2.3. Content Analysis Process

All 118,388 retrieved tweets were included in the dataset (Figure 1). First, we excluded those tweets mentioning any of the aforementioned medications in an unrelated context. For example, Concerta is also the name of a political party in Chile. In this case, any tweets referring to the political party were omitted. Secondly, we excluded all tweets, including hashtags and keywords, not related to health (e.g., political issues). Specifically, Concerta and Ritalin generated 10,773 and 13,987 tweets, respectively, but 10,127 (94%) and 13,567 (97%), respectively, were not related to health. Indeed, most of them included hashtags (#mesacentral, #apoyofirmado, #tumbamadre, #lamarchamasgrande, #Pinerarenuncia) or keywords related to political conflict occurring in Chile. Similarly, Adderall generated 87,808 tweets, of which 86,052 (98.7%) included hashtags or keywords related to political issues (e.g., Trump, impeachment).

Flowchart of data management.

All 8642 remaining tweets were inspected by two raters (M.A.A.-M. and L.d.A.). First, we scanned all of the tweets and excluded 2074 that provided information that was too limited, contained only images or included hashtags of more than one treatment. This process led to the creation of a more concise dataset of 6568 tweets, which we divided into three groups: 4949 (75.4%) stimulants, 605 (9.2%) non-stimulants and 1014 (15.4%) alpha-2-adrenergic agonists.

Next, we created a codebook based on our research questions, our previous experience in analyzing tweets and what we determined to be the most common themes. M.A.A.-M. and L.d.A. analyzed 300 tweets separately to test the suitability of the codebook. Discrepancies were discussed between the raters and with another author (M.L.-V.). After revising the codebook, the raters then proceeded to perform a content analysis of 50% of the tweets in each group, limiting them to a maximum of 1000 tweets randomly selected. Thus, we manually analyzed 1000 tweets from the stimulant group, 303 from the non-stimulant group and 507 from the alpha-2 agonist group (Figure 1). Classification criteria and examples of tweets are shown in Table 1.

Category, definitions and examples of classification. Usernames and personal names were removed.

I like to talk about meds. been on ADHD meds almost consistently from 8 yrs old to now (19). im on Concerta right now and it’s working wonders for me. people are very strung out about medicating kids and i get that but, i really needed it as a kid and need it more as an adult.

Unfortunately concerta didn’t work for me: (but everybody’s different! it was so long ago i can’t remember what my problem with it was haha...i think it just wasn’t strong enough for me. but it’s not a bad drug i know some ppl that take it! make sure you’re eating ok?

I just vividly remember going off Concerta as a kid because it killed my appetite and I have a hard enough time keeping weight on as it is (this 3-week depressive low has already ate away [haha] at 2 or 3 lbs) and I’m afraid of that happening again

Concerta makes me want to eat three leaves of lettuce a day and id still feel bloated.

I was diagnosed at an early age and was put on a few medications. I had some medications that made me very emotional. The last medication I remember being on was concerta and it flattened my mood waaay too much

I was really thirsty, not eating, and super paranoid when I tried vyvanse.

I remember taking my first concerta, it was the 18 mg and I was in matric. Stayed up all night like a maniac

I love the way you explained it! I was diagnosed in 2012, five years into my serving in the military. I took concerta for the first 3 months after my diagnosis and then stopped. I struggled with accepting this diagnosis. Now in 2019 I’ve accepted it & want to get help.

Uhm I’m not doing this willingly. I’m all for medicine. I’m not taking my meds rn because I need to do a new examination of my diagnosis and I need to have 0 trace of concerta in my body by then. I legit can’t wait to get to take meds again.

I have 72 mg Concerta, ive been on it for years but i dont take it every single day.