Table 1.

Description of themes associated with tweets mentioning suboxone^® and methadone.

Theme	Description	Example Methadone Tweet	Example Suboxone® Tweet
Access	patients’ ability to obtain medication legally	“Why do junkies get to queue at the chemist everyday for methadone?”	“@username how are you getting suboxone to those who can. ot afford it?”
Stigma	the negative view of the medication, its users, its clinics, or objects related to medication	“just seen an addict swig her methadone down in the chemist, what an awful life she is living. so thin and gaunt.”	“@username worry about your suboxone popping daughter and not drama”
Pain management	medication being used for to treat pain rather than opioid dependence	“@username It was methadone BID, Norco q6-8h. Just seemed like a lot of opiates for something chronic”	“@username I confess I don’t understand. Suboxone doesn’t strike me as 1st, 2nd or 3rd choice for post-op pain.”
OUD Treatment	treatment for OUD, including MOUD or other ways of treating OUD	“@username the accurate statement is: bupe and methadone are more effective than Vivitrol – show me otherwise.”	“instead of free needles, how about free suboxone & vivitrol? #needle exchange”
Tapering/ withdrawal	tapering oneself off, or the withdrawal associated with, the medication	“@username Just got off methadone could use all the help and prayers I can get ”	“#suboxone withdrawal sucks. Don’t be a junkie, kids.”
Safety/ side effects	the safety of medication or the side effects of medication	“drugs like vicodin, oxycontin and methadone must be carefully monitored as there is a risk of fatal overdose. however, experts say it is …”	“@username highest death rates from overdose in the u.s include traces of suboxone, fentenal or methadone in their toxicology reports!”
Greed/ corruption	an entity acting as drug dealers or promoting medication out of hope for profits or kickbacks	“opioid dependants were created by greedy pharmaceutical co’s & obamacare .check out the number of methadone clinics and who owns them”	“@username 2 to 1 its pharmaceutical lobbyists pushing this. Suboxone makes gazillions”
Continued drug use	continuing to use or abuse opiates or opioids while being prescribed or using medication	“@username My friend has been on methadone for 8 months and is still shooting heroin. I just don’t understand why long-term residential tx isn’t an option. Surely if the drug use hasn’t stopped she needs something more?”	“@username I’ve only encountered 2–3 people who have been sober through suboxone/methadone treatments successfully. Most of the time people just use them as a way to keep doing drugs”
Misuse/ diversion	using medication in ways other than prescribed, using illegally obtained medication, or selling prescribed medication	“made a sell to a dude that stays fucked up and he gave me weed and a methadone pill lol”	“#Busted a visitor at Southern New Mexico Correctional Facility was caught trying to introduce suboxone into the facility! #NMCD #SNMCF #notonourwatch”
Uncategorized	medication and/or its use but does not fall into one of the above categories	“@username Obama was giving out smokes at the methadone clinic again.”	“In PA everyone was on suboxone ”
Unrelated	not related to medication or its use	“Methadone Mary n black eye Bill”	“tales of symphonia and suboxone”