Can a social media strategy that has helped gay men combat HIV now help curb the abuse of powerful opioid drugs? That’s the question a team of researchers at the University of California, Los Angeles (UCLA), is asking in a pilot study highlighted by White House officials last week.
The Harnessing Online Peer Education (HOPE) intervention is just one of more than 200 research projects the Obama administration spotlighted on 6 July, as it announced new actions to tackle the rising opioid epidemic in the United States. Along with the research projects, the administration seeks to better educate opioid prescribers, strengthen prescription drug monitoring, and enable safe disposal of unneeded drugs.
The HOPE intervention, led by psychologist Sean Young, Ph.D., associate professor of family medicine and executive director of the University of California Institute for Prediction Technology, aims to harness the immense power of social media to improve public health. Instead of a taking a clinical approach to reducing opioid abuse, which often involves prescribing alternative medications such as naloxone, the study seeks to change behavior. For the 12-week, $170,000 pilot project, which is funded by the National Institutes of Health (NIH) and will begin later this month, Young’s team plans to recruit about 60 patients from the Ronald Reagan UCLA Medical Center who are experiencing chronic pain, are on long-term opioid therapy, and have reported other behaviors—such as drug or alcohol abuse—that put them at high risk of addiction. The researchers will ask each participant to log into a private Facebook group, where they can share posts, comments, pictures, and private messages among themselves, as well as with the eight peer role models who are also on long-term opioid therapy. The peer role models are expected to share tips and the successes and challenges they’ve experienced in managing their pain.
To assess whether the strategy is working, Young will monitor changes in the participants’ reported use of opioids and other substances. Mostly, however, Young says the effort is a “feasibility and accessibility” study. He would like to determine whether the participants find this type of intervention helpful, easy to use, and accessible, as well as whether they will be willing to discuss sensitive issues in an online community. Young also hopes the results, which should be compiled by the end of the year, will provide enough preliminary evidence to help raise funds for a larger trial testing the use of social media to combat abuse of a broader number of substances.
Previously, Young used a similar online peer support model to encourage a group of homosexual men in Peru to get tested for HIV. That pilot found that the men who participated were 2 to 3 times more likely to get tested for HIV than those in the control group, who participated in online groups without peer role models. Young said participants found the community to be a safe place to communicate, and some of the online relationships continued after the trial concluded.
Young notes that such studies suggest social media have great potential to nudge behavioral changes. “If the correct psychological fundamentals are applied to a social media intervention, then it will have an impact on behavior,” he says. “We should take advantage of existing platforms that have proven to cause behavior change—and cause it rather quickly—and can instantly reach billions of people.”
Jacqueline Lloyd, a deputy branch chief at NIH’s National Institute of Drug Abuse in Bethesda, Maryland, says Young’s study is one of 11 funded under a program aimed at using social media to understand and address substance use and addiction. The HOPE intervention, she says, has “potential for informing how social media and new technologies can be leveraged to deliver low-cost, novel interventions to prevent prescription opioid abuse and overdose.”