Opioids on Twitter: A Content Analysis of Conversations regarding Prescription Drugs on Social Media and Implications for Message Design

Exploring Twitter chatter to assess the type and availability of cannabis-related products in Thailand

Cannabis-related tweets were collected between January and April 2022 to estimate the availability and characteristics of cannabis products advertised on Twitter amid the legalization of recreational cannabis in Thailand. The Twitter API was called using the tweepy Python library to collect cannabis-related tweets in the Thai language. A total of 185,558 unique tweets were collected over the duration of the data collection period based on 83 search terms. Twenty thousand random tweets were manually coded by four Thai native speakers to assess the volume and characteristics of tweets proposing cannabis. 72.6% of collected tweets from the 20,000 random samples were coded as relevant to the study. 54.6% of relevant tweets were advertising cannabis products, 29.8% were personal communications, and 15.6% were related to news or media content. Among the tweets that advertised cannabis products, 94.4% proposed cannabis flower, 2.4% cannabis edibles and 1.8% cannabis concentrates. Consumption of potent forms of cannabis such as cannabis edibles and concentrates increase the risk of harmful side-effects, especially in a population with limited knowledge about these products. Our findings call for additional monitoring efforts and for increasing the public awareness on potent cannabis products emerging in Thailand.

Understanding the Political Frames of the Opioid Crisis: A Content Analysis of U.S. Senators' Tweets

The opioid epidemic in the United States is a public health emergency that has triggered calls to action for policy reforms. However, variations exist between political parties and policymakers on how this issue is communicated to the public. With the substantial growth in the use of social media by policymakers as a tool for disseminating policy-related information affecting their constituents, examining their communication strategies on public health emergency issues is imperative. To better understand how U.S. Senate members use Twitter (now known as X) to communicate opioid-related issues, we conducted a quantitative content analysis of their opioid-related tweets (N = 697) from January 1 to August 25 2022. Findings reveal a significant political divide regarding how senators characterize the opioid crisis, influencing user engagement on Twitter. Guided by the moral foundation theory, the results suggest that Democratic senators were more likely to employ care/harm or fairness/cheating moral foundations, relative to Republican senators, who used more loyalty/betrayal or authority/subversion. Additionally, Democratic senators framed the opioid crisis as a health or policy issue, relative to Republican senators' immigration/border frame. For inclusion of information sources, Democratic senators included significantly more health sources compared to Republican senators' use of media or law enforcement sources. Issue frame and source type significantly influenced user engagement in the form of likes and retweets. These findings provide both practical and theoretical implications.

Understanding and preventing the advertisement and sale of illicit drugs to young people through social media: A multidisciplinary scoping review

ISSUES

The sale of illicit drugs online has expanded to mainstream social media apps. These platforms provide access to a wide audience, especially children and adolescents. Research is in its infancy and scattered due to the multidisciplinary aspects of the phenomena.

APPROACH

We present a multidisciplinary systematic scoping review on the advertisement and sale of illicit drugs to young people. Peer-reviewed studies written in English, Spanish and French were searched for the period 2015 to 2022. We extracted data on users, drugs studied, rate of posts, terminology used and study methodology.

KEY FINDINGS

A total of 56 peer-reviewed papers were included. The analysis of these highlights the variety of drugs advertised and platforms used to do so. Various methodological designs were considered. Approaches to detecting illicit content were the focus of many studies as algorithms move from detecting drug-related keywords to drug selling behaviour. We found that on average, for the studies reviewed, 13 in 100 social media posts advertise illicit drugs. However, popular platforms used by adolescents are rarely studied.

IMPLICATIONS

Promotional content is increasing in sophistication to appeal to young people, shifting towards healthy, glamourous and seemingly legal depictions of drugs. Greater inter-disciplinary collaboration between computational and qualitative approaches are needed to comprehensively study the sale and advertisement of illegal drugs on social media across different platforms. This requires coordinated action from researchers, policy makers and service providers.

