The United States is in the midst of an epidemic of morbidity and mortality due to prescription opioid use.  Over the past 15 years the number of prescription opioid analgesic medications sold in the United States has quadrupled, yet the amount of pain or disability that Americans experience has remained unchanged.  The Centers for Disease Control and Prevention reports that from 2000 to 2014, more than 165,000 people have died from overdoses related to prescription opioid use.

The identification of specific populations that rely heavily on opioids is of strategic importance for risk mitigation efforts. For instance, attention has focused on patients recovering from trauma and surgery,among whom poor coping strategies were associated with long-term reliance on opioids

Despite the increase in the prevalence of mental health disorders and the importance of tracking use of prescription opioids nationally, the extent to which U.S. adults with mental health disorders use prescription opioids has not been thoroughly examined

For years, Marcy Sherman-Lewis went to a beauty salon in St. Joseph, Mo., every few weeks for a haircut and highlights.

It had become something of an ordeal to prepare her husband, Gene Lewis, for this outing; he has Alzheimer’s disease, at 79, and helping him shower and dress, insert hearing aids and climb into the car was a very slow process.

But she could no longer leave him at home alone. And once at the salon, “he just sat, watched TV, slept — didn’t bother anybody,” said Ms. Sherman-Lewis, 62. Her stylist kindly trimmed his hair, too.

Then last month, the salon owner took Ms. Sherman-Lewis aside. “Marcy, he makes my other patrons awfully uncomfortable,” she said.

“I was dumbfounded,” Ms. Sherman-Lewis said. “It’s O.K. for other people’s little grandchildren to be running around sometimes. What am I supposed to do, keep him in a crate in the car?”