Abstract
We explored parents’ views of the trajectories of their adult children’s eventual deaths from drugs with in-depth qualitative interviews from 11 bereaved parents. Parents reported great emotional distress and high financial burdens as their children went through death spirals of increasing drug involvements. These deaths often entailed anxiety-inducing interactions with police or medical personnel, subsequent difficulties with sharing death cause information with socially significant others, and longer term problems from routine interactions. Eventually, though, many of these longer term bereaved parents reported overcoming these obstacles and developing posttraumatic growth. Openly disclosing the nature of the death seemed to be an important building block for their healing.
Epidemic is a particularly apt term to describe the recent spectacular rises in drug poisoning fatalities in the United States. A 2015 survey reported a 137% rise in drug fatalities between 2000 and 2014, and a 200% spike in opioid fatalities (Rudd, Aleshire, Zibbell, & Gladden, 2015). According to preliminary Centers for Disease Control information, the United States is on a path to exceed 60,000 drug deaths in 2016, a 20% rise from the previous year, bringing drug deaths way beyond the numbers of yearly traffic fatalities (40,000) and or yearly suicides (44,000; American Association of Suicidology, 2017; Centers for Disease Control, 2017; National Safety Council, 2017). Drug deaths are a common tragedy in 2017.
At the same time, American society has reconceptualized drug addiction away from its origins in the criminal-legal system into a medical or psychiatric framework. There has always been a duality to drug addiction, with society viewing it both as a criminal problem and as behavior problem requiring social services (Murphy, 2015). As the Affordable Care Act and Medicaid expansion have extended new treatment opportunities to more drug-dependent persons, the pendulum has begun to swing toward offering care and treatment rather than incarceration. Thus, hundreds of thousands of drug-troubled people are finding new opportunities to obtain medical and psychiatric help.
Only a handful of studies exist on the mourners of drug-death decedents. A recent comprehensive review of this limited literature emphasized the obstacles to making sense of the loss through sharing it with others and finding comfort in the deceased person’s memory and recommended further exploration of the large gaps in understanding how families and individuals experience and grieve such deaths (Valentine, Bauld, & Walters, 2016). In many ways, this perspective was the starting point for the present investigation.
An important theme of previous studies is that many drug-death-bereaved people experience disenfranchised grief, which is when society does not acknowledge and support a mourner’s grief, thereby worsening the grieving experience (Doka, 2001). In a comparison of different causes of death, those bereaved from drug or suicidal deaths reported more grief and mental health problems than those bereaved from accidental and natural deaths (Feigelman, Gorman, & Jordan, 2011). Also, half of drug-death-bereaved parents reported hearing statements blaming either the child or the parents for the drug death, compared with only one or none when a child died from an accident or natural causes (Feigelman et al., 2011). However, the Feigelman et al. study involved extensive questionnaires, but no actual interviews, which would enable a finer examination of the trajectory of grief and healing. Also, all the participants came from a single source, the Compassionate Friends Grief Support Groups. Getting participants from many sources would give a clearer picture of the trajectory of the experience for drug-death-bereaved parents.
In a study of 106 drug-death mourners from Great Britain and Scotland, many reported receiving stigmatizing comments from friends and family members such as referring to the deceased as a “junkie” or “drug addict”; consequently, mourners often misrepresented their loved one’s death cause to protect themselves emotionally, and by doing so, denied themselves validation and support for their losses (Valentine, 2018, pp. 77–84). For these people, disenfranchised grief negatively impacted bereavement and support seeking, clearly suggesting that marginalization hindered their healing (Templeton et al., 2016). Among a subset of 32 of these bereaved adults, those living with a loved one’s substance use prior to their deaths reported difficult circumstances surrounding the death, having to negotiate complex procedures in processing the death, experiencing stigma that such deaths attracted, and having feelings of guilt, self-blame, and an unworthiness to grieve (Templeton et al., 2017). These findings, based on a large and diverse sample, are very important for explaining shorter term coping and support-seeking afterward but less valuable for enhancing viewpoints on the longer term healing trajectories and posttraumatic growth of those bereaved from drug death.
