Thematic Analysis of Reddit Content About Buprenorphine-naloxone Using Manual Annotation and Natural Language
Rachel Lynn Graves1, Jeanmarie Perrone, Mohammed Ali Al-Garadi
1From the Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA (RLG, JP); Department of Biomedical Informatics, Emory University School of Medicine, Woodruff Memorial Research Building, Atlanta, GA, USA (MAA-G, Y-CY, AS); Department of Emergency Medicine, School of Medicine, Oregon Health and Science University, Portland, OR, USA (JSL); Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA (KC, GG-H); Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA (AS).
Background:
Opioid use disorder (OUD) is a major public health crisis for which buprenorphine-naloxone is an effective evidence-based treatment. Analysis of Reddit data yields detailed information about firsthand experiences with buprenorphine-naloxone that has the potential to inform treatment of OUD.
Methods:
We conducted a thematic analysis of posts about buprenorphine-naloxone from a Reddit forum in which Reddit users anonymously discuss topics related to opioid use. We used an application programming interface to retrieve posts about buprenorphine-naloxone, then applied natural language processing to generate meta-information and curate samples of salient posts. We manually categorized posts according to their content and conducted natural language processing-aided analysis of posts about buprenorphine tapering strategies, withdrawal symptoms, and adjunctive substances/behaviors useful in the tapering process.
Results:
A total of 16,146 posts from 1933 redditors were retrieved from the /r/suboxone subreddit. Thematic analysis of sample posts (N = 200) revealed descriptions of personal experiences (74%), nonpersonal accounts (24%), and other content (2%). Among redditors who reported tapering to termination (N = 40), 0.063 mg and 0.125 mg were the most common termination doses. Fatigue, gastrointestinal disturbance, and mood disturbance were the most frequent adverse effects, and loperamide and vitamins/dietary supplements the most frequently discussed adverse effects adjunctive substances/behaviors respectively.
Conclusions:
Discussions on Reddit are rich in information about buprenorphine-naloxone. Information derived from analysis of Reddit posts about buprenorphine-naloxone may not be available elsewhere and may help providers improve treatment of people with OUD through better understanding of the experiences of people who have used buprenorphine-naloxone.
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