Which Social Media Platforms Provide the Most Informative Data for Monitoring the Opioid Crisis?

Social media can provide real-time insight into trends in substance use, addiction, and recovery. Prior studies have used platforms such as Reddit and X (formerly Twitter), but evolving policies around data access have threatened these platforms' usability in research. We evaluate the potential of a broad set of platforms to detect emerging trends in the opioid epidemic. From these, we created a shortlist of 11 platforms, for which we documented official policies regulating drug-related discussion, data accessibility, geolocatability, and prior use in opioid-related studies. We quantified their volumes of opioid discussion, capturing informal language by including slang generated using a large language model. Beyond the most commonly used Reddit and X, the platforms with high potential for use in opioid-related surveillance are TikTok, YouTube, and Facebook. Leveraging many different social platforms, instead of a single platform, safeguards against sudden changes to data access and may better capture all populations that use opioids than any single platform.