Examining stigma relating to substance use and contextual factors in social media discussions

Abstract

BackgroundStigma associated with substance use can have severe negative consequences for physical and mental health and serve as a barrier to treatment. Yet, research on stigma processes and stigma reduction interventions is limited. AimWe use a social media dataset to examine: 1) the nature of stigma-related experience related to substance use; and 2) salient affective and temporal factors in the use of three substances: alcohol, cannabis, and opioids. MethodsWe harvested several years of data pertaining to three substances – alcohol, cannabis, and opioids – from Reddit, a popular social networking platform. For Part I, we selected posts based on stigma-related keywords, performed content analysis, and rendered word clouds to examine the nature of stigma associated with these substances. In Part II, we employed natural language processing in conjunction with hierarchical clustering and visualization to explore temporal and affective factors. ResultsIn Part I, internalized stigma was most commonly exhibited. Anticipated and enacted stigma were less common in posts relating to cannabis compared to the other two substances. Work, home, and school were important contexts in which stigma was observed. Part II showed that temporal markers were prominent; post authors shared stories of substance use journeys, and timelines of their experience with quitting and withdrawals. Shame, sadness, anxiety, and fear were common, with shame being more prominent in alcohol-related posts. ConclusionOur findings highlight the importance of contextual factors in substance use recovery and stigma reduction and offer directions for future interventions.