Abstract

Background: Online communities such as Reddit can reveal critical information needs (CINs) among people who discuss opioid use for chronic or acute pain under conditions of stigma and uncertainty. Methods: We used a mixed-method design to analyze 3428 unique Reddit posts from 1 January to 31 December 2022. Sentence-BERT embeddings and K-means clustering identified eight dominant themes, followed by qualitative analysis of a random subsample of 400 posts. Results: The most prevalent theme was seeking alternatives to opioids for pain relief (28.00%), followed by medications for chronic pain (19.84%) and kratom use experiences (14.64%). Qualitative findings showed recurrent concerns about addiction, stigma in clinical encounters, withdrawal, treatment access, and peer-to-peer discussion of kratom, tianeptine, cannabis, and other substitute substances. Conclusions: The study suggests an unmet need for accessible, nonstigmatizing, and clinically grounded information on pain management, tapering, and lower-risk alternatives to opioid use. These results have implications for addiction prevention, harm reduction, and patient-facing communication strategies for clinical practice and community health.

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