Using Social Listening Data to Monitor Misuse and Nonmedical Use of Bupropion

February 14, 2017

Post-marketing surveillance for medical products often relies on traditional, centralized reporting of adverse event (AE) reports. Cases of individuals misusing or abusing medications are often not submitted through formal adverse event reporting chains due to the sensitive nature of patients' experiences.

Scholarly reviews of non-medical drug abuse often focus on certain drug classes traditionally associated with misuse such as stimulants, opioids, and benzodiazepines. While research on the risks of medication misuse has ignored drugs like antidepressants, Epidemico was used to identify patterns of antidepressant abuse behaviors otherwise unseen by industry and regulators. Our most recent publication in JMIR Public Health and Surveillance is titled "Using Social Listening Data to Monitor Misuse and Nonmedical Use of Bupropion: A Content Analysis". Rather than focusing on formal adverse event reporting data, our team undertook proactive outreach to explore data in topic-specific forums, working with forum operators to establish terms of use and thorough de-identification protocols. This engagement also facilitated deeper conversations about the ethical implications of analyzing user-generated content.

We identified posts within the online harm reduction and drug user forums Bluelight and Opiophile to gather conversations related to the nonmedical use of 3 antidepressants: buproprion, venlafaxine, and amitryptyline. Using a combination of automated processing and manual review we found cases of misuse and abuse of drugs, gained contextual insights into intended effects, routes of administration, drug sources, and user experiences. To do so, we worked with pharmaceutical safety and harm reduction forum administrators to help bridge the vocabularies of pharmacoepidemiology, regulatory science, and vernacular language. Beginning with a modified version of the MedDRA Standardized MedDRA Queries (SMQs) for "Drug abuse, dependence and withdrawal", we identified additional constructs of interest to understand how people discuss changes in drug tolerance and other facets of experience not conventionally included within that SMQ.

Figure 1


The study demonstrated the capability of Epidemico's social listening tools to identify characteristics of misuse and abuse of medications deemed to have low or no abuse potential. We found that about 8.6% of posts that mentioned one of the selected antidepressant drugs also described how or why people abused them. We also identified patterns illustrating how users communicated about drug misuse and abuse; for example, the majority of forum posters actually discouraged the non-medical use of all three antidepressants.

We are excited to continue exploring more methods and sources to help industry, regulators, and patients understand how and why people use antidepressant drugs in unprescribed ways.​