JMIR Publications

ABSTRACT

Background:

Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding potential harmful effects of excessive and disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the APA and is recognized as a behavioral addiction by the WHO. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement.

Objective:

This study aimed to identify substance use patterns and health-related concerns among gamers.

Methods:

We used the public streaming Reddit API to collect and analyze all posts from the popular subreddit, r/stopgaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances which may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative guidelines for IGD, as proposed by the APA. A Chi-Square Test of Independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD.

Results:

10,551 posts were collected from Reddit from 6/2017 – 12/2022. After filtering the dataset for substance-related keywords, a total of 1,057 were included for further analysis of which 286 mentioned both gaming and the use of one or more substances. Among posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing-games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD were identified in 191 (66.8%) posts. More than half, 62.9% (n=180), of posts discussed a health issue, with the majority of those posts (n=144) citing mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a statistically significant association between IGD and substance use (p<0.001) based on a Chi Square test and there was a significantly increased odds of IGD among those who self-reported substance use (OR=2.20, p<0.001) as well as those who discussed mental health (OR=1.57, p<0.001).

Conclusions:

As gaming becomes more prevalent, better understanding of the interplay and convergence between disordered gaming, substance use, and negative health impacts can inform the development of interventions to mitigate risks and promote healthier gaming habits.