Medication experiences in the treatment of opioid use disorders: Insights from Reddit.

Background and aims: Better understanding the challenges faced by patients on medications for opioid use disorder (MOUD), including methadone and buprenorphine, is critical to increasing their use/retention. Social media platforms such as Reddit offer a space for patients to share their experiences with medications. We aimed to identify and characterize challenges faced by patients taking MOUD through analysis of discussions from the r/Methadone and r/suboxone subreddits.

Design, setting and participants: Mixed methods study applying natural language processing methods to 37 278 posts from both subreddits from their origin in 2011 until 31 December 2022. Independent topic analyses used Correlated Topic Models to extract the main themes discussed.

Measurements: We labeled, validated and grouped the topics into macro classes and computed topic shares. We interpreted and compared topics across subreddits informed by the patient-centered medication experience framework.

Findings: We found 27 and 34 challenge-related topics for the r/Methadone and r/suboxone subreddits, respectively. Topics were grouped into three macro-topics: (i) healthcare-related issues, including misunderstandings/confusion around appointments, prescriptions, bottle checks, telehealth technology and health insurance coverage; (ii) medication-related issues, including withdrawal, cravings, dosage, side effects, mixing with other medications/drugs; and (iii) treatment discontinuation, including tapering protocols. Patients conveyed highly specialized knowledge about dosage and tapering strategies and spoke from experience. Key differences between r/Methadone and r/suboxone were driven by their dispensing requirements (clinic-based vs. take-home), with 20.05% vs 14.74% of posts related to healthcare service, primarily for logistic and interpersonal issues with healthcare providers.

Conclusion: People who post on the r/Methadone and r/suboxone subreddits appear to have detailed knowledge of medications for opioid use disorder and want more control over their dosing, effects, side effects and discontinuation. Acknowledging this expertise and establishing stronger patients' partnerships with the healthcare team and system might result in better treatment outcomes.