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This paper examined news in comparison to user-generated content related to opioids to understand the role of second-level agenda-setting in public health. We analyzed 162,760 tweets about the opioid crisis, and compared the main topics and their sentiments with 2998 opioid stories from\n                    <jats:italic toggle=\"yes\">The New York Times<\/jats:italic>\n                    online. Evidence from this study suggests that second-level agenda setting on social media is different from the news; public communication about opioids on X\/Twitter highlights attributes that are different from the ones highlighted in news. The findings suggest that public health communication should strategically utilize social media data, including obtaining consumer insight from personal tweets, listening to diverse views and warning signs from issue tweets, and tuning to the media for policy trends.\n                  <\/jats:p>","DOI":"10.1177\/13591053241312043","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T20:51:11Z","timestamp":1738270271000},"page":"4366-4384","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["What\u2019s on the agenda? 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