Digital Health Technology Shows Promise for Efforts To Address Drinking Among Youth

A group of people in a circle looking at their cell phones.

Underage drinking and alcohol misuse by young adults are serious public health concerns in the United States. The 2022 National Survey on Drug Use and Health (NSDUH) found that 15.1% of people ages 12 to 20 and 50.2% of people ages 18 to 25 reported drinking alcohol in the past month, with 8.2% of 12- to 20-year-olds and 29.5% of 18- to 25-year-olds reporting binge drinking in the past month.1,2 Surveys also consistently find that young people are among the biggest users of the internet and mobile devices.

“There is an urgent need for innovative interventions to prevent alcohol misuse among our nation’s young people,” said National Institute on Alcohol Abuse and Alcoholism (NIAAA) Director George F. Koob, Ph.D. “Internet and mobile technologies have the potential to significantly expand our prevention efforts.”

In December 2023, NIAAA held a webinar, “Harnessing Technology and Social Media to Address Alcohol Misuse in Adolescents and Emerging Adults,” featuring NIAAA-supported research conducted by Maureen Walton, M.P.H., Ph.D., of the University of Michigan and Mai-Ly Steers, Ph.D., of Duquesne University.

In her talk titled “Optimizing Prevention of Alcohol Misuse and Violence Among Adolescents and Emerging Adults,” Dr. Walton discussed the importance of early interventions and how strategies that address multiple factors simultaneously may be more effective in preventing alcohol misuse over time. She also emphasized the potential benefits of more selective alcohol prevention interventions for youth at risk for binge drinking, as opposed to universal interventions that are designed to reach a broader age group.

Dr. Walton, Rebecca Cunningham, M.D., and colleagues previously developed SafERteens. SafERteens is a single-session, motivational interview-based intervention delivered by a therapist to youth ages 14 to 18 during an emergency department visit for a medical illness or injury. The researchers found that alcohol-related consequences and severe aggression were reduced in the year following the intervention.

Dr. Walton’s team has expanded SafERteens to include digital boosters such as telehealth sessions with a health coach and text messages to reduce violence and alcohol misuse. Preliminary data from a recent study show that participants who received SafERteens plus digital boosters reduced their alcohol consumption, their involvement with violence, and the consequences associated with alcohol use and violence over the course of the study.

“Digital technology is an exciting and feasible way to extend interventions and prevention to youth in real time in their daily lives,” said Dr. Walton.

In her talk, “Social Media Use - Friend or Foe? How It Has Been Problematic Yet Holds Promise for Addressing College Drinking,” Dr. Steers discussed the relationship between social media and alcohol consumption, particularly among college students. Although much about social media’s influence on alcohol use is unknown, research has consistently found a link between young people’s exposure to alcohol-related social media posts and their alcohol consumption and related problems. Alcohol-related social media posts by young people have also been found to be robust predictors of alcohol consumption and problems.

Dr. Steers and her colleagues are examining factors that influence young people’s susceptibility to alcohol-related social media content and the individual differences that affect their drinking patterns. The researchers have found that some of the main reasons that college students who drink post alcohol-related content on social media are to obtain attention and approval from their peers and to convey status or popularity. In addition, exposure to other people’s alcohol-related content may normalize drinking and portray it as socially rewarding, both of which can in turn influence a student’s alcohol consumption.

Although social media is linked to increased alcohol misuse, it also holds promise for addressing alcohol misuse among college students. Dr. Steers and her team are working to develop novel interventions targeting students ages 18 to 26 who drink excessively and who are also avid social media users. As a step toward a more standardized measure for research, her team created an alcohol-related content and drinking scale in which students use their alcohol-related posting behavior to recall their drinking retrospectively. The researchers are using this tool within the context of personalized normative feedback−a brief intervention that corrects perceptions of normal behavior−by giving people feedback on their self-reported drinking and their perceptions of how much they think their peers drink.

“Given that we know for sure that social media is a major source of social influence, future research should really try to leverage it as a tool to promote the reduction of drinking,” said Dr. Steers.

Dr. Koob added, “Digital technology offers a path into people’s daily lives and can reach people where they are and on their terms. Therefore, it provides opportunities to reach broader segments of society, from people who are reluctant to get help for an alcohol problem to youth who may be at risk for initiating or escalating alcohol use.”

NIAAA also supports a variety of other studies that are leveraging social media and other technologies to develop novel alcohol prevention and treatment interventions for youth. Such studies include:

  • Developing social media-inspired games to help reset perceptions of normal behaviors surrounding alcohol
  • Expanding use of existing mobile phone-based apps to reduce alcohol-related sexual assault on college campuses as well as to reduce alcohol use and post-traumatic stress disorder after sexual assault
  • Using virtual reality to provide insight into alcohol’s effects on behavior


1 Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. 2022 National Survey on Drug Use and Health. Table 2.27B—alcohol use in past month: among people aged 12 or older; by age group and demographic characteristics, percentages, 2021 and 2022. [cited 2023 Dec 8]. Available from: https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs2022/NSDUHDetTabsSect2pe2022.htm#tab2.27b

2 SAMHSA, Center for Behavioral Health Statistics and Quality. 2022 National Survey on Drug Use and Health. Table 2.28B—binge alcohol use in past month: among people aged 12 or older; by age group and demographic characteristics, percentages, 2021 and 2022. [cited 2023 Dec 8]. Available from: https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs2022/NSDUHDetTabsSect2pe2022.htm#tab2.28b