By Jessica Milette, MSW/RSW
August 31 is International Overdose Awareness Day, a day where we honour and remember those who have died by drug poisoning.
We lead multifaceted lives, and the deaths of those we love who have died by drug poisoning contain multitudes. The death of a loved one can bring intense grief, shock, anger, shame, or guilt. People who use drugs, and those who love them that they leave behind, face stigma in North America’s dominant, settler culture.
It is this stigma of drug poisoning deaths, the othering of another’s valid grief, that places a barrier to one of the greatest things we can offer to ourselves and each other: connection. Those who have died by drug poisoning are parents, children, siblings, aunts, and friends. Those who welcomed us with open arms for an embrace, those who worked alongside us, and those who have faced much suffering and marginalization.
Grief can be an isolating experience; having opportunities to heal in community and share the stories of those we love who have died are so important. It is never about HOW they died, but WHO they are. Saying their name out loud, listening to their favourite music, and sharing stories of joy can help. Sometimes we need to share our stories of frustration, guilt, or sorrow with others who have experienced the death of a loved one.
We don’t have to be impacted by the death of a loved one by drug poisoning to support others in our community who are in pain. Grief and the losses we face cannot be fixed. We can feel helpless in the face of seeing someone we care about in the depths of grief. One of the biggest things we can do as supporters is to not shy away from grief – those grieving can feel supported when others ask them about their person or use their name in conversations. Sometimes telling grievers to “call me if you need anything” can feel overwhelming. By offering specific, practical support like mowing their lawn or dropping off groceries gives grievers a choice. If they do not accept the support you offer, be open to listening to what support they do need as what you may have found helpful might not be the type of support they need. A helpful phrase I’ve used to communicate to people in my life when I need some grief support, or when I’ve offered support to those in my life grieving has been: “Would you like help (with a task or to brainstorm), would you like to be heard (where I will sit and listen without judgment and sit with you in your grief), or would you like a hug (sometimes we need a hug through a tough moment)?”
In addition to these personal losses, we also face these losses as a community. State of Emergencies declared by public health authorities due to the drug poisoning crisis are more common than they were before. The Canadian Healthcare system is still reeling from a pandemic and is unable to meet the current demands to address this health crisis. Drug poisoning deaths are highest for those in our community that face high levels of marginalization, oppression, and stigma despite human beings’ universal needs for safety, connection, community, and care..
People who use drugs, like all human beings living on Stolen Land on Turtle Island deserve access to care, community, connection, and safety in all areas of their wellbeing. Harm Reduction is an important but often underappreciated pillar in Canada’s healthcare system that offers safety, community, compassion, and care while keeping the dignity of the person who uses drugs at the heart of this work. Harm Reduction workers create community for those who may feel isolated or have been excluded from other communities they belong to due to their drug use. They provide spaces for people to learn new ways to be in relationship with drugs, how to be safe when using drugs, and getting connected to other supports for their whole health. Not all drug use is inherently problematic, and harm reduction support can look like many things: from helping those wishing to be abstinent from drug use to helping those who are still using drugs to use them in safer ways.
Just like we come in community to honour those who have died, through community we can continue to hold systems accountable and advocate for equity, justice, safety and health for all.
By Jessica Milette, MSW, RSW
When death knocks on the door of a community, each of us are impacted. Sometimes a death will touch many lives across a community, whether people knew the deceased personally or not. We may grieve the death of a family member, friend, or acquaintance, a well-known community member, or someone we are linked to by age, location, circumstances, etc. Community grief can feel overwhelming – we must tend to our own grief, but others in our life are grieving and hurting too. Each person in a community will grieve differently depending on their relationship to the person who has died, their own prior experiences of loss, and the unique coping strategies they rely on in grief.
Developed by psychologist Susan Silk and Barry Goldman following Susan’s experience with a health crisis and her diagnosis with breast cancer, Ring Theory helps us learn how to support others and ourselves when a community death occurs.
