Background: According to the latest medical evidence, Methadone and buprenorphine-naloxone (Suboxone V R ) are effective treatments for opioid use disorder (OUD). While the evidence basis for the use of these medications is favorable, less is known about the perceptions of the general public about them.Objective: This study aimed to use Twitter to assess the public perceptions about methadone and buprenorphine-naloxone, and to compare their discussion contents based on themes/topics, subthemes, and sentiment. Methods: We conducted a descriptive analysis of a small and automatic analysis of a large volume of microposts ("tweets") that mentioned "methadone" or "suboxone". In the manual analysis, we categorized the tweets into themes and subthemes, as well as by sentiment and personal experience, and compared the information posted about these two medications. We performed automatic topic modeling and sentiment analysis over large volumes of posts and compared the outputs to those from the manual analyses. Results: We manually analyzed 900 tweets, most of which related to access (15.3% for methadone; 14.3% for buprenorphine-naloxone), stigma (17.0%; 15.5%), and OUD treatment (12.8%; 15.6%). Only a small proportion of tweets (16.4% for Suboxone V R and 9.3% for methadone) expressed positive sentiments about the medications, with few tweets describing personal experiences. Tweets mentioning both medications primarily discussed MOUD broadly, rather than comparing the two medications directly. Automatic topic modeling revealed topics from the larger dataset that corresponded closely to the manually identified themes, but sentiment analysis did not reveal any notable differences in chatter regarding the two medications. Conclusions: Twitter content about methadone and Suboxone V R is similar, with the same major themes and similar sub-themes. Despite the proven effectiveness of these medications, there was little dialogue related to their benefits or efficacy in the treatment of OUD. Perceptions of these medications may contribute to their underutilization in combatting OUDs.

BACKGROUND Methadone and buprenorphine-naloxone (Suboxone®) have been discussed and compared extensively in the medical literature as effective treatments for opioid use disorder (OUD). While the evidence basis for the use of these medications is very favorable, less is known about the perceptions of these medications within the general public. OBJECTIVE This study aimed to use social media, specifically Twitter, to assess the public perception of these medications, and to compare the discussion content between each medication based on theme, subtheme, and sentiment. METHODS We conducted a mixed methods descriptive study analyzing individual microposts (“tweets”) that mentioned “methadone” or “suboxone”. We then categorized these tweets into themes and subthemes, as well as by sentiment and personal experience, and compared the information posted about these two medications, including in tweets that mentioned both medications. RESULTS We analyzed 900 tweets, most of which related to access (13.8% for methadone; 12.9% for suboxone®), stigma (15.3%; 14.0%), and OUD treatment (11.5%; 5.4%). Only a small proportion of tweets (16.4% for suboxone® and 9.3% for methadone) expressed positive sentiments about the medications, with few tweets describing personal experiences. Tweets mentioning both medications primarily discussed MOUD in general, rather than comparing the two medications directly. CONCLUSIONS Twitter content about methadone and suboxone are similar, with the same major themes and similar sub-themes. Despite the proven effectiveness of these medications, there was little dialogue related to their benefits or efficacy in the treatment of opioid use disorder. Perceptions of these medications may contribute to their underutilization in combatting opioid use disorder.

Introduction: The height of the opioid epidemic in the US has led to an increasing call for access to medication assisted treatment for opioid use disorder, including buprenorphine initiation from the emergency department (ED).However, only a small percentage of emergency physicians feel prepared or have the necessary training to prescribe buprenorphine. Twitter has increasingly been used as a tool for medical education, and there is growing interest in using this forum to actively engage medical providers and the public. This study examined the views regarding ED initiation of buprenorphine treatment amongst contributors to the quarterly American College of Medical Toxicology (ACMT) tweetchat, #firesidetox, and the demographics of the participants.Methods: A mixed methods descriptive study analyzing individual responses and self-identified demographics among Twitter users participating in the #firesidetox tweetchat regarding the AMCT position statement about ED initiation of buprenorphine treatment.Results: This tweetchat encompassed 87 participants, the majority of whom were clinicians in the US. Physicians accounted for 46% of participants primarily emergency medicine physician toxicologists and authored 75% of the tweets. It consisted of 317 tweets which most frequently described clinical vignettes or experience (46%) or medical education (25%) related to buprenorphine and had themes related to treatment initiation location (ED vs outpatient vs home) (8.6%) and challenges and solutions to buprenorphine administration (8.6%).Conclusions: A tweetchat can be used to disseminate and discuss the adoption of buprenorphine in the ED.Importantly, the tweetchat provides a forum for experts to share narratives and expertise on implementation, and barriers and successes in operationalizing buprenorphine administration in emergency departments.

Background: Methadone and buprenorphine-naloxone (Suboxone®)have been discussed and compared extensively in the medical literature as effective treatments for opioid use disorder (OUD). While the evidence basis for the use of these medications is very favorable, less is known about the perceptions of these medications within the general public. Objective: This study aimed to use social media, specifically Twitter, to assess the public perception of these medications, and to compare the discussion content between each medication based on theme, subtheme, and sentiment. Methods: We conducted a mixed methods descriptive study analyzing individual microposts ("tweets") that mentioned "methadone" or "suboxone". We then categorized these tweets into themes and subthemes, as well as by sentiment and personal experience, and compared the information posted about these two medications, including in tweets that mentioned both medications. Results: We analyzed 900 tweets, most of which related to access (13.8% for methadone; 12.9% for suboxone®), stigma (15.3%; 14.0%), and OUD treatment (11.5%; 5.4%). Only a small proportion of tweets (16.4% for suboxone® and 9.3% for methadone) expressed positive sentiments about the medications, with few tweets describing personal experiences. Tweets mentioning both medications primarily discussed MOUD in general, rather than comparing the two medications directly. Conclusions: Twitter content about methadone and suboxone are similar, with the same major themes and similar sub-themes. Despite the proven effectiveness of these medications, there was little dialogue related to their benefits or efficacy in the treatment of opioid use disorder. Perceptions of these medications may contribute to their underutilization in combatting opioid use disorder.