JMIR Publications

ABSTRACT

Background:

The complex unfolding of the US opioid epidemic in the last twenty years has been the subject of a large body of research in the medical and pharmacological areas and it has sparkled a multidisciplinary discussion on how to implement interventions and policies to effectively control its impact on public health.

Objective:

In this work, leverage the social media platform Reddit as the primary data source to investigate the opioid crisis. We aim at finding a large cohort of Reddit users interested in non-medical use of opioids and at tracing the temporal evolution of their interest. We develop a methodology to include slang vocabulary, and we extensively characterize patterns of non-medical consumption of opioids, with a focus on routes of administration and drug tampering.

Methods:

We use a semi-automatic information retrieval algorithm to identify subreddits discussing nonmedical opioid consumption. We develop a methodology based on word embedding to find alternative slang and colloquial terms referring to opioid substances, routes of administration, and drug tampering methods. We model the preferences of adoption of substances and routes of administration estimating their prevalence and temporal unfolding. Ultimately, through the evaluation of odd ratios based on co-mention, we measure the strength of association between opioid substances, routes of administration, and drug tampering.

Results:

We identify 32 subreddits discussing non-medical opioid usage during 2014-2018, and we observe the evolution of interest of over 86K Reddit users potentially involved in firsthand opioid usage. We learn the language model of opioid consumption and provide alternative vocabularies of opioid substances, routes of administration, and drug tampering. We propose a data-driven taxonomy of non-medical routes of administration. We model the temporal evolution of interest in opioid consumption: we rank the popularity of adoption of opioid substances and routes of administration, observing relevant trends such as the surge of synthetic opioids like fentanyl and the increasing interest in rectal administration. We measure 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.

Conclusions:

In this work, we investigate some important consumption-related aspects of the opioid epidemic using Reddit data. We believe that our approach may give a novel perspective for a more comprehensive understanding of non-medical abuse of opioids substances, and it may inform the prevention, treatment, and control of the public health effects.