The Emotional Struggle After a Patient's Overdose Death

In early December, while flipping though our local paper, we noticed an obituary for a young man with a familiar name. The young man was one of the fathers in our primary-care pediatric practice. He had a community-college education, a good job, a lovely wife and child. And, as we learned in his obituary, he died of a heroin overdose. What’s worse: He’s only one of a few parents we’ve lost in recent months to overdose.

Like many of you, we live and practice in a middle-class community that despite its economic advantages, is struggling with addiction and overdose. Many articles have been written about the societal problem and possible solutions, but today we want to focus on recognizing the impact addiction has on us and our staff.

We recognize that the shock and sadness are not the same as if we were direct family members of the addict, and yet the news of the death of this patient’s father sent us and our staff into a mini depression. How could it not? At our small practice we pride ourselves on really getting to know our patients and their families.

For us, the guilt is real. Could we have seen this coming? What can we do now for the surviving spouse and child? Our care coordinator can (and has) given referrals to counselors and support groups but many families, either out of ignorance or prejudice, reject mental health interventions. On the positive side, we have seen an increase in mental-health referral follow through since introducing a co-located program with a local agency in our office.

It is important that we acknowledge that our emotions over the deaths of parents in our practice can spill over into patient care. Therefore, it is critical that we are coping with our emotions so that it doesn’t impact our medical decision making or judgment. For example, with teenage patients who admit to marijuana use and refuse treatment. We have followed all the known best practices up to and including supporting parents who commit their children to treatment programs. Unfortunately, for some patients who lack self-awareness that they have a problem, there is a limit to what we can do. And this only increases our feelings of guilt.

How do you handle emotional, bad news at your practice? Do you have supports in place for staff? How do you encourage patients to utilize mental health resources? Please share your ideas. We need them!