Like a ripple on water when we drop a pebble into it, imagine a series of concentric circles. Those directly impacted by the crisis or death are in the innermost ring, with each outer ring consisting of those further removed from the crisis or death. Generally the immediate family, or those who lived with the deceased,are in the innermost ring, with close friends and other family in the next ring, co-workers and acquaintances in the next ring, and those in our greater community in the outer rings.
When someone experiences a death, those in outer rings pour comfort in, while those in inner rings are allowed to “dump” their thoughts or feelings out. When someone in an inner ring is dumping out their feelings, those in outer rings can show up with acceptance and care, listening and validating the person’s experiences.
Pouring comfort in can also be the offer of specific, practical help. This approach seeks the griever’s consent to accept specific support and comfort, it lets the griever say yes or no to the offer, and can confirm what kinds of support are most helpful to them. It’s important to offer support on the griever’s terms.
When a community faces loss, many who are impacted want to share their feelings about the loss. Susan recalled during her cancer treatment how some folks she did not have very close relationships with in her community would show up unannounced, forcing her to accept support, or people would talk about their own feelings about her diagnosis. Dumping feelings onto someone in an inner circle is not helpful. It can leave those experiencing the loss most personally as if their loss is unacknowledged. When we know which ring we sit in after a death, we can connect to our own outer rings anytime we need to tend to our feelings of grief. If we find ourselves thinking about reaching out for support from someone who is in an inner circle compared to our relationship to the deceased, we should take a step back. Is there someone else that may be located in the same ring as us, or someone in a ring outside of us that we can reach out to instead? Sometimes actually drawing out the rings of folks in our own life impacted by a death can clarify where we need to support others, and who we can connect with for our own support.
Whether supporting others, or seeking support ourselves, a helpful phrase may be “Would you like to be heard, helped, or hugged?” Being heard means receiving supportive listening and validation. Being helped may mean brainstorming and collaborative problem-solving, or providing specific practical help with tasks. Sometimes there are no words or help we can offer, but, if welcome, our steady presence and a comforting hug can communicate our support.
Each person in a community will be impacted differently by a community death. It’s important to remember this theory about who we need to pour comfort into, and who we ourselves can dump out to as we navigate a community loss.
Articles Reviewed for Blog Post:
https://www.latimes.com/opinion/op-ed/la-xpm-2013-apr-07-la-oe-0407-silk-ring-theory-20130407-story.html (actual article in LA Times first written by Susan Silk – first link is PDF version of same article)
Jim – Grief and policing
Jim – ” I believe that policing is a profession that is constantly filled with loss. Whether it is losing a partner, a friend, or a loved one, police officers are always dealing with the pain of loss. I also talk about my own personal experience with grief, and how I have learned to cope with it. I hope that this video will help other police officers who are struggling with grief.”
Jim – Police culture and grief
Jim talks about how grief is a natural part of life, but it can be especially difficult to deal with when you’re in the police culture. There’s a lot of pressure to bottle up your emotions and not show weakness, but that’s not healthy. It’s important to find healthy ways to cope with your grief, whether it’s talking to a therapist, joining a support group, or simply spending time with loved ones. You’re not alone, and there are people who care about you and want to help.
Kristal – The Value of all Those Lost
Kristal emphasizes that the lives of those lost to drug poisoning had value, they were an opportunity that was lost, and that the community is missing so much in their absence.
Kristal – Drug Poisoning During Pandemic Stigma
Kristal discusses how the pandemic has created additional stigma surrounding those who use drugs. She discusses how it seems like some losses are treated as more deserving of being mourned than others. Many people have had to grieve privately instead of publically within a community. She touches on the state of the public health system during the pandemic.
By Jessica Milette, MSW, RSW
A parent sits across from me, anxiously wringing their hands. They will be returning to work after the sudden death of their child. “What if they ask? Do I tell them that they died of an overdose?” Terror flashes across their face. “What if they judge me? My child? What if they think I’m a terrible parent?” We take a moment to reflect on their child and I ask them to tell me about them. They pause, but then I notice their hands aren’t as tense as they cross them over their shoulders. “They were so thoughtful and gave the best hugs. Their smile would light up any room.”
