Drug use behaviors, trauma, and emotional affect following the overdose of a social network member: A qualitative investigation

Macmadu, Alexandria; Frueh, Lisa; Collins, Alexandra B.; Newman, Roxxanne; Barnett, Nancy P.; Rich, Josiah D.; Clark, Melissa A.; Marshall, Brandon D. L.

doi:10.1016/j.drugpo.2022.103792

Cited by 10 publications

(8 citation statements)

References 61 publications

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“…The burdens are so overwhelming, and there is so much to deal with, that the coping strategies they are using at the time are not viewed as sufficient. That the death of a loved one leads to, sustains, or increases, drug use is in line with other research (Caparrós & Masferrer, 2021; Lee et al, 2020; Macmadu et al, 2022; Parisi et al, 2019; Schlosser & Hoffer, 2022).…”

Section: Discussionsupporting

confidence: 86%

“…Drug use and the so-called “complicated grief” are also found to be interconnected (Parisi et al, 2019). Despite this, the experiences of persons using drugs losing people close to them to a DRD have been given little attention in research, and there is a need to gain an increased understanding of the relationship between being bereaved following a DRD and drug use (Macmadu et al, 2022; Masferrer et al, 2016; Valentine et al, 2016). Given this literature gap, we sought through our research project to gain insight into the relationship between experiencing DRD and personal drug use.…”

Section: Introductionmentioning

confidence: 99%

“…Cumulative overdose events are found to be associated with a severe response to grief and loss (Kenny et al, 2022). Macmadu et al (2022) point out that people who use drugs experience profound and recurring trauma, bereavement, and other emotional effects following the overdoses of people they know. Schlosser and Hoffer (2022) highlighted how complex social relations shaped the grief of people who use opioids and how their mourning was interrupted by involvement with social services and criminal legal systems.…”

Section: Introductionmentioning

confidence: 99%

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Grieving a Drug-Related Death in the Context of One's Own Drug Use: An Exploratory Study

Selseng,

Stroebe,

Lindeman

et al. 2023

Contemporary Drug Problems

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Drug-related deaths (DRDs) are a major societal challenge. People who use drugs are at particular risk of witnessing DRDs, and of losing people close to them to a DRD, and experiencing an overdose or other health issues themselves. People who experience sudden, unexpected, and stigmatized deaths, such as DRDs, are found to struggle more afterward than when the death is more natural and expected. Additionally, people who use drugs are more likely to experience a complicated grieving process following the loss of someone. Despite this, knowledge about the connections between a person's own drug use and reaction following bereavement from a DRD is scarce. This article makes a start at filling this knowledge gap. Based on interviews with people who used drugs and were bereaved following DRDs, the article explores how the bereaved spoke about the relationship between their drug use and losing a close friend or intimate partner to a DRD. We present four types of stories about the relationship between grief following DRDs and drug use. Informed by the Dual Process Model of Coping with Bereavement, we discuss the stories and highlight how drug use is used to handle emotional overload, how drug use leads to uncommon expressions of grief, and how the relationship between grief and drug use may lead to an avoidance of the reality of loss. We point out that drug use and grief are strongly intertwined and how stigma associated with DRDs and drug use creates obstacles to openness and relating to social networks in support processes.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Grieving a Drug-Related Death in the Context of One's Own Drug Use: An Exploratory Study

Selseng,

Stroebe,

Lindeman

et al. 2023

Contemporary Drug Problems

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“…RAPIDS participants were recruited into this qualitative study via informational flyers provided by research assistants at baseline and follow-up survey visits. Prospective participants were referred to the senior author (AM) for further information about the study and eligibility screening, as described previously [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…Eligibility criteria for this qualitative study were the same as RAPIDS and included: being 18–65 years of age, having Rhode Island residency, being able to complete interviews in English, providing informed consent, and self-reporting use of heroin, illicit stimulants, counterfeit prescription pills, or any drug by injection in the previous month. Additionally, eligible participants were required to have known someone who experienced an overdose in the 90 days prior to their interview [ 28 ]. Women (including transwomen) were purposively sampled to ensure gender-specific experiences were adequately captured.…”

Section: Methodsmentioning

confidence: 99%

Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation

et al. 2023

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Background The ongoing COVID-19 pandemic has disproportionately affected structurally vulnerable populations including people who use drugs (PWUD). Increased overdose risk behaviors among PWUD during the pandemic have been documented, with research underscoring the role of influencing factors such as isolation and job loss in these behaviors. Here, we use qualitative methods to examine the impact of the COVID-19 pandemic and pandemic-related response measures on drug use behaviors in a sample of PWUD in Rhode Island. Using a social-ecological framework, we highlight the nested, interactive levels of the pandemic’s influence on increased overdose risk behaviors. Methods From July to October 2021, semi-structured interviews were conducted with 18 PWUD who self-reported any increase in behaviors associated with overdose risk (e.g., increased use, change in drug type and/or more solitary drug use) relative to before the pandemic. Thematic analysis was conducted using a codebook with salient themes identified from interview guides and those that emerged through close reading of transcribed interviews. Guided by a social-ecological framework, themes were grouped into individual, network, institutional, and policy-level influences of the pandemic on drug use behaviors. Results Individual-level influences on increased overdose risk behaviors included self-reported anxiety and depression, isolation and loneliness, and boredom. Network-level influences included changes in local drug supply and changes in social network composition specific to housing. At the institutional level, drug use patterns were influenced by reduced access to harm reduction or treatment services. At the policy level, increased overdose risk behaviors were related to financial changes, job loss, and business closures. All participants identified factors influencing overdose risk behaviors that corresponded to several nested social-ecological levels. Conclusions Participants identified multi-level influences of the COVID-19 pandemic and pandemic-related response measures on their drug use behavior patterns and overdose risk. These findings suggest that effective harm reduction during large-scale crises, such as the COVID-19 pandemic, must address several levels of influence concurrently.

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Exploring trauma and wellbeing of people who use drugs after witnessing overdose: A qualitative study

Song,

Desai,

Meyer

et al. 2023

International Journal of Drug Policy

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Drug use behaviors, trauma, and emotional affect following the overdose of a social network member: A qualitative investigation

Cited by 10 publications

References 61 publications

Grieving a Drug-Related Death in the Context of One's Own Drug Use: An Exploratory Study

Grieving a Drug-Related Death in the Context of One's Own Drug Use: An Exploratory Study

Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation

Exploring trauma and wellbeing of people who use drugs after witnessing overdose: A qualitative study

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