What Google and Wikipedia Tell Us About Global Interest in Substance Use Disorder

Article information

Alibudbud, R., & Cleofas, J. V. (2023). Global utilization of online information for substance use disorder: An infodemiological study of Google and Wikipedia from 2004 to 2022. Journal of Nursing Scholarship, 55(3), 665–680. https://doi.org/10.1111/jnu.12844 

What this study is about

When people want to understand a health issue, many do not begin in a clinic. They begin online. They search Google. They read Wikipedia. They look for symptoms, causes, treatments, diagnostic terms, and sometimes reassurance. This study asks: How has the world used online information about substance use disorder over time?

The authors used an infodemiological approach. Infodemiology means studying patterns of online information behavior—what people search for, when interest rises or falls, and what related topics appear alongside a health concern. Instead of surveying individuals directly, the study examined large-scale public data from Google Trends and Wikipedia Pageviews. 

The focus was substance use disorder, a clinical term used when substance use becomes harmful, difficult to control, and associated with distress, impairment, or health risk.

Why this matters

The internet has a complicated relationship with substance use. On one hand, online spaces can facilitate drug sales, misinformation, unsafe advice, and stigma. On the other hand, the internet can also provide education, prevention messages, treatment information, harm reduction resources, and pathways to care. 

This is why the authors describe the internet as paradoxical in relation to substance use disorder. It can worsen problems, but it can also help solve them.

For nurses, this is especially important. Nurses are not only direct care providers. They are also educators, advocates, researchers, public health workers, and increasingly, digital health professionals. If people are searching online for substance use disorder information, nurses need to know what they are searching for—and whether the information they find is accurate, accessible, and non-stigmatizing. 

What the researchers did

The researchers collected data from two major online sources:

1. Google Trends
   They searched for the topic “Substance use disorder (Disorder)” worldwide from January 2004 to June 2022. Google Trends reports search interest using relative search volume (RSV), scaled from 0 to 100.
2. Wikipedia Pageviews
   They collected monthly views of the “Substance use disorder” Wikipedia page from July 2015 to June 2022, the earliest available period for that tool. 

They also examined top and rising related topics and queries, which show what people were searching alongside substance use disorder. Finally, they used ARIMA forecasting models to predict possible search and pageview trends up to December 2025. The graphs on pages 4 and 5 show the observed and predicted trajectories for Google searches and Wikipedia pageviews. 

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What the study found

1) Google searches increased dramatically

Google search interest in substance use disorder rose from an RSV of 9 in 2004 to 82 in 2022. The article describes this as an increase of more than 900%. 

This suggests that global public interest in substance use disorder information has grown substantially over nearly two decades.

2) Wikipedia pageviews also increased

Wikipedia pageviews rose from 9,328 monthly views in July 2015 to 15,000 monthly views in June 2022. 

This matters because Wikipedia is often one of the first sources people encounter when they search for health information. Increasing pageviews suggest that more people are using Wikipedia to understand substance use disorder.

3) Online interest is expected to keep growing

Using ARIMA forecasting, the study predicted that by December 2025:

• Google RSVs would rise from 82 to 124, and
• Wikipedia monthly pageviews would rise from 15,000 to 17,243. 

The forecasting graphs in Figures 1 and 2 show a continuing upward trend. In plain terms: online demand for substance use disorder information is not slowing down.

4) Search interest varied by country

Google Trends ranked 37 countries based on search volume. The countries with the highest search interest were:

• Ethiopia
• Finland
• United States
• Kenya
• Canada

The lowest-ranked countries included Turkey, Mexico, Spain, Japan, and Indonesia. 

The authors interpret this pattern as showing higher online information utilization in parts of North America and Sub-Saharan Africa, and lower utilization in parts of Asia and Southern Europe. They note that lower searching in some Asian contexts may reflect how drug use is often framed more as a criminal issue than a clinical or public health issue. 

5) People searched for diagnosis, specific substances, treatment, and comorbidities

The search-related topics and queries provide a window into what people wanted to know.

