The 764 Network is an unprecedented threat to pediatric health. As an EM physician, and as a parent that has seen the effects of 764 firsthand, we know the dangers that online networks like this pose.
The 764 Network was founded by Texas teenager Bradley Cadenhead. Cadenhead regularly blackmailed and sextorted children as he navigated multiple online platforms using hundreds of accounts. He rapidly gained online notoriety for forcing minors to engage in self-harm, and then post violent and sexual imagery of themselves, material he then used for blackmail and recruitment. Other tactics 764 uses include forced drug use, animal abuse, sextortion, and physical assault.
764 is now a decentralized and global network. In recent months, 764’s popularity has significantly increased; the FBI is currently investigating hundreds of 764-related cases. The group’s international presence is also rapidly spreading. Splinter groups include “CVLT” and the “8884” network. Together, these groups form an online ecosystem of cybercriminals collectively referred to as the “COM“.
The depravities that COM-affiliated groups engage in is due to Nihilistic Violent Extremism (NVE). Born in a misanthropic worldview that aims entirely to accelerate the violent collapse of society, NVE networks include online groups such as 764, the COM, and the True Crime Community, and can be found on every major online platform.
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Twenty-one months after I nearly lost him to suicide, my son opened up about what led him into NVE. Social isolation and the fear of school shootings drove him to a very dark view of the world. His story was about losing belonging and hope.
Increasingly extreme and violent content in his social media feeds did not help. Socially isolated and sliding into a major depressive episode, he became exactly the profile these networks are built to find: isolated, neurodiverse, and disaffected.
Parents have been told to discuss online activity with their children and to look for direct messages. Unfortunately, this is insufficient. Firstly, children often hide their online activity. Many platforms also erase history and messages.
Second, no one needs to direct message your child to entrap them. My son never had a direct message exchange with anyone in 764, yet he was likely hours away from live-streaming his suicide and has permanent scars from NVE self-harm. As a passive consumer, he watched 12 to 14 hours of NVE and gore content a day, self-harming to “just feel something,” carving symbols into his body to find belonging. If parents say, “He doesn’t talk to strangers online, I checked,” that does not clear him. Algorithms and passive consumption are just as dangerous.
There may be no suicide plan, but a child victimized by 764 can be pushed to suicide within minutes or die after taking self-harm too far. And unfortunately, with the increasing rates of pediatric self-harm and suicidal ideation, clinicians have almost normalized these risk factors.
In my son’s case, I knew something was terribly wrong. Both of us begged for more intensive treatment, but were dismissed because he had no specific suicide plan. By the time we reached the ED, he had self-harm cuts deep enough to leave permanent scars. My son told the staff he did not want to die, but had blacked out from blood loss during a recent self-harm incident, and was terrified of his suicidal thoughts.
But because he did not have a specific plan, we were placed on a weeks-long list for a partial hospitalization program and told to take him home. I had no idea what 764 was. He did not admit to the staff that he had a secret online life. I just knew that if I took him home, he may not make it through the night.
Clinicians noted that he had extensive self-harm, some of which resembled Satanic imagery. They missed that these were cut signs for 764, despite FBI bulletins warning of these images. 764 coerces minors into cutting numbers or symbols into their bodies, sometimes livestreaming the self-harm. This can quickly escalate into Child Sexual Abuse Material (CSAM), creating another risk factor for impulsive suicide.
The problem is the question itself. “Does he have a plan?” screens for SI. It does not screen for coerced or ritualized self-harm. A child can be actively harming himself, can be sextorted, can be edging toward violence against himself or others while truthfully telling you he has no plan. He has likely been desensitized to harm, leaving him vulnerable to a life-ending split-second decision. Traditional triage tools do not adequately screen for NVE.
Elementary-age children can be exposed to NVE through mainstream gaming platforms. At 7, my son was exposed to real-life gore content on Roblox. Gaming spaces are key for 764 exploitation, especially Minecraft and Roblox. 764 members follow a carefully planned strategy, initially contacting a victim through these spaces, then inviting them to more private spaces like Discord, where the victim can be groomed, sextorted, and possibly recruited.
A clinician asking about video games will get false reassurance if the parent is going by ratings rather than actual content. This also happens with multiple social media platforms. Innocuous video titles allow NVE to fly under the radar of parents and even platform content detection.
The exposure window opens early. Concerning clinical features include increasing social isolation, intense secrecy regarding online activities, mental health issues, fascination with violent nihilism, and participation in online communities based around violent imagery and gore.
What clinicians can do
Screening for internet usage behaviors is difficult, and limited by a traditional focus that does not account for NVE. We recommend the following open-ended questions:
- “Has the amount or type of harm changed recently? Has it gotten more intense, or started including new symbols or numbers?”
- “Can you walk me through what this represents?”
- “Have you ever taken a photo of it, or been asked to?”
- “Is there anyone online you feel like you’re doing this for, or that you’d want to show?”
- “What have you been watching online?”
- “When you’re online, is there a place or group you go to that feels important to you?”
- “Is there anyone online who knows you well, better than people in person, maybe?”
If self-harm reads as ideological, ritualistic, or numeric, that is worth further investigation. If the family says the self-harm has increased or has a sense that their child’s mental health is decompensating, believe them.
As a child spirals further down the escalation path, they may increasingly hide their online activity and appear more flat and hopeless in mood affect rather than in crisis as they become resigned to a nihilistic worldview. But this means intensive treatment is all the more urgent, before it is too late.
Matthew Turner is an emergency medicine physician at Penn State Milton S. Hershey Hospital in Hershey, Pennsylvania. His scholarship spans emergency medicine, military medicine, infectious disease, medical history, and the intersection of medicine with warfare and public health. He has authored more than 35 peer-reviewed publications, with work appearing in Cureus, Military Medicine, the Emergency Medicine Journal, Emerging Infectious Diseases, the American Journal of Neuroradiology, and other journals.
Dr. Turner has long been interested in the intersection of medicine and history, with publications examining historical disease outbreaks, biological and chemical warfare, ancient pathology, toxicology, and military medical lessons. His work has explored topics ranging from yellow fever and anthrax as possible tools of biological warfare to the medical legacy of historical figures such as Akhenaten, Henry I, Justinian II, and Dominique-Jean Larrey. He also writes about the evolving world of counterinsurgency and counterterrorism, including modern conflict medicine and the use of chemical weapons by violent non-state actors. Professional updates are available on LinkedIn.
Dana Grueser is a parent advocate.
