Grief, Grief Disorder, Prolonged, Overdose Accidental, Substance Use Disorders
Conditions
Keywords
overdose, grief, bereavement, prolonged grief disorder
Brief summary
The United States is facing unprecedented rates of drug overdose deaths, profoundly impacting millions of families who are left to navigate their grief. Those bereaved by overdose experience a unique form of grief characterized by feelings of guilt, shame, and blame, which can worsen their suffering and deter them from seeking help. Individuals coping with overdose loss often endure more severe health consequences compared to those grieving non-drug related deaths, including prolonged grief disorder, substance use disorders, PTSD, depression, and suicidal thoughts. Moreover, bereaved individuals, particularly those with a history of substance use, may engage in risky behaviors as a means of coping, further exacerbating the risk of overdose and mortality within this vulnerable population. Peer grief support interventions have emerged as a promising approach to assist those experiencing such losses. To combat these outcomes, we are collaborating with Peer Community Support Partners (PSCP) in a novel practice-research partnership to implement the RIVER peer grief support model. Though RIVER has shown success in community settings, it has yet to be rigorously evaluated. In a three-aim approach, this study aims to assess the effectiveness of the RIVER model while also enhancing and engaging grievers with support resources via medical examiner offices (MEOs), which routinely contact families during death investigations. This research represents a pivotal advancement in addressing the needs of the overlooked bereaved community, aligning with the NIH's Helping to End Addiction Long-term (HEAL) initiative to develop effective strategies against the opioid crisis. Together, community engagement and rigorous research efforts aim to enhance support for those affected by the tragedy of drug overdose.
Interventions
BEHAVIORALRIVER
RIVER is a peer grief support process intervention developed by Peer Support Community Partners.
BEHAVIORALEnhanced care as usual
The enhanced care as usual condition involves a psychoeducational booklet developed by What's Your Grief, as well as a list of local grief resources.
Sponsors
Stanford University
Peer Support Community Partners
RAND
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Intervention model description
We will conduct a randomized controlled trial (RCT) of peer grief support plus enhanced care as usual vs. enhanced care as usual only (i.e., parallel interventional study model).
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* people who lost a loved one to an unintentional drug overdose death within the past year * age 18 and older * fluently understand English or Spanish * have the capacity to give consent (e.g., excluding those with severe cognitive impairment, those in active psychosis, and those with developmental disabilities).
Exclusion criteria
* people who need hospitalization for psychiatric symptoms or substance use disorders. (Note, people who use drugs but who do not require hospitalization will be included.) * people have active suicidal ideation * people who lost someone to a drug overdose death more than one year ago * people who lost someone to a drug overdose death that was suicidal in nature or of undetermined intent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant Perceived Connectedness | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Continuing Bonds Scale; assessing the extent to which the participant feels bonded to the descendent |
| Participant Avoidance of Grief Reminders | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Grief-Related Avoidance Questionnaire (GRAQ); evaluating the presence and extent of avoidance behaviors due to feelings of grief |
| Participant Grief Symptoms | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Brief Grief Questionnaire; evaluates the presence of prolonged grief |
| Participant Bereavement Coping Strategies | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Coping Assessment for Bereavement (CABLE); evaluating what coping strategies are being utilized and at what frequency |
| Participant Acceptance of the Loss | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Typical Beliefs Questionnaire (TBQ); evaluating the presence of maladaptive cognitions related to complicated grief |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Participant Depression Severity | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Beck Depression Inventory (BDI); evaluating the presence and severity of depressive symptoms |
| Participant Posttraumatic Stress Symptoms | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Posttraumatic Stress Disorder Checklist (PCL-5); evaluating the severity of symptoms associated with posttraumatic stress disorder |
| Participant Physical Pain Severity | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | PEG; evaluating the intensity and interference of physical pain on daily life and well-being |
| Participant Substance Use | Baseline, 3-month follow up, 6-month follow up, and 12-month follow up | Tobacco, Alcohol, Prescription Medications, and Other Substances Tool (TAPS); assessing the presence and frequency of past 30-day substance use |
Countries
United States
Contacts
Primary ContactAlison Athey, PhD
Backup ContactKaren Osilla, PhD
Outcome results
None listed