{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:29:52Z","timestamp":1793345392384,"version":"4.5.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Medications such as buprenorphine and methadone are effective for treating opioid use disorder (OUD), but many patients face barriers related to treatment and access. We analyzed two sources of data\u2014social media and published literature\u2014to categorize and quantify such barriers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this mixed methods study, we analyzed social media (Reddit) posts from three OUD-related forums (subreddits): r\/suboxone, r\/Methadone, and r\/naltrexone. We applied natural language processing to identify posts relevant to treatment barriers, categorized them into insurance- and non-insurance-related, and manually subcategorized them into fine-grained topics. For comparison, we used substance use-, OUD- and barrier-related keywords to identify relevant articles from PubMed published between 2006 and 2022. We searched publications for language expressing fear of barriers, and hesitation or disinterest in medication treatment because of barriers, paying particular attention to the affected population groups described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On social media, the top three insurance-related barriers included having no insurance (22.5%), insurance not covering OUD treatment (24.7%), and general difficulties of using insurance for OUD treatment (38.2%); while the top two non-insurance-related barriers included stigma (47.6%), and financial difficulties (26.2%). For published literature, stigma was the most prominently reported barrier, occurring in 78.9% of the publications reviewed, followed by financial and\/or logistical issues to receiving medication treatment (73.7%), gender-specific barriers (36.8%), and fear (31.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The stigma associated with OUD and\/or seeking treatment and insurance\/cost are the two most common types of barriers reported in the two sources combined. Harm reduction efforts addressing barriers to recovery may benefit from leveraging multiple data sources.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1141093","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T22:36:28Z","timestamp":1682030188000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Barriers to opioid use disorder treatment: A comparison of self-reported information from social media with barriers found in literature"],"prefix":"10.3389","volume":"11","author":[{"given":"Whitney","family":"Bremer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karma","family":"Plaisance","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Bonn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Love","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanmarie","family":"Perrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeed","family":"Sarker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"ref1","volume-title":"Substance abuse and addiction statistics","year":"2023"},{"key":"ref2","volume-title":"2019 National Survey of drug use and health (NSDUH) releases [internet]","year":""},{"key":"ref3","volume-title":"Overdose death rates [internet]. National Institute on Drug Abuse","year":"2022"},{"key":"ref4","volume-title":"Provisional drug overdose death counts","author":"Ahmad","year":"2022"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"109380","DOI":"10.1016\/j.drugalcdep.2022.109380","article-title":"Xylazine spreads across the US: a growing component of the increasingly synthetic and polysubstance overdose crisis","volume":"233","author":"Friedman","year":"2022","journal-title":"Drug Alcohol Depend"},{"key":"ref6","volume-title":"Stigma reduction [internet]","year":"2022"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"102769","DOI":"10.1016\/j.drugpo.2020.102769","article-title":"Tackling the overdose crisis: the role of safe supply","volume":"80","author":"Ivsins","year":"2020","journal-title":"Int J Drug Policy"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"556","DOI":"10.15288\/jsad.2020.81.556","article-title":"Addressing the syndemic of HIV, hepatitis C, overdose, and COVID-19 among people who use drugs: the potential roles for decriminalization and safe supply","volume":"81","author":"Bonn","year":"2020","journal-title":"J Stud Alcohol Drugs"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"108202","DOI":"10.1016\/j.drugalcdep.2020.108202","article-title":"Barriers and facilitators to a novel low-barrier hydromorphone distribution program in Vancouver, Canada: a qualitative study","volume":"216","author":"Ivsins","year":"2020","journal-title":"Drug Alcohol Depend"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e1003002","DOI":"10.1371\/journal.pmed.1003002","article-title":"Opioid-related treatment, interventions, and outcomes among incarcerated persons: a systematic review","volume":"16","author":"Malta","year":"2019","journal-title":"PLoS Med"},{"key":"ref11","doi-asserted-by":"crossref","DOI":"10.17226\/25310","volume-title":"Medications for opioid use disorder save lives [internet]","author":"Leshner","year":"2019"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1097\/HRP.0000000000000075","article-title":"Medication-assisted treatment of opioid use disorder: review of the