Sister, father, son, niece, best friend – some of these words might be how you would describe your loved one who has died of an overdose or drug poisoning. People Who Use Drugs (PWUD) are not defined by their substance use – they are a million other things to those who love and miss them dearly. Drug poisoning and overdose deaths are stigmatized in our society. The focus is on how the person died, not who they are. Society still holds onto old notions and beliefs about drugs which come with a value judgment about people who use drugs, which further contributes to stigma. Not everyone who uses drugs is an addict and not all drug use is inherently problematic. People who use drugs deserve dignity and respect when we are remembering and honouring those who have died by overdose or drug poisoning.
More stigma means less support for people using drugs and those that support them. Much work has been done and continues to be done to dispel myths and stigma about addiction, drug use, and those who use drugs. Addiction is an illness: something that someone lives with, not something that defines them. These same values and judgments society has about drug use aren’t attached to folks who die of other illnesses. Society tends to view drug use and those who use them as a black and white issue. However, those who love someone who uses drugs weave a rich, colourful tapestry made of stories, reminders, and feelings about their loved one.
In my years as a grief therapist, those left behind want to share a special moment or memory about their loved one with a trusted other. When one is grieving a drug-poisoning death, this trust and sacredness without judgment offers the freedom to sit in the entirety of their grief—the grief they felt when their loved one was alive and when they died. Taking the time to use a loved one’s name in conversation, and asking the griever to share something about their loved one is a powerful tool for us on our grief journey. By initiating these types of conversations, we let the griever know that if they wish to, they can talk about their loved one. Sharing our stories are some of the most powerful ways one finds connection and healing through grief. It helps us feel less alone in our grief by sharing about what makes our person special. Those we love and grieve aren’t just a person who uses drugs – they are so much more. May each of us continue to share stories about our loved ones and the many facets their lives hold.
*DISCLAIMER* The scenario described in the article is a general reflection upon themes the author has witnessed through their grief counselling work and does not represent a specific individual in order to protect the confidentiality of service users.
Nicole – Stigma Surrounding Drug Use
Nicole discusses how the stigma around drug use has an impact on how people feel able to grieve when those in their community are lost.
Nicole – Pandemic’s Effect on Grieving as a Community
Nicole discusses the ways the pandemic has affected the way people grieve as a community.
Nicole – Grieving as a community
Nicole discusses the power of grieving together as a community. Finding connection and trust.
The Saint Elizabeth Foundation offers a project called the Reflection Room – a space for thinking and talking about dying, death, and grief.
The Reflection Room project is an evidence-based participatory art installation that was developed by researchers at the SE Research Centre and Memorial University in 2016. The project included a research component that evaluated the impact of Reflection Rooms as the project adapted over time to address changing needs.
The Reflection Room project was first developed to support people in community and healthcare settings to move from death-denying to death-discussing. From the first installation, the Reflection Room project has gone through three Phases of adaptation and continues to evolve.
Common elements across Reflection Rooms, whether they are set up to include an entire room, hallway, or corner of a room, include a quiet, calming space that invites visitors to read other people’s stories and post their own. The rooms are unstructured and unfacilitated, allowing visitors to engage with the space however they wish.
Over a five-year period from 2016-2020, the Reflection Room project was installed in 62 places across Canada, including in conferences, art galleries, hospices, and hospitals (Phases 1 and 2). Over a thousand stories were shared by individuals during their visits to these various Reflection Rooms. Results from the study from this period showed that storytelling can be an important part of grieving.