In the present study, based on previous work with longer term suicide-bereaved parents (Feigelman, Jordan, McIntosh, & Feigelman, 2012), we suspected that longer term drug-death-bereaved parents (whose losses had occurred 5 or more years previously) would be more amenable to posttraumatic growth than shorter term bereaved parents (whose deaths had occurred within the previous 3 years); also, another important element would be examining the trajectory of the drug death for the mourner, as anticipating the death might lead to both relief and guilt after the death.
Method
Participants
The 11 interviewees (9 mothers, 2 fathers) were recruited from different individuals and organizations that provide support to drug-death mourners, including professional counselors (n = 4), and relevant organizations including Survivors of Suicide Support Groups (n = 2), drug treatment and recovery support groups (n = 2), Facebook and Group for Recovery After Substance Abuse Passing (GRASP; n = 2), and Compassionate Friends (n = 1). Interviewees were aged 59 to 74. Most were college graduates, working at or retired from professional positions such as guidance counselor, social worker, teacher, financial analyst, accountant, salesperson, and small business owner.
Children who died from drug-induced causes (10 men and 1 woman) were on average age 26.8 at the time of their deaths, White (all), heterosexual (n = 10), and biological offspring (n = 10). Slightly over half were from divorced parent households (n = 6) and were described by parents as underemployed or unemployed during the years immediately prior to their deaths (n = 6). They died anywhere from 9 months to 21 years previously (M = 6 years).
Procedure
The first or second author completed interviews at the interviewee’s home, the author’s home, nearby restaurants, or by phone. Researchers contacted the drug-death bereavement community seeking volunteers to participate in a 1- to 2-hour interview about the loss of their child to drugs. We asked mental health counselors with drug-death-bereaved patients to recruit volunteers from current or former patients, and we asked members of relevant support groups to participate. The first author interviewed support group members; the second author interviewed patients or former patients. The interview included (a) obtaining basic demographic information on the bereaved parent and the deceased child; (b) asking about any experiences of being stigmatized, humiliated, or avoided after their child’s death; (c) inquiring whether the interviewee disclosed or concealed the cause of their child’s death and any changes in disclosure over time; (d) outlining their child’s evolution from first using drugs till death; and (e) indicating how their activities, goals, and social contacts evolved since their child’s death including listing any activities to memorialize their child.
All interviews were transcribed, carefully examined, and organized around the five themes listed earlier with additional subthemes added for such subjects as applying tough love and the approximate time length of the death spiral, and so forth. Responses were listed on an Excel spreadsheet where we discerned response patterns showing more newly bereaved persons reporting more instances of concealing the deaths, more cases of being stigmatized and humiliated, and fewer descriptions of their own posttraumatic growth compared with longer term bereaved persons.
At the outset of each interview, whether it was conducted in person or by telephone, which only applied to two cases, respondents were advised that if they found any of our questions unsettling or disturbing, they did not have to answer those questions. All were asked to verbally confirm their participation in the research and were told that their names and any significant details that might help to identify them would be changed to fully protect their privacy and confidentiality. During the interviews, both interviewers did not use any electronic devices to record these events. All interviews were transcribed by hand, necessitating periodic pauses so that the interviewers could catch up to what the respondents were saying. Once all the interviews were completed, participants were presented with draft copies of the results and were invited to suggest changes to correct any errors or misinterpretation that had taken place. Only three respondents offered corrections to further explain their behavior and redress initial misinterpretations. At the conclusion of the data gathering process, about half of the respondents expressed gratitude that their loss stories were being heard (perhaps for the first time) and that they were able to contribute to this process; another expressed gratitude that her son’s life was being memorialized positively, and another respondent jokingly suggested that her former friend might read her story about being cast aside after her son’s drug death and feel remorseful about her rejection.
