Background: Opioid overdose deaths remain a critical public health challenge in the United States. Social media platforms have emerged as important venues for information sharing, peer support, and shaping public discourse about the opioid crisis. Twitter/X is widely used to discuss opioid use, prevention, policy, and personal experiences. However, little is known about how these conversations are structured, who the key voices are, and what topics are most shared. Few studies have used social network analysis to investigate these trends. This study aimed to uncover the structure of the opioid-related network and identify key influencers, top hashtags, and top content producers. Methods: We used NodeXL to import, visualize, and analyze data from public Twitter/X accounts. A total of 32,745 tweets containing the keyword “opioid” were collected between December 18, 2024, and March 26, 2025. Results: Network analysis of opioid-related conversations on Twitter/X identified 21,654 users and 32,743 interactions. The network showed low density, but clustered communities centered on the opioid crisis. Top accounts were primarily health-related, though AI-driven accounts also played a growing role in information dissemination. Key themes included fentanyl, crisis, and overdose, with hashtags such as #opioid and #fentanyl most frequent. Findings highlight both public concern and the influence of AI-driven accounts in shaping online opioid discourse. Conclusion: Twitter/X provides key insights into the actors and narratives influencing discussions about opioids. The growing role of AI systems underscores the need for public health officials to enhance their digital presence and prioritize accurate information over misinformation.
Alshahrani et al. (Tue,) studied this question.