'Parents Need to Stay on Top' of Which Emojis Are Codes for Drugs, Expert Says — Here's a List – PEOPLE

Countless messages, comments and posts are dedicated to drug sales on the internet, and parents must be aware of efforts — from local vendors to larger criminal groups — to market illicit substances to their children, experts say.
"That could be social media, internet pharmacies or the dark web," Dr. Tim K. Mackey, the CEO of S-3 Research and a professor of global health at UC San Diego, tells PEOPLE. "A lot of the dealers are involved in all three of those areas or multiple platforms at the same time. They then deliver the drugs through the mail or through food-delivery services."
In the process, dealers often use emojis as code language, prompting the DEA to release an emoji chart that reviews everything from dealer signals to counterfeit pills, many of which are made of the highly dangerous synthetic opioid fentanyl. Drug traffickers often mix the substance with other drugs because it's cheap to manufacture, a small amount goes a long way, and, if it doesn't kill you, it quickly ensnares one in addiction.
While counterfeit pills (see the emoji chart below) can look just like standard prescriptions — such as the stimulant Adderall or painkillers like Percocet — they are completely fake and often lethal.
And they're everywhere. In 2021, the DEA seized 20.4 million fake pills and 15,000 pounds of fentanyl powder. Laboratory analysis in 2021 revealed that four of every 10 fake pills with fentanyl contained a potentially lethal dose. 
RELATED: Counterfeit Meds Sold on Social Media Are Killing Kids: 'My Son Took One Pill and Died,' Says Mom
According to the DEA's One Pill Can Kill public-awareness campaign, Fentanyl is as much as 100 times more powerful than morphine. In fact, the CDC says that synthetic opioid (mainly fentanyl) overdose and poisoning is the leading cause of death for those ages 18-48 and is getting worse.
For more about the faces of America's fentanyl epidemic and the fight to end it, pick up the latest issue of PEOPLE, on newsstands Friday, or subscribe here.
It all raises the question: How can parents protect their children?
First, be aware of the emojis that drug dealers often use online when peddling their wares, Mackey says.
These emojis (see the chart above) are used as a menu to describe what a seller has available, the mode of delivery, and the seller's contact information. Sometimes the emojis are used with hashtags, sometimes with text.
"Unfortunately, they're very dynamic and change over time," says Mackey, "and parents need to stay on top of them."
Mackey also advises that parents keep tabs on all deliveries and packages that come to the home, including those being transported by trusted food delivery services and popular shipping carriers.
"A lot of product comes domestically and isn't scanned or inspected the same way it'd be if it came internationally," he says.
RELATED: Fentanyl-Related Deaths Are Surging in Black American Communities: 'The Numbers Are Astronomical,' Says Expert
Plus, seek to understand why your child might be using encrypted communications apps, he suggests, "because these platforms tend to expose youth to higher-risk content."
He also points out that he sees the internet being used for drug-marketing purposes — but then the actual transaction later occurs on a different platform or a more private platform where the communication is more message-to-message.
As for when dangerous habits might be formed, research "points to high-stress events for kids and young adults, such as finals week, as triggers for initiation into substance use disorder," Mackey says.
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Finally, he suggests that parents keep an eye on their kids' digital social circles.
"These are different than in-person social circles," he says, "and they can impact real-world behavior."

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