• Rachel A Elphinston, Scotti RequenaSimoneSRecover Injury Research Centre, The University of Queensland, Brisbane, Australia; School of Psychology, The University of Queensland, Brisbane, Australia., Daniel Angus, Dominique de Andrade, Christopher R Freeman, and Melissa A Day.
• Recover Injury Research Centre, The University of Queensland, Brisbane, Australia; National Health and Medical Research Council Centre of Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Brisbane, Australia; School of Psychology, The University of Queensland, Brisbane, Australia; Addiction and Mental Health Services, Metro South Hospital and Health Service, Brisbane, Australia. Electronic address: rachelel@uq.edu.au.
• J Pain. 2020 Jul 1; 21 (7-8): 881-891.

AbstractCodeine is one of the most common opioid medicines for treating pain. Australia introduced policy changes in February 2018 to up-schedule codeine to prescription-only medicine due to concerns of adverse effects, opioid dependency, and overdose-related mortality. This study investigated the frequency and content of messages promoted on Twitter by 4 Australian peak pain organizations, pre- and postpolicy implementation. A time series analysis examined frequency of Twitter posts over a 48-week period. Text analysis via Leximancer examined message content. Results showed that promotion and education of the pending policy change dominated the Twitter feed prior to up-scheduling. However, immediately following policy change, there was a shift in content towards promoting conferences and research, and a significant decrease in the frequency of codeine-related posts, compared to opioid-related non-codeine posts. The findings suggest that pain organizations can provide timely and educational policy dissemination in the online environment. They have implications for individuals with chronic pain who use the Internet for health information and the degree to which they can trust these sources, as well as health professionals. Further research is required to determine if public health campaigns can be targeted to prevent opioid-related harm and improve pain care via this increasingly used medium. PERSPECTIVE: This study presents a first look at what information is being communicated by influential pain organizations that have an online Twitter presence and how messages were delivered during a major policy change restricting access to codeine medicines. Insights could drive targeted future online health campaigns for improved pain management.Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.

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