Understanding the prevalence of misinformation in health topics online can inform public health policies and interventions. However, measuring such misinformation at scale remains a challenge, particularly for high-stakes but understudied topics like opioid-use disorder (OUD)--a leading cause of death in the U.S. We present the first large-scale study of OUD-related myths on YouTube, a widely-used platform for health information. With clinical experts, we validate 8 pervasive myths and release an expert-labeled video dataset. To scale labeling, we introduce MythTriage, an efficient triage pipeline that uses a lightweight model for routine cases and defers harder ones to a high-performing, but costlier, large language model (LLM). MythTriage achieves up to 0.86 macro F1-score while estimated to reduce annotation time and financial cost by over 76% compared to experts and full LLM labeling. We analyze 2.9K search results and 343K recommendations, uncovering how myths persist on YouTube and offering actionable insights for public health and platform moderation.

Widespread stigma, both in the offline and online spaces, acts as a barrier to harm reduction efforts in the context of opioid use disorder (OUD). This stigma is prominently directed towards clinically approved medications for addiction treatment (MAT), people with the condition, and the condition itself. Given the potential of artificial intelligence based technologies in promoting health equity, and facilitating empathic conversations, this work examines whether large language models (LLMs) can help abate OUD-related stigma in online communities. To answer this, we conducted a series of pre-registered randomized controlled experiments, where participants read LLM-generated, human-written, or no responses to help seeking OUD-related content in online communities. The experiment was conducted under two setups, i.e., participants read the responses either once (N = 2,141), or repeatedly for 14 days (N = 107). We found that participants reported the least stigmatized attitudes toward MAT after consuming LLM-generated responses under both the setups. This study offers insights into strategies that can foster inclusive online discourse on OUD, e.g., based on our findings LLMs can be used as an education-based intervention to promote positive attitudes and increase people's propensity toward MAT.

Opioid use disorder (OUD) is a leading health problem that affects individual well-being as well as general public health. Due to a variety of reasons, including the stigma faced by people using opioids, online communities for recovery and support were formed on different social media platforms. In these communities, people share their experiences and solicit information by asking questions to learn about opioid use and recovery. However, these communities do not always contain clinically verified information. In this paper, we study natural language questions asked in the context of OUD-related discourse on Reddit. We adopt transformer-based question detection along with hierarchical clustering across 19 subreddits to identify six coarse-grained categories and 69 fine-grained categories of OUD-related questions. Our analysis uncovers ten areas of information seeking from Reddit users in the context of OUD: drug sales, specific drug-related questions, OUD treatment, drug uses, side effects, withdrawal, lifestyle, drug testing, pain management and others, during the study period of 2018-2021. Our work provides a major step in improving the understanding of OUD-related questions people ask unobtrusively on Reddit. We finally discuss technological interventions and public health harm reduction techniques based on the topics of these questions.

Understanding the neurobiology of opioid use disorder (OUD) using resting-state functional magnetic resonance imaging (rs-fMRI) may help inform treatment strategies to improve patient outcomes. Recent literature suggests temporal characteristics of rs-fMRI blood oxygenation level-dependent (BOLD) signals may offer complementary information to functional connectivity analysis. However, existing studies of OUD analyze BOLD signals using measures computed across all time points. This study, for the first time in the literature, employs data-driven machine learning (ML) modeling of rs-fMRI BOLD features representing multiple time points to identify region(s) of interest that differentiate OUD subjects from healthy controls (HC). Following the triple network model, we obtain rs-fMRI BOLD features from the default mode network (DMN), salience network (SN), and executive control network (ECN) for 31 OUD and 45 HC subjects. Then, we use the Boruta ML algorithm to identify statistically significant BOLD features that differentiate OUD from HC, identifying the DMN as the most salient functional network for OUD. Furthermore, we conduct brain activity mapping, showing heightened neural activity within the DMN for OUD. We perform 5-fold cross-validation classification (OUD vs. HC) experiments to study the discriminative power of functional network features with and without fusing demographic features. The DMN shows the most discriminative power, achieving mean AUC and F1 scores of 80.91% and 73.97%, respectively, when fusing BOLD and demographic features. Follow-up Boruta analysis using BOLD features extracted from the medial prefrontal cortex, posterior cingulate cortex, and left and right temporoparietal junctions reveals significant features for all four functional hubs within the DMN.

Since 1999, the opioid epidemic has killed around 645,000 people in America--a number that would no doubt be even higher were it not for naloxone, an opioid antagonist that can effectively reverse the effects of an overdose. However, time is critical: if naloxone is not administered promptly, the victim's chances of survival diminish rapidly. In a paper published August 14 in Device, a team of researchers describe a device designed to detect the signs of an overdose and automatically deliver a dose of naloxone in as little as 10 seconds. The device–which researchers describe as a "robotic first responder"–is named the "implantable system for opioid safety" (iSOS). It's implanted under the user's skin, in the same way as a heart loop recorder.

