Bereavement and support in the conduct of everyday life: Insights from dual experiences of loss and drug use.

Aims: Individuals with a history of heavy drug use are especially vulnerable to losing loved ones to drug-related deaths, and drug use and complicated grief reactions are closely linked. However, limited knowledge exists on supporting them through bereavement. The present study, which was conducted in Norway, aims to provide a comprehensive understanding of how individuals dealing with heavy drug use and bereavement can be supported through professional support services. The bereaved person's reflections on help experiences are seen as grounded in their conduct of everyday life. Methods: We conducted qualitative interviews with individuals who have experienced bereavement in the context of heavy drug use. Using reflexive thematic analysis, we examined their stories and reflections on what was helpful and unhelpful, aiming to identify key themes, providing an understanding of how individuals dealing with heavy drug use and bereavement can be supported. Results: Five themes were identified. The first theme, 'Support Complexity', addresses the uncertainty about strengthening the help provided for processing losses. The other themes - "The Ripple Effect of Trust and Distrust", "Offering Supportive Communication", "Fostering Tailored Support" and "Promoting Support Through Companionship" - point to the key dimensions of the support that can help strengthen responses to drug-related bereavement. Conclusions: The study underlies how diverse expectations, norms and positions in the help provision setting influence the nature of support, as well as the access to, acceptance of and adaption to support initiatives. Furthermore, we discuss how the support context can provide multifaceted and contextualised bereavement support tailored to the various needs of the bereaved. The study also underscores the need for provider training focused on the intersections of bereavement and drug use.