National trend data indicate that more lives have been lost due to opioid overdoses than individuals that have died in armed conflict (e.g. wars) since World War II (1). Opioid misuse has always been a concern, but the increase pressure and marketing from pharmaceutical companies resulted with over 10 million people misusing prescription opioids in 2018 (2). These high rates of misuse, abuse, and overdose led to the federal government declaring the national opioid crisis a public health emergency. While mortality attributed to opioid overdose affects nearly all age groups, the Substance Abuse and Mental Health Services Administration (SAMHSA) data indicate that opioid misuse is highest in individuals in their early to late 20’s (3).
As the opioid epidemic continues, there are three distinct waves in the rises of opioid death. The current third wave began in 2013 and is attributed to significant increases in overdose deaths involving synthetic opioids, particularly those with fentanyl. Opioid-related overdose death rates, especially those associated with illicitly manufactured fentanyl and fentanyl analogs, have been rapidly increasing among all age groups (4). There has also been a rising trend of polysubstance use related to overdose deaths involving synthetic products in combination with other drugs, such as heroin, benzodiazepines, methamphetamine, and cocaine (5, 6).
One of the Centers’ for Disease Control and Prevention (CDC) strategies to combat the opioid overdose epidemic includes increasing public awareness about opioid overdoses and to make safe choices about opioids (3). Another key strategy to address opioid-related overdoses is the distribution of naloxone. The availability of naloxone, an opioid antagonist which rapidly reverses the effects of an opioid overdose, is a first line of defense in countering the incidence of opioid-related overdose deaths (7). These strategies recognize that people who use drugs can be informed and encouraged to do so in safer ways to prevent opioid overdoses and deaths.
The popularity and extensive use of social media by many individuals has expanded in the last decade with 90% of adults between the ages of 18 and 29 reported using at least one social media site (8). With its relative ease, convenience, and privacy, social media is an ideal platform for individuals to gather and discuss topics related to opioids. Online data collection can facilitate access to hard-to-reach groups that may be marginalized from research, such as current opioid misusers (9). Reddit is an online social media platform where millions of people from around the world post, vote, and comment in communities organized around their interests. Reported Reddit users (“Redditors”) are young, with 22% of adult users between 18 and 29 years old (10). Reddit allows users to post freely with more anonymity. Reddit posts are unique in that there is no limit to the length of posts, information is moderated through readers’ voting, and information can be posted without verification. Users can post within “subreddits” on various topics, and create new posts, or respond to the posts of others to create discussions. Redditors are allowed to anonymously post and comment in a variety of subtopics with no character limits in self-moderated discussions (11, 12). While these conversations are occurring on Reddit, these posts do allow for more opening sharing than what is observed through other less anonymous social media platforms, which is less anonymous.
Previous research has supported the promise of Reddit as an effective platform for health promotion (13, 14). Reddit posts can be a source of lay information regarding opioids. These platforms also allow for the shaping of social norms among users. This study seeks to understand the nature and significance of Reddit discussions regarding opioid overdoses and safe choices. These informal and social posts provide insight into the complexities and nuances of the opioid epidemic. This work seeks to understand the meanings created by individuals who are using opioids and understanding their world view. Reddit has the potential for designers of health communication, aimed at persuasive opioid messaging, to test their messaging (Silberman & Record, 2021). Additionally, the text mining of Reddit data may better inform providers of health prevention services, community verified alternative addition treatment (15). This exploratory research examines a large dataset of Redditors comments by computationally collecting and cleaning data and thematically analysing the comments.