Is This Safe? Examining Safety Assessments of Illicit Drug Purchasing on Social Media Using Conjoint Analysis

Abstract

Background: Illicit substance sales facilitated by social media platforms are a growing public health issue given recent increases in overdose deaths, including an alarming rise in cases of fentanyl poisoning. However, little is known about how online users evaluate what features of social media posts convey safety, which can influence their intent to source illicit substances. Objectives: This study adapts conjoint analysis which assessed how attributes of social media posts (i.e., features) influence safety evaluations of mock posts selling illicit substances. 440 participants were recruited online for self-reporting use or purchase of controlled substances or prescription medicines recreationally. The following attributes were tested: drug packaging, drug offerings, profile photo of seller, payment info provided, and use of emojis. Results: Packaging was ranked the most important attribute (Average Importance =43.68, Offering=14.94, Profile=13.86, Payment=14.11, Emoji=13.41), with posts that displayed drugs in pill bottles assessed as the most safe. Attribute levels for advertising multiple drugs, having a blank profile photo, including payment information, and including emojis also ranked higher in perceived safety. Rankings were consistent across tested demographic factors (i.e., gender, age, and income). Survey results show that online pharmacies were most likely to be perceived as safe for purchasing drugs and medications. Additionally, those who were younger in age, had higher income, and identified as female were more likely to purchase from a greater number of platforms. Conclusions: These findings can assist in developing more precise content moderation for platforms seeking to address this ongoing threat to public safety.

Keywords:

• Online drug purchasing
• controlled substances
• drug dealing
• social media
• online content moderation
• conjoint analysis

Acknowledgments

The authors would like to thank Sawtooth Software for providing access to the software required to implement this study via their academic grant program.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 https://bit.ly/3RxSBHS.

Additional information

Funding

This research was supported by the National Institute on Drug Abuse (Award 1R21DA050689-01). The funding source did not have involvement in the study design; collection, analysis and interpretation of data; in the writing of the report; nor in the decision to submit the article for publication. Author TKM is an employee of the startup company S-3 Research LLC. S-3 Research is a startup funded and currently supported by the National Institutes of Health—National Institute of Drug Abuse through a Small Business Innovation and Research contract for opioid-related social media research and technology commercialization. TKM is also the CEO and a member of S-3 Research LLC with ownership interest. Authors reports no other conflict of interest associated with this manuscript.