{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:09:28Z","timestamp":1789664968336,"version":"4.0.1"},"reference-count":49,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recovery from opioid use disorder (OUD) is a complex, nonlinear process involving substantial health, psychological, and social challenges. Although online social support has been shown to benefit individuals with OUD, less is known about how recovery stages, such as the initial or stable stages, are expressed and experienced in online communities. Specifically, the linguistic features characterizing each stage, the social support exchanged at each stage, and the feasibility of predicting these stage transitions from user-generated content remain largely unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to develop a computational framework and present empirical insights for understanding OUD recovery in online communities by characterizing the language individuals use at different stages, the social support they receive, and the transitions they undergo over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We collected 32,810 posts and 324,224 comments from\n                      <jats:italic>r\/OpiatesRecovery<\/jats:italic>\n                      , the largest Reddit community dedicated to opioid recovery from 2014 to 2022. We fine-tuned pretrained language models to classify posts into 5 recovery stages and identify 11 categories of social support in comments. Recovery trajectories were constructed for 2936 users who posted multiple times. Mann-Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests and one-way multivariate analysis of covariance were used to compare linguistic features and social support across recovery stages and transitions. In addition, we predicted recovery-stage transitions using fine-tuned RoBERTa (Robustly Optimized BERT Pretraining Approach) and open-source large language models (Llama-3.1-8B-Instruct and Qwen2.5-14B-Instruct) evaluated in zero-shot and few-shot settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Individuals in early-stage recovery used significantly more negative, painful, and passive language compared to those in later stages (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). They also received more informational support (eg, advice and factual guidance) but less emotional support (eg, encouragement and sympathy;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). Notably, posts followed by observed recovery-stage progression were associated with significantly more informational support than posts followed by no observed stage change (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). Regarding the prediction of individuals\u2019 future recovery transitions, fine-tuned RoBERTa outperformed prompted open-source large language model baselines in this benchmark (\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>1<\/jats:sub>\n                      -score=0.59 vs 0.43), although this task remained highly challenging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reveals distinct linguistic and social support patterns across OUD recovery stages, identifying an association between informational support and observed recovery-stage progression. Although automatically detecting stage transitions remains challenging, these findings may inform future research on timely, stage-appropriate support strategies in online recovery communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/91054","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:53:00Z","timestamp":1789663980000},"page":"e91054-e91054","source":"Crossref","is-referenced-by-count":0,"title":["Language, Social Support, and Recovery-Stage Transitions in Opioid Use Disorder on Reddit: Computational Analysis"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8608-8653","authenticated-orcid":false,"given":"Xinchen","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6150-2501","authenticated-orcid":false,"given":"Huai-yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8838-3023","authenticated-orcid":false,"given":"Yu","family":"Chi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1274719","article-title":"Opioid use disorder: current trends and potential treatments","volume":"11","author":"Lee","journal-title":"Front Public Health"},{"key":"R2","unstructured":"2023 NSDUH annual national report. 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[doi: 10.1080\/16066359.2020.1837781]","DOI":"10.1080\/16066359.2020.1837781"},{"issue":"5","key":"R41","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1097\/ADM.0000000000000238","article-title":"Assessing the validity of online drug forums as a source for estimating demographic and temporal trends in drug use","volume":"10","author":"Paul","journal-title":"J Addict Med"},{"key":"R42","doi-asserted-by":"publisher","DOI":"10.1177\/2055207617743354","article-title":"What makes online substance-use interventions engaging? A systematic review and narrative synthesis","volume":"4","author":"Milward","journal-title":"Digit Health"},{"key":"R43","doi-asserted-by":"crossref","unstructured":"Funder DC Ozer DJ . Evaluating Effect Size in Psychological Research: Sense and Nonsense. Vol 2. Adv Methods Pract Psychol Sci SAGE Publications; 2019:156-168. [doi: 10.1177\/2515245919847202]","DOI":"10.1177\/2515245919847202"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1177\/1745691620984483","article-title":"Small effects: the indispensable foundation for a cumulative psychological science","volume":"17","author":"G\u00f6tz","journal-title":"Perspect Psychol Sci"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","first-page":"27","DOI":"10.5055\/jom.2007.0036","article-title":"Patterns of illicit drug use and retention in a methadone program: a longitudinal study","volume":"3","author":"Davstad, MA","journal-title":"J of Opioid Management"},{"key":"R46","doi-asserted-by":"crossref","unstructured":"Naji L Dennis BB Bawor M et al. A Prospective Study to Investigate Predictors of Relapse among Patients with Opioid Use Disorder Treated with Methadone. Vol 10. Subst Abuse SAGE Publications; 2016. [doi: 10.4137\/SART.S37030]","DOI":"10.4137\/SART.S37030"},{"issue":"2","key":"R47","doi-asserted-by":"publisher","DOI":"10.18502\/ijps.v15i2.2691","article-title":"Addiction recovery: a systematized review","volume":"15","author":"Inanlou","journal-title":"IJPS"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.2196\/48905","article-title":"Investigating substance use via Reddit: systematic scoping review","volume":"25","author":"Chi","journal-title":"J Med Internet Res"},{"key":"R49","doi-asserted-by":"crossref","unstructured":"Hovy D Spruit SL . The social impact of natural language processing. Presented at: Proceedings of the 54th Annual Meeting of the Association for Computational Linguistics (Volume 2: Short Papers); Aug 7-12, 2016:591-598; Berlin, Germany. 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