Effects of Substance Use, Recovery, and Non-Drug-Related Online Community Participation on the Risk of a Use Episode During Remission From Opioid Use Disorder: Longitudinal Observational Study.

BACKGROUND: Opioid addiction is currently one of the most pressing public health issues. Despite several treatment options for opioid addiction, the recurrence of use episodes during remission remains high. Research indicates that meaningful membership in various social groups underpins the successful transition from addiction to long-term remission. However, much of the current literature focuses on online peer-support groups for individuals in remission from substance use, sometimes also called recovery groups, a term we will use in line with the terminology used by the online community we studied. In contrast, online group memberships that promote substance use and groups that are unrelated to substance use and remission (non-drug-related groups) are rarely studied. OBJECTIVE: This study aims to understand whether engagement with a variety of Reddit subforums (subreddits) provides those in remission from opioid use disorder (OUD) with social capital, thereby reducing their risk of a use episode over several years. More specifically, it aims to examine the different effects of engagement with substance use, recovery, and non-drug-related subreddits. METHODS: A data set of 457 individuals in remission from OUD who posted their remission start date on Reddit was collected, of whom 219 (47.9%) indicated at least one use episode during the remission period. Using a Cox proportional hazards model, the effects of the number of non-drug-related, recovery, and substance use subreddits an individual had engaged with on the risk of a use episode were tested. Group engagement was assessed both in terms of the absolute number of subreddits and as a proportion of the total number of subreddits in which an individual had posted. RESULTS: Engagement with a larger number of non-drug-related online communities reduced the likelihood of a use episode irrespective of the number of posts and comments made in these forums. This was true for both the absolute number of non-drug-related communities (P<.001) and the proportion of communities with which a person engaged (P<.001). The findings were less conclusive for recovery support and substance use groups; although participating in more recovery support subreddits reduced the risk of a use episode (P<.001), being part of a higher proportion of recovery support groups relative to other subreddits increased the risk (P=.01). A higher proportion of substance use subreddits marginally increased the risk of a use episode (P=.06); however, the absolute number of substance use subreddits significantly reduced the risk of a use episode (P=.002). CONCLUSIONS: Our work indicates that even minimal regular engagement with several non-drug-related online forums may provide those in remission from OUD with an opportunity to grow their social capital and reduce the risk of a use episode over several years.

Can we prevent social identity switches? An experimental-computational investigation.

Previous studies suggested that social identity switches are rapid and highly effective, raising the question of whether people can intentionally control such switches. In two studies, we tested if participants could exert top-down control to prevent a social identity switch triggered by the experimental context. In Study 1, participants (N = 198) were given a writing task aimed at prompting a switch from their parent identity to their feminist identity. Before the prompt, half of the participants (the experimental group) were instructed to remain in their parent identity, avoiding an identity switch; the control group was not given such instructions. We found no significant difference between the groups in either self-reported salience or the implicit computational measure of salience based on participants' linguistic style, both measures suggesting a switch in both groups. Study 2 (N = 380) followed the same design but included a monetary incentive to prevent the switch in the experimental group. The groups differed significantly in their self-reported salience but not in the implicit measure, which suggests limited ability to avoid the switch even when participants report being able to do so. These results point to limited intentional control over exogenously triggered identity switches, with important practical implications.