Prescription Drug Abuse:Does Social Media Play a Role?

Catherine B KempSocial Media Marketing & Communication

CM 210-01, Spring 2012Social Media Monitoring Project, Final Report

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Prescription Drug Abuse:Does Social Media Play a Role?

As discussed in the mid-term report for this project, posted March 16, 2012, recent studies have cited an alarming increase in the number of adolescents and college students who admit to illicit or recreational use of prescribed opiate analgesics and stimulant medications.

From: Paulozzi, L. J. (2011, November 4). Vital Signs: Overdoses of Prescription Opioid Pain Relievers -- United States, 1999-2008. Morbidity & Mortality Weekly Report , 60 (43), p 1491 3

Prescription Drug Abuse:Does Social Media Play a Role?

Paulozzi reported in an article published in 2011 that, in 2008 in the U.S., opiate pain relievers were involved in 73.8% of the 20,044 reported deaths due to prescription drug overdoses.

Prescription Drug Abuse:Does Social Media Play a Role?

Swanson, J., Wigal, T., & Volkow, N. (2011, September). Contrast of Medical and Nonmedical Use of Stimulant Drugs, Basis for the Distinction, and Risk of Addiction: Comment on Smith and Farah (2011). Psychological Bulletin , 137 (5), p 744

A 2011 review of stimulant use found that the total number of prescriptions dispensed for this therapeutic category has risen steadily each year. In fact there has been an over eleven-fold increase between 1990 and 2010

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Prescription Drug Abuse:Does Social Media Play a Role?

Another study looking at students who had legitimate prescriptions for either type of drug found that 61.7% diverted their stimulants, while 35.1% diverted their analgesics to another person for non-prescribed use.

Garnier, L., Arria, A., Caldeira, K., Vincent, K., & O’Grady, K. (2010, March). Sharing and selling of prescription medications in a college student sample. Journal of Clinical Psychiatry , pp. 262-269. 5

Prescription Drug Abuse:Does Social Media Play a Role?

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Prescription Drug Abuse:Does Social Media Play a Role?

Prescription Drug Abuse:Does Social Media Play a Role?

The principle objective of this monitoring project is to explore whether or not data culled from Social Media can be a useful tool in the phenomenology research of non-medical use of certain prescription drugs- specifically the stimulant Adderall®, and the opiate analgesic OxyContin®.

Prescription Drug Abuse:Does Social Media Play a Role?

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Objectives: To explore the types of interaction and frequency of mentions; To identify any patterns of communication related to these drugs that might emerge; and To explore some of the methodological, ethical, and practical issues that must be considered in this format.

Prescription Drug Abuse:Does Social Media Play a Role?

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Prescription Drug Abuse:Does Social Media Play a Role?

Method:The volume and context of mentions of each drug were tracked daily, over the 6 week period of February 16- March 28, 2012 on the following social networking sites. Facebook Twitter Google Plus

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Results: Overview

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Prescription Drug Abuse:Does Social Media Play a Role?

Source: actionly.com

Total “buzz” volume (top) vs. Index of mentions: total number of blog postsFeb 16- Mar 28, 2012Adderall® shown in blue in both graphs:Sharp decrease in total number of mentions during period coinciding with Spring BreakThe peak volumes coincide with period immediately following Spring breakOxycontin® shown in orange (top) and pink (bottom):Note large fluctuations in % of total mentions while absolute number has more narrow variationPeak volume in late February coincides with increased mentions of new restrictions on availability of the drug, in Canada.Increased volume in mid March coincides with increased mentions of radio personality Rush Limbaugh and OxyContin® addiction.

Sources: Top graph- actionly.comBottom graph- icerocket.com

Results: Adderall®

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Prescription Drug Abuse:Does Social Media Play a Role?

13Source: actionly.com

Source: actionly.com

Adderall® in popular cultureJuicy J, Deez Bitches Rollin (2011) lyrics:

“College hoes love alcohol, and poppin Adderall”(click on lyric to play)

Video was not exported from SlideRocket

Adderall® Twitter cloud,

02/16/12-03/27/12

adderall [1068] xr [144] need [97] sorrynotsorryy [52] taking [51] online [51] coffee [49] buy [49]day [47] take [45] sleep [41] much [39] qah8wi9p [37] love [33] makes [31] college [30] out [30] took [29]shit [29] one [29] right [28] alive [28] more [27] night [27] days [27] consider [27] misery [26] wish [26]alcohol [25] oscars [25] charmofthesouth [25] time [24] life [24] ve [23] know [23]]

Source: actionly.com

Source: actionly.com

Source: actionly.com

Adderall® ObservationsThe vast majority of mentions were contained in "Tweets".There was a sharp drop in the number of "Adderall®" mentions on all three networks during the first 2 weeks of March, possibly coincident with Spring Break.Conversely, there was a sharp increase in "Adderall®" mentions on the three networks in the latter half of March.Review of individual messages revealed a "mixed bag" of message types, including lyrics, online pharmacies, partying, studying, and house cleaning.

