The ‘TikTok Benadryl Challenge’

On April 17 2023, a viral tweet about a deadly “Benadryl challenge” spreading on TikTok claimed that a boy in Ohio died after participating in it:

A different tweet from April 17 2023 made similar claims, crediting the New York Post as a source (and describing TikTok as a “Chinese owned platform”):

A 13 year old boy from Ohio has died after participating in a dangerous trend on TikTok.

The “Benadryl Challenge” sees teens take 12-14 tablets a day while documenting the effects for TikTok videos.

The boy, Jacob Stevens, who was filmed doing the challenge by a group of friends, had a seizure on camera and spent 6 days on a ventilator before tragically dying.

The trend started back in 2020 and that same year a 15 year old girl died while participating in the challenge.

The boys father has called on TikTok to impose safeguards and ID checks before creating an account on the Chinese owned platform.

Source: NY Post

Rumors about TikTok and the “Benadryl challenge” rested on a significant amount of context.

What is Benadryl?

“Benadryl” is a common over-the-counter antihistamine used in North America. Wikipedia briefly summarized its composition and active ingredient relative to market:

In the United States and Canada, the active ingredient [in Benadryl] is diphenhydramine. In the United Kingdom, the active ingredients of Benadryl are the antihistamines acrivastine or cetirizine. Benadryl is also sold as a cough medicine in Australia, India and New Zealand containing diphenhydramine, as well as the antitussive dextromethorphan or the expectorant guaifenesin.

WebMD also maintained a resource page on Benadryl, and GoodRX indicated that the drug was one of the few broadly considered safe for use during pregnancy. According to everydayhealth.com, Benadryl (or diphenhydramine) takes effect in 20 to 30 minutes.

Recreational Use of Benadryl

Wikipedia’s “Benadryl” entry contained a sub-section about recreational usage of Benadryl, applying the scrutiny that was markedly absent from fearmongering tabloid articles about the “Benadryl challenge”:

In May 2020, the Cook Children’s Medical Center in Fort Worth, TX reported that 3 teenagers had been hospitalized as a result of diphenhydramine overdose. They claimed that the teenagers had gotten information on how to abuse Benadryl from the social media app TikTok. That August, an Oklahoma teen reportedly died from a Benadryl overdose. After a later-deleted Facebook post by the teen’s family member claimed that the death was the result of a “Benadryl challenge,” news outlets reported on the dangers of the supposed social media trend. This prompted the FDA to release a statement on the dangers of high doses of diphenhydramine.

In that summary, a detail about the August 2020 “Benadryl challenge” rumor emerged, indicating that the initial “Benadryl challenge” claim originated with a “later-deleted Facebook post” from a family member of the Oklahoma teen.

Wikipedia’s editing logs often provide an inadvertent record of changes in public perception. An archived copy of the Benadryl page as it existed on April 13 2020 lacked several sections visible on the live version. One draft archived on June 24 2020 contained an oddly formatted section about recreational use (with no mention of a “Benadryl challenge”):

Many people have taken a large amount of Benadryl to try to develop a sorta high sensation. The body slowly starts to develop an immunity to the drug.

As a person starts to notice that they are no longer having the same effect as before, tend to increase the dose of Benadryl.

What most do not realize or do not wish to realize is that when they have a cold or fever that the Benadryl may no longer have an effect on their cold due to their body building an immunity to the drug.

There is also a overdose problem that may happen when a person keeps upping the doses of Benadryl. This is a dangerous situation due to the likelihood it could cause a person to have seizures or even worse death…

This is a dangerous drug and should not be abused if you truly believe you or someone you know is in this situation please contact an authorities or someone that may help your loved one. Please talk to them or if you are doing this kind of behavior please identify it in yourself that you may think you do not need help, but you do and do not wait until it is too late.

On the same day, another Wikipedia editor reverted the page and removed the section. The entry remained unchanged between June 24 2020 and November 2 2020, when a section labeled “Benadryl Topical Packaging Change” was added to it; it read:

Johnson & Johnson altered the packaging of Benadryl Itch Stopping Gel after some people mistakenly ingested it. In 2010, The U.S. Food and Drug Administration (FDA) reported over 100 cases of people swallowing the topical medication. This was because people mistaken the packaging of Benadryl Extra Strength Itch Stopping Gel as an oral Benadryl for allergies. The company, Johnson & Johnson has since redesigned the bottle stating “for skin use only” and have added a sticker on top as another precaution.

