when in-person connection was challenging, if not impossible. But along with interacting with friends, some kids began communicating with people offering the opportunity to purchase drugs, many of which can be delivered directly to their homes.

“The purchasing of illicit drugs via social media platforms is probably happening more because of the pandemic, but it’s not something that’s new,” says Dr. Kelsey Bradshaw, a clinical child psychologist with Sharp Mesa Vista Hospital. “Social media has become a way for young people to communicate with others. Naturally, these platforms have also become a way that they communicate their needs for substances, and people try to take advantage of that because they assume there’s more anonymity.”

While Dr. Bradshaw suggests that the young people who are purchasing drugs through social media are likely those already involved in substance use, he notes that the increased isolation and boredom could have intensified teens’ curiosity for trying drugs.

“Many young people felt isolated due to limitations of attending school, engaging in activities or seeing friends,” he says. “For some, this may have increased consideration of trying drugs as something to do or to cope with distressing emotions. The challenge with fentanyl is that some young people may not intend to use fentanyl but end up with it, thinking it is something safer.”

An increased risk for overdose and death
Along with being made to look like candy, fentanyl is illicitly added to pills incorrectly labeled as common pain, antianxiety, ADHD or other prescription medications. Some young people unknowingly buy and ingest drugs laced with fentanyl, potentially leading to overdose and even death.

Young people in San Diego are not immune to the risk of drug use, overdose and death. In 2021, the San Diego County Medical Examiner reported 12 children under the age of 18 died from an accidental overdose — the youngest was just 13.

It’s become such a crisis among people of all ages that county officials are now offering naloxone, a medication designed to rapidly reverse opioid overdose at no cost and without a prescription to any person at risk of an overdose or to their loved ones. Naloxone blocks the brain’s opioid receptors and restores normal breathing in people who have overdosed on fentanyl, heroin or prescription painkillers.

What parents can do
So, how can parents ensure kids don’t seek out illegal substances — either online or in person — and what signs of potential drug use should parents watch for? Dr. Bradshaw encourages parents to have discussions with their children, watch for changes in behavior, and monitor their technology and social media for issues beyond just substance use.

“It’s about having those preemptive discussions,” he says. “When it comes to technology and social media use, it’s important to have a good foundation of regularly monitoring kids’ use and having early discussions regarding your expectations and rules surrounding them.”

Signs to watch for
While it can be challenging for parents to determine if changes in behavior are due to pandemic-related stress or might be related to drug use, Dr. Bradshaw recommends parents watch for these signs:

• Their child just doesn’t seem “right” or to be acting like themselves

• Their behavior isn’t typical — acting despondent, aggressive, angry or with fewer inhibitions

• They are sleeping more than usual or up at unusual hours

• They are withdrawn or acting more secretive

• They are no longer interested in friendships or things they once enjoyed

• They are showing physical changes, such as sudden weight loss, frequent nosebleeds, bloodshot or watery eyes, or shakes and tremors

“When you’re noticing any of these signs or have other concerns, it’s time to have a conversation about what might be going on,” Dr. Bradshaw says. “You can gradually bring it up, perhaps by saying something along the lines of, ‘I’m noticing this and I just want to talk to you about it.’”

Dr. Bradshaw suggests that parents refrain from immediately becoming punitive or adamant about setting limits on social media use. Rather, start with an openness to listen to the child and hear their thoughts on the subject and whether they might need help.

Important conversations to have
He says that conversations about drug use can be held in two phases. The first is meant to be exploratory, as opposed to confrontational.

When simply checking in with their child, Dr. Bradshaw suggests parents might say, “I’m hearing these stories about kids trying drugs for the first time by purchasing them on social media, and then some of the kids accidentally overdose because there’s fentanyl in the drugs. Have you heard about this or know anyone who might be doing it? What are your thoughts or concerns about it?”

He then recommends that if a parent has a real concern that their child might be using illegal substances or struggling with the temptation to do so, the parent should try to create an opening to ask direct questions. They might ask, “Have you or your friends ever thought about buying drugs from someone online?” And then reiterate that if they find themselves coming across this — in their own life or within their friend group — they are available to talk with them and provide support.

“It’s about being in tune with your child and looking for opportunities to connect with them,” Dr. Bradshaw says. “Consider whether there are conversations that you should be having with your child now to further your connection and create an open line of communication, so that if something does come up someday, you have a better chance of trying to help them through.”

How to get help
If parents believe their child is experiencing social-emotional challenges or might already be using illicit substances, Dr. Bradshaw recommends they seek treatment from a trained mental health professional. They can start with their child’s or teen’s primary care doctor to discuss any concerns and determine what type of treatment might be appropriate.

If your child is in crisis, the 988 Suicide & Crisis Lifeline is a network of local crisis centers that provide free and confidential emotional support 24 hours a day, 7 days a week. In San Diego, calls and texts made to 988 will be connected to the county’s Access and Crisis Line (ACL), which can also be reached by calling 888-724-7240 or via Up2SD.org. The ACL offers support and resources in over 200 languages from experienced counselors on all behavioral health, mental health and substance use topics.

Additionally, mental health care for people of all ages in San Diego is available at Sharp. Expert medical teams treat anxiety, depression, substance use, eating disorders, bipolar disorder and more. However, if you or a loved one are at immediate risk of self-harm, it is important to go to the nearest emergency room or call 911.

Learn about child and adolescent inpatient and outpatient programs, including substance use programs, at Sharp Mesa Vista Hospital.