From #Dr00gtiktok to #harmreduction: Exploring Substance Use Hashtags on TikTok

The rise of TikTok as a primary source of information for youth, combined with its unique short-form video format, creates urgent questions about how substance use content manifests and spreads on the platform. This paper provides the first in-depth exploration of substance use-related content on TikTok, covering all major substance categories as classified by the Drug Enforcement Agency. Through social network analysis and qualitative coding, we examined more than 2,333 hashtags across 39,509 videos, identified 16 distinct hashtag communities and analyzed their interconnections and thematic content. Our analysis revealed a highly interconnected small-world network where recovery-focused hashtags like #addiction, #recovery, and #sober serve as central bridges between communities. Through manual coding of 351 representative videos, we found that Recovery Advocacy content (33.9%) and Satirical content (28.2%) dominate, while direct substance depiction appears in only 26% of videos, with active use shown in just 6.5% of them. This suggests TikTok functions primarily as a recovery support platform rather than a space promoting substance use. We found strong alignment between hashtag communities and video content, indicating organic community formation rather than attempts to evade content moderation. Our findings inform how platforms can balance content moderation with preserving valuable recovery support communities, while also providing insights for the design of social media-based recovery interventions.