Damian McNamara

October 29, 2013

SEATTLE — Twitter content about opioids is commonly about abuse of these medications, according to a study of 2100 tweets sent in a week.

"It was very enlightening to explore Twitter on this topic," Jeanmarie Perrone, MD, from the University of Pennsylvania in Philadelphia, told Medscape Medical News.

The study demonstrates that Twitter can foster a better understanding of prescription opioid use and abuse and, Dr. Perrone added, there may be wider implications "for public health messaging about the dangers of these drugs."

Prescription opioid misuse is a concern for emergency physicians across the country.

In the study, presented here at the American College of Emergency Physicians 2013 Scientific Assembly, Dr. Perrone and her team turned to social media for insight about the prescription drug epidemic.

It's very novel to look at opioid use via Twitter. No one has ever done that before.

They used the Twitter Archiving Google Spreadsheet to search for keywords. They included 50 tweets for each keyword for 7 days, and excluded retweets and any tweets not in English.

Tweets were qualitatively analyzed as being about therapeutic use or about abuse. For example, tweets that reported using prescription opioids to get high were classified as abuse, whereas tweets about analgesia were considered use. Some tweets — for example, "I need a Percocet" — could not be classified.

Tweets promoting use, whether psychoactive or analgesic, were classified as positive, and tweets reporting adverse results were classified as negative.

"We discovered that tweets about prescription opioid drugs are commonly about abuse, and that use of these drugs, either therapeutically or for abuse, is described favorably in the majority of tweets," Dr. Perrone explained to Medscape Medical News.

Table: Proportion of Tweets About Opioids

Keyword Related to Abuse (%) Positive Comments (%)
Percocet 39.6 69.3
Percs 55.0 70.0
Oxycontin 53.9 66.0
Oxys 65.0 72.0
Vicodin 44.6 72.9
Hydros 37.5 75.0


Tweets often referred to receiving prescription opioids for dental procedures, from a doctor or emergency department visit, or from friends to treat pain. People also frequently tweeted that they were taking prescription opioids to help them sleep, and reported getting high while taking opioids for pain. They also used Twitter to report adverse effects.

"It's very novel to look at opioid use via Twitter," said Vikhyat Bebarta, MD, from the San Antonio Military Medical Center in Texas, who was asked by Medscape Medical News to comment on the study. "No one has ever done that before. We have a hard time measuring opioid-related outcomes and use. We often look at this retrospectively; Twitter could represent a real-time measurement."

Future research could address any correlation between these Twitter metrics and actual opioid use or health outcomes, he added.

Dr. Perrone and Dr. Bebarta have disclosed no relevant financial relationships. Dr. Bebarta is an active duty member in the US Air Force and his comments reflect his own opinions, not those of the Department of Defense.

American College of Emergency Physicians (ACEP) 2013 Scientific Assembly: Abstract 344. Presented October 15, 2013.


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