Tweets about prescription opioid use may reveal insights into the prescription drug epidemic. We qualitatively assessed 2,100 tweets about prescription opioids utilizing a Twitter Archiving Google Spreadsheet® and determined whether the tweet represented: abuse (i.e., use to get high), not abuse (i.e., use as analgesic), or was not characterizable (e.g., "I need a Percocet") and whether the connotation was positive (i.e. promote psychoactive or analgesic use), negative (i.e., adverse event), or not characterizable. Abuse was commonly described and the majority of terms (>66%) represented a positive connotation. Twitter can be a resource to observe trends in perceptions about prescription opioid use.

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