Twitter activity surrounding the Finnish green party's cannabis legalisation proposal: A mixed-methods analysis

Background: In September 2021, a Finnish political party, the Greens, voted to include cannabis policy reform in their party programme, which would legalise the use, possession, manufacture and sale of cannabis. A rapid public discussion has emerged on different social media platforms, including Twitter. Methods: We downloaded 10 days of Twitter data and prepared it for further text analysis, including sentiment, topic modelling and thematic content analysis. Results: Before the proposal, the average daily number of tweets was approximately 140. However, during the week of the proposal, there was a significant increase in tweet volume, reaching a peak of 6,600 tweets on a single day, with a daily average of over 2,700 tweets. Sentiment analysis showed that during the public discussion, the sentiment scores of the tweets were more likely to be positive. Through topic modelling analysis, we obtained the weight of the topic for each tweet, which enabled us to identify the most representative tweets in our corpus. To narrow the sample size for content analysis, we selected tweets that had a topic percentage distribution of over 0.95 (N=188) for closer thematic content analysis. Several positive and negative themes emerged, which were then categorised under broader topics. Similar themes were identified in the most retweeted, liked and commented tweets, which came mainly from known public figures, including politicians, health experts and NGO leaders. Conclusion: Our results show that the discussion was not limited to cannabis legalisation, but instead covered a variety of topics related to drug policy.

The Role of Media in Addressing Opioid Use Disorder: Examining Causal Attributions and Emotions as Mediators of Media Influence on Stigma and Policy Support

This study examined the influence of media on stigma and public support for policy interventions that address opioid-related problems. Data from a survey of 997 U.S. adults indicate that media exposure to opioids and relevant topics significantly influenced stigma and support for punitive and public health-oriented policies, even after direct and indirect experiences with opioid misuse were controlled for. However, differences emerged in terms of what led people to endorse each type of policy intervention. When people attributed opioid misuse to individual-oriented causes after media exposure, they were more likely to support punitive policies. When people recognized pharmaceutical-oriented causes, they tended to support public health-related policies.In addition to causal attributions, emotions (fear, anger, and sympathy) served as mediators with different effects on stigma and policy support. Although exposure to opioid-related stories positively influenced all three emotions, media influence was most likely to elicit sympathy, which was negatively associated with social stigma. However, people who felt anger tended to stigmatize individuals with opioid use disorder and not to support either of the policy interventions. The overall findings suggest that communication efforts addressing the opioid situation should find frames that reduce social stigma and encourage support for public health-related policies.

Promoting Mental Health on Social Media: A Content Analysis of Organizational Tweets

This study analyzed tweets posted over 1 year from three mental-health organizations in the United States, along with audience engagement data of comments, retweets, and likes. The results revealed that tweets focused on mental illnesses or mental health received more engagement than those that emphasized event promotion or relationship building. In addition, there were more gain-framed than loss-framed messages, although the latter triggered more public engagement. Thematic framing was used more frequently than episodic framing and related to higher levels of engagement. Call-to-action (CTA), other audience engaging methods and multimedia strategies were used in various frequencies in these tweets; and the use of CTA, other engaging methods, photos/pictures, and external links, but not videos, were positively related to public engagement. Theoretical contributions and practical implications regarding using social media for mental health promotion were offered.

Coping with outbreaks: Toward an infectious disease threat (IDT) appraisal model for risk communication

Through an online, nationally representative survey (N = 1,164), this study examines how individuals perceive and cope with infectious disease outbreaks. Findings inform risk and crisis communication strategies for health organizations. This study explored how individuals' threat appraisals (perceived controllability, perceived predictability, and perceived responsibility) and their cognitive (i.e., information seeking) and conative coping (i.e., protective actions) differ by infectious disease threat (IDT) type (i.e. airborne, bloodborne, foodborne, sexually-transmitted, waterborne, or zoonotic/vectorborne) in epidemic situations. Findings revealed that IDT types varied significantly based on individuals' appraisals of predictability, controllability, and responsibility for different disease types. Across all disease types, predictability was the most impactful factor related to participants' information seeking and planned protective action taking.

Using Social Media to Examine Themes Surrounding Fentanyl Misuse and Risk Indicators

