Over the past decade, deaths from drug overdose have increased worldwide, accounting for more than half a million deaths per year. In the US-the leading country for death by overdose-the death rate has more than doubled since 1999.

More than 106,000 people died in the US alone in 2021, and the primary drug responsible for these deaths is a synthetic opioid known as fentanyl – a drug 100 times more potent than morphine that is sold illegally and often mistaken for less deadly painkillers or anxiety medication.

2023 Drug od death rates 2

According to the Minnesota Department of Health, Black and Indigenous people of color are twice as likely to die of an overdose – a statistic that only increases when additional marginalized identities are included (such as being transgender, disabled, or living in poverty).

In 2020, I lost a good friend to an accidental fentanyl overdose, and quickly understood the stigma and shame that comes with losing loved ones this way. He was a Marine veteran in his mid-twenties, and had the most contagious smile of anyone I had ever known. The night of his death, a dozen other deaths occurred in the same small town from accidental fentanyl overdose.

As a death care worker in the United States, Mark Riley has worked with numerous families who have suffered from loss due to overdose. “In the late 90’s the community I served was suffering from a terrible Methamphetamine issue. As I continued my career into the 2000’s, I served many whose lives were ended by Oxycontin and other powerful pharmaceutical opiates, continuing to modern times where fentanyl has become a grim reaper for many of our younger community members.” Many of these community members were his own friends and family.

Dying from Overdose: Overcoming Stigma and Barriers to Mourning

Close up of drug syringe and cooked heroin

The Stigma of Drug Overdose

If you grew up in the US, you might have been subjected to a D.A.R.E (Drug Abuse Resistance Education) mindset which taught us that using substances was the ultimate shame, which always felt in conflict with the way the western medical industry pushes similar “cleaner” versions of the drugs we were taught to fear. This shame carries many into their death, after living a life where help was inaccessible and drug use may have been a direct response to abusive and impoverished environments.

 Riley believes that delays for answers, as well as shame and stigma, can contribute to complicated and unresolved grief. 

“When talking about her passing with people outside her world, I noticed that their reaction to hearing about her death changed when I mentioned the word overdose.” states Parker, a TalkDeath reader who asked to remain anonymous. Parker felt that their best friend’s death was deemed less meaningful due to the circumstances of her death.

The experience of losing a loved one to drug overdose is complicated for reasons beyond the social stigma. Sasha Corney, a death doula in training, felt the conflicting emotions that overdose deaths create, when she discovered her mother alone in her home. “There was a feeling of sadness that she had died alone [from an overdose]. And there was a sense of relief that I didn’t have to worry anymore.”

The Barriers of Drug Overdose Death

Caucasian sad woman sitting at the sofa with depression

The complex emotions and grief survivors go through is often intensified by the logistical barriers of postmortem care. Life insurance payouts, for example, become more complicated when drug overdose is involved. Many companies will claim they cover death by drug overdose, but if the drug overdose is deemed intentional or involves “illegal drugs” they may deny the family a payout.

In cases of accidental overdose, which has been the most common in Mark Riley’s work, families typically spend a lot of time and effort trying to figure out how it happened. “The impact on our business and the grieving families includes the state medical examiner/coroner systems that work to determine the toxicology of the individual. They are so backlogged that bereaved families must wait 5-7 months for any kinds of answers.” Riley believes that delays for answers, as well as shame and stigma, can contribute to complicated and unresolved grief.

Coping With Drug Overdose Loss

Upholding the legacy of a loved one can be as simple as remembering who they were outside of their struggles. “The tragic end of a life, due to overdose, does not remove the good that life shared with others.” states Riley.

Surrounding yourself with other people who knew and loved someone you’ve lost can be essential to move through the grief. “Reconnecting with our shared friends from school and spending time with her family, getting to talk about her with people who understand, helps me feel she is still with me and has been instrumental in moving through my grief”, Parker says.

Some people find it helpful to get involved in drug education and prevention. When my friend died, his mom used her political power as a school board member to bring fentanyl testing strips and narcan training to school staff, as well as additional training and education for staff and students alike.

Corney’s husband is now a Drug & Alcohol Harm Reduction Program Manager, and Corney herself is actively trying to help people who overdose on the streets of Columbus, Ohio.



Naloxone kits as distributed in British Columbia, Canada. Naloxone can save the life of an individual who is overdosing. Image via James Heilman.

I often wondered if there was more that I could have done to help my friend when he needed more support than I was able to offer. Gentle reminders to yourself (and from your own support system) that their death was not your fault are hard to accept, but important in being able to continue to live your life the way you and your loved one would have wanted you to.

Grief will always look different for everyone, and it’s essential to remember that you are allowed to take as much time as you need to work through the pain of losing a loved one to an overdose.

Sage Agee
Sage Agee [he/they] is TalkDeath’s Social Media Manager and Staff Writer. He is a certified Death Doula and runs a small-scale trans community farm called Phototaxis Farming Project. His writing focuses on death positivity, gender identity, sexuality, and parenting. He has written for The Washington Post, Insider, Parents Magazine, and more. Most of the time he is covered in dirt and looking for cool bugs.


    Leave a reply

    Your email address will not be published. Required fields are marked *

    You may also like