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Psychological justice: addressing drug-related deaths as a health and social risk for families, communities, and services
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Date
2024
Authors
O'Callaghan, Daniel
Journal Title
Journal ISSN
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Publisher
University College Cork
Published Version
Abstract
Drug-related deaths represent a significant practice concern for global public health, and a continual increase in associated fatalities presents acute social and health challenges for families, communities, and services worldwide. Amid the urgent requirement for adaptive state policy responses to address rising death figures, each number represents the loss of human life that embodies a social identity as somebody’s loved one. Behind the statistics, countless individuals grieve the untimely loss of a child, a parent, a client, a sibling, or a friend. Lamentably, many are forced to grieve in silence, as drug-related bereavement can foster a disenfranchised grief that requires therapeutic intervention but concurrently inhibits access to support through shame, isolation, and self-blame. If unprocessed, people who grieve a drug-related death are at increased risk for harmful short- and long-term health outcomes, including increased risk of death.
People who use drugs navigate a range of social, health, and justice contexts, forming various levels of sustained personal and professional relationships. When a person dies, people within this social context are left to mourn the loss of life and the loss of potential represented by a premature and preventable death. However, grief can manifest differently dependent on several interpersonal, relational, and contextual factors. To appropriately target grief supports, it is important to discern how drug-related determinants interact with, and influence, bereavement processes. Thus, this doctoral thesis addresses a gap in the literature, identified within a scoping review (Chapter 2), by examining the grief experiences of three subgroups who are at risk for experiencing a drug-related death: peers in active addiction, families, and healthcare professionals.
Through a series of peer-reviewed academic articles, this thesis shares the voices of 38 drug death bereaved individuals who represent family members, staff within various healthcare professions, and people who experienced the death of a peer during their own active addiction. Theoretically grounded within the dual process model of coping with bereavement, each study employs an in-depth qualitative methodology to explore complex and multifaceted grief experiences. Chapter 4 conveys the experience of posttraumatic growth for families, identifying key facilitators of resilience. Chapter 6 and Chapter 8 address bereavement for healthcare professionals, spanning occupations in social work, addiction, and emergency medicine. Chapter 6 explores their complex grief reactions, while Chapter 8 identifies the challenges of working with clients who died during the COVID-19 pandemic. In Chapter 9, people who were in active addiction report how their grief experiences were shaped by stigma following the death of a peer.
This research identifies the drug-related death of a loved one as a critical period for intervention where suitably targeted supports are currently profoundly limited. The work presented in this thesis contributes to the validation and recognition of diverse grief experiences for groups that grieve in silence, providing a more holistic understanding of complex inter- and intra-group grief processes. In providing actionable recommendations, this thesis aims to improve standards of evidence to support the implementation of adaptive and heterogenous drug-related bereavement policy and practice responses. Tailoring evidence-informed bereavement supports to address the specific needs of the bereaved is crucial, potentially lifesaving, particularly as social positioning and relational capital play a significant role in the manifestation of grief responses.
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Keywords
Drug-related death , Bereavement , Complicated grief , Addiction , Overdose
Citation
O'Callaghan, D. 2024. Psychological justice: addressing drug-related deaths as a health and social risk for families, communities, and services. PhD Thesis, University College Cork.