The Connection Between Coping With Grief And Addiction

Grief is a natural but complicated experience, and it requires support and healthy coping skills.

For many people, grief can become overwhelming, and as a result, it often leads to substance abuse or exacerbates existing addictions.

For people dealing with grief and substance use disorders (SUDs), grief-informed addiction care can provide vital resources for managing difficult emotions.

Types Of Grief

People associate grief with the loss of a loved one. Indeed, this type of loss certainly causes strong emotions and overwhelming difficulties.

However, people may experience other types of grief, and these forms of grief may not be acknowledged or understood as well as the loss of a friend or family member.

Though some people experience loss more intensely than others, any type of loss may trigger the need for grieving.

Some of these losses may include:

• divorce
• ending a friendship or romantic relationship
• loss of familiarity (e.g., moving to a new location)
• job loss
• pregnancy loss
• fertility loss
• loss of independence due to aging or disability
• loss of abilities due to illness or injury
• loss of religious beliefs and values
• loss of social support (e.g., when coming out as LGBTQ)

The perception of loss varies from person to person, and each person deals with loss differently.

For instance, one person may not feel a sense of loss when moving to a new location, and therefore, they may not feel grief as a result of this experience.

However, a person who is more sensitive to change may feel a profound sense of loss over the same experience.

Types Of Drug Use And Grief

People who use drugs and alcohol to self-medicate may choose different substances, depending on their circumstances and the feelings they want to mitigate.

Depressants And Grief

Depressants are drugs that slow activity in the central nervous system (CNS). People use these substances to promote sleep or relaxation.

For example, alcohol is considered a depressant, and people sometimes use it to reduce anxiety and lower inhibitions in social situations.

Some depressants, such as sleeping pills, are available with a prescription. Like alcohol, these drugs carry a risk of dependence and addiction.

During times of grief, people may use depressants to combat anxiety, anger, and stress. They may also use these drugs to mitigate sleep loss.

According to the Sleep Foundation, people experiencing grief tend to take longer to fall asleep, wake up after falling asleep at night, and spend a large amount of their time in bed awake.

Stimulants And Grief

Stimulants are drugs that speed up CNS activity. They promote wakefulness and motivation by increasing a brain chemical called dopamine.

Doctors prescribe stimulants for people with conditions that impact dopamine, such as narcolepsy and attention-deficit/hyperactivity disorder (ADHD).

When taken in excessive amounts or consumed by people without a dopamine condition, stimulants can cause euphoria and create a risk of addiction.

Illicit stimulants, such as cocaine and methamphetamine, also cause euphoria and addiction.

Grieving may prompt a person to abuse stimulants for several reasons.

Some of these reasons include:

• seeking focus and energy for funeral arrangements or other tasks
• inducing euphoria to combat unpleasant emotions
• compensating for lack of sleep
• seeking relief from grief-induced brain fog

Opioids And Grief

Opioids are drugs that promote relaxation and pain relief when they attach to the brain’s opioid receptors.

Examples include prescription pain medications such as morphine and hydrocodone, as well as heroin, which is a street drug.

People experiencing grief may use opioids for the same reasons why they may use depressants: to provide temporary anxiety relief and induce sleep.

Opioids may also appeal to people experiencing trauma along with grief, as these drugs release endorphins that promote feelings of safety and well-being.

Bereaved people may seek opioids for physical pain as well. Research on spousal loss reveals that grief promotes inflammation, often causing aches and pains.

Difficulties Associated With Grief

Grief is a complex process, and it often creates additional difficulties. Like grief itself, these difficulties can create risk factors for substance abuse.

Consequences Of Loss

When a person experiences a significant loss, that loss can impact their life in unexpected ways.

For example, a person who has recently lost a loved one or ended a romantic relationship will experience more than a loss of companionship.

This person has also lost any routines associated with the other person, any support that this other person used to offer, and other touchstones that may have provided a sense of stability.

As a result, they may experience feelings of emptiness and instability, which they may attempt to mitigate by using drugs and alcohol.

Loneliness And Disenfranchised Grief

Bereaved people often report feelings of loneliness and isolation.

During times of grief, friends of bereaved people may emotionally distance themselves, as they may not know how to best respond to their friend’s loss.

A specific type of grief, called disenfranchised grief, can create a particular experience of loneliness.

Disenfranchised grief refers to any type of grief that falls outside of societal expectations.

Some examples include:

• stigmatized cause of death or loss
• grieving longer or more intensely than expected
• losses unrelated to death
• death of someone in a distant or unrecognized relationship
• loss of sentimental objects

People experiencing disenfranchised grief receive less support than those experiencing societally acceptable grief. As a result, they may experience increased loneliness.

Loneliness, regardless of the cause, is a long-established risk factor for substance abuse and addiction.

When experiencing loneliness, people often use substances in an attempt to numb or soothe those feelings.

Stress

Emotionally taxing circumstances, including grief, heighten stress levels.

In addition to difficult emotions, bereaved people often also have to deal with increased responsibilities, such as making funeral arrangements and paying medical bills.

