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When an obscurity becomes trend: social-media descriptions of tianeptine use and associated atypical drug use.

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Title: When an obscurity becomes trend: social-media descriptions of tianeptine use and associated atypical drug use.
Authors: Smith, Kirsten E. (AUTHOR), Rogers, Jeffery M. (AUTHOR), Strickland, Justin C. (AUTHOR), Epstein, David H. (AUTHOR)
Source: American Journal of Drug & Alcohol Abuse. 2021, Vol. 47 Issue 4, p455-466. 12p.
Subjects: Drug utilization, Nootropic agents, Social media, Serotonin transporters, Virtual communities
Abstract: Background: Originally believed to be an atypical antidepressant acting at serotonin transporters, tianeptine is now known to also be an atypical agonist at mu-opioid receptors. Its nonmedical use may be increasing amidst the broader context of novel drug and supplement use. Objectives: To analyze social-media text from current, former, and prospective tianeptine users for better understanding of their conceptualizations of tianeptine, motives for and patterns of use, and reported benefits and harms. Methods: Reddit posts were obtained and thematically coded; additional quantitative analyses were conducted. Results: A total of 210 posts mentioning tianeptine were made between 2012 and 2020. Eighteen thematic categories were identified, 10 of which were consistent with expected themes. Two independent raters coded all text, generating 1,382 unique codes, of which 1,090 were concordant (78.9% interrater agreement). Tianeptine use was frequently associated with use of other drugs, particularly kratom, phenibut, and racetams. People conceptualized and variously used tianeptine as an opioid, antidepressant, and "nootropic" (cognitive enhancer). Between 2014 and 2020, mentions of positive effects decreased, while mentions of adverse effects and withdrawal increased. Motivations for use included substitution or withdrawal mitigation for other drugs (especially opioids) and for kratom itself; self-treatment for psychiatric symptoms; and improvement of quality of life, mood, or performance. Descriptions of tolerance, withdrawal, and addiction were evident. Intravenous use was rare and strongly discouraged, with detrimental effects described. Conclusion: Tianeptine is recognized as an opioid (though not only an opioid) in online communities. Posts describe benefits, acute risks, and patterns of co-use that warrant greater clinical attention. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Drug & Alcohol Abuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: When an obscurity becomes trend: social-media descriptions of tianeptine use and associated atypical drug use.
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  Data: <searchLink fieldCode="AR" term="%22Smith%2C+Kirsten+E%2E%22">Smith, Kirsten E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rogers%2C+Jeffery+M%2E%22">Rogers, Jeffery M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strickland%2C+Justin+C%2E%22">Strickland, Justin C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Epstein%2C+David+H%2E%22">Epstein, David H.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Drug+%26+Alcohol+Abuse%22">American Journal of Drug & Alcohol Abuse</searchLink>. 2021, Vol. 47 Issue 4, p455-466. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Drug+utilization%22">Drug utilization</searchLink><br /><searchLink fieldCode="DE" term="%22Nootropic+agents%22">Nootropic agents</searchLink><br /><searchLink fieldCode="DE" term="%22Social+media%22">Social media</searchLink><br /><searchLink fieldCode="DE" term="%22Serotonin+transporters%22">Serotonin transporters</searchLink><br /><searchLink fieldCode="DE" term="%22Virtual+communities%22">Virtual communities</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Originally believed to be an atypical antidepressant acting at serotonin transporters, tianeptine is now known to also be an atypical agonist at mu-opioid receptors. Its nonmedical use may be increasing amidst the broader context of novel drug and supplement use. Objectives: To analyze social-media text from current, former, and prospective tianeptine users for better understanding of their conceptualizations of tianeptine, motives for and patterns of use, and reported benefits and harms. Methods: Reddit posts were obtained and thematically coded; additional quantitative analyses were conducted. Results: A total of 210 posts mentioning tianeptine were made between 2012 and 2020. Eighteen thematic categories were identified, 10 of which were consistent with expected themes. Two independent raters coded all text, generating 1,382 unique codes, of which 1,090 were concordant (78.9% interrater agreement). Tianeptine use was frequently associated with use of other drugs, particularly kratom, phenibut, and racetams. People conceptualized and variously used tianeptine as an opioid, antidepressant, and "nootropic" (cognitive enhancer). Between 2014 and 2020, mentions of positive effects decreased, while mentions of adverse effects and withdrawal increased. Motivations for use included substitution or withdrawal mitigation for other drugs (especially opioids) and for kratom itself; self-treatment for psychiatric symptoms; and improvement of quality of life, mood, or performance. Descriptions of tolerance, withdrawal, and addiction were evident. Intravenous use was rare and strongly discouraged, with detrimental effects described. Conclusion: Tianeptine is recognized as an opioid (though not only an opioid) in online communities. Posts describe benefits, acute risks, and patterns of co-use that warrant greater clinical attention. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of American Journal of Drug & Alcohol Abuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=152024108
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        Value: 10.1080/00952990.2021.1904408
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        Type: general
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      – SubjectFull: Social media
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      – SubjectFull: Serotonin transporters
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            NameFull: Strickland, Justin C.
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              Text: 2021
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