Barriers to opioid use disorder treatment: A comparison of self-reported information from social media with barriers found in literature

Abstract

IntroductionMedications such as buprenorphine and methadone are effective for treating opioid use disorder (OUD), but many patients face barriers related to treatment and access. We analyzed two sources of data—social media and published literature—to categorize and quantify such barriers.MethodsIn this mixed methods study, we analyzed social media (Reddit) posts from three OUD-related forums (subreddits): r/suboxone, r/Methadone, and r/naltrexone. We applied natural language processing to identify posts relevant to treatment barriers, categorized them into insurance- and non-insurance-related, and manually subcategorized them into fine-grained topics. For comparison, we used substance use-, OUD- and barrier-related keywords to identify relevant articles from PubMed published between 2006 and 2022. We searched publications for language expressing fear of barriers, and hesitation or disinterest in medication treatment because of barriers, paying particular attention to the affected population groups described.ResultsOn social media, the top three insurance-related barriers included having no insurance (22.5%), insurance not covering OUD treatment (24.7%), and general difficulties of using insurance for OUD treatment (38.2%); while the top two non-insurance-related barriers included stigma (47.6%), and financial difficulties (26.2%). For published literature, stigma was the most prominently reported barrier, occurring in 78.9% of the publications reviewed, followed by financial and/or logistical issues to receiving medication treatment (73.7%), gender-specific barriers (36.8%), and fear (31.5%).ConclusionThe stigma associated with OUD and/or seeking treatment and insurance/cost are the two most common types of barriers reported in the two sources combined. Harm reduction efforts addressing barriers to recovery may benefit from leveraging multiple data sources.

Which Social Media Platforms Provide the Most Informative Data for Monitoring the Opioid Crisis?

“…Many research groups have also created models to automatically identify posts on X and Reddit with discussion related to opioids. (42,43,109,(124)(125)(126)(127) Others have used these platforms to characterize factors that influence opioid use, recovery, and the opioid epidemic generally (6,8,(128)(129)(130)(131)(132), with particular interest shown to the impact of the COVID-19 pandemic (103,120,(133)(134)(135)(136)(137)(138)(139) and co-use between opioids and other drugs (140,141).…”

A linguistic analysis of dehumanization toward substance use across three decades of news articles

“…Computational linguistics and natural language processing methods have been used in several substance use related tasks. These include public perceptions of medical cannabis use (43), Reddit-based self-reported barriers to treatment seeking (12), and identifying emerging drug-related words and slang (44). At the population level (e.g., U.S. counties and states), a handful of studies have examined social media language and substance use rates, such as excessive drinking (45, 46), opioid mortality (47,48), and, more generally, pharmacovigilance (49).…”

“…The War on Drugs, in particular, embedded dehumanizing policies into both the criminal justice and healthcare systems, dramatically increasing incarceration and negatively impacting the health and well-being of communities (9). Since the dehumanization of PWUS contributes to stigma, it is thus associated with lower support for non-discriminatory drug laws (10), inhibited helpseeking behavior (11,12), and worse health outcomes (13). Understanding historical patterns of dehumanization and consequently discovering mitigation protocols are significant public health and public policy concerns.…”