How Do Drug-Death-Bereaved Parents Adjust to Life Without the Deceased? A Qualitative Study

Abstract

Knowledge about how bereaved persons grieve can enhance quality in providing the support and potential services that they need. We aimed to identify ways in which drug-death-bereaved Norwegian parents go on with their lives and what inhibits or promotes adaptation during their grieving. Reflexive thematic analysis was used to analyze 14 semistructured in-depth interviews. We generated three themes: (I) processing grief emotions, (II) proactive coping, and (III) giving and receiving support and assistance. Processing guilt rumination, reflections on blame and a burden of grief emotions characterized grieving early on. Using cognitive strategies and functional-support-giving were found to be the most frequently used strategies. Oscillation between processing stressors and reorientation to the world promoted adjustment to ongoing life. We discuss characteristics of parents who struggle to reorient and outline important implications for policy and practice.

Exploring the mental health correlates of overdose loss

“…Moreover, acknowledging the overlap between overdose and suicide loss, comparison groups consisting of suicide and sudden‐natural loss survivors were employed to further illuminate any shared or unique mental health challenges. Consistent with the extant literature on overdose bereavement, we hypothesized that a substantial proportion of survivors of overdose loss will meet or exceed the symptom severity threshold that reflects a positive screen for PGD and PTSD, in a manner that is similar to suicide loss survivors given the shared grief‐related themes and outcomes reported elsewhere (e.g., Feigelman et al., 2011; Titlestad et al., 2020). Furthermore, we suspect the presence of elevated symptoms of Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and prevalence of suicide risk among overdose loss survivors based on levels of stigma, guilt, and shame, as well as pre‐existing mental health difficulties often experienced in this loss group.…”

“…Moreover, acknowledging the overlap between overdose and suicide loss, comparison groups consisting of suicide and suddennatural loss survivors were employed to further illuminate any shared or unique mental health challenges. Consistent with the extant literature on overdose bereavement, we hypothesized that a substantial proportion of survivors of overdose loss will meet or exceed the symptom severity threshold that reflects a positive screen for PGD and PTSD, in a manner that is similar to suicide loss survivors given the shared grief-related themes and outcomes reported elsewhere (e.g., Feigelman et al, 2011;Titlestad et al, 2020).…”

“…Another proxy for the deleterious mental health consequences of overdose loss can be speculated based upon levels of stigma, guilt, shame, and a protracted search for why the death occurred (e.g., Feigelman et al., 2018; Titlestad et al., 2020). For instance, research with suicide loss survivors suggests that adverse mental health outcomes may be the product of, among other factors, these thematic grief challenges (Hanschmidt et al., 2016).…”

How do Professionals in Municipal Health and Welfare Relate to Bereaved Persons During the Acute Phase of a Drug-Related Death? A Qualitative Study

“…The number of persons bereaved through overdose is significant: in Norway, there were at least 3240 such bereaved persons in 2020, and in the USA, there were between 706,300 and 1,059,450 such bereaved in 2019. Individuals bereaved through DRD have received little attention in the literature, although the sparse research that does exist shows a lack of support and understanding for the bereaved after a drug or alcohol-related death ( Feigelman et al, 2012 ; McKell et al, 2018 , p. 143; Richert et al, 2021 ; Templeton et al, 2017 ; Titlestad et al, 2020 ; Titlestad et al, 2021 ); Valentine, 2017 ; Valentine et al, 2016 ).…”

Advice to policy-makers for improving services to the drug-death bereaved

“…The scarce research on this group supports an assumption that the grief of bereaved after DRD is disenfranchised grief, that the cause of death results in less social support and openness around the grieving process ( Doka, 2002 ; Titlestad, Mellingen, et al, 2020 ). The Norwegian Drug death related bereavement and recovery project (END) is devoted to the study of several aspects of DRD bereavement and recovery, e.g., how the DRD-bereaved experience grief and stigma and are supported by health and social care services ( Dyregrov et al, 2020 ; Dyregrov & Selseng, 2021 ; Løberg et al, 2019 ; Titlestad, Mellingen, et al, 2020 ; Titlestad, Stroebe, & Dyregrov, 2020 ). A major rationale of the project is to communicate advice to service providers and policymakers in order to reduce stigma and improve the quality of life of the bereaved.…”