What types of social support for opioid overdoses do people who use drugs offer one another? An analysis of online discussion boards Open Access

Prood, Nadya (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/rr171x224?locale=en



The United States is currently facing an opioid epidemic. One way to tackle this epidemic may be to understand how opioid users are communicating with one another about overdoses. We proposed that this could be accomplished by examining expressions of social support on online discussion boards. The research aim was to examine what kinds of social support (emotional support, instrumental support, informational support, appraisal support) were being communicated through interactions on online opioid overdose discussion boards.


A qualitative study design was chosen to answer the proposed research aim. Sampling was performed at three levels: discussion board, forum and thread. A census of all threads that met the inclusion and exclusion criteria were analyzed. The data collected were from a total of seven threads with 143 posts by 81 unique usernames. Thematic analysis was chosen as the analysis method for this study because it allows for easy use of additional theory.


Analysis of the discussion boards showed that all four types of social support were present: informational, emotional, instrumental and appraisal and subthemes for each type of support emerged. For information support, the subthemes of overdose prevention, mechanism of how an overdose occurs, and responding to an overdose became apparent. For emotional support, the subthemes of safety, caring, and trust appeared. For instrumental support the subthemes of skill-based knowledge and insider knowledge became apparent. For appraisal support the subthemes of affirmations and feedback emerged.


Limitations of the study were that posters’ demographics were not available, the size of readership of the discussion board was unknown, no double coding was performed, and the findings were not generalizable. Strengths of the study were, it was the first of its kind in the opioid literature, a census was used to collect data and it was guided by theory. Future research should aim to examine the accuracy of informational support; to analyze the role of virtual communities to provide social support, and to gather and analyze demographics of the users of discussion boards.


Table of Contents


Table of Contents


Chapter 1: Introduction           1


Chapter 2: Literature Review 3


Opioid Overdoses       3


Social Network Theory           5


Social Support 5


Peer Support   6


Online Discussion Boards      7


Current Media: Online Discussion Boards and Opioid Overdoses    8


Pro-Anorexia Discussion Boards and Social Support            9


Opioids, Discussion Boards, and Social Support       9


Research Aim 10


Chapter 3: Methods    11


Study Design  11


Data Collection & Sampling   11


Analysis          15


Ethics  16


Chapter 4: Results       18


Informational Support 18


Overdose Prevention   18


Presence of Fentanyl and Carfentanil 18


Drug Potency  20


Combining Multiple Drugs    21


Using Drugs Unaccompanied 23


Mechanism of How an Overdose Occurs       23


Responding to an Overdose    24


Access to Naloxone and Narcan         26


Emotional Support      26


Safety  27


Caring 27


Trust    28


Instrumental Support  29


Skill-Based Knowledge          30


Insider Knowledge      31


Appraisal Support       31


Affirmations    32


Feedback         32


Chapter 5: Discussion 33


Overview of Findings 33


Limitations and Strengths       37


Implications and Future Research      39


Conclusion      40


References       41


Appendix A: Codebook          48




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