Forum77: An Analysis of an Online Health Forum Dedicated to Addiction Recovery

Prescription drug abuse is a pressing public health issue, and people who misuse prescription drugs are turning to online forums for help. Are such forums effective? We analyze the process of opioid withdrawal, recovery and relapse on Forum77, MedHelp.org's online health forum for substance abuse recovery. Applying Prochashka's Transtheoretical Model for behavior change, we develop a taxonomy describing phases of addiction expressed by Forum77 members. We examine activity and linguistic features across the phases USING, WITHDRAWING and RECOVERING. We train statistical classifiers to identify addiction phase, relapse and whether a user was RECOVERING at the time of her last post. Applying our classifiers to 2,848 users, we find that while almost 50% relapse, the prognosis for ending in RECOVERING is favorable. Supplementing our results with users' own accounts of their experiences, we discuss Forum77's efficacy and shortcomings, and implications for future technologies.

[1]  Lorinda M. Sheppard,et al.  Why Physicians Are Unprepared to Treat Patients Who Have Alcohol‐ and Drug‐related Disorders , 2001, Academic medicine : journal of the Association of American Medical Colleges.

[2]  W. Pratt,et al.  Managing the Personal Side of Health: How Patient Expertise Differs from the Expertise of Clinicians , 2011, Journal of medical Internet research.

[3]  Mark Dredze,et al.  Measuring Post Traumatic Stress Disorder in Twitter , 2014, ICWSM.

[4]  M. Gossop,et al.  Effects of information on the opiate withdrawal syndrome. , 1988, British journal of addiction.

[5]  J. Strang,et al.  Self-detoxification by Opiate Addicts , 1991, British Journal of Psychiatry.

[6]  Scott Counts,et al.  Unraveling abstinence and relapse: smoking cessation reflected in social media , 2014, CHI.

[7]  A T McLellan,et al.  Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. , 2000, JAMA.

[8]  Eric Horvitz,et al.  Characterizing and predicting postpartum depression from shared facebook data , 2014, CSCW.

[9]  M. Farrell,et al.  Opiate withdrawal : Withdrawal syndrome , 1994 .

[10]  Andrew McCallum,et al.  Conditional Random Fields: Probabilistic Models for Segmenting and Labeling Sequence Data , 2001, ICML.

[11]  Philip Resnik,et al.  Using Topic Modeling to Improve Prediction of Neuroticism and Depression in College Students , 2013, EMNLP.

[12]  J. Pennebaker,et al.  Psychological aspects of natural language. use: our words, our selves. , 2003, Annual review of psychology.

[13]  P. Bebbington,et al.  The Efficacy of Alcoholics Anonymous: The Elusiveness of Hard Data , 1976, British Journal of Psychiatry.

[14]  Carolyn Penstein Rosé,et al.  Understanding participant behavior trajectories in online health support groups using automatic extraction methods , 2012, GROUP '12.

[15]  J. Pennebaker,et al.  Who talks? The social psychology of illness support groups. , 2000, The American psychologist.

[16]  Julie Hepworth,et al.  An Interpretative Phenomenological Analysis of Participation in a Pro-anorexia Internet Site and Its Relationship with Disordered Eating , 2006, Journal of health psychology.

[17]  M. T. Høybye,et al.  Online interaction. Effects of storytelling in an internet breast cancer support group , 2005, Psycho-oncology.

[18]  M Sheeren,et al.  The relationship between relapse and involvement in alcoholics anonymous. , 1988, Journal of studies on alcohol.

[19]  Keith Humphreys,et al.  Social networks as mediators of the effect of Alcoholics Anonymous. , 2002, Addiction.

[20]  Noémie Elhadad,et al.  Cancer Stage Prediction Based on Patient Online Discourse , 2010, BioNLP@ACL.

[21]  L. Brooke The National Library of Medicine. , 1980, Hospital libraries.

[22]  J Scott Tonigan,et al.  Is it beneficial to have an alcoholics anonymous sponsor? , 2010, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[23]  Загоровская Ольга Владимировна,et al.  Исследование влияния пола и психологических характеристик автора на количественные параметры его текста с использованием программы Linguistic Inquiry and Word Count , 2015 .

[24]  Saul Greenberg,et al.  One size does not fit all: applying the transtheoretical model to energy feedback technology design , 2010, CHI.

[25]  Keith Humphreys,et al.  CIRCLES OF RECOVERY Self-Help Organizations for Addictions , 2003 .