Background: Opioid misuse is a crisis in the United States, and synthetic opioids such as fentanyl pose risks for overdose and mortality. Individuals who misuse substances commonly seek information and support online due to stigma and legal concerns, and this online networking may provide insight for substance misuse prevention and treatment. We aimed to characterize topics in substance-misuse related discourse among members of an online fentanyl community. Method: We investigated posts on a fentanyl-specific forum on the platform Reddit to identify emergent substance misuse-related themes potentially indicative of heightened risk for overdose and other adverse health outcomes. We analyzed 27 posts and 338 comments with a qualitative codebook established using a subset of user posts via inductive and deductive methods. Posts and comments were independently reviewed by two coders with a third coder resolving discrepancies. The top 200 subreddits with the most activity by r/fentanyl members were also inductively analyzed to understand interests of r/fentanyl users. Results: Functional/quality of life impairments due to substance misuse (29%) was the most commonly occurring theme, followed by polysubstance use (27%) and tolerance/dependence/withdrawal (20%). Additional themes included drug identification with photos, substances cut with other drugs, injection drugs, and past overdoses. Media-focused subreddits and other drug focused communities were among the communities most often followed by r/fentanyl users. Conclusion: Themes closely align with DSM-V substance use disorder symptoms for fentanyl and other substances. High involvement in media-focused subreddits and other substance-misuse-related communities suggests digital platforms as acceptable for overdose prevention and recovery support interventions.

Opioids in Satirical News Shows: Exploring Topics, Sentiments, and Engagement in Last Week Tonight on YouTube

Prescription drug misuse and opioid overdose have become one of the most serious health crises in the US health system. In this study, we examined Last Week Tonight as hosted by John Oliver in order to explore topics, sentiments, and reactions by referring to online comments on YouTube. Using an unsupervised machine learning approach, we analyzed 33,741 user generated comments taken from three selected episodes published between 2016 and 2021. Our results revealed 13 topics: the politicization of the opioid crisis, side effects of opioid use, seeking help, legal issues, reactions to the John Oliver show, drug addiction, the US in comparison with other countries, case settlements, the drug business, addiction and pharmaceutical companies, profitability of companies from deaths, drugs and elections, as well as general awareness and education. In addition, we found that opioid side effects, seeking help, and the drug business had received the highest user engagements in terms of likes and replies. Our study suggests that comments with positive sentiments were more likely to cause a more widespread engagement from YouTube users than negative comments.

Cross-Country Analysis of the Association of Cultural Dimensions with Prescription Opioid Consumption and Implications for Health Education

Background and Purpose: Over 247,000 people died in the U.S. from overdoses related to prescription opioids in 1999-2019, leading the WHO to deem the situation an epidemic. The purpose of this study is to examine whether culture is related to perceptions and behaviors around opioid consumption because culture has been shown, for example, to influence decision-making strategies, risk-taking, and responses to self-congruent communications. Methods: Scores for country-wide dimensions of culture from Hofstede and opioid consumption data from the International Narcotics Control Board were used to study a possible relationship. The relationship was tested by including a set of economic and socio-economic indicators from the World Bank, the United Nations, and PROSPERED. Results: The scores for the cultural dimension of individualism are correlated with opioid consumption on a country level, with higher levels of individualism connected to higher consumption. This correlation is robust to the inclusion of economic and socio-economic variables (GDP per capita, inflation, income inequality, unemployment, education, life expectancy, median age, and sick leave coverage). Conclusions and Importance: Because messages that reinforce a group's cultural value are more meaningful and effective in motivating action, educational health messages about opioid consumption in the U.S. need to be designed with culture in mind to disrupt decisions to take opioid analgesics unless medically justified or to limit their use. More research is needed on how to design self-congruent individualistic versus collectivistic persuasive appeals.

Anti-Vaccine Discourse on Social Media: An Exploratory Audit of Negative Tweets about Vaccines and Their Posters

As the anti-vaccination movement is spreading around the world, this paper addresses the ever more urgent need for health professionals, communicators and policy-makers to grasp the nature of vaccine mis/disinformation on social media. A one-by-one coding of 4511 vaccine-related tweets posted from the UK in 2019 resulted in 334 anti-vaccine tweets. Our analysis shows that (a) anti-vaccine tweeters are quite active and widely networked users on their own; (b) anti-vaccine messages tend to focus on the "harmful" nature of vaccination, based mostly on personal experience, values and beliefs rather than hard facts; (c) anonymity does not make a difference to the types of posted anti-vaccine content, but does so in terms of the volume of such content. Communication initiatives against anti-vaccination should (a) work closely with technological platforms to tackle anonymous anti-vaccine tweets; (b) focus efforts on mis/disinformation in three major arears (in order of importance): the medical nature of vaccines, the belief that vaccination is a tool of manipulation and control for money and power, and the "freedom of health choice" discourse against mandatory vaccination; and (c) go beyond common factual measures-such as detecting, labelling or removing fake news-to address emotions induced by personal memories, values and beliefs.

