Key takeaway
SAMHSA's technology protocol says social networks and online mutual-help groups can offer support across distance, and a kind of anonymity a local room cannot. The same protocol says those tools create new risks, and that technology should add to in-person care rather than replace it. No company is recommended.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
A phone can be the way you find a meeting in another time zone, and it can also be the way last night's party arrives in your hand. SAMHSA's TIP 60 holds both facts at once. Social networking and online mutual-help groups offer support that crosses geography, and a kind of anonymity that an in-person room cannot. The same paragraph says those tools expose people to new risks. Providers should know both sides and help clients reduce internet security and privacy risks.
The protocol is not meant to replace in-person contact. Technology-assisted care can supplement treatment, prevention, and recovery support, and it can reach people who might not get help otherwise. It is also not meant to promote any particular tool or any company that builds or hosts one. A referral conversation does not pick a favorite app either.
If a post leaves you thinking about suicide, call or text 988. If someone may be overdosing or will not wake, call 911. A comment thread is not emergency care.
What the support side actually is
Online mutual-help is a meeting or a conversation that does not require you to be in the same town. Crossing distance, and a kind of anonymity an in-person room cannot offer, is the opening TIP 60 names. It is not a finding that typing is better than sitting with people.
It is also not clinical care by another name. A visit with a clinician is the telehealth guide. A public group is not that visit. A peer specialist and a mutual-aid meeting are separated from a referral line on the peer-support guide. An online group can be mutual aid. It is not a prescription. SMART Recovery, a mutual-help program with its own meetings, is described in the overview. The wider circle of people, not accounts, is the support-network guide. A screen can be one door into it. TIP 60's point is that the door does not close the others.
Images are triggers, not just content
NIDA describes craving cues that include images related to drug use, social situations that remind someone of using, and contact with the drug itself, along with stress, places, and moods. Cognitive behavioral therapy, on NIDA's treatment page, is partly practice for meeting those cues without returning to use. The cue can be a picture. It does not have to be the drug in the room.
The Matrix handbook says triggers are people, places, objects, feelings, and times, and that the brain associates them with substance use. One trigger can move a person toward use. The first coping step it names is to prevent exposure when you can. A photo of friends who use, of a bar, or of the drug is exposure of that kind. Leaving the image, muting the account, or not opening the app is the same idea as not walking into the bar. It is a behavior change. It is not a moral score, and a picture can still land.
Cravings differ by person. Two people can see the same image and not feel the same urge. An acute craving, in that NIDA description, can last as long as 20 minutes. That is a description of duration. It is not a plan to sit alone with suicidal thoughts or with chest pain until a timer ends. The science stays on the triggers guide. The counseling side is the relapse-prevention guide.
Privacy is a separate problem from craving
TIP 60's privacy chapter tells programs to help people shrink the risks that come with seeking support online. Health information on a phone is one of those risks. What a treatment program may tell someone else is a different question, on the privacy guide. A caption you publish is still a choice you control.
A clinician's portal is not a story for a public account. A recovery group that asks you to use your full name, your workplace, or your address is asking for more than the anonymity point in TIP 60. You can decline. You can also decide that telling some people is part of how you want to live. The protocol does not assign that choice. It does say the risks are new, which means an old habit of posting everything is worth a second look.
SAMHSA's protocol does not publish a daily minute limit for people in recovery. "Use it less" is not a plan. "This account shows drugs, alcohol, or people I used with, so I am done following it" is the exposure step the Matrix handbook already describes.
FindTreatment.gov lists programs if the feed is standing in for care you do not have.
Call or text (800) 653-9376 if you want help sorting programs.
Additional Resources
Sources cited on this page:
- SAMHSA TIP 60, Part 2, Chapter 2: Internet security and privacy (NCBI Bookshelf)
- SAMHSA TIP 60: Using Technology-Based Therapeutic Tools in Behavioral Health Services (NCBI Bookshelf)
- NIDA: Product Prototypes to Combat Drug Craving
- NIDA: Treatment
- SAMHSA Matrix Intensive Outpatient Treatment: Client's Handbook (SMA15-4154)
- 988 Suicide & Crisis Lifeline
- SAMHSA FindTreatment.gov
Common Questions
Does SAMHSA recommend a particular app or network?
No. TIP 60 says it is not meant to promote any particular technology-based tool or any company that builds or hosts one. It describes a category: social networking and online mutual-help. A product review is outside that document.
Can an online group replace treatment or a local meeting?
TIP 60 says electronic media are not meant to replace in-person contact. Technology-assisted care can supplement treatment and can reach people who might not otherwise get help. Distance and a kind of anonymity are the openings it names. They are not a full plan of care. The telehealth guide is the clinical visit. A public feed and an online group are a different hour.
Why can a post make me want to use?
NIDA says images related to drug use, social situations that remind someone of using, and being around the drug can set off craving, along with stress, places, and moods. SAMHSA's Matrix handbook says the brain links people, places, and objects with use, and that preventing exposure is the first way to interrupt that path. A photo can be the exposure. Leaving it applies that step. The handbook's own example is cash, not an app, and leaving a photo is not a guarantee the urge stays gone.
Is it safe to post that I am in treatment?
TIP 60 says online support exposes people to new risks, and that clients should get help minimizing security and privacy risks. A public post is not the same as a clinical record. Records from a substance use program can fall under a federal privacy rule, explained on the privacy guide. A post you control is still visible to people you may not have meant to tell.
What if I see something and then feel unsafe?
Close the app and get a person. If you might act on thoughts of suicide, call or text 988. If someone will not wake, cannot breathe, or may be overdosing, call 911. An online group is not an emergency service. NIDA says an acute craving can last as long as 20 minutes, and that the urge can override a firm intention not to use. Do not wait out chest pain, a seizure, or suicidal thoughts inside a comment thread.