Social media as an emerging tool for reducing prescription opioid misuse risk factors.

Keith Heinzerling,Hendry Perez,Sung-Jae Lee,Sean D Young,Navkiran Gill,Lillian Gelberg

doi:10.1016/j.heliyon.2020.e03471

Abstract

Interventions are urgently needed to reduce prescription opioid misuse risk factors, including anxiety and concomitant use of sedatives. However, only a limited number of randomized controlled opioid intervention trials have been conducted. We sought to determine whether an online behavior change/support community, compared to a control Facebook group, could reduce anxiety and opioid misuse among chronic pain patients. 51 high-risk non-cancer chronic pain patients were randomly assigned to either a Harnessing Online Peer Education (HOPE) peer-led online behavior change intervention or a control group (no peer leaders) on Facebook for 12 weeks. Inclusion criteria were: 18 years or older, a UCLA Health System patient, prescribed an opioid for non-cancer chronic pain between 3 and 12 months ago, and a score of ≥9 on the Current Opioid Misuse Measure (COMM) and/or concomitant use of benzodiazepines. Participation in the online community was voluntary. Patients completed baseline and follow-up assessments on Generalized Anxiety Disorder screener (GAD-7), COMM, and frequency of social media discussions about pain and opioid use. Compared to control group participants, intervention participants showed a baseline-to-follow-up decrease in anxiety, and more frequently used social media to discuss pain, prescription opioid use, coping strategies, places to seek help, and alternative therapies for pain. Both groups showed a baseline to follow-up decrease in COMM score. Preliminary results support the use an online community interventions as a low-cost tool to decrease risk for prescription opioid misuse and its complications.

Highlights

Prescription opioid misuse and abuse have reached epidemic proportions, nearly quadrupling from 2000 to 2014 [1]
We examined the potential peer-mediated effect on the intervention and found no differences in the Current Opioid Misuse Measure (COMM) and GAD-7 scores across the peer leaders
A 12-week intervention online support community for chronic pain patients at high risk for opioid misuse resulted in reduced anxiety and more frequent discussions about chronic pain and safe opioid management

Summary

Introduction

Prescription opioid misuse and abuse have reached epidemic proportions, nearly quadrupling from 2000 to 2014 [1]. A 2013 study found that prescription opioids were the most frequently misused of all prescription medications, and accounted for more fatal overdoses than cocaine and heroin combined [2, 3]. Despite these complications, opioid prescribing for chronic pain skyrocketed during those years [4]. Interventions that successfully reduce anxiety and risk for prescription opioid misuse might have a important public health impact due to the large number of chronic opioid patients with comorbid mood disorders [6, 7]. Anxiety is a significant risk factor for opioid misuse and abuse, ; a limited number of randomized controlled opioid intervention trials have been conducted to date, with no studies showing improvements in anxiety [8]

Methods

Results

Conclusion