A virtual academy of polydrug use: Masters,novices and the art of combinations

Negotiating drug knowledge in online forums

The Internet has become a primary source of increasingly extending lay health information (Cline & Haynes, 2001). Based on user activity, the Internet questions and challenges former knowledge hierarchies (Manning, 2014), for example, it sometimes results in struggles over expertise in health and criticism of the health professions (e.g., Ziebland, 2004). Furthermore, the Internet also enables participation in discussions in cases when physical distance would be an obstacle to meeting face to face (Barratt, Allen, & Lenton, 2014). Thus, it can be argued that the meaning of “community” has changed, as physical space is expanded by virtual space (Murguía, Tackett-Gibson, & Lessem, 2007).

Drug users also interact online. Research has shown that the Internet has become an essential source of information about drugs and drug use (e.g., Barratt, Lenton, & Allen, 2013; Manning, 2014; Murguía et al., 2007; Walsh, 2011). It provides a platform for sharing experiences surrounding the production, mediation and circulation of drug knowledge, enabling the reconstruction of power relations around drug knowledge and thus operating as an alternative to traditional authorities. In this context, Boyer, Lapen, Macalino, and Hibberd (2007) talk about “innovative users” who experiment with new drugs and then mediate their experiences to other users through the Internet. However, the virtual environment of drug knowledge can be understood not only as a celebration of drugs and experiences of being high but also as a terrain of vernacular harm reduction, as the ideas and conceptions of drug-related risks are shared by users on the Internet (Davey, Schifano, Corazza, & Deluca, 2012; Soussan & Kjellgren, 2014). Consequently, information shared in online drug communities can have a multifold impact on contemporary drug use (Rosino & Linders, 2015).

Previous studies of online drug communities have focused on discussions around a single substance, for example, cannabis (e.g., Månsson, 2014; Månsson & Ekendahl, 2013) or DMT (Rosino & Linders, 2015); around the non-medical use of prescription drugs (Rönkä & Katainen, 2017); or around new psychoactive substances, also known as “NPS”, “legal highs” and “designer drugs” (see Davey et al., 2012; Duxbury, 2015; Soussan & Kjellgren, 2014). The aim of this study was to focus on how users create, mediate and circulate knowledge about combining multiple substances (polydrug use) and how users employ current information technology for these purposes. This focus is expected to involve a logic related to combinations of substances that may portray current types of drug-use skills in a more realistic manner. Studies on NPS have emphasised the importance of users’ experience in knowledge production due to the fact that the features of these new substances may be largely unknown. Duxbury (2015, p. 6) calls this kind of information creation “a marginalized form of citizen science”. Interestingly, this coincides closely with polydrug use since there is an obvious lack of information about the effects of the combinations of different substances. We are especially interested in how online discussions function as a context for learning and sharing experiences of polydrug use in Finnish and Swedish online forums.

Polydrug use is a general term describing a wide variety of substance-use behaviours; for example, it can be categorised with regard to the timing of the ingestion of multiple substances. A rough dichotomy of concurrent and simultaneous polydrug use has been applied in many studies (e.g., Schensul, Convey, & Burkholder, 2005). In this study, we define polydrug use as the mixing of two or more substances at the same time or in temporal proximity. While polydrug use is found to be associated with poorer physical and mental health and various social problems (e.g., Kelly, Chan, Mason, & Williams, 2015; Roth et al., 2015), current knowledge is very limited about different patterns of substance combinations, the intentions of users and social processes leading to polydrug use. At the same time, research shows that there is an upward trend in the prevalence of polydrug use (EMCDDA, 2014; Martin, 2008), seen in both recreational use (e.g., Measham & Moore, 2009; Quintero, 2009) and in problem use (e.g., Gossop, Marsden, & Stewart, 2002).

This study aims to improve our understanding of the creation and communication of knowledge about polydrug use in online settings. We are especially interested in what aspects forum users bring forward when they communicate about substance combinations (instead of about single substances). In addition we want to examine whether knowledge concerning this particularly risky and complex type of drug consumption differs from that of other drug-related knowledge shown in earlier research.

Discussing “combos” on Finnish and Swedish websites

In drug slang the term “combo” signifies the intentional mixing of drugs with the aim of attaining a particular desired effect. As the expectations of the “high” vary, both between individuals and situations, there exist endless ways to blend different kind of substances (e.g., Schensul et al., 2005). Optimising different nuances of pleasure by means of different substance combinations requires a certain expertise and pharmacological awareness. Furthermore, since substance combinations might be risky due to the unpredictable co-effects of different substances, the mixing of substances requires distinct knowledge so as to avoid those risks. For these reasons, we explore what kind of knowledge of the risks and pleasures of polydrug use is shared in online discussion forums. As far as we know, this kind of online sharing of the competence to make drug combos has not been studied earlier.

