“The System is Overwhelming and Frustrating and Discouraging”: Stress and Social Support for Affected Family Carers in an Unregulated Drug Crisis

BACKGROUND: Family members and other affected carers are essential supports for the wellbeing of people who use drugs who are at risk of an overdose. This study explores the perspectives of family carers whose loved ones are at risk of overdose and/or who have lost a loved one to a past fatal overdose in the Fraser East region of British Columbia (BC). METHODS: In this qualitative study, we conducted reflexive thematic analysis of 22 interviews examining the experiences of family carers of loved ones who have experienced unwitnessed drug poisoning. Interviews were carried out between August 2020 and August 2021. This study was guided by community-based participatory action research (CB-PAR) principles by involving peer researchers at all research stages. RESULTS: Family carers experienced tremendous stress while supporting their at-risk loved ones, particularly relating to stress caused by the unregulated drug supply. Family carers also encountered substantial stress when navigating healthcare services, engaging with substance use services and finding support in the Fraser East region of BC. Their experiences were marked by traumatic episodes and severe instability, leading to crises such as damaged relationships and overdose incidents of loved ones. Some family carers experienced stress alleviation through informal supports such as peers with shared lived experience and faith-based engagements. CONCLUSIONS: The findings of this study offer unique insights into the distinct stressors and support experiences of family carers, with particular focus on the unregulated drug supply crisis and the fragmented nature of both informal social networks and formal support systems.