After the data were collected, we provisionally wrote up the results following the outline we had developed for the interviews. After sharing this draft among the coauthor team, one member of the group envisioned a new ordering of results, presenting them chronologically. Subsequently, a draft was prepared following this diverging plan, and once all members of the team viewed the alternative formulation, all agreed this presented a far more meaningful and superior organization of the results than the earlier scheme.
Results
This section summarizes the findings from the in-depth interviews. We discuss the results chronologically. First, we mention the death spiral; this is when, perhaps for the first time, the parent becomes painfully aware of the lethal potential of their child’s drug use. For our respondents, it may have occurred when one mother discovered one of her son’s letters to a friend where he described his deep dependency and inability to stop using drugs or another mother’s discovery that her drug-addicted daughter stole and sold her coveted record collection of 60 s and 70 s Beatles’ music. The Death Spiral awakens in the bereaved person’s mind a feeling that this child might die from drug-related complications. This period is followed by the Crash, the cataclysmic event of the death. Next comes the task of initially sharing the details of the death with close friends and family. Following this period, there are longer term routine situations that occur and occasionally pose healing-related difficulties for the bereaved. Memorialization and Posttraumatic Growth comes last. This last stage did not apply to some of our shorter term (less than 3 years) more recently bereaved interviewees.
These parents reported that their child’s drug involvement went into a death spiral. When parents learned of the death, relevant official personnel often treated them insensitively. Most parents found sharing the details difficult, a problem that seemed to recur in later routine situations. Nevertheless, some parents overcame these obstacles to experience posttraumatic healing and growth.
Death Spiral
Each informant offered a unique story of the trajectory of their child’s initial uptake of drugs leading to the eventual death. Some parents had long, torturous experiences with their children with multiple relapses, difficult incidents such as thefts of family property, humiliating experiences such as bailing their child out of jail, and seeing their children struggle against the dominance of drugs.
Lenore reported a typical scenario: Matthew grew up in an intact family, a middle child in a three-child family. When he started high school, he was an honor student and played on the lacrosse team. He was hoping to get a scholarship to play lacrosse in college. Then, during his high school sophomore year, the stability of his social world collapsed with my divorce from his father, revealing that my ex- had severe problems with gambling and drugs. This was followed by three of Matthew’s four grandparents dying within a 3-year period. All these changes led to Matthew’s drug taking. At first, Matthew started with cigarettes, marijuana, and beer. But, it wasn’t long before, under the laissez-fare care of his father, Matthew’s drug use changed to pill popping and heroin use. I tried to get PINS ( I spent over $200,000 for special schools and treatment programs for Robbie. Robbie was always breaking things and getting into trouble. Once he conned me into getting him an expensive electric guitar. I learned a few months later that he pawned it for drug money. I’d call him regularly to see how he was doing, and occasionally I found him under the influence of drugs; whenever I confronted him about it, he’d bark at me. Eventually, for self-protection, I had to keep my distance from him. The drug involvement was sometimes so intense parents anticipated their child’s death. I would often go around “waiting for the shoe to drop” so to speak, anticipating John’s death. I’d go around in a fog sometimes, thinking about it, waiting for the next catastrophe. One time, when I was on my way home, thinking about him, worrying about what I’d find when I opened the door, I wasn’t paying close attention where I was walking, and I tripped and fell; my injury required surgery, and I was incapacitated for months afterwards. Despite his biological father’s departure at age 3, Tim grew up in a relatively stable home. He was not much of a student, dropped out of high school, [and] joined the Army where he completed his GED. His drug problems did not start until he finished his army tour and was given OxyContin for chronic pain relief instead of the back surgery that he should have been offered. Tim moved onto using street