Identifying and Characterizing Medical Advice-Seekers on a Social Media Forum for Buprenorphine Use

Abstract

Background: Online communities such as Reddit can provide social support for those recovering from opioid use disorder. However, it is unclear whether and how advice-seekers differ from other users. Our research addresses this gap by identifying key characteristics of r/suboxone users that predict advice-seeking behavior. Objective: The objective of this analysis is to identify and describe advice-seekers on Reddit for buprenorphine-naloxone use using text annotation, social network analysis, and statistical modeling techniques. Methods: We collected 5258 posts and their comments from Reddit between 2014 and 2019. Among 202 posts which met our inclusion criteria, we annotated each post to determine which were advice-seeking (n = 137) or not advice-seeking (n = 65). We also annotated each posting user’s buprenorphine-naloxone use status (current versus formerly taking and, if currently taking, whether inducting or tapering versus other stages) and quantified their connectedness using social network analysis. To analyze the relationship between Reddit users’ advice-seeking and their social connectivity and medication use status, we constructed four models which varied in their inclusion of explanatory variables for social connectedness and buprenorphine use status. Results: The stepwise model containing “total degree” (p = 0.002), “using: inducting/tapering” (p < 0.001), and “using: other” (p = 0.01) outperformed all other models. Reddit users with fewer connections and who are currently using buprenorphine-naloxone are more likely to seek advice than those who are well-connected and no longer using the medication, respectively. Importantly, advice-seeking behavior is most accurately predicted using a combination of network characteristics and medication use status, rather than either factor alone. Conclusions: Our findings provide insights for the clinical care of people recovering from opioid use disorder and the nature of online medical advice-seeking overall. Clinicians should be especially attentive (e.g., through frequent follow-up) to patients who are inducting or tapering buprenorphine-naloxone or signal limited social support.

Temporal trends in health worker social media communication during the COVID‐19 pandemic

“…Although many alternative approaches to access Reddit data exist, we chose the RedditExtractoR package because it provides an easy‐to‐use, mostly code‐free interface to search Reddit and retrieve user‐generated data. Recently, the RedditExtractoR package has been instrumental for studies investigating online discourse about diverse health‐related topics (e.g., medication use [Garcia et al, 2022 ; Smith et al, 2021 ]; suicidal ideation [Mason et al, 2021 ]; eating disorders, [Nutley, 2021 ]).…”

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

“…Of all shortlisted social media platforms, X (formerly Twitter) and Reddit were by far the most commonly used in existing literature. The topics of studies using these two platforms range from correlating opioid-related discussion volume and opioid-related overdose death rates (2,(7)(8)(9)(10)41,42,70,71), characterizing trends and themes in online discussion of OUD and OUD treatment (4,27,(37)(38)(39)(40)70,74,87,(103)(104)(105)(106)(107)(108)(109)(110)(111)(112)(113)(114)(115)(116)(117)(118)(119)(120)(121), and characterizing public sentiment towards the opioid epidemic generally (39,82,93,108,122,123). Many research groups have also created models to automatically identify posts on X and Reddit with discussion related to opioids.…”