title: The Canary in the Coal Mine Tweets: Social Media Reveals Public Perceptions of Non-Medical Use of Opioids.
abstract: OBJECTIVE
  Non-medical prescription opioid use is a growing public health concern. Social media is an emerging tool to understand health attitudes, beliefs, and behaviors.
  
  
  METHODS
  We retrieved a sample of publicly available Twitter messages in early 2014, using common opioid medication names and slang search terms. We used content analysis to code messages by user, context of message (personal vs general experiences), and key content themes.
  
  
  RESULTS
  We reviewed 540 messages, of which 375 (69%) messages were related to opioid behaviors. Of these, 316 (84%) originated from individual user accounts; 125 messages expressed personal experience with opioids. The majority of personal messages referenced using opioids to obtain a "high", use for sleep, or other non-intended use (87,70%). General attitudes regarding opioid use included positive sentiment (52, 27%), comments on others peoples opioid use (57, 30%), and messages containing public health information or links (48, 25%).
  
  
  CONCLUSIONS
  In a sample of social media messages mentioning opioid medications, the most common theme amongst English users related to various forms of opioid misuse. Social media can provide insights into the types of misuse of opioids that might aid public health efforts to reduce non-medical opioid use.
authors.affiliation: Division of General Internal Medicine, School of Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Chan
authors.affiliation: Division of General Internal Medicine, School of Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lopez
authors.affiliation: Division of General Internal Medicine, School of Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Urmimala
authors.initials: U
authors.lastname: Sarkar
mesh_terms: D000082:Acetaminophen; D000701:Analgesics, Opioid; D001294:Attitude to Health; D003142:Communication; D003625:Data Collection; D004338:Drug Combinations; D015438:Health Behavior; D006801:Humans; D006853:Hydrocodone; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D011634:Public Health; D061108:Social Media; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; C083640:acetaminophen, hydrocodone drug combination; D000082:Acetaminophen; D006853:Hydrocodone