“Trying to Avoid Fentanyl and Other Dangerous Fakes”: A Thematic Analysis of Risk-Mitigating Strategies in Opioid Reddit Posts
Abstract Background: The opioid crisis has fuelled dramatic increases in fatal drug overdoses, with illicitly manufactured fentanyl and fentanyl analogues driving the opioid-related overdose death rates among all groups. One way to address these overdose deaths is through increasing public awareness about opioid overdoses and encouraging people who use drugs to make safe choices about opioids. The ease, convenience, and privacy of social media sites provide an inside look into the world of opioid users. This study seeks to understand the nature and significance of Reddit discussions regarding opioid overdoses and safe choices. Methods: We systematically searched Reddit during the month of August (2019). We collected 4,844 posts, across 25 distinct r/opiates subreddit forums using the search terms “opioids,” “drugs,” and “fentanyl”. We then used qualitative thematic analysis methods to code 49 unique original posts. Results: The posts from these Reddit discussions provide insight into this online opioid community and how they are sharing and normalizing risk-mitigating strategies to avoid opioid-related overdoses through (1) recognizing the dangers and avoiding fentanyl; (2) knowing the signs and symptoms of opioid overdoses; and (3) having and using naloxone to treat opioid overdoses. Conclusions: These informal and social interactions provide insight into the complexity the opioid epidemic crisis and can inform future strategies and interventions to address the opioid crisis.