[26]  Joshua M Sharfstein,et al.  Confronting the stigma of opioid use disorder--and its treatment. , 2014, JAMA.

[27]  Beth Sproule,et al.  Changing patterns in opioid addiction: characterizing users of oxycodone and other opioids. , 2009, Canadian family physician Medecin de famille canadien.

[28]  Alison Noble,et al.  Self-detoxification attempts among methadone maintenance patients: what methods and what success? , 2002, Addictive behaviors.

[29]  B P Smyth,et al.  Lapse and relapse following inpatient treatment of opiate dependence. , 2010, Irish medical journal.

[30]  D. Finfgeld,et al.  THERAPEUTIC GROUPS ONLINE: THE GOOD, THE BAD, AND THE UNKNOWN , 2000, Issues in mental health nursing.

[31]  Leonard J. Paulozzi,et al.  Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. , 2011, MMWR. Morbidity and mortality weekly report.

[32]  T Parran,et al.  Prescription drug abuse: A question of balance , 1997 .

[33]  W. Velicer,et al.  The Transtheoretical Model of Health Behavior Change , 1997, American journal of health promotion : AJHP.

[34]  M Farrell,et al.  Opiate withdrawal. , 1994, Addiction.

[35]  Consensus Panel Betty Ford Institute What is recovery? Revisiting the Betty Ford Institute Consensus Panel Definition , 2012, International Journal of Mental Health and Addiction.

[36]  B. Jeong,et al.  Activities on Facebook Reveal the Depressive State of Users , 2013, Journal of medical Internet research.

[37]  Eric Horvitz,et al.  Predicting Depression via Social Media , 2013, ICWSM.

[38]  M. Gossop,et al.  Lapse, Relapse and Survival among Opiate Addicts after Treatment , 1989, British Journal of Psychiatry.

[39]  J. Read,et al.  Application of the Transtheoretical Model to substance abuse: historical development and future directions. , 2005, Drug and alcohol review.

[40]  Michael Hemmingson The Big Book , 2009 .

[41]  Jennifer Ann Rode,et al.  Competing Online Viewpoints and Models of Chronic Illness , 2011 .

[42]  A Thomas McLellan,et al.  Setting the standard for recovery: Physicians' Health Programs. , 2009, Journal of substance abuse treatment.

[43]  Robert Newman,et al.  Prescription Drug Abuse , 2014, Annals of Internal Medicine.

[44]  James W. Pennebaker,et al.  Linguistic Inquiry and Word Count (LIWC2007) , 2007 .

[45]  J Scott Tonigan,et al.  Helping other alcoholics in alcoholics anonymous and drinking outcomes: findings from project MATCH. , 2004, Journal of studies on alcohol.

[46]  Robert L Stout,et al.  Determining the relative importance of the mechanisms of behavior change within Alcoholics Anonymous: a multiple mediator analysis. , 2012, Addiction.

[47]  L. Baker,et al.  Internet use and stigmatized illness. , 2005, Social science & medicine.

[48]  Eric Horvitz,et al.  Predicting postpartum changes in emotion and behavior via social media , 2013, CHI.

[49]  G. Norman,et al.  SMOKING CESSATION AND STRESS MANAGEMENT : APPLICATIONS OF THE TRANSTHEORETICAL MODEL OF BEHAVIOR CHANGE , 1998 .

[50]  Suzi Lyons,et al.  Lapse and relapse following inpatient treatment of opiate dependence. , 2010 .

[51]  R. West Time for a change: putting the Transtheoretical (Stages of Change) Model to rest. , 2005, Addiction.

[52]  Howard Carter,et al.  A PRELIMINARY INVESTIGATION , 2010 .

[53]  W F Velicer,et al.  The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. , 1991, Journal of consulting and clinical psychology.

[54]  J. Frost,et al.  Sharing Health Data for Better Outcomes on PatientsLikeMe , 2010, Journal of medical Internet research.

[55]  Xin Tu,et al.  Social Structure and Depression in TrevorSpace , 2014, CSCW.

[56]  P. Klemm,et al.  Online Cancer Support Groups: A Review of the Research Literature , 2003, Computers, informatics, nursing : CIN.

[57]  Keith Humphreys,et al.  Self-Help Organizations for Substance Use Disorders , 2016 .

[58]  Anna Lembke,et al.  Why doctors prescribe opioids to known opioid abusers. , 2012, The New England journal of medicine.

[59]  Eric Horvitz,et al.  Major life changes and behavioral markers in social media: case of childbirth , 2013, CSCW.