Effects of substance-use, recovery, and non-using online community participation on risk of relapse during opioid recovery: A longitudinal observational study (Preprint)

Abstract

Opioid addiction presents one of the most pressing public health issues of the day. Despite several treatment options for opioid addiction, relapse rates remain high. Research indicates that meaningful membership in various social groups underpins the successful transition from addiction to long-term recovery. However, much of the current literature focuses on online recovery support groups rather than online group memberships that go beyond substance use and recovery.

The aim of this study is to understand whether engagement with a variety of Reddit subforums (subreddits) provides those who are recovering from opioid addiction with social capital, thereby reducing their risk of relapse across several years. More specifically, it examines the different effects that engagement with subreddits related to substance use, recovery, and non-using interests, respectively, have.

A dataset of N=457 recovering opioid addicts who self-announced the date of their recovery on Reddit was collected, of which 219 (48%) indicated to have relapsed at least once during the recovery period. Using a Cox proportional hazards model, the effects of number of non-using, recovery, and substance use subreddits an individual had engaged with on risk of relapse were tested. Group engagement was assessed both in terms of absolute numbers of communities an individual had posted in and as a proportion of total online communities.

Engaging with a larger number of non-using online communities reduced the likelihood of relapse irrespective of the number of posts and comments made in these forums. This was true for both the absolute number of non-using communities (P<.001) and as a proportion of communities a person engaged with (P<.001). Findings were less conclusive for recovery and substance use groups: Although participating in more recovery subreddits reduced relapse risk (P<.001), being part of a higher proportion of recovery groups relative to other subreddits increased risk (P=.01). A higher proportion of substance use subreddits increased relapse risk marginally (P=.06), but the absolute number of substance use subreddits reduced the risk of relapse significantly (P=.002).

Our work indicates that even minimal regular engagement with several non-using online forums may provide those who are recovering from opioid addiction with an opportunity to grow their social capital and reduce the risk of relapse across several years.