Candyflipping and Other Combinations: Identifying Drug–Drug Combinations from an Online Forum

Over the last two decades, novel psychoactive substances (NPS) have emerged as synthetic compounds or derivatives of known drugs. Analyzing 20 years of posts from the Lycaeum forum using natural language processing and machine learning, the study found that discussions about NPS often describe combining nootropics with sedative-hypnotics, and stimulants with plant hallucinogens or psychiatric medications. Conversations mentioning synthetic hallucinogens tended to separate into those about amphetamine-derived and ergot-derived compounds, and rarely mentioned plant hallucinogens. Bath salts were commonly discussed alongside sedative-hypnotics or nootropics, while canonical stimulants appeared with plant hallucinogens and psychiatric medications. All substances were frequently compared to MDMA, DMT, cocaine, or atropine to describe their effects. This represents the largest analysis of online polysubstance use patterns to date.

Study at a glance

Abstract

Novel psychoactive substances (NPS) refer to synthetic compounds or derivatives of more widely known substances of abuse that have emerged over the last two decades. Case reports suggest that users combine substances to achieve desired psychotropic experiences while reducing dysphoria and unpleasant somatic effects. However, the pattern of combining NPS has not been studied on a large scale. Here, we show that posts discussing NPS describe combining nootropics with sedative-hypnotics and stimulants with plant hallucinogens or psychiatric medications. Discussions that mention sedative-hypnotics most commonly also mention hallucinogens and stimulants. We analyzed 20 years of publicly available posts from Lycaeum, an Internet forum dedicated to sharing information about psychoactive substance use. We used techniques from natural language processing and machine learning to identify NPS and correlate patterns of co-mentions of substances across posts. We found that conversations mentioning synthetic hallucinogens tended to divide into those mentioning hallucinogens derived from amphetamine and those derived from ergot. Conversations that mentioned synthetic hallucinogens tended not to mention plant hallucinogens. Conversations that mention bath salts commonly mention sedative-hypnotics or nootropics while more canonical stimulants are discussed with plant hallucinogens and psychiatric medications. All types of substances are frequently compared to MDMA, DMT, cocaine, or atropine when trying to describe their effects. Our results provide the largest analysis to date of online descriptions of patterns of polysubstance use and further demonstrate the utility of social media in learning about trends in substance use. We anticipate this work to lead to a more detailed analysis of the knowledge contained online about the patterns of usage and effects of novel psychoactive substances.