drugs afterwards and was charged for three different offenses. I was able to get him bailed out for two of the charges, but he had to serve the third charge, 2 years in prison. When he was in jail, I kept sending him money every week to keep him safe and to keep his spirits up; I was also afraid he might have taken his life, otherwise. In jail, drugs were widely available, so some of my money probably fueled his drug habit, but I felt I had no choice. Thousands were spent for this and for bailing him out at different times, and I’m still in debt from doing all this. Shortly after Tim was released from an early jailing, he came back to live in my (and his step-father’s) home. But not long afterwards, we had no other choice but to change the locks at our home because we couldn’t stop Tim from stealing from us, credit cards, cash, anything of value. I wanted him out of my house, but when I gave him over to his biological father, instead of taking him into his house and supervising him, he brought him over to live with my elderly mother. He remained there for the next several months before he wound up in jail again. His final 2 years were spent in jail, at my home, jail briefly again, and finally he died at his drug dealer’s house at age 34. Tim was primarily a heroin addict; he had been twice saved with Narcan from overdosing. Within a month before his death, I sat down with Kevin and had a serious talk with him after his second near-fatal OD from heroin. I guess you want to die, how do you want me to handle your death and funeral when it happens, I asked. I was surprised that he had an elaborate and thought out answer for me. He said I don’t care if you have a funeral service for me or not, but please cremate my body and take part of my ashes and have them made into a diamond. I said I would honor his wishes. After he died, I found out there were only two companies, one in Illinois and another in Great Britain that made diamonds from cremated remains. [She proudly pointed to a platinum broach attached to a necklace with a diamond in it.] My son Michael was living in his own apartment with his girlfriend before his death. He was a college grad and thought of himself as a budding writer. He had saved up a lot of money from his job and decided to make a grand tour of Europe and Asia to broaden his horizons. It sounded like a good idea to me. I didn’t know the extent of his previous drug taking. For all I knew he probably drank alcohol heavily, smoked pot, and may have taken other drugs like LSD or tranquillizers, like many other young people did. When he and his girlfriend were traveling around in India, Michael had a drug-related seizure on an important religious holiday, and he couldn’t get to see a doctor in the big city hospital where he fell sick. The next thing I heard was that he had died, and we had to transport his body back home for burial. He was only 24.
Most of these parents knew about tough love, which would be defined as turning their backs on their child temporarily to avoid becoming enmeshed in a cycle of codependency. Sally reported that she and her husband applied tough love to David after his first hospitalization: We said to him you can’t come back to live here again unless you stay in treatment. I don’t think he was able to do that then. So he got his own apartment where he lived for the last 3 years of his life.
The contrast between families was striking. In Sally’s family, her son David was the only family member with a history or current involvement with drugs. In Maria’s home, however, at least two other family members had histories or current drug problems. Likewise, even though Charlotte changed the locks, thereby denying Tim entry, Tim eventually stayed at his grandmother’s home, where his substance-abusing uncle was living. It appeared that tough love policies were less likely in families with multiple members involved with drugs.
Overall, many parents reported that their child’s drug involvement came at great cost emotionally and financially. Those perceiving the death as resulting from illness, or a poorly understood brain disease, seemed relatively more able to honor the deceased person’s life and remember the joy they brought to other family members. Those perceiving the death as a life style choice seemed relatively less able to positively frame the deceased person’s life. For example, one person said “we will not talk about them any further, since it only makes us angry and sad.” Some parents struggled between these two polar responses to the death.
Summing up this section, as many parents perceived their child in a death spiral, discovering the seriousness of their addictions, a good many, a majority possibly, resolutely began to anticipate the deaths.
