Internet chatter may spot trends in opioid abuse

Monitoring Internet chatter is a promising way to spot trends in abuse of prescription opioids (pain relievers), according to a pilot study presented today at the American Pain Society meeting in San Antonio.

"Prescription opioid abuse is an enormous problem in this country and rapidly growing," Dr. Nathaniel Katz, from Tufts University in Boston. "It's ahead of cocaine and heroin as drug abuse problems in the United States and there really is no systematic monitoring of prescription opioid abuse."

In a pilot study, Katz said, he and his colleagues showed that monitoring the Internet "systematically, quantitatively, and prospectively" provides useful "leading edge information about prescription drug abuse trends."

They created a system to capture Internet messages posted on a variety of popular sites dedicated to drug abuse and harvested almost 50,000 postings over a 6-month period. They focused on three opioid drugs - Vicodin and OxyContin, two painkillers that are widely abused, and Kadian, a sustained-release oral morphine preparation that past research has shown is less attractive to abusers.

"These relationships held up in our research," Katz said. "Indeed, we saw an enormous number of mentions on the Internet of Vicodin and OxyContin and very few mentions of Kadian."

Analysis of the content of 234 randomly selected messages indicated that the number of Internet posts endorsing recreational use of Kadian was significantly less than for OxyContin or Vicodin.

In an unpublished substudy, the researchers looked at one opioid for which there was a sudden increase in the number of media mentions of abuse of this drug at one particular point in time but no mentions before that.

"We found that about 6 months before it first got picked up in the media, we saw the beginnings of a steady increase in mentions on the Internet," Katz told Reuters Health.

Monitoring Internet messages might "help alert us and be an early warning system for changing trends in prescription drug abuse that one could potentially create interventions around," Katz suggests.

For example, if a company finds that their new drug is suddenly becoming a drug of abuse, there are measures they could take - such as changing the formulation - that could lower its potential for abuse, he explained.