Deep learning models have demonstrated promising results in estimating treatment effects (TEE). However, most of them overlook the variations in treatment outcomes among subgroups with distinct characteristics. This limitation hinders their ability to provide accurate estimations and treatment recommendations for specific subgroups. In this study, we introduce a novel neural network-based framework, named SubgroupTE, which incorporates subgroup identification and treatment effect estimation. SubgroupTE identifies diverse subgroups and simultaneously estimates treatment effects for each subgroup, improving the treatment effect estimation by considering the heterogeneity of treatment responses. Comparative experiments on synthetic data show that SubgroupTE outperforms existing models in treatment effect estimation. Furthermore, experiments on a real-world dataset related to opioid use disorder (OUD) demonstrate the potential of our approach to enhance personalized treatment recommendations for OUD patients.

Background: Electronic health records (EHRs) are a data source for opioid research. Opioid use disorder is known to be under-coded as a diagnosis, yet problematic opioid use can be documented in clinical notes. Objectives: Our goals were 1) to identify problematic opioid use from a full range of clinical notes; and 2) to compare the characteristics of patients identified as having problematic opioid use, exclusively documented in clinical notes, to those having documented ICD opioid use disorder diagnostic codes. Materials and Methods: We developed and applied a natural language processing (NLP) tool to the clinical notes of a patient cohort (n=222,371) from two Veteran Affairs service regions to identify patients with problematic opioid use. We also used a set of ICD diagnostic codes to identify patients with opioid use disorder from the same cohort. We compared the demographic and clinical characteristics of patients identified only through NLP, to those of patients identified through ICD codes. Results: NLP exclusively identified 57,331 patients; 6,997 patients had positive ICD code identifications. Patients exclusively identified through NLP were more likely to be women. Those identified through ICD codes were more likely to be male, younger, have concurrent benzodiazepine prescriptions, more comorbidities, more care encounters, and less likely to be married. Patients in the NLP and ICD groups had substantially elevated comorbidity levels compared to patients not documented as experiencing problematic opioid use. Conclusions: NLP is a feasible approach for identifying problematic opioid use not otherwise recorded by ICD codes. Clinicians may be reluctant to code for opioid use disorder. It is therefore incumbent on the healthcare team to search for documentation of opioid concerns within clinical notes.

Large-scale models require substantial computational resources for analysis and studying treatment conditions. Specifically, estimating treatment effects using simulations may require a lot of infeasible resources to allocate at every treatment condition. Therefore, it is essential to develop efficient methods to allocate computational resources for estimating treatment effects. Agent-based simulation allows us to generate highly realistic simulation samples. FRED (A Framework for Reconstructing Epidemiological Dynamics) is an agent-based modeling system with a geospatial perspective using a synthetic population constructed based on the U.S. census data. Given its synthetic population, FRED simulations present a baseline for comparable results from different treatment conditions and treatment conditions. In this paper, we show three other methods for estimating treatment effects. In the first method, we resort to brute-force allocation, where all treatment conditions have an equal number of samples with a relatively large number of simulation runs. In the second method, we try to reduce the number of simulation runs by customizing individual samples required for each treatment effect based on the width of confidence intervals around the mean estimates. In the third method, we use a regression model, which allows us to learn across the treatment conditions such that simulation samples allocated for a treatment condition will help better estimate treatment effects in other conditions. We show that the regression-based methods result in a comparable estimate of treatment effects with less computational resources. The reduced variability and faster convergence of model-based estimates come at the cost of increased bias, and the bias-variance trade-off can be controlled by adjusting the number of model parameters (e.g., including higher-order interaction terms in the regression model).

The machine learning model analyzed health data from nearly 700,000 patients in Alberta who received opioid prescriptions between 2014 and 2018, cross-referencing 62 factors such as the number of doctor and emergency room visits, diagnoses, and sociodemographic information. Researchers found the top risk factors for opioid use disorder included frequency of opioid use, high dosage, and a history of other substance use disorders. The model predicted high-risk patients with an accuracy of 86 per cent when it was validated against a new sample of 316,000 patients from 2019. According to the study, the findings suggest early detection of opioid use disorder is possible with a data-driven approach and may provide timely clinical intervention and policy changes to help curb the current crisis. "It's important that the model's prediction of whether someone will develop opioid use disorder is interpreted as a risk instead of a label," said first author Yang Liu, a post-doctoral fellow in psychiatry, in the release.

Opioid Use Disorder (OUD) is a public health crisis costing the US billions of dollars annually in healthcare, lost workplace productivity, and crime. Analyzing longitudinal healthcare data is critical in addressing many real-world problems in healthcare. Leveraging the real-world longitudinal healthcare data, we propose a novel multi-stream transformer model called MUPOD for OUD prediction. MUPOD is designed to simultaneously analyze multiple types of healthcare data streams, such as medications and diagnoses, by finding the attentions within and across these data streams. Our model tested on the data from 392,492 patients with long-term back pain problems showed significantly better performance than the traditional models and recently developed deep learning models.