Quintero and Bundy (2011) distinguish between different websites where drug-related content may be discussed, for example with a focus on drug-use prevention, harm reduction or drug control. Generally, these kinds of websites are sponsored by a public authority or some other institution. In addition, there are websites maintained by individuals. Our analysis is based on two online forums following different principles. The Finnish Addiction Link, and particularly its sub-forum called Sauna (http://www.paihdelinkki.fi/keskustelu/viewforum.php?f=1), has been the most popular site dealing with the latest topics on substance abuse and the addiction scene in Finland. The website is provided by an NGO, the A-Clinic Foundation, which is a pioneer in Finnish online drug discussion. The A-Clinic Foundation is the biggest provider of alcohol and drug treatment services in Finland. The foundation has also put a lot of emphasis on preventive work, and the idea of the Sauna forum is to promote a harm-reduction policy by offering possibilities for users to share risk information related to drug use. Originally we intended to focus the study only on Finland, but due to our collaboration with Sweden, data from a Swedish discussion site were included in our exploration. The Swedish forum, called Flashback, with its sub-forum Droger (https://www.flashback.org/f3), is currently the largest online message board in Sweden. The Flashback forum is politically uncommitted and founded on the idea of freedom of speech.

The forums chosen for this study represent the most popular sites of discussion on drug use in each country. Despite some differences, both websites have similar rules that users are expected to comply with. The moderator will remove messages that contain intimidation, harassment, criminal activity (such as selling or buying drugs) or an invitation to such activity, advertising or the infringement of copyright. Similar websites are found around Europe. The goal of our study is not to make comparisons between Finnish and Swedish online discussions but, rather, to focus on the common features of those discussions.

Social learning of drug use

Drug-use practices have to be learned. In his classic article “Becoming a marihuana user” Howard S. Becker (1953) describes the social learning process involved in starting to experience pleasure from smoking marihuana. According to Becker, individuals will only be able to use marihuana for pleasure when they first learn the technique required to smoke it so that it produces the wanted effects. The second stage of the process is to learn to get a high, which requires that the individual learns to recognise the effects caused by marihuana and connect them with its use. Third, they have to learn to find those sensations enjoyable, as in the beginning the sensations might not be automatically pleasurable. To acquire the concepts that make learning drug use possible, the beginner needs to participate in groups in which marihuana is used (Becker, 1953, 1963).

While Becker presented his social learning theory of marihuana use a long time ago, it has maintained its accuracy and is repeatedly applied to new topical areas. For example, Athey, Boyd, and Cohen (2017) utilise it in their study of medical cannabis users, and Pawson, Kelly, Wells, and Parsons (2016) apply it in their study of prescription pill smokers. Rosino and Linders (2015), who analysed conversations within an online community of DMT users, have developed the social learning theory outlined by Becker so that it can be applicable in studies of virtual communities. Most importantly, they propose a supplementary stage to Becker’s model that both precedes and permeates all the other stages. This additional stage, “learning to communicate and comprehend knowledge and interpretation”, relates to the distinctive aspects of online settings by emphasising written communication, modes of articulation, technological proficiency, and community norms and argot (Rosino & Linders, 2015, pp. 730–732). As Halbert and Kotarba (2007) also demonstrate, drug subcultures – described by Becker as occurring in a physical environment and in face-to-face encounters – can now also operate in virtual environments (see also Davey et al., 2012; Rosino & Linders, 2015; Soussan & Kjellgren, 2014). This also holds for polydrug use since, as in the case of a single substance (like marihuana or DMT), creating and enjoying drug combos includes social learning based on access to advice from experienced users.

Master and novice positions

Online communities establish a forum wherein drug users are free to produce different subject positions (Barratt et al., 2014). As the parties in drug discussions on Internet sites do not know each other, they need to make their own positions visible. Indeed, participants in an online community assess each other’s level of experience and knowledge on the grounds of self-presentations performed primarily through text (Rosino & Linders, 2015). Moreover, in a virtual community, one needs to reproduce one’s position(s) continuously due to the situational nature of the interaction.

