BACKGROUND:
Youth
and adolescent non-medical use of prescription medications (NUPM) has become a
national epidemic. However, little is known about the association between
promotion of NUPM behavior and access via the popular social media
microblogging site, Twitter, which is currently used by a third of all teens.
OBJECTIVE:
In
order to better assess NUPM behavior online, this study conducts surveillance
and analysis of Twitter data to characterize the frequency of NUPM-related
tweets and also identifies illegal access to drugs of abuse via online
pharmacies.
METHODS:
Tweets
were collected over a 2-week period from April 1-14, 2015, by applying NUPM
keyword filters for both generic/chemical and street names associated with
drugs of abuse using the Twitter public streaming application programming
interface. Tweets were then analyzed for relevance to NUPM and whether they
promoted illegal online access to prescription drugs using a protocol of
content coding and supervised machine learning.
RESULTS:
A total
of 2,417,662 tweets were collected and analyzed for this study. Tweets filtered
for generic drugs names comprised 232,108 tweets, including 22,174 unique
associated uniform resource locators (URLs), and 2,185,554 tweets (376,304
unique URLs) filtered for street names. Applying an iterative process of manual
content coding and supervised machine learning, 81.72% of the generic and
12.28% of the street NUPM datasets were predicted as having content relevant to
NUPM respectively. By examining hyperlinks associated with NUPM relevant
content for the generic Twitter dataset, we discovered that 75.72% of the
tweets with URLs included a hyperlink to an online marketing affiliate that
directly linked to an illicit online pharmacy advertising the sale of Valium
without a prescription.
CONCLUSIONS:
This
study examined the association between Twitter content, NUPM behavior
promotion, and online access to drugs using a broad set of prescription drug
keywords. Initial results are concerning, as our study found over 45,000 tweets
that directly promoted NUPM by providing a URL that actively marketed the
illegal online sale of prescription drugs of abuse. Additional research is
needed to further establish the link between Twitter content and NUPM, as well
as to help inform future technology-based tools, online health promotion
activities, and public policy to combat NUPM online.
Below: Word cloud for generic instance
Below: Word cloud for street instance
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