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Opioid misuse is a public health crisis in the US, and misuse of synthetic opioids such as fentanyl have driven the most recent waves of opioid-related deaths. Because those who misuse fentanyl are often a hidden and high-risk group, innovative methods for identifying individuals at risk for fentanyl misuse are needed. Machine learning has been used in the past to investigate discussions surrounding substance use on Reddit, and this study leverages similar techniques to identify risky content from discussions of fentanyl on this platform.

A codebook was developed by clinical domain experts with 12 categories indicative of fentanyl misuse risk, and this was used to manually label 391 Reddit posts and comments. Using this data, we built machine learning classification models to identify fentanyl risk.

Our machine learning risk model was able to detect posts or comments labeled as risky by …