Finally, on November 14 2020, a sub-section titled “Benadryl challenge” was added under the “Society and culture” section of the Benadryl entry. As of that edit, it read:

Benadryl may have mood-elevating properties and in some cases, has the potential to lead to hallucinogenic effects. Having hallucinogenic effects can be an issue as it leads to potential abuse of the drug for recreational purposes. In August 2020, a 15-year-old teen reportedly died as a result of doing the “Benadryl challenge” on social media app TikTok. The “Benadryl challenge” posted on TikTok dares viewers to intake high doses of Benadryl to induce hallucinations.

In May 2020, Cook Children’s Medical Center in Fort Worth, Texas had warned about the Benadryl challenge after three teens were treated for overdosing on the antihistamine. One of the teens took 14 Benadryl pills in total and ended up having hallucinations and a very high heart rate of 199. Consuming an excessive amount of the drug is very dangerous as it can lead to unpleasant side effects that can even be fatal.

On 24 September 2020, the US Food and Drug Administration (FDA) issued a warning regarding the “Benadryl challenge.” It warned that taking an excessive dose or a higher than recommended dose of the drug can lead to serious health problems like seizures, heart problems, coma, or death. The FDA contacted TikTok and “strongly urged” the social media app to remove any videos relating to the ‘Benadryl challenge”. The manufacturer Johnson & Johnson had also warned people about this “Benadryl challenge” and the risks it possess.

Most material related to the “Benadryl challenge” mentioned the United States Food and Drug Administration (FDA)’s issuance of a “drug safety communication” regarding a “Benadryl challenge” on September 24 2020. Titled “FDA warns about serious problems with high doses of the allergy medicine diphenhydramine (Benadryl),” it explicitly noted the issuance was based on “news reports,” rather than having access to a database of cross-checked and validated reports of challenge-related overdoses:

The U.S. Food and Drug Administration (FDA) is warning that taking higher than recommended doses of the common over-the-counter (OTC) allergy medicine diphenhydramine (Benadryl) can lead to serious heart problems, seizures, coma, or even death. We are aware of news reports of teenagers ending up in emergency rooms or dying after participating in the “Benadryl Challenge” encouraged in videos posted on the social media application TikTok.

We are investigating these reports and conducting a review to determine if additional cases have been reported. We will update the public once we have completed our review or have more information to share. We also contacted TikTok and strongly urged them to remove the videos from their platform and to be vigilant to remove additional videos that may be posted.

In November 2022, we published an article about a similar viral rumor involving “NyQuil chicken.” In both cases, the FDA addressed rumors and speculation, citing “news reports.”

TikTok was almost universally identified as the source of the purported “Benadryl challenge,” but Erowid.org (a database of psychoactive substances) maintained a resource on recreational use of Benadryl. On its entry for Erowid, a “reception” section explained:

Due to the subject matter presented on Erowid.org, the site has drawn praise and criticism from both the media and medical officials. Edward Boyer, an emergency-room physician, and toxicologist, while admitting that Erowid has a plethora of useful information, once argued the site may cause more harm than good to potential drug users. Boyer has since come to cautiously admire [Erowid’s creators], and no longer refers to their site as ‘partisan,’ though he still sometimes argues that Erowid minimizes adverse effects and includes too much unreliable – and potentially harmful – data in its quest to present all sides. ‘Erowid is so comprehensive, and so much of the information is correct that, unless you’re an expert in medical toxicology, you may miss the dangerous information that’s close to the surface.'”

On Reddit, a subreddit devoted to recreational usage of Benadryl (diphenhydramine), r/DPH, was “gated,” although anyone with internet access could view the subreddit by clicking “Continue”:

In spite of readily accessible, long-available recreational Benadryl usage guides across the internet, the relatively new TikTok was named as the sole culprit behind the “spate” of “Benadryl challenge deaths.”

TikTok Trepidation in April 2023

WSYX’s initial story about Jacob Stevens was published on April 15 2023, during a period when TikTok was already firmly entrenched in the news cycle.

On April 14 2023, several outlets reported that lawmakers in the state of Montana “banned” the app. On April 16 2023, Politico.com published “Biden and Congress want to ban TikTok. At this point it may be impossible,” followed by The Verge’s “Republicans demand a ban on lawmakers using TikTok” on April 18 2023.

Politico.com’s reporting provided a geopolitical angle for handwringing over TikTok against a backdrop of tensions between the United States and China. It began by describing a federal-level focus on eradicating TikTok from American devices and app stores:

As the federal government escalates its efforts against TikTok, it’s coming up against a stark reality: Even a politically united Washington may not have the regulatory and legal powers to wipe TikTok off American phones.

