Rocky Mountain Poison and Drug Safety, Denver, CO, United States.
Department of Emergency Medicine, University of Colorado Hospital, Aurora, CO, United States.
JMIR Public Health Surveill. 2021 Dec 20;7(12):e29187. doi: 10.2196/29187.
Opioid use disorder and its consequences are a persistent public health concern for Australians. Web activity has been used to understand the perception of drug safety and diversion of drugs in contexts outside of Australia. The anonymity of the internet offers several advantages for surveilling and inquiring about specific covert behaviors, such as diversion or discussion of sensitive subjects where traditional surveillance approaches might be limited.
This study aims to characterize the content of web posts and compare reports of illicit sales of tapentadol and oxycodone from sources originating in Australia. First, post content is evaluated to determine whether internet discussion encourages or discourages proper therapeutic use of the drugs. Second, we hypothesize that tapentadol would have lower street price and fewer illicit sales than oxycodone.
Web posts originating in Australia between 2017 and 2019 were collected using the Researched Abuse, Diversion, and Addiction-Related Surveillance System Web Monitoring Program. Using a manual coding process, unstructured post content from social media, blogs, and forums was categorized into topics of discussion related to the harms and behaviors that could lead to harm. Illicit sales data in a structured format were collected through a crowdsourcing website between 2016 and 2019 using the Researched Abuse, Diversion, and Addiction-Related Surveillance System StreetRx Program. In total, 2 multivariable regression models assessed the differences in illicit price and number of sales.
A total of 4.7% (28/600) of tapentadol posts discussed an adverse event, whereas 10.27% (95% CI 9.32-11.21) of oxycodone posts discussed this topic. A total of 10% (60/600) of tapentadol posts discussed unsafe use or side effects, whereas 20.17% (95% CI 18.92-21.41) of oxycodone posts discussed unsafe use or side effects. There were 31 illicit sales reports for tapentadol (geometric mean price per milligram: Aus $0.12 [US $0.09]) and 756 illicit sales reports for oxycodone (Aus $1.28 [US $0.91]). Models detected no differences in the street price or number of sales between the drugs when covariates were included, although the potency of the pill significantly predicted the street price (P<.001) and availability predicted the number of sales (P=.03).
Australians searching the web for opinions could judge tapentadol as safer than oxycodone because of the web post content. The illicit sales market for tapentadol was smaller than that of oxycodone, and drug potency and licit availability are likely important factors influencing the illicit market.
阿片类药物使用障碍及其后果一直是澳大利亚人关注的一个持续的公共卫生问题。网络活动已被用于了解在澳大利亚以外的情况下对药物安全性的看法和药物的转移。互联网的匿名性为监测和调查特定的秘密行为提供了几个优势，例如转移或讨论敏感话题，而传统的监测方法可能受到限制。
本研究旨在描述网络帖子的内容，并比较源自澳大利亚的他喷他多和羟考酮非法销售的报告。首先，评估帖子内容以确定互联网讨论是否鼓励或不鼓励药物的合理治疗用途。其次，我们假设他喷他多的街头价格低于羟考酮，非法销售也少于羟考酮。
使用 Research Abuse，Diversion，and Addiction-Related Surveillance System Web Monitoring Program 收集 2017 年至 2019 年间源自澳大利亚的网络帖子。使用手动编码过程，将社交媒体、博客和论坛中的非结构化帖子内容分类为与可能导致伤害的伤害和行为相关的讨论主题。通过 Research Abuse，Diversion，and Addiction-Related Surveillance System StreetRx Program 在 2016 年至 2019 年期间通过众包网站收集了结构化的非法销售数据。总共使用 2 个多变量回归模型评估了非法价格和销售数量的差异。
共有 4.7%（28/600）的他喷他多帖子讨论了不良事件，而 10.27%（95%CI 9.32-11.21）的羟考酮帖子讨论了这一主题。共有 10%（60/600）的他喷他多帖子讨论了不安全使用或副作用，而 20.17%（95%CI 18.92-21.41）的羟考酮帖子讨论了不安全使用或副作用。他喷他多的非法销售报告有 31 份（每毫克的几何平均价格：澳元 0.12[美元 0.09]），羟考酮的非法销售报告有 756 份（澳元 1.28[美元 0.91]）。纳入协变量后，模型检测到两种药物在街头价格或销售数量上没有差异，尽管药丸的效力显著预测了街头价格（P<.001），而供应情况预测了销售数量（P=.03）。
澳大利亚人在网上搜索意见时，可能会因为网络帖子的内容而认为他喷他多比羟考酮更安全。他喷他多的非法销售市场比羟考酮小，药物效力和合法供应情况可能是影响非法市场的重要因素。