evidence and future directions","volume":"23","author":"Connery","year":"2015","journal-title":"Harv Rev Psychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1001\/jamapediatrics.2021.4606","article-title":"Access to medications for opioid use disorder and associated factors among adolescents and young adults: a systematic review","volume":"176","author":"Pilarinos","year":"2022","journal-title":"JAMA Pediatr"},{"key":"ref14","first-page":"200","article-title":"Primary care management of opioid use disorders: abstinence, methadone, or buprenorphine-naloxone?","volume":"63","author":"Srivastava","year":"2017","journal-title":"Can Fam Physician Med Fam Can"},{"key":"ref15","doi-asserted-by":"crossref","DOI":"10.31478\/202004b","article-title":"Treatment, et al. improving access to evidence-based medical treatment for opioid use disorder: strategies to address key barriers within the treatment system","author":"Madras","year":"2020","journal-title":"NAM Perspect"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e4","DOI":"10.1097\/ADM.0000000000000679","article-title":"Opioid policy changes during the COVID-19 pandemic \u2013 and beyond","volume":"14","author":"Davis","year":"2020","journal-title":"J Addict Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"108387","DOI":"10.1016\/j.jsat.2021.108387","article-title":"Differential impacts of COVID-19 across racial-ethnic identities in persons with opioid use disorder","volume":"129","author":"Mistler","year":"2021","journal-title":"J Subst Abuse Treat"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e1914672","DOI":"10.1001\/jamanetworkopen.2019.14672","article-title":"Machine learning and natural language processing for geolocation-centric monitoring and characterization of opioid-related social media chatter","volume":"2","author":"Sarker","year":"2019","journal-title":"JAMA Netw Open"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s41060-019-00175-3","article-title":"Harnessing social media data for pharmacovigilance: a review of current state of the art, challenges and future directions","volume":"8","author":"Pappa","year":"2019","journal-title":"Int J Data Sci Anal"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.jbi.2015.02.004","article-title":"Utilizing social media data for pharmacovigilance: A review","volume":"54","author":"Sarker","year":"2015","journal-title":"J Biomed Inform"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1007\/s40264-019-00858-7","article-title":"Recommendations for the use of social Media in Pharmacovigilance: lessons from IMI WEB-RADR","volume":"42","author":"van Stekelenborg","year":"2019","journal-title":"Drug Saf"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s12911-018-0621-y","article-title":"Utility of social media and crowd-intelligence data for pharmacovigilance: a scoping review","volume":"18","author":"Tricco","year":"2018","journal-title":"BMC Med Inform Decis Mak"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12911-021-01394-0","article-title":"Text classification models for the automatic detection of nonmedical prescription medication use from social media","volume":"21","author":"Al-Garadi","year":"2021","journal-title":"BMC Med Inform Decis Mak"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e6426","DOI":"10.2196\/jmir.6426","article-title":"Scaling up research on drug abuse and addiction through social media big data","volume":"19","author":"Kim","year":"2017","journal-title":"J Med Internet Res"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e189","DOI":"10.2196\/jmir.2741","article-title":"An exploration of social circles and prescription drug abuse through Twitter","volume":"15","author":"Hanson","year":"2013","journal-title":"J Med Internet Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e280","DOI":"10.2196\/jmir.5144","article-title":"Establishing a link between prescription drug abuse and illicit online pharmacies: analysis of twitter data","volume":"17","author":"Katsuki","year":"2015","journal-title":"J Med Internet Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1111\/phn.12809","article-title":"Mining twitter to explore the emergence of COVID-19 symptoms","volume":"37","author":"Guo","year":"2020","journal-title":"Public Health Nurs"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1093\/jamia\/ocaa116","article-title":"Self-reported COVID-19 symptoms on Twitter: an analysis and a research resource","volume":"27","author":"Sarker","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e26459","DOI":"10.2196\/26459","article-title":"Loss of smell and taste in patients with suspected COVID-19: analyses of patients\u2019 reports on social media","volume":"23","author":"Koyama","year":"2021","journal-title":"J Med Internet Res"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e31259","DOI":"10.2196\/31259","article-title":"Understanding the #longCOVID and #longhaulers conversation on twitter: multimethod study","volume":"2","author":"Santarossa","year":"2022","journal-title":"JMIR Infodemiology"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"ooab075","DOI":"10.1093\/jamiaopen\/ooab075","article-title":"Mining long-COVID symptoms from reddit: characterizing post-COVID syndrome from patient reports","volume":"4","author":"Sarker","year":"2021","journal-title":"JAMIA