Effects of bereavement by drug-related death: a systematic review and grounded theory study

Abstract

OBJECTIVE: The project aimed to explore the effects of bereavement by drug-related death (DRD). The systematic review aimed to synthesise studies exploring the experiences of drug death bereaved family members, friends, and staff providing a caring role. The empirical study aimed to explore the effects DRDs on staff members in substance use services and resulting support needs.

METHODS: The review searched five databases to identify qualitative studies exploring DRD bereavement experiences of family, friends, or staff members. Results were analysed and brought together using thematic synthesis. For the empirical study grounded theory methodology was used. Eight practitioners employed in substance use services were interviewed and two provided feedback on emerging theory.

RESULTS: Nineteen studies met eligibility criteria for the systematic review. One overarching concept of Omnipresent Stigma was found to frame and complicate all features of drug death bereavement. Bereavement entailed a significant burden in various domains and support was found to be inhibited. During the empirical study a theory emerged of ‘managing the contradictions of responsibility.’ This core process determined how staff experienced bereavement and provided insight into resulting support needs.

DISCUSSION: Drug death bereavement itself is stigmatised and under recognised. Both studies emphasise significant unmet support needs. Strategies and interventions focussing above the level of the individual may be most productive in rectifying this situation.