Mackey Tim K, Kalyanam Janani
Global Health Policy Institute, San Diego, CA, USA.
Division of Global Public Health, University of California, San Diego School of Medicine, San Diego, CA, 92093, USA.
F1000Res. 2017 Nov 2;6:1937. doi: 10.12688/f1000research.12914.1. eCollection 2017.
A counterfeit fentanyl crisis is currently underway in the United States. Counterfeit versions of commonly abused prescription drugs laced with fentanyl are being manufactured, distributed, and sold globally, leading to an increase in overdose and death in countries like the United States and Canada. Despite concerns from the U.S. Drug Enforcement Agency regarding covert and overt sale of fentanyls online, no study has examined the role of the Internet and social media on fentanyl illegal marketing and direct-to-consumer access. In response, this study collected and analyzed five months of Twitter data (from June-November 2015) filtered for the keyword "fentanyl" using Amazon Web Services. We then analyzed 28,711 fentanyl-related tweets using text filtering and a machine learning approach called a Biterm Topic Model (BTM) to detect underlying latent patterns or "topics" present in the corpus of tweets. Using this approach we detected a subset of 771 tweets marketing the sale of fentanyls online and then filtered this down to nine unique tweets containing hyperlinks to external websites. Six hyperlinks were associated with online fentanyl classified ads, 2 with illicit online pharmacies, and 1 could not be classified due to traffic redirection. Importantly, the one illicit online pharmacy detected was still accessible and offered the sale of fentanyls and other controlled substances direct-to-consumers with no prescription required at the time of publication of this study. Overall, we detected a relatively small sample of Tweets promoting illegal online sale of fentanyls. However, the detection of even a few online sellers represents a public health danger and a direct violation of law that demands further study.
美国目前正面临一场假冒芬太尼危机。掺有芬太尼的常见滥用处方药的假冒版本正在全球范围内制造、分销和销售，导致美国和加拿大等国的过量用药和死亡人数增加。尽管美国缉毒局对芬太尼在网上的隐蔽和公开销售表示担忧，但尚无研究探讨互联网和社交媒体在芬太尼非法营销及直接面向消费者销售方面所起的作用。作为回应，本研究使用亚马逊网络服务收集并分析了五个月的推特数据（2015年6月至11月），这些数据是通过关键词“芬太尼”筛选出来的。然后，我们使用文本过滤和一种名为双词主题模型（BTM）的机器学习方法，对28711条与芬太尼相关的推文进行分析，以检测推文集里潜在的模式或“主题”。通过这种方法，我们检测到771条在网上推销芬太尼的推文子集，然后将其筛选至9条包含外部网站超链接的独特推文。其中6个超链接与在线芬太尼分类广告相关，2个与非法在线药店相关，1个因流量重定向无法分类。重要的是，在本研究发表时，检测到的一家非法在线药店仍然可以访问，并且提供芬太尼和其他受控物质的销售，无需处方即可直接面向消费者。总体而言，我们检测到宣传芬太尼非法网上销售的推文样本相对较少。然而，即使只检测到少数在线卖家也代表着一种公共卫生危险和直接的违法行为，需要进一步研究。
