In this case report, we present a patient on Medication for Opioid Use Disorder (MOUD) for opioid use disorder (OUD) enrolled in an outpatient addictions clinic located inside a metropolitan academic hospital. He had been stable on methadone for more than six years, and had requested to be transitioned to buprenorphine due to economic constraints. He had initially been unsuccessful completing traditional induction due to withdrawal symptoms. By using the rapid micro induction technique, which benefits from the use of ancillary medications for comfort, the patient successfully transitioned to buprenorphine while monitored in the clinic for six days, with fewer reported symptoms of withdrawal. This shows a modified, expedited approach of transition from methadone to buprenorphine after a patient cannot tolerate full abstinence from opioids during traditional induction.

Background: The coronavirus disease (COVID-19) pandemic has impacted patients receiving methadone maintenance treatment (MMT) through opioid treatment programs (OTPs), especially because of the unique challenges of the care delivery model. Previously, documentation of patient experiences during emergencies often comes years after the fact, in part because there is a substantial data void in real-time. Methods: We extracted 308 posts that mention COVID-19 keywords on r/methadone, an online community for patients receiving MMT to share information, on Reddit occurring between January 31, 2020 and September 30, 2020. 215 of these posts self-report an impact to their MMT. Using qualitative content analysis, we characterized the impacts described in these posts and identified four emergent themes describing patients\' experience of impacts to MMT during COVID-19. Results: The themes included (1) 54.4% of posts reporting impediments to accessing their methadone, (2) 28.4% reporting impediments to accessing physicial OTPs, (3) 19.5% reporting having to self-manage their care, and (4) 4.7% reporting impediments to accessing OTP providers and staff. Conclusions: Patients described unanticipated consequences to one-size-fits-all policies that are unevenly applied resulting in suboptimal dosing, increased perceived risk of acquiring COVID-19 at OTPs, and reduced interaction with OTP providers and staff. While preliminary, these results are formative for follow-up surveillance metrics for patients of OTPs as well as digitally-mediated resource needs for this online community. This study serves as a model of how social media can be employed during and after emergencies to hear the lived experiences of patients for informed emergency preparedness and response.