Harnessing the Power of Social Media to Understand the Impact of COVID-19 on People Who Use Drugs During Lockdown and Social Distancing

Abstract

Objectives:This paper uses a social media platform, Reddit, to identify real-time experiences of people who use drugs during the COVID-19 lock-down.Methods:Reddit is a popular and growing social media platform, providing a large, publicly available dataset necessary for high performance of machine learning and topic modeling techniques. We used opioid-related “subreddits,” communities where Reddit users engage in conversations about drug use, to examine COVID-19-related content of posts and comments from March to May 2020. This paper investigates the latent topics of users’ posts/comments using Latent Dirichlet Allocation, an unsupervised machine learning approach that uncovers the thematic structure of a document collection. We also examine how topics changed over time.Results:The final dataset consists of 525 posts and 9284 comments, for a total of 9809 posts/comments (3756 posts/comments in r/opiates, 1641 in r/OpiatesRecovery, 1203 in r/suboxone, and 3209 in r/Methadone) among 2342 unique individuals. There were 5256 posts/comments in March; 3185 in April; and 1368 in May (until May 22). Topics that appeared most frequently in COVID-19-related discussions included medication for opioid use disorder experiences and access issues (22.6%), recovery (24.2%), and drug withdrawal (20.2%).Conclusions:During the first three months of the COVID-19 pandemic, people who use drugs were impacted in several ways, including forced or intentional withdrawal, confusion between withdrawal and COVID-19 symptoms, take-home medication for opioid use disorder issues, and barriers to recovery. As the pandemic progresses, providers and policymakers should consider these experiences among people who use drugs during the early stage of the pandemic.

Synthesizing evidence on the impacts of COVID-19 regulatory changes on methadone treatment for opioid use disorder: Implications for U.S. federal policy

“…40,42 The review shows that, as a result of such frustrations, some individuals felt they had to self-manage withdrawal or reported that they wished to stop methadone treatment altogether (El-Bassel, 2022; Krawczyk 2021). 37,51 These experiences described align with long-running complaints about care provided by OTPs among methadone patients. 14 In designing its new take-home rules, SAMHSA could help address these issues, such as allowing patients to appeal an OTP's decision around take-homes or otherwise request a second opinion.…”

“…The review reveals that, in the context of pandemic flexibilities, patients often viewed their lack of access to take-homes as unjust, discriminatory, burdensome, and expressed concern at being required to come to the clinic daily even in the midst of a pandemic (Krawczyk 2021, Harris, 2021; El-Bassel, 2022). 37,40,51 Some patients with ongoing substance use or who lacked housing were frustrated that they were excluded from take-home privileges, and others voiced frustrations about being given increased take-home doses that were subsequently rolled back (Lavender 2021; Suen, 2022; Harris, 2021). 32,38,40 Some were denied additional doses and not believed by staff when their doses had spilled, lost, or were stolen from them (Nobles, 2021; Harris, 2021).…”

Investigating Substance Use via Reddit: Systematic Scoping Review

“…Studies, n (%) Description Reasons mentioned [19][20][21]23,25,[28][29][30][31]33,35,[37][38][39]42,45,49,[52][53][54][55][56]60,65,72,73] 26 (43) The anonymous nature of Reddit enables a more candid and open discussion of stigmatized topics.…”

“…Anonymous data [18,19,[21][22][23][26][27][28][29][30][31]33,34,38,45,55,57,60,61,65,[72][73][74][75] 24 (40) Reddit is one of the most popular social networking sites.…”

Accelerating Opioid Use Disorders Research by Integrating Multiple Data Modalities

“…Additionally, pre-existing imaging data can be used to identify neural features, such as reduction in subcortical integrity, associated with OUD [77]. Patterns and motives of use can even be extracted from social media [78][79][80]. One study identified comments and conversations on suicide among opioid users on Instagram, representing a key health risk factor for OUD on a platform heavily utilized by young adults [80].…”