In 2020, Phase 3 of its adaptation and evaluation began with the SE Research Centre being asked to expand the reach of the Reflection Room to long-term care home communities in Ontario to respond to some of the accumulated pandemic-related grief in those communities. With the support of the Saint Elizabeth Foundation, Ontario Health Central, Family Councils Ontario, Ontario Centres for Learning, Research and Innovation in Long-Term Care, and Ontario Association of Residents’ Councils, over 50 homes signed up to host a Reflection Room®. In order to adapt to the environment of long-term care homes, an easy-to-set-up ‘kit’ incorporating instructions and materials (e.g., Reflection Cards, a red curtain to display Reflection Cards, candles, etc.) was developed and sent to homes free of cost. Overwhelmingly positive feedback has demonstrated that the Rooms support communities to work through grief by having a quiet space to rest and reflect, disclose emotions, process thoughts, and feel connected to others through sharing stories. The project often is complementary to other existing initiatives in long-term care homes such as palliative care committees and spiritual programs.
A collection of the stories shared over the course of the project is available to view on the Reflection Room website.
If you want to learn more about the project, contact email@example.com and listen to the Grief Stories podcast episode 64.
Neeliya Paripooranam, MSc, is a Project and Communications Manager at the SE Research Centre, overseeing the Reflection Room® project. Celina Carter, RN PhD, is a Senior Research Associate at the SE Research Centre. Paul Holyoke, PhD, is the Vice President, Research and Innovation at SE Health. Justine Giosa, PhD, is the Scientific Director, SE Research Centre and Adjunct Assistant Professor in the School of Public Health Sciences at the University of Waterloo. Hana Irving, MA, is the Director, Philanthropic Programs for the Saint Elizabeth Foundation.
By Meghan Sheffield
In the first days of July, there aren’t many flowers blooming, I learned.
I’d sent a text saying “Hello friends, I’m putting out a call for flowers. I went to public school with Kory, the young man who died in downtown Cobourg this week, and though I hadn’t seen him in recent years, I feel the loss of him on a community level, as I imagine you do, too. Some of Kory’s people are gathering tonight in vigil at the bank where he died, and I’m gathering flowers from those of us who have gardens to share with this grieving community. Do you have some blooms in your garden that you’d be willing to share?”
Kory died as a result of a toxic drug poisoning that took his life in the bank vestibule where he was sheltering. His friends were grieving, angry, disbelieving. The wider community was in shock that this could happen here, in such an ordinary place, to a local boy, born and raised.
Those who knew him best, who had been with him in what became his last days and months, began to talk about holding a vigil, a time and place to be together in their grief.
As it turned out, the tulips and peonies had faded and finished, and the dahlias and zinnias hadn’t begun to flourish yet. I got some nervous replies about the current state of the garden. A mom from my daughter’s class texted to say that they were sorry, but just didn’t really have much to offer right now.
Then the first yes rolled in. “Yes, I will pull something together. We have one million daisies.”
A man’s whole life. One million daisies.
As it turned out, there was an abundance to be had, if you knew where to look, if we just widened the margins of “the garden” and looked to the edges of the wild places.
We know that trauma of all kinds is inequitably distributed in our society, and that access to healing resources is even more inequitable. For community members who rely on a prohibited, criminalized supply of certain substances, the experience is not just a risk of personal harm, but of compounding losses and grief. It means mourning in isolation because the cause of death is so stigmatized. It means administering life-saving medicine and performing chest compressions in the glow of flashing lights, while still in mourning for the most recent loss.
I spent an hour driving around, picking up mason jars filled with blooms from doorsteps all over town. There were daylilies and hydrangea, wild vetch and bladderwort, fragrant bee balm and holy basil, and yes, one million daisies.
At the vigil, the jars of flowers were joined by an eagle feather and abalone shell, offerings of cigarettes, and a can of Molson resting on the window sill outside the bank. Candles were lit, stories were told, tears were shed.
Those of us who didn’t know Kory well, who were present to show our support, to acknowledge the community and systemic level failures that had led us to this place, were invited to hold a perimeter of care for those in the centre, who were grieving, by standing at the edges of the gathering.
For days after the sunset vigil, at the doorstep of an ordinary bank, flowers bloomed on the grey cement sidewalk on main street. Wild, fleeting, beauty.