Self-Advocacy and Perceptions of the Role of Government in the Xylazine Era of the Overdose Crisis: A Qualitative Analysis of Reddit Content

Abstract

Background:

The current phase of the overdose crisis is characterized by an unpredictable, quickly evolving drug supply, which includes adulterants like the veterinary sedative xylazine. Analyzing social media content is 1 method of exploring how people who report using drugs (PWRUD) utilize virtual communities to exchange information and self-organize. Our objective was to use Reddit content to explore how PWRUD use virtual communities to exchange knowledge, information, and ideas about the role of government in the changing illicit drug supply in the xylazine era.

Methods:

We completed a qualitative content analysis of Reddit content that contained the words “xylazine” or “tranq” from 10 subreddits commonly used by PWRUD. We collected content posted on or before January 18, 2023. Content was analyzed until meaning saturation was reached.

Results:

We analyzed 1803 posts (55% of 3284 included in the final sample). Three themes emerged: PWRUD attributed government actions for shifts in the drug supply and saw government as apathetic or neutral toward people who use drugs. Reddit was used to advocate for preferred government actions in the drug supply (eg, safe drug supply, decriminalization, public drug checking). People also used Reddit as a venue for mutual aid to fill information gaps about xylazine generally and in their local drug supplies.

Conclusions:

Virtual communities are an important means of self-advocacy and information exchange for people who use drugs to voice opinions, preferences, and experiences with government actions to affect the drug supply in the era of xylazine and other novel adulterants.