opioid use. Fourteen of 15 families approached agreed to participate, and aside from children <18 years old, fewer than 10% of those approached were excluded (typically based on considerations of Thai fluency among the elder generations). Eligible individuals underwent a formal process of informed consent, during which the study requirements, potential risks and benefits, and alternatives to participation were explained. All procedures were approved by the institutional review boards of the respective institutions in the United States and Thailand, including the Human Investigations Committee at Yale University School of Medicine, the Ethics Committee at the Faculty of Medicine, Chulalongkorn University, and the Ethics Committee of the Thai Ministry of Public Health. Enrollment of subjects was conducted with the prior approval of the local community leaders, village elders, and family heads.