A few weeks ago [in early 2023] it looked like the company’s days in America were numbered. President Joe Biden’s administration had just demanded that the Chinese-owned video app be sold or face an outright ban in the United States. That effort quickly drew support from Capitol Hill, and gained momentum after the remarkably bipartisan grilling of the company’s CEO [in March 2023] — with lawmakers accusing TikTok of serving as a Trojan horse for Beijing to “manipulate America” and suck up reams of sensitive data on U.S. citizens.

But now, interviews with lawmakers, legal and national security experts and former officials in two administrations — including some directly involved in the TikTok effort — suggest that a ban may simply face too many hurdles to ever work.

Some insiders are even starting to worry that the government may never be able to meaningfully restrict TikTok’s use — and are considering alternative approaches to mitigate any threat it poses.

In short, the Benadryl challenge emerged amid recurring concerns about the TikTok app itself (described above as a putative “Trojan horse.”)

The New York Post‘s ‘Benadryl Challenge’ Article

On April 17 2023, the New York Post published “Boy, 13, dead after TikTok ‘Benadryl Challenge,’ grieving dad warns other parents.”

The Post indicated its information was sourced from Columbus, Ohio’s WSYX (“Local teen dies attempting Tik Tok challenge, parents warn other families.”) That April 15 2023 article originally reported:

COLUMBUS, Ohio (WSYX) — A local teen is dead after overdosing on an over-the-counter medication. He was trying to copy a Tik Tok challenge.

The teen’s family spoke only with ABC 6.

The challenge was to take 12 to 14 pills, which would create a hallucination, but instead, that overdose killed 13-year-old Jacob Stevens. Jacob’s family told ABC 6 that he was on a ventilator for about a week.

WSYX said that the family of the boy spoke only with the outlet, and the article did not contain any corroboration from medical experts about its claims. WSYX also described two potentially conflicting scenarios: that the teens were innocently mimicking what they saw on TikTok, and that high doses of Benadryl purportedly induced hallucinations — in other words, the drug was being used recreationally.

It looked as if the New York Post‘s April 17 2023 article was a slightly modified version of WSYX’s sparse local reporting. However, it included claims about another death in 2020 for which the “Benadryl challenge” was blamed (before launching into a section about the horrors of TikTok):

Unfortunately, Jacob isn’t the first victim of the Benadryl Challenge.

In August 2020, a 15-year-old girl fatally overdosed on the allergy drug during another ill-fated attempt at the stunt.

Following the spate of deaths, manufacturer Johnson & Johnson issued a public advisory regarding the challenge, warning: “The Benadryl TikTok trend is extremely concerning, dangerous and should be stopped immediately.”

The Food and Drug administration also put out a public service announcement.

“Taking higher than recommended doses of the common over-the-counter (OTC) allergy medicine diphenhydramine (Benadryl) can lead to serious heart problems, seizures, coma or even death,” the agency wrote.

According to both pieces, Stevens died in April 2023 and a teenaged girl died in August 2020; text about the previous fatality linked to another New York Post article. (For the record, “spate” is defined by Oxford Languages as “a large number of similar things or events appearing or occurring in quick succession,” not “two similar things appearing and occurring over the course of nearly three years.”)

Wikipedia’s “Benadryl Challenge” section (on the “Benadryl” entry) provided several citations regarding its mention of the Cook Children’s Medical Center in Fort Worth, Texas in May 2020. One was a WFAA article published on July 14 2020, “Cook Children’s says it treated three teens for Benadryl overdoses in May following TikTok challenge.”

WFAA’s reporting on the initial rumor could be described as an object lesson in inadvertently misleading coverage. It kicked off with “Cook Children’s Medical Center in Fort Worth issued a warning to parents [in July 2020] about the popular video-sharing social media app TikTok after the hospital treated three teens who overdosed on Benadryl (Diphenhydramine) in May [2020].”

The story quoted a nurse practitioner, but neither the staffer nor the outlet seemed to consider that “using common household items to get high” was common prior to and in places other than TikTok. No mention appeared of the many other longstanding guides to recreational use of Benadryl, mentioning only searches of TikTok:

Nurse practitioner Amber Jewison treated all three patients in under a week in May [2020].

Two, she said, were admitted in one day.

In one case, a teen took 14 pills in one night and was rushed to the hospital when she became intoxicated.

“We have seen kids who overdose in suicide attempts,” Jewison said. “But this was different. These kids weren’t trying to harm themselves. They watched a video and it told them exactly how many milligrams to take and to see how it made them feel.”

In a number of videos WFAA found, some users provided step-by-step instructions about taking large amounts of the allergy drug, often accompanied with an energy drink.

