Over the past two decades, drug overdoses have claimed the lives of over 560,000 individuals in the United States. Most of the cases involved opioid-related deaths from both prescription medications and illegal substances. In 2017, in response to the severity of the trend, the opioid crisis was declared a public health emergency.
Funeral directors should recognize the many challenges they face when supporting grieving families who have lost someone to opioid-related deaths. In addition, they should familiarize themselves with safety practices, self-care, and their role in the community.
Related: Opioids: Contributing to Both Health and Death
The impact of the opioid epidemic
“Opioid” is an umbrella term often used interchangeably with words like opiates, painkillers, and narcotics. There are over 100 different types of prescribed opioids to alleviate pain or to treat coughing and diarrhea. They include morphine, codeine, fentanyl, methadone, tramadol, and heroin.
Medical opioids have commonly been prescribed worldwide for pain relief. However, the United States has outpaced every other country in per capita opioid consumption.
Opioids trigger nerve receptors in the brain and body, regulating pain, stress, mood, breathing, and gastrointestinal functions. By activating the receptors, opioids block the brain’s sensation of pain. They can also stimulate dopamine production, creating feelings of euphoria, frequently described as “a high.”
Opioid tolerance and addiction
“Opioid use can lead to death due to the effects of opioids on the part of the brain which regulates breathing.” (World Health Organization (August 29, 2023)
It is the intense happiness that causes addiction. Used short-term, opioids are generally safe. However, over more extended periods of use, individuals can develop an addiction. It is a condition that leads to opioid usage other than its intended purpose or misuse by crushing tablets and opening capsules to snort the powder. Some dissolve the powder in water to inject it into veins.
The longer a person takes opioids, the greater their tolerance towards the drug. It creates a dangerous cycle where a larger dose is needed to experience the initial high, putting them at greater risk of drug overdose.
Individuals may also find themselves switching from pills to heroin and fentanyl. Both drugs are said to be cheaper and more readily available. “In a recent survey of people in treatment for opioid addiction, almost all—94%—said they chose to use heroin because prescription opioids were ‘far more expensive and harder to obtain.’” (NIDA January 1, 2018)
Funeral directors are increasingly encountering families affected by opioid deaths, a situation compounded by a life taken tragically and too soon. “Opioid-related deaths are highest among individuals between the ages of 40 and 50 years.” (National Library of Medicine, January 17, 2024).
Supporting grieving families affected by opioid deaths
A primary element in the role of the funeral professional is to support grieving families after an opioid-related death. They must assist free of judgment.
The stigma attached to drug overdoses causes grieving families to fear social discrimination, shame, isolation, and unworthiness of support. Funeral directors must be compassionate as they guide individuals through their grieving process.
Social media can escalate the stigma experienced by families bereaved through substance misuse. Rumors and gossip spread quickly about something families may want to remain private. It can soon exacerbate and add to their complicated grief. Funeral professionals must respect the family’s privacy and gain their trust when offering support.
Accountability for drug-related deaths
Opioid-related deaths may encounter legal complications. If death appears suspicious or unnatural, a coroner’s investigation may take place, requiring a medical examination and delaying the funeral.
Increasingly, friends, family, and fellow opioid users of overdose victims are facing homicide charges. According to CDC statistics, over 50% of drug overdose victims obtain their drugs from friends and family. Therefore, many defendants are likely to be known to the deceased.
People positioned to save lives may hesitate to call 911 if they fear facing murder or manslaughter charges. Bystanders present at the scene of death who choose not to seek medical assistance might experience feelings of guilt. The funeral director needs to approach them with empathy.
Funeral arrangements for drug-related deaths
Funeral directors are often the first non-family members to converse with during bereavement. Understanding terminology and the effects that opioids contribute to both health and death can put funeral professionals in a valuable position when providing support to families shocked and confused by sudden death.
Being able to answer questions concisely can help ease the confusion. Financial difficulties may be an issue. However, funeral professionals can suggest cheaper alternatives.
Open casket viewings aim to leave a positive image of the deceased. Sometimes, the recommendation is to wait until after embalming for reasons such as decomposition, which may have started if a body had been left unfound for a few days. Corpses discovered face down may have suffered livor mortis, a condition in which gravity forces the blood to settle in the lower part of the body, subsequently leaving staining, such as on the face.
Safety precautions for funeral professionals when handling opioid overdose victims
Funeral directors and embalmers face hazards when handling opioid overdose corpses and must take safety precautions.
Embalmers risk encountering a dangerous drug in the workplace by inhaling airborne particles from crushed opioids when handling clothing or contacting fentanyl patches. They must always wear appropriate levels of personal protective equipment (PPE).
Funeral professionals must be aware of the risk of fentanyl overdose at the funeral home. Encountering fentanyl can be deadly. It’s believed that fentanyl is about 80 times stronger than morphine and several hundred times more potent than heroin.
Fentanyl residue remains on the deceased’s skin and personal possessions, which embalmers could absorb in several ways, such as through the skin, inhalation, ingestion, and contact with mucous membranes.
Kidney damage caused by opioid use can create challenges for embalmers, such as excess nitrogenous waste neutralizing the effects of formaldehyde. Therefore, using a stronger solution for the listed hazardous chemical is needed.
Symptoms of opioid overdose
As employees within the funeral industry are at risk of opioid overdose, it is crucial to recognize the symptoms, which include,
- Unconsciousness
- Slow or shallow breathing
- Vomiting
- Inability to speak
- Blue or pale skin or lips
- Gurgling sounds
- Limpness in arms and legs
Naloxone
All funeral directors and personnel involved in the funeral home should receive training to make them aware of the dangers involved when working around opioids. A naloxone kit must be readily available. Naloxone is an antidote for opioid overdose. If administered immediately, it can reverse an opioid overdose, but it is only effective in the body for 30 to 90 minutes. Therefore, it is crucial to call 911.
Community education and support
As recognized and trusted community members, funeral directors can provide education, help prevent opioid addiction, and support those who have lost someone to opioid-related deaths.
Participating in support meetings helps the funeral director better understand the group’s demographics, enabling them to tailor resources to meet their needs.