Crash
Finding the body and interacting with personnel from police and the medical examiner’s office was very difficult. Generally, police officers offered little to no compassion or support and defined the death site as a potential crime scene. As Maria put it, I discovered Adrienne’s limp body on the floor of her room and also saw the hypodermic needle in her hand. Initially, I was in shock and immobilized, and my grandson, who was living with us at that time, called the police. Once they arrived, they wouldn’t let me go near her. I wanted to fix her hair and take it off her face. I wanted to see that her eyes were closed and that she looked peaceful, but they wouldn’t let me get close to her. They carted her off in a body bag. I ran after them to give them the needle that fell out of her hand. I had a sharp disagreement about everything they were doing in my home and with one younger policeman in particular, but an older policeman eventually calmed things down between us. All the police were very businesslike about it. Not a single one of them had any consoling things to say to me. Imagine, a young, 30-year-old woman dies, and no one has a kind word to say about it to the mother. All I can say is they were very cold and business-like. My husband and I learned about our son Mack’s death from one of our son’s friends who lived in the same apartment building where he lived. We later found out that Mack died from a cocaine-induced hanging. When we arrived at his apartment, yellow crime scene tape was draped around the doorway, preventing us from entering the apartment. We stood by to see Mack’s body carried out in a body bag and were told to report to the county medical examiner’s office to identify the body. At the office, we were shown a photograph of Mack and asked to identify him that way. We didn’t want to identify him from the photo and asked if we could see Mack in the morgue. The agent there told us that the official ME (Medical Examiner) policy only permitted photo identification. We then insisted on speaking to an administrator who eventually granted us an opportunity to actually see Mack’s body. I saw John’s body on the living room sofa. I called his name, struggled to turn him over, and found his face to have a mottled appearance to it. I shook him and tried to push him upright. I saw he wasn’t breathing, but I hit his chest, even though I knew nothing was going to happen; I had to do it. Then, I called the police. I was all by myself at the time, and it was terrifying.
Initially Sharing the Details
Many respondents reported difficulties in openly talking about their child’s drug death with others. Either parents or other close family members believed that openly discussing the drug involvement would dishonor their deceased child’s memory. Some felt it was shameful to have a child die this way.
Sally reported: I had no qualms about talking about my son David’s death and saying that it was a drug overdose, but my husband Peter was deeply ashamed of it. To this day, 12 years after the death, he has never told his coworkers how David died. He said David had some heart malfunction and that caused his death. He didn’t want David’s memory to be sullied in any way. He even told this same story to his relatives about David’s death. But, behind his back and on the q.t. (meaning on the quiet or secretly), I felt I had to tell them the real reason, which we never talk about in front of Peter. Peter has always gone very quiet about David’s death. He didn’t interfere with my support group participation and my ongoing writing, which is usually done anonymously, but he doesn’t want to get involved in any of these grief support activities himself. I have to respect his own different way of grieving from mine. My surviving son, Albert, 2 years older than David, has always been open in acknowledging David’s death from drugs. Shortly after David died, I was very angry with him for causing my husband such shame and agony, but as time passed, my anger to David faded. I have to respect Peter. I try my best not to embarrass him by talking openly about the death in front of him. I don’t want to throw it up in his face. After I found John’s dead body on the living room couch, I thought he may have had a massive heart attack like his father, who died that way 4 years ago. But I was trying to fool myself, I guess. I knew very well that John was abusing drugs. He had been in and out of rehabs for several years and had spent his entire inheritance of $50,000, after his father’s death, on cocaine. As I said, I hoped John had died from an [sic] coronary embolism like his father, but when John’s toxicology report came back a few months after his death, it showed cocaine. And there it was in black and white—so dreadful to have that information. I was wiped from it. After I got that report, I stayed home for several days. I only told just a few close friends and my therapist how he really died. Everybody knew my boy was a sensitive and gentle soul. He suffered from depression and social anxiety, both helped by his prescribed medications. But, no one but me (and my psychiatrist) knew about his use of street drugs toward the end of his life and that he had died as a result of overdosing on his prescribed meds plus fentanyl. At the funeral, I just wanted to focus on the beautiful things in Darin’s life: his humane caring for people and animals and his gentle, quiet manner. We had a lovely service for him at our local church with friends and relatives honoring him. Even now, amongst my small group of very close friends, I continue to withhold the complete story, that Darin had died from an overdose of street drugs—I’m afraid it will only diminish their respect for him.
