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Overdose: Bereavement. What Happens Now?

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Overdose: Bereavement

What happens now?

The Scottish Government would like to thank and acknowledge the work of, the National Forum on Drug-related Deaths: Service User Group, Scottish Drugs Forum and the Scottish Network for Families Affected by Drugs, in the production of this booklet.

This booklet is aimed at family and friends of an individual who has died of a suspected overdose. When someone has died in this way a range of emotions and physical sensations are likely to be experienced. As well as shock and numbness, this can include sadness, anger, guilt, relief, despair and fear.

It is hoped that this booklet will assist towards supporting people who have been bereaved as a result of suspected overdose by explaining some of the procedures that can take place following an overdose, coping with grief (what you may experience and what can help) and sources of additional help.

The role of the Procurator Fiscal

The Procurator Fiscal has a duty to investigate all sudden, suspicious, accidental, unexpected and unexplained deaths and any death occurring in circumstances such as to give rise to serious public concern. This duty is separate from the Procurators Fiscal role in the investigation and prosecution of crime. In most cases the death certificate cannot be issued until the cause of death has been established. The funeral cannot take place until the death certificate has been issued.

Investigation

When a report is received by the Procurator Fiscal he or she has a duty to investigate the cause and the circumstances surrounding the death. In making enquiries the Procurator Fiscal will be assisted by the police. The police will normally interview relatives and others who can provide information about the circumstances of death. It is usual for the police to obtain information about the deceased's recent medical history. In addition to information which is provided by the next of kin, the police will speak to the family doctor.

Post mortem

In the circumstances of a suspected overdose, a post mortem examination is required to establish the exact cause of death. Such an examination will be carried out as soon as possible, normally within a day or two of the death. It may be necessary for formal identification of the body. It is not essential that the deceased is identified by the next of kin if someone else can do this instead.

If close family members wish to view the body the police or Procurator Fiscal can make suitable arrangements where possible.

If there are any cultural, religious or other objections to a post mortem examination the Procurator Fiscal should be told as soon as possible. There may be legal reasons why a post mortem is unavoidable, but where possible the wishes of the next of kin will be respected.

Cause of death

If the cause of death can be established at the post mortem the pathologist will issue a death certificate. However, sometimes it may be necessary for samples, such as blood or urine, to be taken and analysed before the precise cause of death can be established. (This is sometimes referred to as 'toxicology'). The sample will be taken during the post mortem examination and then sent to a laboratory for analysis. The scientific analysis of samples can take several weeks.

In certain circumstances, to allow for the funeral to proceed, the Procurator Fiscal can arrange for a temporary death certificate to be issued. The cause of death on a temporary certificate might be 'unascertained meantime' or 'undetermined pending toxicology'. The doctor who attended following the death may have entered a 'presumed' cause of death on the temporary certificate.

If the forensic examination of the samples reveals the cause of death then a form will be sent to the Registrar indicating the actual cause of death and the Registrar's records will be updated.

Getting help with funeral costs

A funeral payment is a payment to help people on a low income with the essential costs of a funeral. You must show that you have met these expenses. You do not have to repay a funeral payment, although it can be recovered from the estate of the person who has died.

Who can claim a funeral payment?

You can claim a funeral payment if you or your partner is receiving Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance ( ESA) or Pension Credit. If you are getting Child Tax Credit and your award is high enough, you can claim a funeral payment. If you are getting Working Tax Credit with an extra amount for disability, you can also claim a funeral payment. Your capital (for example, savings) does not affect a funeral payment.

Responsibility for the funeral

You will not be granted a funeral payment just because you are paying for a funeral. The Jobcentre Plus office has to accept that it is reasonable for you to be responsible for the funeral costs and that there is no one else who should be paying for it. If you are claiming funeral costs for your child who has died or if you are the partner of the person who has died, you can be paid a funeral payment as long as you meet the benefit conditions. This applies to lesbian and gay partners as well as heterosexual partners. It also applies whether you were married, in a civil partnership or just living together.

If you are a close relative, family member or a friend of the person who has died, you may be able to get a funeral payment, but it will depend whether there are other relatives alive who are not on benefit.

The Citizens' Advice Bureau ( CAB) provides further information about funeral payments. To find out more go to www.adviceguide.org.uk or visit your local CAB office.

It can be helpful to prepare a written statement about the person who died which includes a description of them, the positive aspects of their life and perhaps a photograph, to give to journalists. The police press officer or police family liaison officer are also people you could ask for advice about dealing with the media.

Media interest

When someone has died of a suspected overdose, it may attract public interest and circumstances may be reported by the media. This can be very stressful, particularly when insensitive or inaccurate information is communicated or, for example, it focuses only on the problems the person had without mentioning the good things about them.

It can be helpful to prepare a written statement about the person who died which includes a description of them, the positive aspects of their life and perhaps a photograph, to give to journalists. The police press officer or police family liaison officer are also people you could ask for advice about dealing with the media.

Coping with guilt can be one of the most difficult aspects of bereavement. Pain may be felt in trying to accept that we were not able to prevent the death of someone close and regret for things not said or done.

Coping with grief:
What you may experience

Shock: The death of someone close to you can come as a tremendous shock. In shock, you may feel shaky, numb and out of touch with things around you. Shock is common during the days and weeks immediately following a death.

Fear: Upset and confusing emotions can make grief a frightening experience. You may fear for yourself/loved ones being left alone and fear a similar event happening again. You may fear 'losing control' or 'breaking down', all of which are normal reactions.

