In the days and weeks after their daughter’s death from a heroin overdose, Hope and Pete Troxell were supported by fellow members of Save Our Children, a peer support group run by the Crossroads Center in Frederick for families with loved ones dealing with addiction.
Some of Hope’s family members also comforted the couple, they said. But to a large extent, the Troxells were met with silence after their loss.
“My husband’s family wasn’t there,” Hope said. “I don’t think they knew what to say. You wonder, can’t people text or call and say, ‘We miss you at a family function. We want to see you. How can we help?’ If it was not for the Lord himself, I know my husband and I could not have made it.”
The silence that often follows a fatal overdose is just one of the common experiences among surviving family members who find themselves shouldering complex emotions with few resources, said Linda Beckman, a grief counselor for Hospice of Frederick County.
That realization led the agency to establish its own support group in December for the family and friends of those who die of an overdose. It’s one of a scant number of groups — now growing in number — that cater to the network of loved ones left behind after deaths that most frequently occur among men and women aged 25 to 34, according to data collected from 2015 to 2017 by the Frederick County Overdose Fatality Review Team.
As the county continues to address the problem of opioid and substance abuse, Beckman hopes that more resources will emerge — not only for those suffering with addiction, but also for their families and friends.
“It can be very isolating after someone dies from an overdose,” said Beckman, a primary coordinator for the hospice support group. “I think people can be unwilling to open up about their loss or aren’t met with support because there’s still stigma, regardless of the national epidemic. I think we still live in a society where the disease of addiction is considered a moral deficiency.”
The Overdose Fatality Review Team is also working to meet the needs of surviving family and friends, said Andrea Walker, the director of the Behavioral Health Services Division of the Frederick County Health Department.
The multi-agency group began reviewing overdose deaths in April 2015 to develop plans for reducing them. But in the nearly three years since the team was established, members have increasingly recognized the importance of reaching out to family, Walker said.
The group was recently awarded a $15,000 grant from the Maryland Department of Health to fund a Family Outreach Coordinator for the remainder of fiscal 2018. Walker expects to receive full funding next year for the new coordinator, who will be responsible for contacting family members and connecting them to services such as counseling or recovery groups.
“We don’t want to create this program so structured, assuming we know what people need,” Walker said. “But having been through that situation myself more than once, I know that everyone behaves differently in that time of crisis. We want to have somebody who can help them through that period and customize interventions based on the people we serve.”
Complexity of grief
The Troxells are intimately acquainted with the emotions that accompany fatal overdoses. Their daughter, Alicia, was only 34 when she died, on Oct. 25, 2017, after injecting a dose of heroin laced with fentanyl.
She was seven months pregnant, and her unborn son — to be named Camden — did not survive.
“She was a beautiful young lady,” Pete said. “She had a good job, she had a college education, but the painkillers took over. And once she got hooked, she couldn’t stop chasing ‘em.”
Hope proudly explained that Alicia started as a cleaning person at SAIC-Frederick — now called Leidos Biomedical Research Inc. — and worked her way up to an administrative assistant position. A few years after she gave birth to twin girls, she started online classes at the University of Phoenix and earned an associate degree in business.
But in 2013, Hope said, Alicia was prescribed OxyContin for a worsening case of scoliosis and began to misuse the medication. In June 2013, she separated from an acrimonious marriage with her first husband. The divorce was final in 2014.
Until that point, Alicia seemed to be managing fairly well, her parents said. But at the beginning of 2015, she took a leave of absence from work to handle a custody dispute. She lost guardianship of her daughters later that year.
When she returned to work at Leidos, the company decided to let her go, Hope said. That combination of factors — especially the loss of her daughters, whom she loved dearly — took the fight out of Alicia.
“I think she just gave up,” Hope said.
“You can’t keep pounding someone into the ground and expect them to get through it,” Pete added. “I don’t think folks care about these people on drugs. But they are something to somebody, no matter what they do.”
Hope kept tabs as Alicia’s reliance on OxyContin appeared to worsen. The family shared a phone plan, and Hope noticed that searches for different pharmacies appeared on her daughter’s history in their monthly bills.
At some point later in 2016, Alicia was offered heroin by a friend and quickly became hooked on the new drug. Hope remembered texting her daughter every week and desperately hoping that she’d respond. Both parents received phone calls with a looming sense of anxiety, fearful of bad news.
By August 2017, though, Alicia appeared more receptive to treatment. Her second husband died of a heart attack that month, Hope said, and Alicia — pregnant by then — started a recovery program at the Joseph S. Massie inpatient recovery center in Cumberland.
She dropped out of that program after a few days, but later went back and completed a full 28-day recovery cycle. She graduated in October, and went to stay with her parents in Frederick.
The week before Alicia’s death was wonderful, Pete said. Their daughter seemed like herself again, and was eagerly anticipating the birth of her third child. On the day before she died, she went to Boscov’s department store in Frederick and picked out baby clothes. That night, she and her parents worked on putting together some outfits for Camden.
“She had a little shirt out, and little jeans, and she just looked so good,” Pete said. “And she was excited because while she was there, they had offered her a part-time job in one of their departments. I said, ‘I hope to the Lord that this is a turnaround for her.’”
But the next day, Hope found Alicia slumped on her bed when she went in to give her daughter a daily dose of Subutex, a medication that treats opiate addiction. The family called 911, but Hope knew Alicia was already dead.
“They told us to pump her chest, but I was crying,” she said. “And I told the woman, ‘Ma’am, she’s gone. I know she’s gone.’”
A period of sobriety or entry into treatment before death was one of the trends noted by the Overdose Fatality Review Team in three reports from 2015 to 2017. The optimism that emerges during those periods can make it even harder for family members and friends, who often struggle with feelings of guilt after a fatal overdose.
“The feelings are always, ‘Could I have done more?’” said Carin Miller, who leads the Save Our Children support group in Frederick. “You’ve got so much guilt that you were involved in something that seems so preventable.”
The Troxells struggled with the same feelings after Alicia’s death. Hope had joined Save Our Children only a few months before the overdose, and worried that she could have connected her daughter to resources sooner.
Pete still feels angry at the legal system that completely removed his daughter’s access to her children, and laws that — in his opinion — fail to adequately punish dealers.
Save Our Children was one of the family’s saving graces, Hope said. Members of the group supported the couple for months after Alicia’s death, even driving through the snow in February to take Hope to lunch.
Both Pete and Hope still have days when they feel silenced by grief. But peer support has helped, Hope said, as has the couple’s faith.
Hope built a memorial to Alicia inside the house, complete with a cross and pictures of her daughter and granddaughter in happier times. Pete still says hello to her every time he drives down U.S. 15 and passes Resthaven Memorial Gardens, where Alicia is buried.
“I tell her we love her and we miss her,” Pete said. “And what matters most to me is that I told her before she died, ‘I forgive you for everything you’ve done. Everything.’ She kept telling us she was so sorry. But you love them no matter what, unconditionally.”