Opioid Use Stigmatization and Destigmatization in Healthcare Professional Social Media

Abstract

Stigmatization of opioid use constitutes a significant barrier to addressing the opioid crisis. Increasing use of social media by healthcare professionals provides an opportunity to foster destigmatization. However, little is known about stigmatization and destigmatization within healthcare professional social media communities. Accordingly, this study investigates the use of stigmatizing and destigmatizing language in three such communities: Medical Twitter, Public Health Twitter, and Epidemiology Twitter. Using a dataset of 2,319 tweets discussing opioids and associated with these Twitter communities, we analyzed each tweet for evidence of stigmatizing or destigmatizing language based on guidance from the National Institute on Drug Abuse. The results indicate that overall use of both stigmatizing and destigmatizing language is currently low across communities compared to the overall volume of opioid-related content. Additionally, there are measurable changes in stigmatizing and destigmatizing language on quarterly bases between 2012 and 2020. During this time, Public Health Twitter has seen a quarterly 19% reduction in rates of stigmatizing (IRR = 0.81, 95% CI 0.67 to 0.97), and all communities have experienced a quarterly 57% increase in destigmatizing language (IRR = 1.57, 95% CI: 1.33 to 1.85). This study also reveals that tweets containing stigmatizing and destigmatizing language receive minimal user engagement (measured by likes, retweets, quote tweets, and comments). While the longitudinal findings on increasing use of destigmatizing language are promising, they also indicate a need for increased efforts to encourage broader use of destigmatizing language. Leveraging the social learning potentials of Twitter offers one promising pathway for future initiatives.