Abstract
BACKGROUND: Xylazine has been associated with skin wounds. The rising prevalence of xylazine and its debated role in wound causation have sparked concerns among public health professionals, medical experts, and people who use drugs. OBJECTIVE: This study used a qualitative evaluation of Reddit posts to understand the experiences of people who use drugs concerning xylazine-associated wounds. METHODS: This study explored xylazine discussions on Reddit. Data were collected from 930+ drug-related subreddits via the PRAW Python application programming interface, and natural language processing methods were employed to identify posts that mentioned xylazine and wound-related keywords. Retrieved posts were manually coded for thematic analysis, and a term frequency-inverse document frequency analysis was performed per theme to obtain additional insights. RESULTS: The manual classification of 286 posts revealed predominant themes related to the pathophysiology of xylazine, wound locations on the body, and management strategies. The 3 most frequent xylazine wound-related themes were "Mechanisms of xylazine-associated wounds" (84 posts, 29.4%), "Geographic region" (67, 23.4%), and "Location of wounds on the body" (56, 19.6%). The analysis showed xylazine's presence in the discussions among Reddit's drug-using communities, with a notable focus on wound management and geographic trends. The term frequency-inverse document frequency analysis revealed prominent lexical markers within each theme. CONCLUSIONS: The findings suggest that social media platforms such as Reddit can serve as valuable resources for understanding emerging health issues such as xylazine-associated wounds. The study's findings highlight patterns of use, the characteristics of wounds on people who use drugs, and discussions about wound management. This study adds to a growing body of literature using social media to understand the consequences of emerging drugs on human health.