A variety of behavioral, environmental, developmental, and genetic factors have been documented as contributing to the development of Substance use disorders (SUDs) in youth. For example, it has been suggested that things such as the perceived availability of substances, familial history of anti-social behavior, personal attitudes favorable towards drug use all have strong correlations to the development of substance use in youth [1]. What’s especially troubling is that use initiation at younger ages is also correlated with stronger likelihoods of developing a SUD [2]. Thus, it is crucial that researchers continue to explore contributing factors to youth’s likelihood of substance use.

            It is no secret that today’s youth is the largest consumer of social and digital media. Contemporary media can profoundly influence youth body-image ideals and expose them to unhealthy products and behaviors [3,4]. From this, it would be logical to assume that media’s portrayal of substance use and abuse could have a profound effect on children and adolescents’ views of substances as well as their likelihood to initiate use and potentially develops SUDs. As television and media became more accessible to the average family around the turn of the century, astute scientists began to explore this possible link. In 1997, Bahk discovered in a sample of 224 college students that those who were exposed to media portraying alcohol consumption without the associated negative consequences developed far more favorable attitudes to substance use than those who viewed the same media with the consequences included [5]. Utilizing a similar procedure in 2001, Bahk also found that positive portrayals of alcohol use seemed to increase favorable attitudes towards use in college students. Just as importantly, Bahk also concluded “… the greater the role attractiveness of the drinking character, the more favorable the viewer's attitudes toward drinking and the more potent his or her behavioral dispositions to drink alcohol.” Media as we know it has exponentially grown and expanded since the beginning of this century, and thus it is crucial that we revisit this subject in order to better understand its contemporary implications [6].

            It has been suggested that many young individuals today view their favorite TV show characters as “super peers” and that a large amount of substance consumption by these characters has a significant amount of influence over subsequent viewer drinking behavior [7]. What compounds this issue is that in an examination of the five most popular with youth TV shows between the years of 2002 and 2012 a majority of the episodes sampled (n=125, 83%) contained references to alcohol usage [7].

So how have such effects been playing out in this past decade, one might ask?  In 2013, a study of 1,787 7^th and 8^th graders from 16 different middle schools located across California was conducted, focusing on the reciprocal longitudinal associations between alcohol/drug related media exposure and subsequent alcohol use [8]. The researchers specifically examined exposure to alcohol/drug use through the media platforms of Internet videos, social networking sites, movies, television, magazine advertisements, songs, and video games. Tucker and colleagues discovered that greater substance use media exposure during 7^th grade was significantly associated with higher probabilities of alcohol use in 8^th grade; these results were stable across both gender and ethnicity. Recent studies have continued to find support that social media substance use exposure contributes to the risk of personal use and abuse in adolescents [9,10].

            This effect only continues as one advances in age, and even seems to persist among traditionally considered ‘low-risk’ populations. In a 2014 study was conducted involving 2,346 adolescents who reported never having drank and intent to not do so within the next 12 months, as measured at baseline. At a one-year follow-up, 40% of the sample had begun to use alcohol, with 6% already participating in binge drinking behaviors. After controlling for numerous other outside factors, the authors concluded that alcohol use portrayal in popular movies to youth was a significant independent risk factor for the initiation of drinking [11].

            It is worth noting that these types of trends have also been documented outside the U.S. Hanewinkel and colleagues discovered that the correlation between exposure to alcohol use in movies and subsequent likelihood of adolescent alcohol use and binge drinking was found across six unique European nations [12]. Such trends have even been documented outside of Western cultures overall [13].

            Such effects may not be limited to just visual media; with the growing popularity of music streaming sites such as Soundcloud and Spotify, entire libraries of music are now far more accessible to youth than ever before. And it turns out substance references are increasing in this genre as well; Hardcastle and colleagues found that “…alcohol references increased sharply between 2001 and 2011, when almost one in five (18.5%) songs referred to alcohol and one in eight (12.6%) to heavy drinking.” [14]. Other evidence has found that these references usually frame substance use in a positive manner and highlight positive emotions accompanying use [15]. Further research is needed in order to better map out the most likely large effects music has on influencing the likelihood of substance use in youth populations.

            It’s clear that the multitudes of contemporary media forms can have profound effects on the likelihood of substance use in youth populations. So, what can be done? Besides ceasing the prevalent glorification, some experts believe that the key resides in utilizing media’s power to portray the negative effects of substance use. Movies such as Beautiful Boy, or music from bands such as Black Sabbath serve as good examples of media displaying the severe personal and relational damage that can accompany SUDs [16]. Such accurate portrayals of the negative consequences of substance use may serve as a protective factor against the development of youth SUDS, however further research is needed.