was found face down could develop livor mortis (hypostasis), where the blood pools to the most dependent part of the body. In this case, it develops into a dark staining of the face. During the funeral arrangement process, it would be wise and less confusing if the funeral director were to inform the family that they cannot promise an open casket until they have actually seen the deceased. The funeral director should inform the family that they will make the decision once they observe the condition of the deceased. Another issue is the finalized death certificate from the coroner or medical examiner. The funeral director should discuss with the family that because of the circumstances of death, there will most likely be a temporary death certificate. This prolongs the filing of life insurance and other important paperwork. Depending on the county in which the death certificate is filed, the waiting period can be two weeks to six months. parking lot. For instance, during the visitation the funeral director is approached by a female mourner inquiring if there is another restroom that she can use, indicating that the women’s bathroom has been occupied for a significant amount of time. The funeral director knocks loudly on the bathroom door and receives no response. This should raise a red flag that should not be dismissed. It is important to understand that no location is immune to someone having an overdose, including the funeral home property. If the death occurred from an overdose and law enforcement is trying to establish who was responsible for selling the opioids and the circumstances surrounding the death, it is would not be unusual for law enforcement personnel to arrive at the visitation or funeral. Often, disguised as mourners, they record the license plates of visitors in the parking lot and check the plates at the station. There have been reports of police officers taking photos of the register book to cross-check names. In both of these instances, it allows law enforcement officers to develop leads for an arrest.
questions. The funeral director needs to listen to the family, answer questions clearly, and make sure everyone attends before making the arrangements. It will help to advise the family of the agenda before beginning: Vitals for the death certificate, cremation or traditional service, selection of day and time, service location, who will be officiating, and the casket and vault selection. Laying it out beforehand gives everyone an idea of what to expect. With most unexpected opioid deaths, there is a postmortem examination (autopsy). This can potentially postpone the visitation and funeral. In choosing the day of the service, it is advisable to inform the family of this circumstance and that they may need to work around it. Furthermore, because of the overdose, the deceased may not be found for a couple of days or may be found face down. If not found for many days, and depending on the circumstances, there will be decomposition that could not only affect the embalming operation but also prohibit an open casket. Someone who Visitation and services We are now going to discuss the visitation and funeral ceremony for someone who has died of an overdose. As noted previously, there usually is a stigma surrounding this particular kind of death. Usually, most people are curious about the circumstances of how someone died. They are not only grieving the loss of their loved one but also trying to continue to honor their loved one by combatting rumors and negative small talk during the visitation. To say the family is ashamed and anxious would be an understatement. During the visitation, the funeral director needs to be vigilant for potential arguments or fighting between family members and the friends of the deceased. This is displaced aggression toward the friends, as the immediate family may have decided that the friends could have done more or somehow interceded to help their loved one. Another issue could arise with individuals using or having an actual overdose in the funeral home or in the immediate area. As previously discussed, a friend attending a visitation honoring someone who has died of an overdose may inject an opioid substance in the funeral home bathroom or in the
DANGERS TO FUNERAL DIRECTORS AND EMBALMERS
Finally, and in the most extreme case, someone arrives at the funeral home for a visitation to pay their last respects to their friend who recently died of an overdose. As one last “hurrah,” the friend goes into the funeral home restroom or parking lot and uses some heroin and has a fallout (overdose). Coroners and medical examiners face the same issues as funeral directors and embalmers. Coroners and deputy coroners are often called to scenes of overdose victims. They arrive at a known location where drugs are used, and there is a strong possibility that active drug users will still be there. At that time, there is the potential that the drug user at could overdose while the deputy coroner is there. Also, the coroner’s office can be contaminated by opioids while removing the clothing before the autopsy, thus affecting the coroner or medical examiner. Also, there is always the possibility of an inadvertent stick of a syringe when removing a body from a residence. It is important to remember that opioid residue can remain on the skin, clothing, or personal belongings of someone who died of an overdose. The residue can be absorbed through the tissues or inhaled and cause an overdose.
So why is the opioid overdose crisis so important to understand? How does it affect the death care industry and the medico/legal offices of the coroner or medical examiner? First, let us discuss how funeral directors and embalmers are affected. As discussed earlier, pills are often crushed and snorted for immediate relief, so many opioids can be turned into a powder form. These powders can become airborne while removing or disturbing clothing before embalming. The embalmer unknowingly breathes in the opioid and thus encounters direct contact with the dangerous drug (Wesco, 2019). Another example is removing patches from the deceased before embalming. Patches containing fentanyl may be offered to patients for pain relief during hospital stays. By carelessly removing the patches, the embalmer can come into direct contact with fentanyl and have an accidental overdose.
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