Harm reduction and knowledge exchange—a qualitative analysis of drug-related Internet discussion forums

Abstract

BackgroundNovel psychoactive substances (NPS) are continuously and increasingly appearing on the international drug market. Global Internet forums are a publicly available reality where users anonymously discuss and share information about NPS. The aim of this study was to explore and characterize the discussions about NPS on international Internet forums.MethodsThe most post-frequent NPS discussions were collected from three “leading edge” international Internet forums. A total of 13,082 posts from 60 threads of discussion were systematically examined and interpreted to reveal recurring topics and patterns. Each thread was coded with emerging topics and supporting quotations from the data set. Eventually, codes with coherent meaning were arranged into 51 broader categories of abstraction, which were combined into four overarching themes.ResultsFour themes emerged during the analysis: (1) uncovering the substance facts, (2) dosage and administration, (3) subjectively experienced effects, and (4) support and safety. The first theme dealt primarily with substance identification, pharmacology, and assessed not only purity but also legal status and acquisition. The second theme focused on administration techniques, dose recommendations, technical talk about equipment, and preferred settings for drug use. The third theme involved a multitude of self-reported experiences, in which many different aspects of intoxication were depicted in great detail. The users emphasized both positive and negative experiences. The last theme incorporated the efforts of the communities to prevent and minimize harm by sharing information about potential risks of the harmful effects or contraindications of a substance. Also, online support and guidance were given to intoxicated persons who experienced bad or fearful reactions.ConclusionsThe findings showed that the discussions were characterized by a social process in which users supported each other and exchanged an extensive and cumulative amount of knowledge about NPS and how to use them safely. Although this publicly available knowledge could entail an increase in drug use, the main characteristics of the discussions in general were a concern for safety and harm reduction, not for recruiting new users. Drug-related Internet forums could be used as a location for drug prevention, as well as a source of information for further research about NPS.

Codeine use, dependence and help-seeking behaviour in the UK and Ireland: an online cross-sectional survey

“…A link to the survey was posted via Facebook, Twitter, discussion forums, newsletters, and email circulars, namely from (i) websites dedicated to health, pain and medicine use; (ii) drug addiction organisations; (iii) an online drug discussion forum, where users share their experiences of drug use; 16,17 (iv) e-mail circulars to staff and students at two universities to include young people. The main inclusion criteria for the study was use of medicines containing codeine (prescribed and non-prescribed) in the last three months.…”

From “herbal highs” to the “heroin of cannabis”: Exploring the evolving discourse on synthetic cannabinoid use in a Norwegian Internet drug forum

“…This way of describing the dosage and administration of the drug, as well as the subjectively experienced effects, is common in trip reports shared online (Soussan & Kjellgren, 2014). In the time that followed, several members experimented with the new drugs and posted their experiences for others to read, contributing to a large base of online user-derived information.…”

“…For adolescents or people curious about drugs, the nature of this information is of interest because it has the potential to alter the drug use behaviour of those who obtain it (Norman, Grace, & Lloyd, 2013). Although publicity could entail an increase in drug use, online discussions can also be characterized by a concern for safety and harm reduction among drug users (Soussan & Kjellgren, 2014), and can be framed in a way that privileges the pleasures of getting high (Barratt, Allen & Lenton, 2014). This shows the importance of the Internet for access to userrelevant information about illegal drugs, and it displays the uniqueness of the market for new psychoactive substances, in which online networking sites seem to play a crucial part in marketing and raising awareness of new products (Griffiths et al, 2010).…”

Poisoning Casualties: Alcohol, Pharmaceuticals or “Legal Highs”? Poisoning Cases at Emergency Rooms in The Swedish County Värmland in 2007-2013

“…Furthermore, the prevalence rate of drug-related injury cases is known to be lower when the statistics build on self-reports, as in the case of IDB, in contrast to blood or urine analysis [15]. It has also been documented that individuals under the influence of NPS-induced medical conditions have turned to online drug discussion forums for help instead of emergency rooms [16]. The factors above indicate that drug users tend to avoid emergency health care or abstain from stating the cause of the poisoning for fear of social stigmatisation or legal consequences (consumption of illicit drugs is illegal in Sweden).…”