Longer Term Routine Situations
Even over time, these interviewees reported awkward interactions with others. Several respondents reported rejecting responses from people they had considered close friends. For example, Ellen said, Betty and I had been close friends ever since our children were very little. Betty always said I was her best friend. We carpooled together when the children were in kindergarten and primary school; we sent our kids to the same summer camps and had even spent several family vacations together—I considered her a good friend, as well. When Marshall died of a drug overdose, Betty and her husband came to the funeral and made a shiva call afterwards. They brought lots of food. Then, for the next 4 months, I never heard from Betty again until she called me to mention her daughter’s upcoming baby shower. She indicated that the date was on my son’s birthday and hinted it might be too much for me to attend. I agreed and declined the invitation but sent a baby gift. After the death, I was a bit of a basket case; I had put on a lot of weight and was teary-eyed much of the time. I really needed all of my friends’ help and support when I was so fragile. A few months after the death and still not hearing much from Betty except for the baby shower invitation, I left a message on her answering machine but never got a call back. I guessed that Betty was pulling away from me, and later this was confirmed. Two years after the death, my surviving son ran into a mutual friend of Betty’s and mine and mentioned to her how upset I was from not hearing from Betty. This woman took it upon herself to question Betty as to why she hadn’t called me. My other friend told me that Betty just shrugged it off when confronted and said we were never that close, even before my son’s death. My son John played an important role in guiding this young man (Jack) to treatment several years earlier. The two boys had been well acquainted with each other, and I knew that Jack must have learned from mutual friends that my son had died of an overdose. When I met up with Jack at a social event and went over to hug him, he seemed uncomfortable, awkward, and pulled away. Maybe he was feeling guilty at having survived his own drug use. He didn’t seem to know what to say—but all he needed to say to me was I am sorry. I don’t know if it was my son Robbie’s drug death that caused my being let go from work, but it could have been. After my son’s overdose death, I took some time off from work to arrange for the funeral and burial. And frankly, when I came back to work, although I wasn’t the same old cheerful, upbeat guy I may have been previously, I thought I was doing my job conscientiously as always. My boss never asked how I was feeling after the death. He just kept hounding me with questions, first right after the death, when are you coming back to work and when I was back, he occasionally commented that I didn’t have my old zest and sparkle. How would anyone act two or three weeks after their child’s death? Several months later, I was given a pink slip … In my family, it has always been that when someone dies, their pictures get taken down, and no one talks about them anymore—that’s the way it was after my father died at age 40. My mother was not one to dwell upon the dead. So we never talked about my deceased son either, not with my ex-spouse, my daughter, and my new girlfriend. Thank goodness for the support group where I finally have a chance to talk about my boy. When the doctor asked me how many children I had, I told her I had two. One, my 43-year-old daughter who was married and had two children herself, and my son, who died 15 years ago from a drug overdose. The doctor, visibly uncomfortable, told me we didn’t need to talk about that child. I gave her a piece of my mind and set her straight about the importance of all children in any family. One of the addiction treatment personnel proposed that more Narcan administration training be offered within the community to help those who relapse after discharge. One of the psychiatric residents quipped in response: “Why don’t we just focus on the patients who are motivated to get well. What’s the point of wasting our time and resources? These addicts are only going to relapse again and maybe die anyway, at some later date.” After Kevin died, I went on Facebook and found that some of my Facebook friends criticized me for openly talking about Kevin’s overdose death from heroin. They said I wasn’t grieving properly, whatever that meant; they said, “What do you want to talk about that for? What good will it do now, he is already gone.” About 8 months after Tim’s death, I was talking to my mother, expressing my sorrow and guilt at what I should or could have done to save him. My mother said something that caught me by surprise. She said “Isn’t it time you let go of this?” I thought my mother, of all the people in this world, would understand my grief and remorse. After all, her own son (my brother) had died of a drug overdose a few years back. I couldn’t believe her! And she had always remarked that Tim was such a delight to have around; he lit up the room. I felt so hurt.
