Tag: ethics

The ‘Benadryl Challenge’ started in 2020, and like most social media trends, over time, it fizzled out into cyberspace. The challenge calls for participants to record themselves taking fatal doses of Benadryl – around 300mg, which is 12 times the recommended adult dosage – in pursuit of hallucinations, or a euphoric “high”.

Ironically, the same reasons that got Benadryl (diphenhydramine) pushed to the back of the line when selecting antihistamines, are the very reasons it has regained relevance today. In recent years, the trend has resurfaced on social media platforms, mainly TikTok. Several factors make this challenge appealing to the impressionable youth, such as “going viral”, social validation, and seeking community on the internet amongst their peers. When misused, Benadryl can lead to fatal events not limited to heart rhythm disturbances, irreversible organ damage, seizures, coma, and death.

Benadryl blocks H1 receptors throughout the airways, heart muscles, and central nervous system (CNS), which halts common allergy symptoms and provides adequate relief. Though it is effective for allergy symptom relief, Benadryl crosses the blood brain barrier, binds to H1 receptors in the CNS, and yields unfavorable side effects like drowsiness and sedation. Additionally, Benadryl blocks muscarinic cholinergic receptors, and causes anticholinergic side effects like blurred vision, drowsiness, confusion, urinary retention, and others.

The first report of a death linked to the Benadryl Challenge was a 15-year-old girl in Oklahoma in 2020. In September that same year, the FDA issued a statement warning the public of the dangers of the Benadryl Challenge and encouraged TikTok to remove videos of people participating in the challenge from its platform. TikTok has since barred the hashtags “Benadryl Challenge” and “Benadryl” to discourage users from participating – a responsible gesture indeed. Yet, despite these efforts, the risky challenge has since resurfaced and claimed the lives of 3 teenagers in Connecticut within the past 2 months.[1] This year, America’s Poison Centers have documented 6,179 Benadryl-related calls from teenagers between the ages of 13-19, the highest call volume since the challenge began 6 years ago.[2]

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How do we protect our youth?

Healthcare professionals:

• Educate yourselves on social media trends and challenges that involve Benadryl and other substances
• Provide side effect and overdose counseling when discussing antihistamines, and other OTC medications to further educate patients

Parents and guardians:

• Have open conversations with your children about the dangers of the Benadryl Challenge
• If any signs of a coma or seizure occur, call 9-1-1 immediately
• For urgent guidance during a suspected overdose, call the Poison Control Help line at 1-800-222-1222 to be connected to a trained healthcare professional

Ultimately, with the growing influence of social media, it is imperative that as a collective, we foster an open, judgement-free environment for our youth. One in which we can have honest conversations about peer pressure, substance misuse and the potential dangers of social media trends.

 

[1] https://portal.ct.gov/oca/-/media/oca/oca-recent-publications/oca-statement-diphenhydramine-and-safe-storage-2026-06-10.pdf?rev=1feb34995f34436cbb121d417264c506

[2] https://abcnews.com/GMA/Wellness/amid-social-media-challenge-calls-poison-centers-benadryl/story?id=133796755

Utah is the first state to automize prescription refills through an artificial intelligence (AI)-driven platform: Doctronic. No active doctor reviewing in real time. No healthcare provider oversight. Just AI. The AI-driven platform originally went live in late 2023, but it was not until December 2025, that the state of Utah partnered with the platform to provide care to the residents of Utah.

How Does Doctronic actually work?

The patient completes a questionnaire regarding their symptoms and medication history; subsequently, the interface determines whether a prescription renewal is appropriate. The initial prescription must be written by a doctor, and the program is limited to 190 maintenance drugs that it can refill. Painkillers, injectables, controlled substances and substances for attention disorders are excluded. 

What Problems Does it Aim to Solve?

Three in four Americans navigate life trying to manage their chronic conditions.^[1] Yet people can wait up to an entire month for a primary care visit in several states. This lapse in care results in delays in therapy. Indeed, it is common for a provider to see the patient for a follow up appointment when starting a new therapy, or before approving refills for a maintenance medication. Those of us working behind the counter see first-hand, the prevalence and complexity of this issue. Medication adherence is far more than a term providers lecture patients about. Medication non-adherence is the single, most preventable healthcare crisis that burdens Americans, and it is responsible for approximately 125,000 deaths and accounts for 10% of hospitalizations annually.^[2]

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A common reason for non-adhearance is patients simply not understanding why they are taking the medication and its significance. This is where pharmacists can fill in the gaps and provide adequate counselling at the pharmacy counter. However, automating the prescription renewal process and removing a health care provider completely, does not foster an environment for thorough, personalized counseling. This could potentially lead to unfavorable outcomes when managing chronic conditions. How well can AI communicate the importance of medication adherence when the encounter is not even face-to-face?

Doctronic also boasts an anonymity feature, and claims that no data is stored in their records. This could present obvious challenges, as there would be no opportunity to follow up between visits, and no access to medication history beyond what the patient provides, which often is inaccurate or incomplete. 

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Can a patient-AI relationship rival a patient-provider relationship?

There have been legitimate concerns raised by several organizations as to the clinical soundness of this program. The Utah Academy of Family Physicians stated “[w]ithout the involvement of a trained healthcare provider, we risk the possibility of negative drug interactions…lack of clarity around how and when a patient will be referred to their physician, and the risk of misuse or abuse.” 

The intake survey places a considerable amount of responsibility on the patient to be able to self-identify their symptoms, and to recount which medications they are currently taking as well as the appropriate dose. From my experience, the amount of patients who could independently do so, is few and far between. 

More importantly, if Doctronic can supply up to 90-day supplies for refills, is it possible for a patient to go extended periods of time without visiting their primary care provider? Does this inclusion of AI come with the tradeoff of valuable patient-provider relationships? Is it a possible answer to the barriers people face to visit providers, or does it reinforce the growing mistrust of healthcare providers? 

Final Thoughts: Advancing With Caution

These questions, and several more, should be carefully considered before other states join Utah and fully integrate AI into their healthcare practices as a provider. We will continue to monitor developments and update the community accordingly. 

^[1] https://www.cdc.gov/chronic-disease/about/index.html

^[2] https://psnet.ahrq.gov/issue/hospital-admissions-associated-medication-non-adherence-systematic-review-prospective