Opioid use stigmatization and destigmatization in health professional social media

Abstract

Stigmatization of opioid use constitutes a significant barrier to addressing the opioid crisis. Increasing use of social media by health professionals provides an opportunity to foster destigmatization. However, little is known about stigmatization and destigmatization within health professional social media Accordingly, this study investigates the use of stigmatizing and destigmatizing language in four Twitter communities: Medical, Public Health, Epidemiology, and Mental Health. Using a dataset of 33,981 tweets discussing opioids within these communities, we analyzed tweets for evidence of stigmatizing or destigmatizing language. Use of stigmatizing language is generally low and use of destigmatizing language is variable across communities. Additionally, there are measurable changes in language use on quarterly bases between 2009 and 2021. Mental Health shows a 7.1% quarterly reduction in the frequency of tweets with stigmatizing language (IRR = 0.928, 95% CI 0.877 to 0.984, p = .0159). Mental Health also shows a 5% quarterly increase in the frequency of destigmatizing tweets (IRR = 1.05, 95% CI 1.02–1.09, p = .00258). Medical Twitter experienced a 37% quarterly increase in destigmatizing tweet frequency (IRR = 1.37, 95% CI 1.15–1.64, p = .00291), and Public Health a 16% increase (IRR = 1.16, 95% CI 1.11–1.20, p =0.00000000373). Unfortunately, a regression discontinuity design shows a decrease in Public Health’s use of destigmatizing language since the emergence of COVID-19. While the longitudinal findings are promising, they also indicate a need for increased efforts to encourage broader use of destigmatizing language, especially post-COVID.