Open"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"100061","DOI":"10.1016\/j.dadr.2022.100061","article-title":"Examining stigma relating to substance use and contextual factors in social media discussions","volume":"3","author":"Chen","year":"2022","journal-title":"Drug Alcohol Depend Rep"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"108672","DOI":"10.1016\/j.drugalcdep.2021.108672","article-title":"Socially-supportive norms and mutual aid of people who use opioids: an analysis of Reddit during the initial COVID-19 pandemic","volume":"222","author":"Bunting","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s13011-022-00442-w","article-title":"Concerns among people who use opioids during the COVID-19 pandemic: a natural language processing analysis of social media posts","volume":"17","author":"Sarker","year":"2022","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1080\/15563650.2022.2032730","article-title":"Reddit discussions about buprenorphine associated precipitated withdrawal in the era of fentanyl","volume":"60","author":"Spadaro","year":"2022","journal-title":"Clin Toxicol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e35974","DOI":"10.2196\/35974","article-title":"Consumer-generated discourse on cannabis as a medicine: scoping review of techniques","volume":"24","author":"Habibabadi","year":"2022","journal-title":"J Med Internet Res"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"205630512110190","DOI":"10.1177\/20563051211019004","article-title":"Studying reddit: a systematic overview of disciplines, approaches, methods, and ethics","volume":"7","author":"Proferes","year":"2021","journal-title":"Soc Media Soc"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1097\/ADM.0000000000000940","article-title":"Thematic analysis of reddit content about buprenorphine-naloxone using manual annotation and natural language processing techniques","volume":"16","author":"Graves","year":"2022","journal-title":"J Addict Med"},{"key":"ref39","volume-title":"The python reddit API wrapper \u2014 PRAW 7.6.1 documentation [internet]","year":"2022"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1093\/eurpub\/ckac161","article-title":"Evidence of the emergence of illicit benzodiazepines from online drug forums","volume":"32","author":"Sarker","year":"2022","journal-title":"Eur J Pub Health"},{"key":"ref41","volume-title":"Python-Levenshtein: Python extension for computing string edit distances and similarities [internet]","author":"Bachmann","year":""},{"key":"ref42","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12954-018-0247-5","article-title":"For the Kingston house of recovery for women and children. Need for women-centered treatment for substance use disorders: results from focus group discussions","volume":"15","author":"Elms","year":"2018","journal-title":"Harm Reduct J"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"ooab042","DOI":"10.1093\/jamiaopen\/ooab042","article-title":"Automatic gender detection in twitter profiles for health-related cohort studies","volume":"4","author":"Yang","year":"2021","journal-title":"JAMIA Open"},{"key":"ref44","volume-title":"Abuse NI on D. words matter \u2013 Terms to use and avoid when talking about addiction [internet]","year":"2021"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jsat.2019.01.005","article-title":"A new brief opioid stigma scale to assess perceived public attitudes and internalized stigma: evidence for construct validity","volume":"99","author":"Yang","year":"2019","journal-title":"J Subst Abus Treat"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e1002969","DOI":"10.1371\/journal.pmed.1002969","article-title":"Stigma as a fundamental hindrance to the United States opioid overdose crisis response","volume":"16","author":"Tsai","year":"2019","journal-title":"PLoS Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/ADM.0000000000000355","article-title":"Correlates of stigma severity among persons seeking opioid detoxification","volume":"12","author":"Bozinoff","year":"2018","journal-title":"J Addict Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1001\/jama.2021.1741","article-title":"Overcoming barriers to treatment of opioid use disorder","volume":"325","author":"Olsen","year":"2021","journal-title":"JAMA"},{"key":"ref49","doi-asserted-by":"crossref","DOI":"10.31478\/202011d","article-title":"Combatting the stigma of addiction\u2014the need for a comprehensive health system approach","author":"Atkins","year":"2020"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"E460","DOI":"10.1503\/cmaj.190430","article-title":"Patient-centred care in opioid agonist treatment could improve outcomes","volume":"191","author":"Brothers","year":"2019","journal-title":"CMAJ Can Med Assoc J"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1940","DOI":"10.1377\/hlthaff.2018.05134","article-title":"How is telemedicine being used in opioid and other substance use disorder treatment?","volume":"37","author":"Huskamp","year":"2018","journal-title":"Health Aff"},{"key":"ref52","volume-title":"Telehealth can lower barriers to buprenorphine treatment for opioid use disorder [internet]","year":""},{"key":"ref53","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.jsat.2006.01.002","article-title":"Treatment barriers identified by substance abusers assessed at a centralized intake