“Some colleagues and I watched the videos,” Jewison said. “We had no idea this was happening until they came into the hospital.”

Another citation led to an August 2020 KFOR.com article about the Oklahoma teenager referenced in April 2023 reports about the “Benadryl challenge”; the New York Post claimed in April 2023 that in August 2020, “a 15-year-old girl fatally overdosed on the allergy drug during another ill-fated attempt at the stunt.” By contrast, the KFOR.com piece was titled “Dangerous ‘Benadryl Challenge’ on Tik Tok may be to blame for the death of Oklahoma teen,” and began:

OKLAHOMA CITY (KFOR) – The latest in a growing number of dangerous social media challenges may have resulted in the tragic death of a metro teenager.

Last week, a 15-year-old girl reportedly died from an overdose of Benadryl.

Described by those who cared about her as an otherwise happy and faith-driven teen, she was not one to experiment with drugs.

The article was vague throughout, ending with an unexplained mention of a “deleted” fundraising effort:

The teen’s friends and loved ones are hoping to prevent this tragedy from happening to any other families.

The link to a fundraiser has been deleted from the original source.

WFAA cited a news release from Cook Children’s Center about the “Benadryl challenge,” adding that “officials described the ‘nutmeg challenge’ in the same news release.” In September 2020, Arizona news outlet AZCentral.com reported on guidance with similar language in that state — and attributed the Oklahoma teen’s death to a “challenge”:

“The Banner Poison and Drug Information Center is sharing this as a warning to avoid any potential mishaps that could lead to hospitalizations or worse case scenarios, such as the reported fatality in Oklahoma related to this challenge,” Kramer-Ainza said.

[…]

The Benadryl challenge follows another dangerous TikTok game: the “nutmeg challenge.” In this challenge, TikTok users drink two to four tablespoons of nutmeg with milk or water and film their reactions. The objective is to get high from a large amount of the spice, but doing this can have detrimental effects on the body, according to a study from the American Association for Clinical Chemistry.

We were unable to locate a copy of either press release, but matching language suggested various agencies copied and transmitted it “to avoid any potential mishaps.”

The Real Dangers of Clickbait and Insufficient Reporting

A search of Google News returned an actual spate of news stories reporting a purported “Benadryl challenge” related death in April 2023.

With the exception of Wikipedia, few sites, if any, plainly stated the obvious fact that Benadryl is an over-the-counter drug with a well-known reputation for having recreational applications and hallucinogenic properties. Shoehorning “TikTok challenge” into a headline all but ensures a likelihood the story would spread, and nearly all reporting advised parents to restrict TikTok — the New York Post‘s item read in part:

In light of his son’s tragic death, the devastated Ohioan is also warning parents about the dangers of teens using social media unsupervised.

“Keep an eye at what they’re doing on that phone,” he said. “Talk to them about the situation. I want everyone to know about my son.”

WSYX wrapped their story with the following:

Justin [Stevens] also wants social media platforms like Tik Tok to have age restrictions, including rules like having to provide an ID in order to make an account.

CBS News published “13-year-old Ohio boy dies after attempting the TikTok ‘Benadryl Challenge, his parents say,” reporting:

The tragedy has inspired Jacob’s family to warn other parents to monitor their children’s online activity to avoid anyone else attempting the challenge. His father has also contacted local lawmakers about enacting an age restriction on buying medicine like Benadryl.

The Food and Drug Administration has raised the alarm about overdoses tied to the “Benadryl Challenge” on TikTok for years.

At the very end of the article (under an advertisement), one single sentence read:

Both the company and FDA have advised adults to keep it and other medications out of the reach of children.

Summary

The April 2023 death of an Ohio teen was widely blamed on a “TikTok Benadryl challenge,” and the story emerged during ongoing calls to ban TikTok entirely in the United States. News outlets and the FDA spoke of the “Benadryl challenge” solely as a social media fad, rarely to never mentioning that Benadryl has long served as an over-the-counter intoxicant.

A clickbait New York Post item claimed that a “spate” of “TikTok Benadryl challenge” deaths had taken place, citing a disputed incident in Oklahoma in 2020 and the April 2023 fatality in Ohio. A CBS News article noted in the headline that the claim was uncorroborated.

Viral news articles sensationalizing the “TikTok Benadryl challenge” not only misidentified the risk as TikTok (ignoring myriad internet guides on recreational use of Benadryl), they failed to emphasize the dangers of using household products to get high. That omission led to clicks and shares, but actively and dangerously concealed the likeliest explanation: teenagers experimenting with the only intoxicants readily available to them.