Journal Article

Exploring substance use disorder discussions in Native American communities: a retrospective Twitter infodemiology study

Calac, Alec J., McMann, Tiana, Cuomo, Raphael, Li, Jiawei, Cai, Mingxiang, Mackey, Tim K.

2022

Overview

Background The opioid epidemic has had a devastating impact on youth from American Indian and Alaska Native (AI/AN) Tribes and Villages, which also experience disparate suicide rates. The use of publicly available social media data originating from AI/AN communities may enhance public health response time to substance use disorder (SUD)-related overdose and augment Tribal public health surveillance systems, but these concepts have yet to be adequately explored. The goal of this exploratory analysis was to identify primary and secondary accounts of overdose and characterize relevant contextual factors in the AI/AN population on social media. Methods The Twitter application programming interface was queried for all Tweets containing geocoded data between March 2014 and June 2020 and filtered for the keyword [‘overdose’]. This sample of Tweets ( n  = 146,236) was then restricted to those geolocated from US Tribal lands ( n  = 619). Tweets were manually annotated for primary or secondary accounts of overdose as well as suicidal ideation, substance(s) used, stigma of drug use, and community-wide incidents. Results We collected a total of 146,235 tweets that were geocoded and contained the word ‘overdose,’ of which 9.5% were posted on Tribal lands ( n  = 619). 9.4% of these tweets ( n  = 58) met our study inclusion criteria and were mainly posted from Oklahoma ( n  = 26, 45%) and North Carolina ( n  = 13, 22.4%). Most Tweets ( n  = 41, 71%) described a primary account of an overdose and were mostly posted from 2014 to 2015. Less than half of the Tweets ( n  = 27, 46.5%) referenced a specific substance. Those substances mentioned included alcohol, marijuana, methamphetamine, heroin, laundry softener, cocaine, K2-Spice (synthetic cannabinoid), codeine, morphine, Nyquil, and Xanax. Discussion Though exploratory, our study identified SUD-related content self-reported by AI/AN communities on Twitter, especially in Oklahoma and North Carolina. These results may assist in the future design and detection of infodemiology trends and early warning signs that can better facilitate intervention specific to the ongoing Tribal opioid epidemic. While all data were collected from the public domain, additional care should be given to individual and community privacy.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / American Indian or Alaska Native / Analgesics, Opioid / Application programming interface / Beliefs, opinions and attitudes / Brief Report / Cannabis / Cocaine / Codeine / Digital media / Drug overdose / Drug Overdose - epidemiology / Drug use / Drugs / Epidemics / Harm reduction / Health aspects / Health disparities / Health Promotion and Disease Prevention / Health Psychology / Heroin / Humans / Infodemiology / Keywords / Laundry / Marijuana / Medicine / Medicine & Public Health / Mental health / Metadata / Methamphetamine / Minority & ethnic groups / Morphine / Mortality / Narcotics / Native Americans / North American Indian lands / Online social networks / Opioids / Overdose / Prevention / Public domain / Public health / Public opinion / Response time / Retrospective Studies / Social Media / Social networks / Social Policy / Social Work / Statistics / Stigma / Substance abuse / Substance use / Substance use disorder / Substance-Related Disorders - epidemiology / Suicidal behavior / Suicide / Surveillance / Surveillance systems / User behavior