JMIR Publications

ABSTRACT

Background:

There is growing concern around the use of sodium nitrite (SN) as an emerging means of suicide, particularly among younger people. Given limited information on the topic from traditional public health surveillance sources, we studied posts made to a suicide discussion online forum, ‘Sanctioned Suicide’, a primary source of information on use and procurement of SN.

Objective:

This study aims to determine the trends in SN purchase and usage, as obtained from data mining of the online forum ‘Sanctioned Suicide’. We also determine substances and topics commonly co-occurring with SN, and the geographical distribution of users and sources of SN.

Methods:

We collected all publicly available posts on Sanctioned Suicide from its inception in March 2018 to October 2022. Using data-driven methods including natural language processing and machine learning, we analyzed the trends in SN mentions over time, including the locations of SN consumers, and the sources from which SN are procured. We developed a transformer-based source/location classifier to determine the geographical distribution of the sources of SN.

Results:

Posts pertaining to SN show a rise in popularity and statistically significant correlations with real-life usage of SN with suicidal intent when compared to data from CDC Wonder (⍴=0.7266, P<.001) and the National Poison Data System (⍴=0.86587, P=.001). We observed frequent co-mentions of antiemetics, benzodiazepines, and acid regulators with SN. Our proposed machine learning based source/location classifier is able to detect potential sources of SN with an accuracy of 72.92%, and showed consumption in the United States and elsewhere.

Conclusions:

Vital information about SN and other emerging mechanisms of suicide can be obtained from online forums.