{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T04:33:44Z","timestamp":1769747624225,"version":"3.49.0"},"reference-count":44,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"unspecified","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014405","name":"Centre for Addiction and Mental Health Foundation","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100014405","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,12]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The opioid crisis remains a significant public health emergency. Key contributors to this crisis include an increasingly toxic drug supply and inadequate health policies that rely on strategies to address opioid-related harms and underutilise primary prevention and early intervention approaches. To inform comprehensive prevention and early intervention strategies, research is needed to explore pathways involving hazardous opioid use (ie, daily opioid use that results in, and may arise from, disruptions to health, relationships, work or social functioning) and the individual, social and structural factors that shape such pathways. This qualitative study aims to address this research gap by exploring the substance use journeys of adults with lived or living experiences of hazardous opioid use who are receiving substance use treatment at a large Canadian mental health hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A qualitative descriptive study informed by the life course perspective will be conducted. Data will be collected using participant-led timeline mapping in combination with semistructured interviews. Participants will include 20\u201330 adults who are receiving or have received substance use treatment from the hospital where the study is being conducted. Timelines and interviews will be analysed using thematic analysis. A brief demographic questionnaire will also be administered to describe characteristics of the sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was granted on 1 October 2025 by the Centre for Addiction and Mental Health Research Ethics Board (Protocol no. 2025\/026). Findings will be reported through peer-reviewed publications, lay language reports and\/or academic conferences on mental health and substance use health research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112442","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:45:40Z","timestamp":1769697940000},"page":"e112442","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding opioid use within the substance use journeys of adults receiving treatment: a qualitative study protocol of the participant-led timeline mapping approach"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6398-0964","authenticated-orcid":false,"given":"Maria Jennifer","family":"Estrella","sequence":"first","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Wells","sequence":"additional","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Foy","sequence":"additional","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Quilty","sequence":"additional","affiliation":[{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikki","family":"Bozinoff","sequence":"additional","affiliation":[{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie","family":"Buckley","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"},{"name":"Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Lincoln","sequence":"additional","affiliation":[{"name":"Patient and Family Experience, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Patenaude","sequence":"additional","affiliation":[{"name":"Patient and Family Experience, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farihah","family":"Ali","sequence":"additional","affiliation":[{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Faculty of Applied Health and Community Studies, Sheridan College, Brampton, Ontario, Canada"},{"name":"Ontario Node, Canadian Research Initiative in Substance Matters, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"2026012906452898000_16.1.e112442.1","unstructured":"Centers for Disease Control and Prevention . 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