An estimated 42% of adults in the U.S. — roughly 125 million people — know at least one person who has died of a drug overdose, according to a RAND Corporation study published Wednesday in the American Journal of Public Health. The findings demonstrate the sweeping effects of America’s drug overdose crisis.
In some Southern and New England states, including Massachusetts, where overdose deaths are particularly high, nearly one in two adults has a personal connection to someone who suffered a fatal overdose.
Study authors expect these personal losses will continue to rise as overdoses claim tens of thousands of lives annually. The most recent prediction from the Centers for Disease Control is 111,380 deaths in the U.S. during the 12-month period ending in September 2023.
The RAND findings are based on a survey of 2,072 respondents, conducted in February and March of 2023. Based on the responses, the researchers calculated that 40 million Americans have had short-term to lasting impacts on their mental or physical health tied to grieving an overdose death. Twelve million of those adults continue to mourn their loss with little support, often in isolation, study authors said.
“We’re not talking about this population of people who are really struggling as part of our broader conversation about the overdose crisis,” said Alison Athey, an associate behavioral health scientist at Rand. “These folks really have been left behind.”
Unlike what happens after other types of losses, like suicide, Athey said there’s little formal outreach to people who witnessed an overdose or were left to mourn the death. These steps could help avoid more overdoses, a phenomenon known as contagion often discussed around suicide. Bereaved friends and families aren’t typically connected to clinics that offer counseling, medication or guidance. There’s usually no coordinated response from schools, workplaces or communities when a death occurs after an overdose.
Athey sees two primary reasons for this. One is that most public health programs and funding are, understandably, focused on trying to save lives as fentanyl in pills, cocaine and methamphetamines fuels record fatalities. The other is the view described by family members mourning a drug-related death that they aren’t worthy of attention and service.
“They tell me horror stories about people saying that the person who died deserved to die because they were a drug user,” said Athey, “that it was inevitable that they died by overdose and sort of belittling the survivor who’s left behind and who’s grieving for the person who they loved.”
Leslie Gomes Preston heard similar remarks about her daughter, Kiara Smith, who died after an overdose in 2016. Some parents cope by hiding their grief or cutting off conversations about their dead child. Not Gomes Preston, a resident of Cape Cod. She joined a grief support group, one of many started by families mourning an overdose death.
“I love to talk about it because to me, it proves she was here,” said Gomes Preston, adding that she talks to her daughter daily and feels Kiara’s presence in those moments when she remembers something at just the right time.
At least 20 of Kiara’s high school classmates have also died of overdoses, according to Gomes Preston. Some left children behind. That population is not counted in the RAND study estimate, but the authors said the ripple effects for kids are devastating. Another study found a link between communities with high numbers of overdose deaths and rising rates of childhood suicide.
Study authors worry that the concentration of mourning in states like Massachusetts with high rates of overdose deaths could create vicious cycles within communities.
“Where there’s a death that spurs suffering, that spurs more deaths that spurs more suffering, and there’s an exponential increase,” said Athey. “So thinking at the community and geography level is one way to take a first attempt at addressing this problem.”
That could mean directing more opioid settlement dollars into stopping the cycles of grief and death. So far, communities in Massachusetts have been slow to spend the millions on hand intended to help them address addiction and overdoses.
The widespread reach of the overdose crisis didn’t surprise many people packing groceries this week at the Brookline Food Pantry in Brookline, Mass.
“This shouldn’t be a surprise to anyone,” said Lori Day, who lost an acquaintance recently. “Everyone’s seen it coming and here it is.”
Liam Hafter paused, a handful of carrots in one hand, to mention a cousin’s friend who died about six weeks ago.
“The crisis that started a few years ago continues today,” Hafter said.
Arielle Chernin said four students she knew while attending Brookline High School have since died of an overdose. She spots reminders of them from time to time and said their faces pop up occasionally in social media feeds.
“It’s shocking when you know someone from childhood,” Chernin said. “It makes you think back to signs or ask, ‘Would you have ever predicted this?’ ”
This article was originally published on WBUR.org.
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