NEJM Interview: Jerry Avorn on the role of litigation in addressing product-related damage to health.

In March 2026, YouTube and Meta faced judgments related to unsafe and addictive social media products. These cases follow other high-profile examples of litigation serving as a last resort after policymakers had failed to address evidence that products could harm the health of their users. I'm Stephen Morrissey, Managing Editor of the New England Journal of Medicine, and I'm talking with Jerry Avorn, a professor of medicine at Harvard Medical School, co-director of the Program on Regulation, Therapeutics, and Law at Harvard Medical School and Brigham and Women's Hospital, and the author of the book Rethinking Medications. Dr. Avorn has written a perspective article about the role of the courts in limiting product-related damage to people's health. Dr. Avorn, could you start by talking a bit about these March cases? What were the claims, and what did the juries decide?

Well, there was a question or a concern going back many years that social media might be designed in a way that is almost intended to potentially harm the mental health of vulnerable users, particularly adolescents. And there's been very interesting, both anecdotal and epidemiological evidence that young people who are extensive users of social media might be presented by design with information that may worsen mental health problems, whether it is about self-harm or isolation or eating disorders. And that seems to be an issue which we've not been able to come up with any either regulatory or legislative solutions to curb that problem.

So what's the current state of those March cases? What were the judgments, and are we looking at appeals?

Yeah. We always are looking at appeals in our legal system, at least until it gets to the Supreme Court. And there were some eye-popping judgments. One was for three hundred and seventy-five million dollars in a case brought by the attorney general of the State of New Mexico. Concurrently, there was another judgment of nine million dollars, and in a separate jurisdiction in Texas, there was another very large multi-million dollar decision, all of which concluded that the various social media platforms, Meta and YouTube in particular, had designed their products in a way that would, in a sense, increase addiction to them among vulnerable people, and then present them with information on their scrolls that would actually lead to potential damage to their mental health or to self-harm. Now, yes, in the second part of your question, of course, everything is always subject to appeal, and we do not know now since these cases are so recent. Of course, the social media companies will appeal, and what will happen on appeal at the moment is anyone's guess.

And then looking at Congress and the executive branch, what actions have they taken or considered taking to protect consumers from the potential health harms of social media products?

Well, as listeners and readers will know, there's been a lot of talk about it, but there has been really very, very little to emerge that anybody could recognize as strong regulation on the executive side or strong legislation on the congressional side. And in a sense, that relates to the theme of my piece, which is when