Adolescence is a critical developmental period marked by heightened emotional sensitivity, social stress, and vulnerability to substance use. However, traditional research methods provide limited access to adolescents' authentic experiences, hindering efforts to develop evidence-based prevention and intervention strategies. Social media provides a unique opportunity to observe adolescents' naturally occurring discussions about substance use, offering valuable insights into their opinions, emotions, and lived experiences that can inform early prevention and intervention strategies. In this study, we analyze large-scale Reddit discussions related to substance use among adolescents between 2018 and 2023. Leveraging hour-by-day temporal analysis, sentiment and emotion classification, and transformer-based topic modeling (BERTopic), we examine the interaction between time, emotion, and semantic content in adolescent substance use discourse. Our findings reveal pronounced weekend and late-night peaks in substance-related discussions, a dominance of negative emotions such as sadness and fear, and distinct semantic topics centered on peer relationships, family conflict, emotional distress, and substance-specific experiences. These findings advance our understanding of adolescent substance use in naturalistic online settings and provide empirical evidence to support the development of more timely, targeted, and evidence-based prevention and intervention strategies.
Layla Bouzoubaa, Hyung Wook Choi, Milan Varghese +2cs.CL
Objectives: To develop a codebook for self-stigma across cognitive, affective, and behavioral domains, and to estimate the prevalence, co-occurrence, and temporal patterns of these indicators in Reddit posts by people who use drugs. Methods: We developed a ten-indicator codebook through consensus-based abductive coding spanning cognitive (self-labeling, pessimism/self-defeatism, deservingness/worthlessness), affective (shame, guilt/self-blame, despair/hopelessness), and behavioral (concealment, anticipated rejection, desire to quit, ambivalence) domains; two coders reached substantial agreement (Cohen's k = 0.72). We then scaled classification with a large language model validated against expert coding (k = 0.73, F1 = 0.80), analyzing 72,115 thread-initiating posts from 1,660 English-language users (2006-2025). Results: 3,838 posts (5.3%) from 1,228 users (74.0%) contained self-stigma; all ten indicators discriminated self-stigma posts (RR 3.6 to 86.2), led by self-labeling (56.0%) and despair/hopelessness (48.5%). Self-stigma was integrated: core and behavioral indicators were strongly associated at the user level (OR = 4.65, 95% CI 3.12-6.94, p < 0.001), and 87.0% of posts with behavioral indicators also contained a core indicator. Contrary to progressive models, behavioral indicators emerged earlier than core ones (desire to quit at median position 0.08 vs. shame at 0.38). Nine of ten indicators were stable across posting trajectories; only pessimism increased (OR = 1.62, 95% CI 1.25-2.10). Conclusion: Among people who use drugs online, self-stigma is an integrated phenomenon in which behavioral indicators rarely appear without internalized ones and often precede them. Most expressions remain stable over time, but pessimism about change deepens, marking a target for early digital intervention and showing that progressive stage models do not map directly onto textual disclosure.