Abstract
BackgroundThe 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.ObjectiveThis study leverages Reddit, a social media platform, 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.MethodsWe used a semiautomatic information retrieval algorithm to identify subreddits discussing nonmedical opioid consumption and developed a methodology based on word embedding to find 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. 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.ResultsWe identified 32 subreddits discussing nonmedical opioid usage from 2014 to 2018 and observed the evolution of interest among over 86,000 Reddit users potentially involved in firsthand opioid usage. We learned the language model of opioid consumption and provided alternative vocabularies for opioid substances, routes of administration, and drug tampering. A data-driven taxonomy of nonmedical routes of administration was proposed. We modeled the temporal evolution of interest in opioid consumption by ranking the popularity of the adoption of opioid substances and routes of administration, observing relevant trends, such as the surge in synthetic opioids like fentanyl and an increasing interest in rectal administration. In addition, we measured the strength of association between drug tampering, routes of administration, and substance consumption, finding evidence of understudied abusive behaviors, like chewing fentanyl patches and dissolving buprenorphine sublingually.ConclusionsThis work investigated some important consumption-related aspects of the opioid epidemic using Reddit data. 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.
Highlights
BackgroundIn the last decade, the United States witnessed an unprecedented growth of deaths due to opioid drugs [1], which sparked from overprescriptions of semisynthetic opioid pain medication such as oxycodone and hydromorphone and evolved in a surge of abuse of illicit opioids like heroin [2,3] and powerful synthetic opioids like fentanyl [4,5]
Leveraging and expanding a recent methodology proposed by Balsamo et al [30], we identified a large cohort of opioid firsthand users and characterized their habits of substance use, administration, and drug tampering over a period of 5 years
We investigated the temporal unfolding of the popularity of the opioid substances, measured as the fraction of authors mentioning a substance over the entire opioid firsthand user base, for each trimester from 2014 to 2018
Summary
BackgroundIn the last decade, the United States witnessed an unprecedented growth of deaths due to opioid drugs [1], which sparked from overprescriptions of semisynthetic opioid pain medication such as oxycodone and hydromorphone and evolved in a surge of abuse of illicit opioids like heroin [2,3] and powerful synthetic opioids like fentanyl [4,5]. Researchers have estimated the prevalence of routes of administration for nonmedical prescription opioids [9,31,32,35] and opiates [36,37]; they rarely consider less common ROA, such as rectal, transdermal, or subcutaneous administration [32,38], leaving the mapping of nonmedical and nonconventional administration behaviors greatly unexplored [39,40] Many of these studies [31,32,35] acknowledge that drug tampering, that is, the intentional chemical or physical alteration of medications [41], is an important constituent of drug abuse. 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
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