Firsthand Opiates Abuse on Social Media: Monitoring Geospatial Patterns of Interest Through a Digital Cohort

In the last decade drug overdose deaths reached staggering proportions in the US. Besides the raw yearly deaths count that is worrisome per se, an alarming picture comes from the steep acceleration of such rate that increased by 21% from 2015 to 2016. While traditional public health surveillance suffers from its own biases and limitations, digital epidemiology offers a new lens to extract signals from Web and Social Media that might be complementary to official statistics. In this paper we present a computational approach to identify a digital cohort that might provide an updated and complementary view on the opioid crisis. We introduce an information retrieval algorithm suitable to identify relevant subspaces of discussion on social media, for mining data from users showing explicit interest in discussions about opioid consumption in Reddit. Moreover, despite the pseudonymous nature of the user base, almost 1.5 million users were geolocated at the US state level, resembling the census population distribution with a good agreement. A measure of prevalence of interest in opiate consumption has been estimated at the state level, producing a novel indicator with information that is not entirely encoded in the standard surveillance. Finally, we further provide a domain specific vocabulary containing informal lexicon and street nomenclature extracted by user-generated content that can be used by researchers and practitioners to implement novel digital public health surveillance methodologies for supporting policy makers in fighting the opioid epidemic.Comment: Proceedings of the 2019 World Wide Web Conference (WWW '19

Patterns of Routes of Administration and Drug Tampering for Nonmedical Opioid Consumption: Data Mining and Content Analysis of Reddit Discussions

The complex unfolding of the US opioid epidemic in the last 20 years has been the subject of a large body of medical and pharmacological research, and it has sparked a multidisciplinary discussion on how to implement interventions and policies to effectively control its impact on public health. This study leverages Reddit as the primary data source to investigate the opioid crisis. We aimed to find a large cohort of Reddit users interested in discussing the use of opioids, trace the temporal evolution of their interest, and extensively characterize patterns of the nonmedical consumption of opioids, with a focus on routes of administration and drug tampering. We used a semiautomatic information retrieval algorithm to identify subreddits discussing nonmedical opioid consumption, finding over 86,000 Reddit users potentially involved in firsthand opioid usage. We developed a methodology based on word embedding to select alternative colloquial and nonmedical terms referring to opioid substances, routes of administration, and drug-tampering methods. We modeled the preferences of adoption of substances and routes of administration, estimating their prevalence and temporal unfolding, observing relevant trends such as the surge in synthetic opioids like fentanyl and an increasing interest in rectal administration. Ultimately, through the evaluation of odds ratios based on co-mentions, we measured the strength of association between opioid substances, routes of administration, and drug tampering, finding evidence of understudied abusive behaviors like chewing fentanyl patches and dissolving buprenorphine sublingually. We believe that our approach may provide a novel perspective for a more comprehensive understanding of nonmedical abuse of opioids substances and inform the prevention, treatment, and control of the public health effects

The Pursuit of Peer Support for Opioid Use Recovery on Reddit

Individuals suffering from Opioid Use Disorder and other socially stigmatized conditions often rely on peer support groups to find comfort and motivation while treating their condition. Many may face barriers in accessing peer support treatment, such as shame and social stigma, seclusion, or mobility restrictions. In this study, we quantitatively characterize the potential of the Reddit community in offering these individuals an online alternative to receiving peer support. By analyzing the social interactions of thousands of users during the start of opioid use recovery, we uncover that a particular Reddit community exhibits many characteristics similar to in-person peer support groups, featuring the exchange of support, trust, status, and similar experiences. We find that the supportive behavior of this community nudges users to change their personal behavior, and promotes abandoning opioid-related communities in favor of recovery-oriented relationships. Finally, we find that recognition, acknowledgment, and knowledge exchange are the most relevant factors in sustained engagement with the recovery community. Given this evidence, we suggest that this online community may constitute a complement or a surrogate to peer support groups when in-person meetings are not desirable or possible. Our work might inspire harm reduction policies and interventions to favor successful rehabilitation and is fundamental for future research about the use of digital media for recovery support