Table 3.

Subthemes of tweets mentioning methadone.

Theme	Subtheme	Description	Tweets n (% of theme)	Example
Access
	Cost/coveragea	how methadone is covered or paid for, how much it costs patients	18 (25.7)	“@username methadone is not covered for the working poor either. only those on some type of social assistance.”
	Queuing/distribution	the process of receiving methadone, including the need to stand in line at clinics	13 (18.8)	“i figure that’s either a bus stop right there or a methadone clinic.”
Stigma
	Opioid “substituting”a	using methadone as “trading” one opioid for another, less desirable opioid	13 (17.1)	“Mad they got commercials for methadone and suboxone… like get off the street dope! Try ours instead! FOH”
	Stigma from healthcare providers	prejudice or negative sentiment towards people on methadone or with OUD from healthcare providers	9 (11.4)	“Hours spent in EDs watching derision & annoyance they had with him, the ‘#addict’. Help Us! Why no methadone there & then? #overdose #heroin”
OUD treatment
	Methadone vs suboxonea	directly compares methadone to suboxone	11 (19.3)	“@username I know at least a dozen people who’ve tried to switch from methadone to buprenorphine, only one was successful long term!”
	MOUD successa	successes of any of the MOUD options, including methadone specifically	9 (15.8)	“methadone + suboxone are effective heroin addiction treatments for many people + should remain the first line response. #phcsalome”
	Medical educationa	designed to educate readers, typically contain to facts and data about the opioid crisis or MOUD options	19 (33.3)	“amitiza nnt = 13 for constipation. does not reverse methadone related constipation!!! #hpm17”
Unrelated
	Analogies to methadone	compares unrelated things to methadone, often inferring that the thing compared to methadone is less desirable	24 (18.5)	“@username I’m a full blown crumpet junkie. I’ll have to go on crumpet methadone (English muffins in the states) when I get back just to survive.”
	“Try methadone”	have consistent pattern comprised of “question? You probably have []. This causes []. Try methadone.”	44 (34.1)	“Have freckles? Yes? You suffer from Skitzo. This causes numbness. Try Methadone”

^asubtheme was also seen in suboxone^®-containing tweets.