Reactions to the opioid epidemic: A text-mining analysis of tweets

This study analyzed public reactions to the opioid epidemic using Twitter discourse. Methods: One month of unique tweets (n = 26,079) from July 23, 2018 to August 22, 2018 were identified using the keyword "opioid" in conjunction with the words "crisis, epidemic, misuse, prescription, and death." Twelve topics, each representing more than 1% of all tweets, together accounted for 17,206 (66%) of identified tweets. Results: The top four tweet topics (representing 38% of the total) addressed lawsuits and public policy, people who use opioids to treat persistent pain, programs to alleviate the opioid epidemic, and one specific initiative, the "#onelesspill" movement. The next seven topics (representing 27% of the total) addressed news articles relating to the opioid epidemic. The 12^th topic was a book about the opioid crisis (1.7% of the total tweets). Conclusions: These tweets exhibited polarization of opinions with some people calling for tighter restrictions on opioids and others desperate to preserve their daily use of opioids for alleviation of illnesses characterized by persistent pain. Social media posts can help inform efforts to craft public policy and communication strategies to support optimal opioid stewardship.