Memorialization and Posttraumatic Growth
Despite serious obstacles, many of the longer term bereaved parents eventually experienced some healing and posttraumatic growth. Many described some kind of memorial to their deceased child. For example, Barbara said, Personally, I never felt any shame or at fault about Kevin’s death; we got him the best treatments that money could buy at that time. Eventually, I went to the recovery support groups where people embraced me and wanted to hear my story about losing Kevin. I had always thought of starting a foundation to memorialize Kevin. I soon partnered with another man in recovery, who knew Kevin. He and I eventually started by making donations to promising recovery candidates trying to get them into recovery somewhere. We created a 501-C3 organization, advertised on Facebook, and soon donations started trickling in. Some people gave $5 a month and others $500 or more. So far we’ve raised over $240,000 and have served 286 young people, helping them with their transportation and other expenses to get to South Carolina mostly, where most of the treatment programs we refer to are located. Most all of these young people we helped are still drug-free and feel greatly indebted to us when no one else cared a hoot for them. Two years ago, we were honored by a cosmetics company who gave me a Woman of the Year Award. We put the monetary part of the award back into the foundation. I think Kevin would be proud of the work we are doing. I couldn’t think of a better way to honor his memory than by doing this. Darin had volunteered all through high school at an animal shelter and was hired there after graduation. He planned to make this his career. After his death, I suggested that all donations people wanted to make in his memory be offered to this shelter. After his funeral, I was moping about the house, isolated and feeling depressed. I didn’t know what to do with myself. I was widowed, had left my job to care for Darin’s downward emotional spiral, and now had lost my only child. A month later, the director of the animal shelter called, thanking me for the generous memorial donations the shelter had received. He spoke affectionately of Darin, remembering his loving and competent care of the animals. He then asked how I was doing and suggested that I could work part time at the shelter. It was like he threw me a life line. I was so grateful for this opportunity to do something useful. At first, I was primarily at the front desk receiving injured or abandoned animals and comforting the rescuers who brought them in. This work and environment felt very therapeutic for me. I felt connected once again. The director knew that I had computer and other business skills and after several months of part time work, offered me a full time position. I feel so lucky to be closely affiliated with this shelter’s growth and truly believe that I am carrying on the work that my son felt was meaningful and important; I feel I am memorializing Darin in a very positive way. After Matthew died, I was quiet at first. During those early grieving days, I wrote an op-ed piece for the local county newspaper which elicited numerous negative comments disparaging Matthew. These responses were very hurtful. I went to a Compassionate Friends group, and I soon tired of that—I didn’t want to dwell on the loss and talk about it endlessly. I knew I wanted to do something positive for Matt and start a foundation memorializing him. I wanted to feel joy in the knowledge I had him for 21 years and not get bogged down with all the negative things connected with his drug death. In the first year after Matt’s death, our fund-raising efforts brought in $12,000. I was in close contact with some of the local recovery organizations some of whom do advocacy work at the state capitol. I wanted to do this, too. Before I knew it, I was part of one of the teams that went up to the state capitol lobbying for wider distribution of Narcan in our state, for more drug treatment opportunities and so forth. When we met with legislators, I would usually bring along my small container with some of Matt’s ashes in it. With this in front of them, the legislators found it difficult to dismiss us so easily. I’ve been on several teams going up to the capitol periodically. Now, we’ve got all EMT workers and the police trained and carrying Narcan with them throughout the state. We also successfully got another new law passed so that medical professionals, and not just law enforcement, can now mandate patients to drug treatment. With the new law, treatment can now be covered by medical insurance policies. When Matt died, he was not rated high enough by our insurance policy to be entitled to treatment. There are so many issues that we still need to address. I can’t think of a better way to memorialize Matt than by what I am doing now. When Michael died 21 years ago, there were no groups on the Internet and the only grief resources available were seeing a grief counselor or joining a Compassionate Friends group. My wife and I found Compassionate Friends very helpful, and we became involved in a chapter near our home. After a couple of years of being in the group, the previous leader moved out of state, and I was elected as chapter leader, which I have been for the last 15 years. There’s a lot to it: running the monthly meetings, meeting with newly bereaved members at a diner about a week before the meetings, doing the newsletters and organizing our few annual events like getting a group together to go to the national conferences, doing our balloon release event, and our annual holiday get together. When I was working, it was sometimes a bit hectic doing all these things, but now that I’m retired it is no problem at all … It is now up to veteran bereaved like myself to help the newly bereaved along with their healing journeys.
