Center for Injury Research and Prevention

Neknomination: A Dangerous New Trend in Social Media

June 10, 2014

Peer pressure and cyber bullying are unfortunate, but increasingly well-studied, facets of adolescent life. But what if these two behavior-influencing tactics were combined and used to fuel an over-the-top drinking game? In a new phenomenon called “Neknominate,” this is exactly what occurs. The Neknominate game involves individuals posting videos of excessive, rapid alcohol consumption on social media sites and nominating someone else to “top it” (with video evidence) within 24 hours. Neknominate is the subject of a recent editorial published in Clinical Pediatrics, authored by myself and my colleague Kevin Osterhoudt, MD, MS, medical director of the Poison Control Center at CHOP and an associate fellow at the Center for Injury Research and Prevention at CHOP. 

As Dr. Osterhoudt and I researched this new and dangerous social media trend, one of the more surprising elements was the age range of the known Neknominate-related fatalities this year. In the United Kingdom and the Republic of Ireland, five Neknominate-related deaths were reported in February 2014 among young men ages 19-29 (four from alcohol poisoning and one from drowning after drinking). Why would older teens and adults engage in such risky behaviors?

To gain some insight, I spoke with my CHOP colleague Tracy Evian Waasdorp, PhD, whose expertise includes aggression and bullying, relational aggression, and peer relationships. Dr. Waasdorp explained that in these scenarios, the extreme nature of the drinking game is negated by the number of people who are watching. In other words, the broad audience provided by social media makes the behavior seem positive to those who participate. Other examples of extreme social media “dares” such as the cinnamon challenge and the ice and salt challenge, with countless participants and millions of YouTube views, demonstrates this mindset.

Having a large audience coupled with the fact that a young adult’s brain is still developing (the prefrontal cortex controlling mood and impulses may not fully mature until age 25), Neknominate provides an allure that some youth are unable to turn down. According to Dr. Waasdorp, Neknominate also highlights discrepancies in behavior choices in the “real world” versus the “virtual world.” Many of today’s teens and young adults have grown up with access to social media, and we are still just beginning to understand how this impacts their behavior. Things teens would not necessarily do in person feel less risky online.

Although there have yet to be any reported fatalities attributed to Neknomination in the United States, it is important for medical professionals, school personnel, and parents to be aware of this trend. Just as is the case with more “traditional” forms of bullying, cyber bullying is reduced through awareness, empathy, and a better understanding of the consequences.