Helplessness: Not knowing who to tell and who to ask for help.

Sadness: As the initial shock passes, you may feel intense sadness, a desire to withdraw from contact with family and friends and find it hard to stop crying. Crying is a way of releasing stress, so allow yourself to cry if you need to.

Longing: Longing for the person who has died is common - powerful and desperate longings to see, touch, talk to and be with the lost person can be frightening in their intensity. The need to talk about a person following their death is part of the natural struggle to come to terms with loss.

Guilt: Coping with guilt can be one of the most difficult aspects of bereavement. Pain may be felt in trying to accept that we were not able to prevent the death of someone close and regret for things not said or done. Guilt may also arise from the feelings felt/not felt during bereavement e.g. anger towards the dead person or an inability to cry or show grief openly.

Despair: Despair weakens and drains interest in others, so other relationships may suffer. Life may no longer seem to make sense or have meaning. Feelings of 'no longer caring' or 'not giving a damn' about anything or anyone are not uncommon.

Anger: Anger, although distressing and confusing, is a natural response to loss. You may feel a sense of helplessness at the unfairness of life "why me?" and anger at others who are carrying on as if nothing had happened. Anger may also feel quite specific and focus on blame towards other people - relatives, friends, paramedics, services - who did not seem to help the person enough before they died, or yourself for not doing more. There are also possible feelings of anger towards the person who died as a result of abandonment and/or being left to cope on your own.

Numbness: Our mind slowly allows us to feel our loss slowly. You may experience numbness after the death of someone close, and what has happened may seem unreal. The thought 'this can hardly be happening' may recur. This is a normal reaction that can stop you from feeling too much pain at once and can help you get through the practical arrangements and procedures.

Physical and emotional stress: Loss of appetite, headaches, difficulty in sleeping, difficulty in concentrating and/or exhaustion are all signs of physical stress. The varying range of emotions can lead you to feeling overwhelmed and helpless. However, these are all normal physical and psychological reactions to deep loss.

Alcohol and drugs: The extra tension may lead you to increase your intake of substances which you feel dull the pain temporarily. It is important to seek help if this is happening repeatedly.

Many people find it helpful to talk about what happened and how they feel, over and over again. This can be an important part in the healing process.

Some people want to be left on their own. You may also find it easier to be with a few select people than with groups of people who don't know what has happened.

Coping with grief:
What can help?

Reality: Attending funerals, returning to the scene and talking to people who know what happened, are all ways in which a situation which seems 'unbelievable' may be made more credible and easier to bear.

Support: Sharing with others who have had similar experiences can help. For some, help with the practicalities of everyday life from caring friends and family is a welcome release and will allow them to focus on what has happened for as long as they need. For others, it is a relief to have ordinary things to concentrate on. Many people say that they want to be asked but would like to choose which approach is most helpful.

Talking: Many people find it helpful to talk about what happened and how they feel, over and over again. This can be an important part in the healing process.

Privacy: Some people want to be left on their own. You may also find it easier to be with a few select people than with groups of people who don't know what has happened.

Organisations that can help

Cruse Bereavement Care Scotland is a registered charity which offers free bereavement care and support to people who have experienced the loss of someone close

Riverview House
Friarton Road
Perth PH2 8DF

Tel: 01738 444178

Email and website:
info@crusescotland.org.uk
www.crusescotland.org.uk

Scottish Network for Families Affected by Drugs ( SNFAD) supports families across Scotland that are affected by drug misuse and helps and supports those agencies that in turn represent and support such families. These families and family support groups feel isolated and forgotten, SNFAD aims to reduce this isolation and stigma

85 Berkeley Street
Glasgow
G3 7DX


Tel: 0141 221 0544
Tel: 08080 101 011

Website:
www.snfad.org.uk

Know the Score provides free and confidential information about drugs in Scotland

For free confidential drugs information and advice call 0800 587 587 9

Website:
www.knowthescore.info

Scottish Drugs Forum ( SDF) is the national non-government drugs policy and information agency working in partnership with others to co-ordinate effective responses to drug use in Scotland

91 Mitchell Street
Glasgow
G1 3LN


Tel: 0141 221 1175

Email and website:
enquiries@sdf.org.uk
www.sdf.org.uk

Samaritans provides confidential non-judgmental emotional support, 24 hours a day for people who are experiencing feelings of distress or despair, including those which could lead to suicide

Website:
www.samaritans.org

The Crown Office and Procurator Fiscal Service ( COPFS) is responsible for the prosecution of crime in Scotland, the investigation of sudden or suspicious deaths, and the investigation of complaints against the police. We work closely with our partners in the criminal justice system to help make Scotland a safer place

25 Chambers Street
Edinburgh
EH1 1LA


Tel: 0131 226 2626

Email and website:
PS/COPFS@scotland.gsi.gov.uk
www.copfs.gov.uk

The Scottish Citizens Advice Bureau ( CAB) service is made up of:

  • Citizens Advice Scotland ( CAS)-
    national umbrella body that provides essential services to Scottish citizens advice bureaux
  • Citizens Advice Bureaux-
    independent, local charities that are members of Citizens Advice Scotland. Bureaux provide advice and information to people in need in over 200 locations

Website:
www.cas.org.uk

Breathing Space is a free and confidential phone line service for any individual, who is experiencing low mood or depression, or who is unusually worried and in need of someone to talk to

Tel: 0800 83 85 87
(phone line open 6pm-2am)

Website:
www.breathingspacescotland.co.uk

For more copies please call: 0131 244 5051