Large-Scale Social Media Analysis Reveals Emotions Associated with Nonmedical Prescription Drug Use

Abstract

Background: The behaviors and emotions associated with and reasons for nonmedical prescription drug use (NMPDU) are not well-captured through traditional instruments such as surveys and insurance claims. Publicly available NMPDU-related posts on social media can potentially be leveraged to study these aspects unobtrusively and at scale.

Methods: We applied a machine learning classifier to detect self-reports of NMPDU on Twitter and extracted all public posts of the associated users. We analyzed approximately 137 million posts from 87,718 Twitter users in terms of expressed emotions, sentiments, concerns, and possible reasons for NMPDU via natural language processing.

Results: Users in the NMPDU group express more negative emotions and less positive emotions, more concerns about family, the past, and body, and less concerns related to work, leisure, home, money, religion, health, and achievement compared to a control group (i.e., users who never reported NMPDU). NMPDU posts tend to be highly polarized, indicating potential emotional triggers. Gender-specific analyses show that female users in the NMPDU group express more content related to positive emotions, anticipation, sadness, joy, concerns about family, friends, home, health, and the past, and less about anger than males. The findings are consistent across distinct prescription drug categories (opioids, benzodiazepines, stimulants, and polysubstance).

Conclusion: Our analyses of large-scale data show that substantial differences exist between the texts of the posts from users who self-report NMPDU on Twitter and those who do not, and between males and females who report NMPDU. Our findings can enrich our understanding of NMPDU and the population involved.

Figure 1

Summary comparison between the male and female users from the NMPDU group. (a) Emotional dimensions and (b) the personal and social concern content dimensions.

Figure 2

(a) Sentiment strength distributions for NMPDU and non-NMPDU posts. (b) Comparison of the means and confidence intervals of extreme positive tweets ($\text{sentiment score}>0.5$) and negative tweets ($\text{sentiment score}<--0.5$) in both non-NMPDU and NMPDU categories.