#Opioids: A Mixed-Methods Examination of Top Opioid-Related Content on TikTok

OBJECTIVE: Despite an abundance of public discourse about the opioid crisis in the media, there is little research characterizing opioid-related content on TikTok, a popular video-based social media platform. This study sought to examine how opioids are portrayed on TikTok. METHOD: This study used mixed methods to analyze top opioid-related posts marked with the hashtag "#opioids" collected in May 2023. "Holistic coding" was used to topically categorize multimedia content in posts and to quantify the frequency of mentioning opioid-related content areas (e.g., overdose, pain, fentanyl). Template analysis methods were then used to develop themes. RESULTS: A total of 115 posts were analyzed. The most frequently used opioid-related topic codes include prescription opioids (58.3% of posts), pain (47.0%), overdose (35.7%), and fentanyl (34.8%). Posts were most commonly about challenges to accessing prescription opioids for pain management (37.4%), opioid policy (36.5%), and negative consequences of using opioids (32.2%). Qualitative analysis yielded themes about the potential dangers associated with using opioids, treatment and recovery from opioid use disorder, and barriers to obtaining prescription opioids for pain management. CONCLUSIONS: This study revealed polarizing opinions within opioid-related content on TikTok. The two main stances, dangers of nonmedical opioid use and advocacy for the availability of prescription opioids for pain management, represent nationwide tensions between the opioid and chronic pain crises. The vast audience TikTok garners presents an opportunity for disseminating opioid education, harm-reduction strategies, and treatment options for opioid use disorder that were largely absent among the posts analyzed.