JMIR Publications

ABSTRACT

Background:

In 2021, the United States (US) experienced a 14% rise in fatal drug overdoses totaling 106, 699 deaths, driven by harmful opioid use, particularly among individuals in the perinatal period who face increased risks associated with opioid use disorders (OUD). Increased concerns about the impacts of escalating harmful opioid use among pregnant and postpartum persons is rising. Most of the current limited perinatal OUD studies were conducted using traditional methods, such as interviews and randomized controlled trials to understand OUD treatment, risk factors, and associated adverse effects. However, little is known about how social media data, such as X, formerly Twitter, can be leveraged to explore, and identify broad perinatal OUD trends, disclosure and communication patterns, and public health surveillance about OUD in the perinatal period.

Objective:

Our objective is threefold: First, we aim to identify key themes and trends in perinatal OUD discussions on platform X. Second, we aim to explore user engagement patterns, including replying and retweeting behaviors. Third, we investigate computational methods that could potentially streamline and scale the labor-intensive manual annotation effort.

Methods:

We extracted 6 million raw perinatal-themed tweets posted by global Twitter users during the Opioid Epidemic from May 2019 to October 2021. After data cleaning and sampling, we used 500 tweets related to OUD in the perinatal period by US X users for a thematic analysis using NVIVO software.

Results:

Seven major themes emerged from our thematic analysis: (1) political views related to harmful opioid and other substance use, (2) perceptions of others' substance use, (3) lived experiences of opioid and other substance use, (4) news report articles concerning opioid and other substance use, (5) healthcare initiatives, (6) adverse effects on children's health due to parental substance use, and (7) topics related to non-opioid substance use. Among these seven themes, our user engagement analysis revealed that themes (4) and (5) received the highest average retweet count, and theme (3) received the highest average tweet reply count. We further found that different computational methods excel in analyzing different themes.

Conclusions:

Social media platforms such as Twitter can serve as a valuable tool for analyzing real-time discourse and exploring public perceptions, opinions, and behaviors related to maternal substance use, particularly, harmful opioid use in the perinatal period. More health promotion strategies can be carried out on social media platforms to provide educational support for the OUD perinatal population.