Adderall® Observations, cont.There were few messages characterized as "positive", and even fewer characterized as "negative". The basis for these characterizations by the data provider was not clear.Online pharmacies advertising sale of the drug without a prescription were consistently among the "top Tweeters", generating high volumes of messages to low volumes of followers.There was no clear evidence in this snapshot of Social Media being used for illicit sale of the drug. The online pharmacies had high volume output, but limited reach.It appears that Adderall® has become a euphemism for ADD/ADHD stereotypes, alertness, studying, and staying awake for various reasons. Less frequently it is spoken of in terms of sexual enhancement and 'partying'.

Results: OxyContin®

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Prescription Drug Abuse:Does Social Media Play a Role?

Source: actionly.com 22

Source: actionly.com

OxyContin® Twitter cloud, 02/16/12-03/27/12

oxycontin [1038] ontario [197] addiction [117] drug [107] health [100] funding [90] news [86]experts [84] canada [79] first [73] nations [70] others [66] replacement [64] painkiller [63] follow[63] provinces [61] lead [59] crisis [57] withdrawal [53] pulled [53] leader [49] delisting [48] warns [46]disaster [44] expect [43] fund [43] feared [42] pain [41] new [41] mass [40] drugs [37] nova [34] scotia [34]abuse [34] out [33]

Source: actionly.com

Source: actionly.com

Source: actionly.com

OxyContin® mentions showed lower degree of variability than with Adderall®, in both volume and context.The volume of OxyContin® mentions increased modestly with two main news stories during the study period:- During coverage of the Limbaugh/Fluke controversy; and- Surrounding the withdrawal of OxyContin® from the Canadian market.

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OxyContin® Observations

The majority of OxyContin® mentions were in the context of concurrent news stories.Although there were some online pharmacies advertising sale of the drug without a prescription, there were far fewer than with Adderall®, in both absolute volume, and as a percentage of the total volume.

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OxyContin® Observations, cont.

There is no demographic information available to help classify or stratify data sources.Selection biases: Is this a "random" sample? These posts were written for public consumption. How does this context affect the data? Can reliable inferences be drawn?Can standard observational research methods be adapted for Social Media data sources? What can be done to validate the data? What other data would improve validity and reliability?Is the data relevant to the research being conducted?

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Overall Observations: Methodological Issues

Are existing Ethics Review procedures of study protocols adequate to fully vet protocols of research involving Social Media data sources?Is informed consent of subjects necessary, given that the data is generated in and collected from a public venue?What are the ethical duties of the Social Media sites and the secondary data aggregators?Is there a duty to intervene on the part of the researchers, and if so where does it lie and how should it be executed?Are findings from such research sufficiently reliable and valid to draw inferences?

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Overall Observations: Some Ethical Issues

There is a myriad of privacy issues that need to be addressed that are beyond the scope of this discussion.Before continuing with further clinical, epidemiological, or other scientific research using social networking data sources, some of the important issues are:Explicit privacy policies of the data provider- in this project, none could be found on their websites;Implicit privacy expectations of the data sources;Local policies & procedures of the investigators related to gathering and handling the data;Issues of inferences drawn from un-blinded data: are the investigators subject to libel/slander charges?

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Overall Observations: Privacy Issues

Source: Snyder, J: How to Use Social Media for Market Research. (March 28, 2012) ConverseonURL: http://blog.converseon.com/author/jasper-snyder/

In a March 28, 2012 blog post, author Jasper Snyder noted, "Being able to extract this meaning is a challenge – it’s not easy to do – but it represents a significant opportunity for market researchers to gain competitive advantage." While his comments were directed towards a Market Research audience, the underlying principle are relevant to this discussion.

His approach can help the investigator in ensuring that the data is from the relevant people, discussing the relevant issues. This approach can be a solid foundation from which to begin. To start, he suggests exploration of the following questions:• First, at the research level, you can choose to only include messages in your analysis that

are posted by the people whose opinions you’re interested in. The way you define groups of people here may in fact map to your existing customer segmentation taxonomy.

• Second, you could choose to ‘listen’ only in those venues where the audience whose opinion you’re interested in is likely to be engaging.

• Third, you can make sure that you’re only including in your analysis messages where your product (in this case OxyContin®, Adderral®) is being talked about in a relevant context.

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Future Directions