What types of social support for opioid overdoses do people who use drugs offer one another? An analysis of online discussion boards Pubblico
Prood, Nadya (Spring 2018)
Abstract
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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