Across the years, people searched for general concepts like:

• “substance abuse,”
• “disease,”
• “therapy,” and
• “mental disorder.”

They also searched for diagnostic systems such as:

• DSM-5,
• ICD-10, and
• International Classification of Diseases. 

Over time, searches increasingly included specific substances and disorders, such as:

• opioid use disorder,
• alcohol use disorder,
• cocaine,
• cannabis,
• methamphetamine,
• benzodiazepines,
• depression,
• bipolar disorder, and
• major depressive disorder. 

This suggests that people are not only searching “what is substance use disorder?” They are also searching for diagnosis, treatment, specific substances, and co-occurring mental health conditions.

Why this is important for nurses and public health

This study shows that online health-seeking is now part of the substance use disorder landscape. People may be searching before they talk to a clinician, before they disclose to family, before they enter treatment, or while they are trying to understand someone else’s substance use.

That creates both opportunity and responsibility.

If online information is accurate, accessible, culturally appropriate, and non-stigmatizing, it can support early help-seeking and harm reduction. But if online information is inaccurate, moralizing, sensationalized, or unsafe, it may increase stigma, delay care, or worsen harm. 

Bottom line

This study shows that global online interest in substance use disorder is increasing and likely to keep increasing. Nurses, health educators, and public health organizations should treat Google, Wikipedia, and social media not as peripheral spaces, but as major health information environments. The internet is already where many people go to learn about substance use disorder. The challenge is to make sure what they find helps rather than harms. 

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Policy/practice recommendations

1. Improve the quality of online substance use disorder information
   Health organizations, nurses, and public health agencies should ensure that online information is accurate, updated, non-stigmatizing, and easy to understand. 
2. Use infodemiology for public health surveillance
   Nurse informaticists and public health nurses can monitor search trends to identify rising concerns, misinformation risks, and unmet information needs.
3. Develop online harm reduction and treatment pathways
   Because people search for diagnosis, treatment, and specific substances, websites should clearly link users to helplines, telehealth services, local treatment centers, harm reduction resources, and emergency support.
4. Warn against self-diagnosis while supporting help-seeking
   Since DSM-5 and diagnostic terms are commonly searched, public materials should explain that online information can guide understanding but cannot replace professional assessment. 
5. Create culturally appropriate materials by region
   Countries should tailor digital health messages to local substances, local languages, available services, and cultural/legal realities.
6. Train nurses in eHealth literacy and infodemic management
   Nursing curricula and continuing education should include how to evaluate online health information, correct misinformation, and communicate evidence in language patients understand. 

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Glossary of key terms

• Substance use disorder — A health condition where substance use becomes harmful, difficult to control, and associated with distress, impairment, or risk.
• Infodemiology — The study of health information patterns online, including what people search for and how public interest changes over time. 
• Google Trends — A tool that shows how often people search for a topic on Google over time and across locations.
• Relative search volume / RSV — Google Trends’ normalized score from 0 to 100 showing relative search interest for a topic. A value of 100 represents peak search interest in the selected period and location. 
• Wikipedia Pageviews — Counts of how many times a Wikipedia page is viewed, used here as another indicator of public information-seeking.
• Top related topics/queries — Common topics or search phrases people use alongside the main search topic.
• Rising related topics/queries — Search topics or phrases that show major growth over time.
• ARIMA model — A statistical forecasting method used to analyze time-series data and predict future values. 
• Infodemic — A situation where too much information—including misinformation and disinformation—spreads quickly and makes it harder for people to find trustworthy guidance.
• eHealth literacy — The ability to find, understand, evaluate, and use online health information.
• Nursing informatics — A nursing field focused on using data, information systems, digital tools, and communication technologies to improve care and health systems.
• Harm reduction — Practical strategies that reduce the negative health and social consequences of substance use without requiring abstinence as the only goal.
• Comorbidity — The presence of two or more health conditions at the same time, such as substance use disorder and depression.
• DSM-5 — The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, used by clinicians to classify and diagnose mental disorders.
• ICD-10 — The International Classification of Diseases, 10th Revision, a global system for classifying diseases and health conditions.