unit","volume":"30","author":"Rapp","year":"2006","journal-title":"J Subst Abus Treat"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/08995605.2011.534397","article-title":"Stigma as a barrier to substance abuse and mental health treatment","volume":"23","author":"McFarling","year":"2011","journal-title":"Mil Psychol"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1080\/1533256X.2014.933731","article-title":"Barriers to integrated treatment of substance abuse and trauma among women","volume":"14","author":"Blakey","year":"2014","journal-title":"J Soc Work Pract Addict"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jsat.2018.08.004","article-title":"Understanding barriers to specialty substance abuse treatment among Latinos","volume":"94","author":"Pinedo","year":"2018","journal-title":"J Subst Abus Treat"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1080\/00952990.2019.1694536","article-title":"A systematic review of rural-specific barriers to medication treatment for opioid use disorder in the United States","volume":"46","author":"Lister","year":"2020","journal-title":"Am J Drug Alcohol Abuse"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1007\/s11606-020-06257-4","article-title":"Barriers and facilitators to the use of medications for opioid use disorder: a rapid review","volume":"35","author":"Mackey","year":"2020","journal-title":"J Gen Intern Med"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s11920-020-01201-z","article-title":"Challenges for women entering treatment for opioid use disorder","volume":"22","author":"Huhn","year":"2020","journal-title":"Curr Psychiatry Rep"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"144","DOI":"10.3390\/pharmacy8030144","article-title":"Stigma of opioid use disorder and its indirect effects on student pharmacists\u2019 perceptions and attitudes","volume":"8","author":"Hall","year":"2020","journal-title":"Pharmacy"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"2103","DOI":"10.1177\/1049732320938689","article-title":"Overcoming barriers: individual experiences obtaining medication-assisted treatment for opioid use disorder","volume":"30","author":"Scorsone","year":"2020","journal-title":"Qual Health Res"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"108927","DOI":"10.1016\/j.drugalcdep.2021.108927","article-title":"Racial inequity in medication treatment for opioid use disorder: exploring potential facilitators and barriers to use","volume":"227","author":"Hollander","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"108399","DOI":"10.1016\/j.jsat.2021.108399","article-title":"Gender disparities in access and retention in outpatient methadone treatment for opioid use disorder in low-income urban communities","volume":"127","author":"Marsh","year":"2021","journal-title":"J Subst Abus Treat"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"108685","DOI":"10.1016\/j.jsat.2021.108685","article-title":"Treatment access for opioid use disorder in pregnancy among rural and American Indian communities","volume":"136","author":"Kelley","year":"2022","journal-title":"J Subst Abus Treat"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1097\/JAN.0000000000000482","article-title":"Medications for opioid use disorder during incarceration","volume":"33","author":"McDermott-Winger","year":"2022","journal-title":"J Addict Nurs"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"103803","DOI":"10.1016\/j.drugpo.2022.103803","article-title":"Medication for opioid use disorder treatment continuity post-release from jail: a qualitative study with community-based treatment providers","volume":"110","author":"Stopka","year":"2022","journal-title":"Int J Drug Policy"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"9346","DOI":"10.3390\/ijerph19159346","article-title":"Women-reported barriers and facilitators of continued engagement with medications for opioid use disorder","volume":"19","author":"Fiddian-Green","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1111\/dar.13421","article-title":"A qualitative meta-synthesis of pregnant women\u2019s experiences of accessing and receiving treatment for opioid use disorder","volume":"41","author":"Tsuda-McCaie","year":"2022","journal-title":"Drug Alcohol Rev"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"108918","DOI":"10.1016\/j.jsat.2022.108918","article-title":"A qualitative analysis of barriers to opioid agonist treatment for racial\/ethnic minoritized populations","volume":"144","author":"Husain","year":"2023","journal-title":"J Subst Abuse Treat"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"101289","DOI":"10.1016\/j.ssmph.2022.101289","article-title":"Racial\/ethnic residential segregation and the availability of opioid and substance use treatment facilities in US counties, 2009\u20132019","volume":"20","author":"DiNardi","year":"2022","journal-title":"SSM \u2013 Popul Health"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1141093\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T22:36:34Z","timestamp":1682030194000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1141093\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":70,"alternative-id":["10.3389\/fpubh.2023.1141093"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1141093","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,20]]},"article-number":"1141093"}}