Upvoting stigma? Analyzing themes in substance use stigma within Canadian subreddits.

Area of Science:

• Social Sciences
• Public Health
• Digital Communication

Background:

• Public perceptions of substance use shape drug policy, resource allocation, and stigma globally.
• Stigma remains a significant barrier to harm reduction and treatment engagement, despite public health approaches.
• Understanding online discourse is crucial for informing policy reform and stigma reduction strategies.

Purpose of the Study:

• To examine the prevalence and themes of stigmatizing discourse surrounding illicit substance use in Canadian online communities.
• To identify dominant narratives contributing to stigma in public discussions on Reddit.
• To provide insights for countries considering policy reform and stigma reduction.

Main Methods:

• Collected illicit substance-related posts and comments from major Canadian city subreddits.
• Employed a zero-shot learning approach using the BART-large model for stigma classification (≥90% confidence threshold).
• Conducted qualitative thematic analysis on classified stigmatizing posts to identify dominant narratives.

Main Results:

• 14.4% of analyzed substance-related posts contained stigma.
• Stigma was most frequently associated with crack (18%), cocaine (18%), opioids (15%), and methamphetamine (14%).
• Four dominant stigmatizing narratives were identified: Perceived Enabling vs. Effective Care (37.5%), Punitive Criminalization (23.2%), Exclusion for Safety (22.5%), and Taxpayer Resentment (18.6%).

Conclusions:

• Illicit substance use stigma is prevalent in Canadian online discussions, particularly on Reddit.
• Stigmatizing language and attitudes may impede harm reduction measures and favor punitive policies.
• Addressing these narratives through public education and evidence-based policy reform is essential for inclusive substance use health approaches.