Chen Annie T, Wang Lexie C, Johnny Shana, Wong Sharon H, Chaliparambil Rahul K, Conway Mike, Glass Joseph E
Department of Biomedical Informatics and Medical Education, University of Washington School of Medicine, Seattle, WA, United States.
Department of Linguistics, University of Washington, Seattle, WA, United States.
JMIR Form Res. 2025 Mar 26;9:e57468. doi: 10.2196/57468.
Existing literature shows that persons with substance use disorder (SUD) experience different stages of readiness to reduce or abstain from substance use, and tailoring intervention change strategies to these stages may facilitate recovery. Moreover, stigma may serve as a barrier to recovery by preventing persons with SUDs from seeking treatment. In recent years, the behavior change technique (BCT) taxonomy has increasingly become useful for identifying potential efficacious intervention components; however, prior literature has not addressed the extent to which these techniques may naturally be used to recover from substance use, and knowledge of this may be useful in the design of future interventions.
We take a three-step approach to identifying strategies to facilitate substance use recovery: (1) characterizing the extent to which stages of change are expressed in social media data, (2) identifying BCTs used by persons at different stages of change, and (3) exploring the role that stigma plays in recovery journeys.
We collected discussion posts from Reddit, a popular social networking site, and identified subreddits or discussion forums about 3 substances (alcohol, cannabis, and opioids). We then performed qualitative data analysis using a hybrid inductive-deductive method to identify the stages of change in social media authors' recovery journeys, the techniques that social media content authors used as they sought to quit substance use, and the role that stigma played in social media authors' recovery journeys.
We examined 748 posts pertaining to 3 substances: alcohol (n=316, 42.2%), cannabis (n=335, 44.8%), and opioids (n=135, 18%). Social media content representing the different stages of change was observed, with the majority (472/748, 63.1%) of narratives representing the action stage. In total, 11 categories of BCTs were identified. There were similarities in BCT use across precontemplation, contemplation, and preparation stages, with social support seeking and awareness of natural consequences being the most common. As people sought to quit or reduce their use of substances (action stage), we observed a variety of BCTs, such as the repetition and substitution of healthful behaviors and monitoring and receiving feedback on their own behavior. In the maintenance stage, reports of diverse BCTs continue to be frequent, but offers of social support also become more common than in previous stages. Stigma was present throughout all stages. We present 5 major themes pertaining to the manifestation of stigma.
Patterns of BCT use and stigmatizing experiences are frequently discussed in social media, which can be leveraged to better understand the natural course of recovery from SUD and how interventions might facilitate recovery from substance use. It may be important to incorporate stigma reduction across all stages of the recovery journey.
现有文献表明，患有物质使用障碍（SUD）的人在减少或戒除物质使用方面经历不同的准备阶段，针对这些阶段调整干预改变策略可能有助于康复。此外，耻辱感可能会阻碍康复，因为它会阻止患有物质使用障碍的人寻求治疗。近年来，行为改变技术（BCT）分类法在识别潜在有效的干预成分方面越来越有用；然而，先前的文献尚未探讨这些技术在从物质使用中恢复的自然过程中可能被使用的程度，了解这一点可能有助于未来干预措施的设计。
我们采用三步法来确定促进物质使用康复的策略：（1）描述社交媒体数据中改变阶段的表达程度；（2）识别处于不同改变阶段的人所使用的行为改变技术；（3）探索耻辱感在康复过程中所起的作用。
我们从热门社交网站Reddit上收集了讨论帖子，并确定了关于三种物质（酒精、大麻和阿片类药物）的子版块或讨论论坛。然后，我们使用归纳 - 演绎混合方法进行定性数据分析，以确定社交媒体作者康复过程中的改变阶段、社交媒体内容作者在试图戒除物质使用时所使用的技术，以及耻辱感在社交媒体作者康复过程中所起的作用。
我们检查了748篇与三种物质相关的帖子：酒精（n = 316，42.2%）、大麻（n = 335，44.8%）和阿片类药物（n = 135，18%）。观察到代表不同改变阶段的社交媒体内容，其中大多数（472/748，63.1%）的叙述代表行动阶段。总共识别出11类行为改变技术。在前瞻期、沉思期和准备期，行为改变技术的使用存在相似之处，寻求社会支持和意识到自然结果是最常见的。当人们试图戒除或减少物质使用（行动阶段）时，可以观察到各种行为改变技术，例如重复和替代健康行为以及监测和接收关于自己行为的反馈。在维持阶段，各种行为改变技术的报告仍然频繁，但提供社会支持也比前几个阶段更常见。耻辱感在所有阶段都存在。我们提出了与耻辱感表现相关的5个主要主题。
社交媒体中经常讨论行为改变技术的使用模式和耻辱经历，这可以用来更好地理解从物质使用障碍中康复的自然过程以及干预措施如何促进物质使用的康复。在康复过程的所有阶段纳入减少耻辱感的措施可能很重要。