Discussion
This report focused attention on the grief and healing trajectories of U.S. drug-death-bereaved parents. These 11 parents whose adult children died from drug deaths often anticipated the death in the long death spiral their child experienced. These findings converge with a study in Brazil where family members experienced a “veiled preparation” for possible death among their drug-involved loved ones (Da Silva, Noto, & Formigioni, 2007) and with another study in the United Kingdom and Scotland where close relatives often reported anticipating the death (Valentine, 2018). The British group used the term living bereavement to refer to this anticipation of the death. In contrast, in a U.S. study, 80% of parents bereaved from a suicide death reported being extremely surprised or blindsided at their child’s suicide (Feigelman et al., 2012). A child’s death from drug involvement is often the end of a long trajectory of bad experiences.
These parents had diverging ideas on tough love. If all other household members were free from drug abuse problems, applying tough love seemed more feasible than if other family members also had past or present drug problems. This assertion converges with findings from the UK study (Valentine, 2018). The British group observed that when concurrent drug abuse problems were present in other family members, stress and coping were more difficult for all family members.
Among these 11 parents, healing and growth seemed accelerated when the parents were able to openly disclose the details of their child’s death. Sharing these details with others seemed to enable them to assume leadership positions in peer support organizations like Compassionate Friends, to advocate for better treatments for drug-troubled individuals, and to support others newly bereaved from drug death. These findings converge with data of people bereaved from either suicide or drug death, showing that those who openly disclosed the cause of their loved one’s death had significantly fewer grief difficulties and viewed their mental health more positively, compared with bereaved others who concealed the death cause (Feigelman, Cerel, & Sanford, 2017). Present respondents viewed their advocacy and compassion for others as satisfying and an important commemoration of their child’s life.
Present results are limited in that all interviewees were among parents who sought some sort of treatment after their child’s death, either by seeing a therapist or joining a support group. Parents who do not reach out in this way, or who are unwilling to be interviewed, may respond differently. The present study also overrepresented bereaved mothers; having more women than men is common in bereavement studies. Also, as is true in the majority of drug deaths, the deceased person was a man. Future bereavement studies drawing on official death records sources might more accurately represent the bereaved population at large in terms of its sex ratio and treatment-seeking histories.
Although this study suggested that drug-death-bereaved may confront unique healing challenges associated with anticipating their children’s deaths, we have no basis for supposing that they will find healing any more problematic than others traumatically bereaved. At least two surveys, following up traumatically bereaved parents 5 or more years after the deaths of their children, found diminishing grief problems, complicated grief, and depression as time after their losses had passed (Feigelman et al., 2012; Murphy, Johnson, Wu, Fan, & Lohan, 2003). Previous studies have also shown with more time after loss elapsing, traumatically bereaved parents were more likely to show better mental health and more posttraumatic growth (Dyregrov & Dyregrov, 2008; Feigelman et al., 2012). The evidence obtained in this qualitative study suggests that as time after loss passes, drug-death-bereaved parents, too, much like traumatically bereaved others, are able to arrive at a “new normal” and make important and worthy contributions reflecting their own posttraumatic growth. For these mourners, it is an important task to positively memorialize their deceased children by their posttraumatic growth activities. Present findings suggest that for those whose loved one died from drugs, helping others advances their own healing. It also appears that better adaptations will occur when drug-death-bereaved parents disregard stigmatizing claims that their deceased loved one was at fault and instead believe, as many drug-death-bereaved do, that addiction deaths reflect poorly understood brain diseases or that addiction itself is a bona fide disease much like cancer or heart disease. Ultimately, with sharing precepts such as these, there is almost no limit as to what most of these survivors will be able to accomplish as they act to promote their own posttraumatic growth.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.