Changes in drug use patterns reported on the web after the introduction of ADF OxyContin: findings from the Researched Abuse, Diversion, and Addiction‐Related Surveillance (RADARS) System Web Monitoring Program

Vosburg, Suzanne K.; Haynes, Colleen M.; Besharat, Andrea; Green, Jody L.

doi:10.1002/pds.4248

Cited by 13 publications

(13 citation statements)

References 31 publications

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“…Given the danger surrounding some drugs, these unsolicited expressions could shed light in areas that traditional survey instruments cannot. Examples of recent uses of social media data in research include discovering adverse drug events [ 12 ], studying addiction [ 13 ], tracking the popularity of marijuana concentrates [ 14 ], quantifying drug abuse [ 15 ], and characterizing discussion surrounding the introduction of an abuse-deterrent product [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…The Web Monitoring Program, established in 2014, focuses on the collection and organization of real-time web content about prescription drugs from over 150 million sites on the internet, including social media, blogs, and forums. The RADARS System Web Monitoring Program combines qualitative and quantitative data collection methods; a team of trained researchers collect daily opioid-related posts and manually code them for variables of interest [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Online Conversation Monitoring to Understand the Opioid Epidemic: Epidemiological Surveillance Study

Black¹,

Margolin²,

Olson³

et al. 2020

JMIR Public Health Surveill

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Background Between 2016 and 2017, the national mortality rate involving opioids continued its escalation; opioid deaths rose from 42,249 to 47,600, bringing the public health crisis to a new height. Considering that 69% of adults in the United States use online social media sites, a resource that builds a more complete understanding of prescription drug misuse and abuse could supplement traditional surveillance instruments. The Food and Drug Administration has identified 5 key risks and consequences of opioid drugs—misuse, abuse, addiction, overdose, and death. Identifying posts that discuss these key risks could lead to novel information that is not typically captured by traditional surveillance systems. Objective The goal of this study was to describe the trends of online posts (frequency over time) involving abuse, misuse, addiction, overdose, and death in the United States and to describe the types of websites that host these discussions. Internet posts that mentioned fentanyl, hydrocodone, oxycodone, or oxymorphone were examined. Methods Posts that did not refer to personal experiences were removed, after which 3.1 million posts remained. A stratified sample of 61,000 was selected. Unstructured data were classified into 5 key risks by manually coding for key outcomes of misuse, abuse, addiction, overdose, and death. Sampling probabilities of the coded posts were used to estimate the total post volume for each key risk. Results Addiction and misuse were the two most commonly discussed key risks for hydrocodone, oxycodone, and oxymorphone. For fentanyl, overdose and death were the most discussed key risks. Fentanyl had the highest estimated number of misuse-, overdose-, and death-related mentions (41,808, 42,659, and 94,169, respectively). Oxycodone had the highest estimated number of abuse- and addiction-related mentions (3548 and 12,679, respectively). The estimated volume of online posts for fentanyl increased by more than 10-fold in late 2017 and 2018. The odds of discussing fentanyl overdose (odds ratios [OR] 4.32, 95% CI 2.43-7.66) and death (OR 5.05, 95% CI 3.10-8.21) were higher for social media, while the odds of discussing fentanyl abuse (OR 0.10, 95% CI 0.04-0.22) and addiction (OR 0.24, 95% CI 0.15-0.38) were higher for blogs and forums. Conclusions Of the 5 FDA-defined key risks, fentanyl overdose and death has dominated discussion in recent years, while discussion of oxycodone, hydrocodone, and oxymorphone has decreased. As drug-related deaths continue to increase, an understanding of the motivations, circumstances, and consequences of drug abuse would assist in developing policy responses. Furthermore, content was notably different based on media origin, and studies that exclusively use either social media sites (such as Twitter) or blogs and forums could miss important content. This study sets out sustainable, ongoing methodology for surveilling internet postings regarding these drugs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Online Conversation Monitoring to Understand the Opioid Epidemic: Epidemiological Surveillance Study

Black¹,

Margolin²,

Olson³

et al. 2020

JMIR Public Health Surveill

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“…Findings from a recent study in which the Internet was monitored for abuse-related discussions indicated that abusers are more likely to switch to non-ADF opioids than attempt to prepare reformulated ER oxycodone for non-oral abuse (21). There was no evidence of dose dumping from morphine ARER during any tested conditions, unlike the dose dumping noted with crushed ER morphine, which does not contain any abuse-deterrent properties.…”

Section: Discussionmentioning

confidence: 85%

Syringeability of morphine ARER, a novel, abuse-deterrent, extended-release morphine formulation

Kinzler¹,

Pantaleon²,

Iverson³

et al. 2019

The American Journal of Drug and Alcohol Abuse

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Background: Extended-release (ER) morphine formulations are commonly manipulated for nonoral routes of administration, particularly via injection. Morphine ARER, an abuse-deterrent formulation of ER morphine, has both physical and chemical properties that deter abuse. Objectives: To assess the syringeability of morphine ARER using in vitro laboratory studies. Methods: Intact, cut, or crushed morphine ARER tablets were incubated in 1, 5, or 10 mL of room temperature or 90°C water for 1, 5, 10, or 30 min of agitation. Crushed ER morphine tablets were assessed in 10 mL room temperature water. The difficulty to draw the mixture into a syringe was assessed on a scale of 1 (very easy) to 10 (impossible). If the prepared mixture was syringeable, released morphine was measured analytically. Results: Crushed and cut morphine ARER tablets formed a viscous material when subjected to a liquid environment and were rated as "impossible to syringe" in ≤5 mL water and were slightly syringeable in 10 mL water. In contrast, all syringeability tests of crushed ER morphine were rated as "very easy to syringe". After 30 min in room temperature water, crushed ER morphine released 75% morphine whereas intact, cut, and crushed morphine ARER tablets released a maximum of 12%, 12%, and 5% of the total morphine content. Heating extractions resulted in increased morphine release. Conclusion: The difficulty to syringe morphine ARER when manipulated suggests that morphine ARER has abuse-deterrent properties that may deter intravenous abuse.

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“…2 To address challenges of quickly identifying newly emerging synthetic opioids, novel data sources such as web or social media data may serve as potential early warning systems. Prior work has mainly focused on automated identification of messages indicating misuse, 3 detection of online illicit pharmacies, evaluating opinions around certain compounds, 4 understanding spread of norms, and comparing online findings to survey data. 5 However, there is particularly limited work examining fentanyl and fentanyl analogs (now the leading cause of overdose deaths) and limited work that directly compares findings from these novel approaches to death data to describe how much lead time an early warning system based on online data could potentially provide.…”

Section: Introductionmentioning

confidence: 99%

Increases in Online Posts About Synthetic Opioids Preceding Increases in Synthetic Opioid Death Rates: a Retrospective Observational Study

2019

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Changes in drug use patterns reported on the web after the introduction of ADF OxyContin: findings from the Researched Abuse, Diversion, and Addiction‐Related Surveillance (RADARS) System Web Monitoring Program

Cited by 13 publications

References 31 publications

Online Conversation Monitoring to Understand the Opioid Epidemic: Epidemiological Surveillance Study

Online Conversation Monitoring to Understand the Opioid Epidemic: Epidemiological Surveillance Study

Syringeability of morphine ARER, a novel, abuse-deterrent, extended-release morphine formulation

Increases in Online Posts About Synthetic Opioids Preceding Increases in Synthetic Opioid Death Rates: a Retrospective Observational Study

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