JMIR Publications

ABSTRACT

Background:

Non-medical use of prescription drugs can cause overdose (OD) and thus represents a serious public health crisis. In this digital era, social networking services (SNS) provide viable platforms for individuals to acquire excessive amounts of medications, including prescription medications, despite their illicitness. Therefore, dynamically changing methods of illicit trading of medications should routinely be monitored to encourage the appropriate use of medications.

Objective:

To specify characteristics of medications traded on X (the platform formerly known as Twitter), and characteristics of individuals who trade in or use pharmaceutical drugs obtained through X.

Methods:

This is an observational, cross-sectional study, based on the publicly available open data using X (Twitter) posts, conducted between September 18, 2022 and October 1, 2022. X (Twitter) posts that included the term “Okusuri Mogu Mogu” in Japanese during the study period were investigated; “Okusuri” means medications, and “Mogu Mogu” is an onomatopoeia for eating or biting in Japanese. Characteristics of X posts that were retrieved using the search term “Okusuri Mogu Mogu”, and categorization of names of medications within posts related to trading (buying or selling), as well as all hashtags appearing in the posts were analyzed.

Results:

In this cross-sectional study, 549 X posts that included the term “Okusuri Mogu Mogu” in Japanese between September 18, 2022 and October 1, 2022 were identified. Of these posts, 67 (12.2%) and 170 (31.0%) referenced buying and selling of medications, respectively. Among the sum of 237 posts, 1,041 medication names were mentioned. Nervous system drugs were dominant, representing 82.1% of the mentioned medication names, when classified according to the Anatomical Therapeutic Chemical (ATC) classification. Although this trend is consistent with our previous survey conducted in March 2021, the average daily count of medication names was substantially (5-fold) higher. Consequently, the diversity of medications expanded. When a total of 866 hashtags appearing in posts were sorted into six categories, individuals’ desire for “community formation” emerged as a dominant hashtag category.

Conclusions:

Not only stringent pharmacovigilant measures by regulatory authorities to prevent illicit transactions of prescription medications but social approaches that could direct individuals to appropriate medical or psychiatric resources, would also be beneficial to support vulnerable and potentially isolated individuals, particularly those who use SNS. Clinical Trial: This research does not contain RCT.