{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T09:47:44Z","timestamp":1777715264890,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Psychiatry Med"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:p>Opioid use disorder is a growing epidemic, with an alarming number of associated deaths. In 2014, in the United States, 18,893 lethal overdoses were related to prescription opioids and 10,574 due to heroin. Despite the growing number of treatment options for substance use disorders, which are chronic, relapsing-remitting conditions, relapse rates remain as high as 91%. In the United States, 7.5 million children reside with at least one patient who abuses drugs or alcohol. Mothers are twice as likely to lose custody of their children. They have higher rates of comorbid abuse and psychopathology and limited social supports. Child service agencies, commonly involved in these scenarios, are often pressured to find permanent placement for children, within an expedited timeframe, inconsistent with the need for sufficient time for recovery and goals of family inclusion and unity. We present the complicated case of a 25-year-old woman with a history of opioid use disorder and depression, who, after being in and out of treatment programs for years, had a lethal overdose. She had a significant family history of addiction and had lost custody of her children. This challenging, but common presentation draws attention to challenges in providing treatment during this opioid epidemic.<\/jats:p>","DOI":"10.1177\/0091217417720900","type":"journal-article","created":{"date-parts":[[2017,8,9]],"date-time":"2017-08-09T09:47:00Z","timestamp":1502272020000},"page":"196-201","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["The opioid epidemic"],"prefix":"10.1177","volume":"52","author":[{"given":"Nitin","family":"Chopra","sequence":"first","affiliation":[{"name":"Addictions Division, Centre for Addiction and Mental Health, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren H","family":"Marasa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,8,9]]},"reference":[{"key":"bibr1-0091217417720900","unstructured":"Hedden SL, Kennet J, Lipari R, et\u00a0al. Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health, http:\/\/www.samhsa.gov\/data\/sites\/default\/files\/NSDUH-FRR1-2014\/NSDUH-FRR1-2014.pdf (2016, accessed 6 July 2017)."},{"key":"bibr2-0091217417720900","unstructured":"Center for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Mortality File. Number and age-adjusted rates of drug-poisoning deaths involving opioid analgesics and heroin: United States, 2000\u20132014, http:\/\/www.cdc.gov\/nchs\/data\/health_policy\/AADR_drug_poisoning_involving_OA_Heroin_US_2000-2014.pdf (2016, accessed 6 July 2017)."},{"key":"bibr3-0091217417720900","first-page":"1","volume":"190","author":"Hedegaard H","year":"2015","journal-title":"NCHS Data Brief"},{"key":"bibr4-0091217417720900","unstructured":"National Institute on Drug Abuse. Drug facts: heroin, http:\/\/www.drugabuse.gov\/publications\/drugfacts\/heroin (2016, accessed 6 July 2017)."},{"key":"bibr5-0091217417720900","unstructured":"Center for Disease Control and Prevention. Prescription painkiller overdoses: a growing epidemic, especially among women, http:\/\/www.cdc.gov\/vitalsigns\/prescriptionpainkilleroverdoses (2016, accessed 6 July 2017)."},{"key":"bibr6-0091217417720900","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12480"},{"key":"bibr7-0091217417720900","unstructured":"Volklow, N. Prescription opioid and heroin abuse, https:\/\/www.drugabuse.gov\/about-nida\/legislative-activities\/testimony-to-congress\/2015\/prescription-opioid-heroin-abuse (2016, accessed 6 July 2017)."},{"key":"bibr8-0091217417720900","first-page":"107","volume":"4","author":"Hahn KL","year":"2011","journal-title":"Am Health Drug Benefits"},{"key":"bibr9-0091217417720900","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5413"},{"key":"bibr10-0091217417720900","first-page":"176","volume":"103","author":"Smyth BP","year":"2010","journal-title":"Ir Med J"},{"key":"bibr11-0091217417720900","volume-title":"Textbook of substance abuse treatment","author":"Galanter M","year":"2015","edition":"5"},{"key":"bibr12-0091217417720900","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.04.004"}],"container-title":["The International Journal of Psychiatry in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0091217417720900","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0091217417720900","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0091217417720900","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:14:39Z","timestamp":1777457679000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0091217417720900"}},"subtitle":["Challenges of sustained remission"],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1177\/0091217417720900"],"URL":"https:\/\/doi.org\/10.1177\/0091217417720900","relation":{},"ISSN":["0091-2174","1541-3527"],"issn-type":[{"value":"0091-2174","type":"print"},{"value":"1541-3527","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}