19 Kerry's story: Kerry is a 47-year-old mother with one adult son and three minor children – a daughter who is 16, another daughter who is 6, and a son who is 4. For 13 years, Kerry was a manager at a shipping warehouse, and she was up for a promotion to be a district area manager. In 2013, while driving home from work, Kerry was in a car accident that resulted in her requiring spine surgery. Her surgeon prescribed two non-abuse-deterrent pain-relieving opioids, one short-term and one longer-acting. Staff kept her pain very well controlled while she was in the hospital. When she was discharged, Kerry received a prescription for 60 extended-release, long-acting opioids (a 30-day supply) and 120 of the short-acting opioids for “breakthrough pain as needed.” [Information required: any factors showing a predisposition toward addiction, past prescription history, allergies, basic medical information, history of mental illness, criminal record, exposure to adverse childhood experiences, prior involvement with social services] Kerry remained on both medications for several months. When her surgeon began to taper Kerry from the opioids, she continued to report pain that interfered with her sleep and work. Her surgeon told her that due to the nature of her injury, complete relief was unlikely, and she should see her family doctor for ongoing pain management. Kerry’s family doctor was sympathetic and prescribed the same opioids she’d been taking, but after she requested early refills several months in a row, he refused further prescriptions. There was no discussion of alternative withdrawal protocols. [Information required: past prescription history and current dosage, past engagement with opioids, prescriptions by other physicians, allergies, basic medical information] Kerry had to have the medications to get through the day. On days when she ran out, she felt too debilitated to go to work, and many days when she went to work, she left early. She never revealed her medication use to her employer, nor did she take advantage of her Employer Assistance Program (EAP) benefits. Finding sources who would prescribe the opioids to stay on top of her growing need for pain medicine became a priority. Several doctors and pharmacies refused to write prescriptions or fill them for her. A few noticed via the prescription drug- monitoring program that she was seeing more than one doctor at a time and frequenting several pharmacies. Also during this period, Kerry enrolled in two different detoxification programs, but once discharged, she could not remain abstinent and she returned to opioids shortly after each one. [Information required: past prescription history and current dosage, past engagement with opioids, prescriptions by multiple physicians, allergies, basic medical information, traumatic experiences, social and environmental factors, experience and outcomes from treatment programs] Eventually, Kerry was arrested for speeding in her car and she failed a sobriety test. She was arrested, and her children were temporarily placed into foster care. Because she was able to prove that the opioids she was on were prescribed for her, she pled guilty to a misdemeanor and was placed on probation. Her children were returned, with the child welfare system providing in-home supervisory services pursuant to a family service plan. [Information required: past prescription history and current dosage, past engagement with opioids, prescriptions by multiple physicians, allergies, basic medical information, traumatic experiences, social and environmental factors, experience and outcomes from treatment programs, family support and treatment programs and outcomes, care plans from family services] Unfortunately, because she missed so much work, Kerry lost her job and could not find other employment. She then lost her house because she fell behind in her mortgage. For two weeks, the family lived in the one-bedroom apartment of her adult son until the landlord threatened to evict him, so they moved to a family shelter. At the shelter, Kerry applied for and was granted TANF, Medicaid and Food Stamps for herself and her three minor children. As a requirement for receiving these federal benefits, Kerry also completed the interviews necessary to file for child support from her former husband (her 16-year-old daughter’s father) and from her two younger children’s fathers.