In the analysis, we explore what kind of knowledge related to the pleasures and risks of combining substances is produced and reproduced in online forums and how the interactive positions are expressed and negotiated in relation to this knowledge. In doing this we are influenced by positioning theory. Harré and van Langenhove (1999) consider the concept of positioning to be a more dynamic alternative to the concept of social role. In a conversation, speakers always adopt a position that is linked to some storyline. The positions vary according to the storyline and thus an individual can adopt several positions. We are particularly interested in positions that deal with the storyline of the social learning of drug combinations in the online context. We investigate the positions merely in this specific interaction without any aim to evaluate what the users’ competence and knowledge of drug combinations would be in an offline context or in some other storyline. In this sense the positions we identify and analyse here express the user’s situational identities in the online interaction. As the initial positions may sometimes be challenged and repositioning may occur, fluid positionings are inevitable in coping with varying situations (Harré & van Langenhove, 1999). Finally, we explore the production of competence in making substance combos when seen through the lens of social learning. We do not strive to describe online discussion in the different stages of the social learning process, as do Rosino and Linders (2015), but focus on the setting for social learning that the production and expression of different positions provide.

Research questions

How is expertise built in online communications related to polydrug use (e.g., Barratt et al., 2014; Duxbury, 2015; Manning, 2014)?

Data and method

Both in the Finnish forum Sauna and in the Swedish forum Flashback, the discussion threads that concern polydrug use were typically opened with a view to discuss some specific drug combination, for instance combining opiates and cannabis. However, in this study we were interested in the threads that specifically concerned the term “combo”. In addition to that, we narrowed the data to concern when the term combo was used in the thread title. As both discussion forums can be searched, we entered the keywords “komb*” and “comb*” in the search tool so as to identify those threads that deal with this term at a general level. This search was conducted on 25 March 2015 and resulted in 40 threads. From these 40 threads we removed those containing fewer than five messages, as they were clearly less popular discussion openings. After that, our final data consisted of eight threads (comprising 452 messages) from the Sauna forum and 23 threads (comprising 374 messages) from the Flashback forum (see Appendix 1). Most of these threads deal with pleasant and unpleasant experiences of combining drugs, whereas some threads have a neutral approach to drug combos. Among all the discussions that take place in these forums, the threads included in our data represent a limited portion. However, the rigorous analysis of the data sample selected for this study is adequate to enable the saturation of the dynamics of competence positioning and social learning, thus revealing the more general nature of the interaction that occurs online where drug combinations are discussed.

The data were captured as Word files, eventually comprising 214 single-spaced Microsoft Word pages. This material was analysed by applying the social learning storyline outlined by positioning theory. All of the threads included messages that fit into the social learning storyline, such as asking for advice or proving expertise. Other storylines were also recognised, such as showing empathy or making fun of the topic, but these were excluded from our analysis. It turned out that each thread could include several separate debates from which common themes were “pleasure seeking” and “risk avoidance”. These themes dominated the online discussion of drug combos.

We noticed that in their interaction with each other, forum users tended to adopt more or less novice and master positions. By means of these positions, the users expressed to other interaction parties how experienced drug combo users they were in the issue at stake. The distinctive feature of novices is that they present themselves as persons with no or very little experience of making drug combos. Typically, they openly ask for advice from experienced users. Masters, in turn, claim to have a lot of experience and knowledge of combos. They express great insight into different combos and they keenly demonstrate their expertise and competence. These masters tend to teach the other discussion parties how to manage different combos. However, the boundaries between these two positions were not always clear and were rather in constant movement. Due to this, we then analysed the discussion threads by examining how and through what kinds of strategies the positions were produced, expressed, negotiated and reproduced.

After the analysis based on positioning theory, we reflected on and interpreted the results from the wider point of view of social learning of combining substances, especially in an online context.

Results

Before we address the negotiations of competence positions, we describe the situational nature of varying forms of knowledge regarding the pleasures and risks of combining substances. In the data excerpts we do not take a stand on the discussants’ gender since in their pseudonyms gender was not apparent in all cases. In each debate the discussants are numbered separately, always starting from number 1 (e.g., D1 = Discussant 1). A clarifying vocabulary for the slang terms, abbreviations and brand names of substances is found in Appendix 2.

Discussion and conclusion

The Internet has become a space for disseminating drug information wherein knowledge, practices and new innovations in polydrug use are also shared. In discussion forums, drug consumers meet “innovative users” (Boyer et al., 2007) who experiment with new combos and report their experiences to others. However, the discussion is not confined to celebrating the effects of good combos, it also includes a lot of risk talk (cf. Davey et al., 2012; Manning, 2014; Soussan & Kjellgren, 2014). Information on substance combinations shared in online discussion forums can thus be regarded as “a marginalized form of citizen science”, as Duxbury (2015, p. 6) has stated. In this article, we show ways in which online discussion forums constitute a kind of virtual academy where knowledge related to polydrug use is produced and circulated, and where experienced users mediate their expertise to less experienced ones.

