Parents who have cared for a dying child at home may be at higher risk of suicide after the child dies, by overdosing on the powerful painkillers used to ease the child’s condition, say two papers in this week’s BMJ.

Little research has been done on suicide rates for bereaved parents, say the authors. But there is substantial evidence that parents who have lost a child suffer deeper and more long-lasting grief than others suffering bereavements.

And one recent study showed that the death of a young child in particular put parents at heightened suicide risk - especially in the month following the death.

Recent advances in caring for the terminally ill - palliative care - mean that more and more of these patients are being cared for in the home. After the loved one has died, parents or other carers are encouraged to return any unused morphine or other painkillers (opioids) to the pharmacy for safe disposal. But despite the best efforts of medical staff, this may not happen - resulting in powerful drugs being left in the hands of grieving loved ones.

Currently there is no official guidance on what to do about leftover drugs remaining in carers’ homes, say the authors, and if the misuse of opioids continues the situation must be addressed.

An accompanying editorial describes the immense distress suffered by parents caring for dying children. Once the child has died, many child cancer units provide bereavement support for families, with surveys suggesting this is generally to a high standard.

But there is very little guidance or research on how healthcare staff can best give this support, says the author. Looking after the carer before, during and in the aftermath of death is essential. Much more research is needed on how these families can best be supported at this difficult time, she concludes.