The complex unfolding of the US opioid epidemic in the last 20 years has been the subject of a large body of medical and pharmacological research, and it has sparked a multidisciplinary discussion on how to implement interventions and policies to effectively control its impact on public health. This study leverages Reddit as the primary data source to investigate the opioid crisis. We aimed to find a large cohort of Reddit users interested in discussing the use of opioids, trace the temporal evolution of their interest, and extensively characterize patterns of the nonmedical consumption of opioids, with a focus on routes of administration and drug tampering. We used a semiautomatic information retrieval algorithm to identify subreddits discussing nonmedical opioid consumption, finding over 86,000 Reddit users potentially involved in firsthand opioid usage. We developed a methodology based on word embedding to select alternative colloquial and nonmedical terms referring to opioid substances, routes of administration, and drug-tampering methods. We modeled the preferences of adoption of substances and routes of administration, estimating their prevalence and temporal unfolding, observing relevant trends such as the surge in synthetic opioids like fentanyl and an increasing interest in rectal administration. Ultimately, through the evaluation of odds ratios based on co-mentions, we measured the strength of association between opioid substances, routes of administration, and drug tampering, finding evidence of understudied abusive behaviors like chewing fentanyl patches and dissolving buprenorphine sublingually. We believe that our approach may provide a novel perspective for a more comprehensive understanding of nonmedical abuse of opioids substances and inform the prevention, treatment, and control of the public health effects.

中文翻译：

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非医疗类鸦片消费的给药途径和药物篡改模式：Reddit讨论的数据挖掘和内容分析

在过去的20年中，美国阿片类药物流行病的复杂发展一直是众多医学和药理学研究的主题，并且引发了关于如何实施干预措施和政策以有效控制其对公共卫生影响的多学科讨论。这项研究利用Reddit作为研究阿片类药物危机的主要数据源。我们的目标是找到一群热衷于讨论阿片类药物使用的Reddit用户，追踪其兴趣的时间演变，并广泛描述阿片类药物非医学消费的模式，重点是给药途径和药物篡改。我们使用半自动信息检索算法来识别讨论非医学类阿片类药物消费量的亚药物，发现了86种以上，000 Reddit用户可能参与了第一手阿片类药物的使用。我们开发了一种基于单词嵌入的方法，以选择涉及阿片类物质，给药途径和药物篡改方法的替代口语和非医学术语。我们对采用药物的偏好和给药途径进行了建模，估算了它们的患病率和时间变化，观察了相关趋势，例如芬太尼等合成阿片类药物的激增以及对直肠给药的兴趣日益增加。最终，通过基于共提的比值比评估，我们测量了阿片类物质，给药途径和药物篡改之间的关联强度，找到了对咀嚼芬太尼贴剂和舌下溶解丁丙诺啡等滥用行为的证据。