According to our findings, just as in a physical environment, beginners in this virtual community are provided with cues and models from the more experienced users when practicing techniques, pursuing pleasure and avoiding the risks of combining substances (see also Rosino & Linders, 2015). In this process, participants take the positions of masters or inexperienced novices. By means of these interactive positions the users demonstrate and share their knowledge of drug combos. In a virtual environment, this requires constant explicating and maintaining of positions (see Harré & van Langenhove, 1999). This occurs by asking for advice, presenting one’s expertise, challenging other participants, repositioning oneself, defending one’s position or proving one’s competence.

In these negotiations, different perceptions of pleasure and risk awareness are employed as tools and sometimes even as weapons. Attaining pleasure from substance combos requires expertise gained through experience and familiarity with them. Respect for first-hand experience has also been shown to be a general feature in other types of online drug communities (Davey et al., 2012; Duxbury, 2015; Rosino & Linders, 2015). In addition to expertise in the pharmacological characteristics of different combinations, managing pleasure also requires skills in order to create functional combos for different purposes and social situations (such as partying, chilling or working). The analysis also provided insight into the various ways in which risks were conceptualised: besides the consequences of the pharmacological co-effects, such as overdoses or unpredictable behaviour under intoxication, online discussants tended to appeal to legal and moral orders. In other words, the socio-cultural meanings of drug use are produced and reproduced in the online context. In this sense the online discussants behave in line with some well-known studies that have argued that the effects of the drugs are not just determined by pharmacological properties (Becker, 1953, 1963; Gomart & Hennion, 1999; Zinberg, 1984).

Online forums function as an environment for social learning of combining substances where knowledge of benign combos and warning experiences of risky combos are mediated and circulated among users. These forums are also spaces wherein inexperienced users can consult those who have gained competence in the area. The online community also guides beginners in the kind of co-effects that are perceived as pleasurable or not. In addition, the unwritten moral rules of this certain area of drug culture are learned in the negotiation of competence positions. In this regard, the online setting shares similar features with the offline setting explained by Becker (1953, 1963).

However, as a learning environment, online forums provide assets that are not found in offline environments. For example, all information is archived in the forums and can be searched through and applied long after the actual discussion has taken place. Also, the selection of advice and ideas gathered in one place is much more extensive than in offline environments.

One interesting finding is that the learning process of making drug combos also deviates from what Becker described about learning to smoke marijuana, as the users are hardly beginners in drug use. Even in cases when users might have profound experience of single drug use, they might still be novices in combining drugs. Knowledge related to managing combos represents advanced skills and a wide experience of the pharmacology of different combinations. Expertise by experience manifests as a salient factor in claiming authority, but in an online context the expertise is under renegotiation and participants have to adjust themselves to the constantly changing definitions of it. It is also likely that the discussants do not know each other personally. These characteristics imply that when compared to face-to-face interactions, the master and novice positions are more fluctuating, fluid and under suspicion.

Through the revolution of “new media”, virtual online communication has grown alongside offline communication, both complementing it and providing an alternative arena for social learning of polydrug use. On the one hand, online drug knowledge may in many cases be preferred in contrast to information gained from offline communities in terms of its gathered width and depth (Barratt et al., 2013). On the other hand, Murguía and Tackett-Gibson (2007) have suggested that many drug users still prefer concrete and trustworthy face-to-face interactions, rather than the Internet, when acquiring drug information. In the end, it is important to recognise that these two contexts for seeking information and social learning of polydrug use do not exist in their own rights, but are intertwined and mutually supportive. They “bleed into one another”, as Walsh (2011, p. 62) puts it. Nevertheless, online and offline contexts for drug information each have their own logic of interaction: while the virtual world functions solely upon faceless interaction, many situational factors may be brought more to the fore in the offline world, in face-to-face user encounters. An important topic for future research would be to study how the online worlds of polydrug use, or drug use in general, are incorporated into the everyday life of different drug users.

As Barratt (2011) and Manning (2014) have highlighted, the users of online forums like to present themselves as responsible and risk-aware drug users. Online forums provide a social context for vernacular harm reduction, as earlier studies have shown (Duxbury, 2015; Manning, 2014; Soussan & Kjellgren, 2014). Especially since the co-effects of drug combinations are risky, more lay information on this topic is needed. While sharing knowledge on how to use drugs in a safe way, the combo experts of online forums take informal positions as “public health actors” preventing risky drug use. At the same time, they provide important knowledge for official public health actors to plan well-informed interventions for risky combinations and situations of drug use.