Social presence for strategic health messages: An examination of state governments' use of Twitter to tackle the Covid-19 pandemic

Scholars investigated the role of social presence theory in numerous communication contexts. However, we have limited knowledge about the impact of social presence strategies on public attention during a pandemic. This study fills this gap by investigating the connections between social presence strategies, Covid-19 strategies, and public attention. Twitter data of state governments from January 21, 2020 to July 21, 2020 were downloaded for this study. Content analysis of 1500 randomly selected posts revealed that social presence strategies were effective in generating public attention on Twitter. Furthermore, expressing appreciation, providing guidance, and informing the publics about governments' actions generated public attention. Theoretical and practical implications are discussed.

Identifying features of source and message that influence the retweeting of health information on social media during the COVID-19 pandemic

Background

Social media has become an essential tool to implement risk communication, giving health information could gain more exposure by retweeting during the COVID-19 pandemic.

Methods

Content analysis was conducted to scrutinize the official (national and provincial) public health agencies’ Weibo posts (n = 4396) to identify features of information sources and message features (structure, style content). The Zero-Inflated Negative Binomial (ZINB) model was adopted to analyze the association between these features and the frequency of the retweeted messages.

Results

Results indicated that features of source and health information, such as structure, style, and content, were correlated to retweeting. The results of IRR further suggested that compared to provincial accounts, messages from national health authorities’ accounts gained more retweeting. Regarding the information features, messages with hashtags#, picture, video have been retweeted more often than messages without any of these features respectively, while messages with hyperlinks received fewer retweets than messages without hyperlinks. In terms of the information structure, messages with the sentiment (!) have been retweeted more frequently than messages without sentiment. Concerning content, messages containing severity, reassurance, efficacy, and action frame have been retweeted with higher frequency, while messages with uncertainty frames have been retweeted less often.

Conclusions

Health organizations and medical professionals should pay close attention to the features of health information sources, structures, style, and content to satisfy the public’s information needs and preferences to promote the public's health engagement. Designing suitable information systems and promoting health communication strategies during different pandemic stages may improve public awareness of the COVID-19, alleviate negative emotions, and promote preventive measures to curb the spread of the virus.

Twitter usage during global pandemic and corporate reputation in Nigeria

This study is a meta-analysis of empirical studies in social media strategies and reputation research. The research goal is to give a clearer idea of the broad directions and paradigm shifts in Twitter usage discourse over the years. Its major goal is to examine thematic trends, theoretical framework and methodology that have characterized the discourse. Sixty relevant articles were identified, coded and content-analyzed. Findings revealed that dominant themes include stakeholder perceptions of communication strategies, social network sites, dynamics of global pandemic (i.e Covid-19 pandemic) and corporate reputation. Also, experiment, case study and survey are the dominant research methods that characterize research in this discourse. Findings also revealed large domination of the Situational Crisis Communication Theory (SCCT) and the Image Repair Theory. However, research in this area lacks significant empirical evidence from Africa and Nigeria in particular, where the global pandemic seems to be a recurring phenomenon. The majority of the reviewed journal articles were conducted in the Western clime, with little attention on Africa. Scholarship needs to move beyond this point to provide a holistic and balanced view on the crisis by exploring cases in Africa and particularly, in Nigeria. This gap will provide an opportunity for understanding the global pandemic (i.e. Covid-19) dynamics in Africa and will further determine whether findings can be consistent across the world.

Social Media Mining Toolkit (SMMT)

There has been a dramatic increase in the popularity of utilizing social media data for research purposes within the biomedical community. In PubMed alone, there have been nearly 2,500 publication entries since 2014 that deal with analyzing social media data from Twitter and Reddit. However, the vast majority of those works do not share their code or data for replicating their studies. With minimal exceptions, the few that do, place the burden on the researcher to figure out how to fetch the data, how to best format their data, and how to create automatic and manual annotations on the acquired data. In order to address this pressing issue, we introduce the Social Media Mining Toolkit (SMMT), a suite of tools aimed to encapsulate the cumbersome details of acquiring, preprocessing, annotating and standardizing social media data. The purpose of our toolkit is for researchers to focus on answering research questions, and not the technical aspects of using social media data. By using a standard toolkit, researchers will be able to acquire, use, and release data in a consistent way that is transparent for everybody using the toolkit, hence, simplifying research reproducibility and accessibility in the social media domain.