Additionally, they must also adjust to their new circumstances, whether those circumstances involve a lost loved one, a new disability, or any other significant change.

This prolonged stress can cause an imbalance of cortisol, a stress hormone that has a connection to substance abuse.

Some people, especially those without support, may use drugs and alcohol as a way to deal with the stress.

Emotional Complications

The prolonged stress and sadness of grief may alter brain chemistry, and for some, this can cause mental health complications such as depression and anxiety.

These emotional difficulties, in turn, can contribute to substance use disorders.

According to co-occurring disorder research, people who experience mental health conditions are particularly susceptible to substance abuse, and vice versa.

Drugs And Alcohol As Coping Mechanisms

When difficult circumstances, such as grief or mental illness, cause substance abuse, it is often because people use substances as a coping mechanism.

People may use drugs and alcohol due to a lack of support and healthy coping skills, or they may use substances in an attempt to ignore their grief.

Drugs and alcohol can temporarily numb painful feelings. Many drugs cause euphoria, which can counteract sad and angry emotions.

Unfortunately, many of these substances often cause a “crash” or rebound effect, causing the person to feel worse than they did before the high.

This rebound effect often contributes to addiction, as many people cope with the crash by using more drugs, creating a vicious cycle.

Grief, Trauma, And Substance Abuse

Grief may also create trauma, especially if the loss occurred in a sudden or terrifying way. Some people develop post-traumatic stress disorder (PTSD) as a result.

They may experience symptoms such as:

• hypervigilance
• separation anxiety
• feelings of dread
• flashbacks
• nightmares
• sleep disturbances

Traumatic grief may increase vulnerability to substance abuse, and PTSD is linked to addiction.
Often, people dealing with PTSD use substances to reduce symptoms.

Complicated Grief And Substance Use Disorders

Some people experience complicated grief, which is grieving that persists much longer and more intensely than average.

Research on grief and addiction reveals that people with existing SUDs have a heightened risk of experiencing this type of grief.

Likewise, complicated grief increases a person’s risk of alcohol abuse and smoking.

Grief And Substance Abuse Complications

Several factors can complicate grief and substance abuse. These include individual and community-based complications.

Cultural Attitudes Toward Grieving

Cultural attitudes toward the grieving process may complicate substance abuse treatment.

For example, U.S. law does not require employers to provide paid bereavement leave, and employees are often expected to return to work quickly after a loss.

When a person belongs to a culture that minimizes the grieving process, they may struggle to ask for help regarding grief-related struggles, including substance abuse.

Lack Of Support And Resources

A lack of support and resources may also complicate grief and substance abuse. For example, unpaid bereavement days and substance abuse can both cause financial difficulties.

Funeral payments and other bereavement-related costs can also become financially overwhelming.

Some people dealing with grief and SUDs may be unable to pay for addiction treatment as a result.

A lack of support can be systemic, but it may also occur on an individual level, such as when grieving people distance themselves from loved ones.

People experiencing disenfranchised grief, which is not taken as seriously as other types of grief, may also lack support.

This loss of emotional support may leave a bereaved person with few options when they want to seek addiction help.

Grief And Shame

Addiction often creates feelings of shame, as a result of its connection to depression and the stigma attached to it.

Grief may also create shame for multiple reasons. A person may feel ashamed of the amount of time it takes for them to heal from their loss, or they may feel shame for grieving in unexpected ways.

For example, some people cry very little while grieving, and they may feel judged for doing so.

Other sources of grief-related shame may include disenfranchised grief and survivor’s guilt.

When a person experiences both grief and substance abuse, they may experience shame related to both conditions, and they may avoid seeking help as a result.

Grief And Addiction Recovery: Awareness For Addiction Care Providers

Many addiction care providers offer grief-informed treatment options, as people receiving SUD treatment often report experiencing bereavement.

Providers should also understand that recovery itself can bring about a grieving experience for many people.

Addiction recovery does help people regain their mental wellness, make healthier choices for themselves, and live more vibrant lives overall.

However, as people heal from addiction, they experience several losses as well.

These may include:

• the loss of friends who still use drugs
• the loss of social opportunities
• the loss of drug- and alcohol-related activities
• the loss of routine and familiarity
• the loss of drug-induced euphoria

Even for people who welcome recovery and want to build healthier lives, these losses can create challenges during treatment.

When people do experience these challenges, they may feel confused and question whether they have enough motivation to heal.

By acknowledging recovery-related losses, addiction care providers can validate their clients’ experiences and help them contextualize their feelings.

Addiction Treatment Options For People Experiencing Grief

For people dealing with bereavement, addiction care should acknowledge grief and its challenges. Several types of substance abuse treatment may prove helpful for these individuals.

Inpatient Or Residential Addiction Treatment

Inpatient and residential treatment provide meals and a bed along with addiction therapy, support groups, and recreation.

These programs offer a significant amount of structure and stability. Grief can often feel chaotic, so the reliability and orderliness of these programs may appeal to people who crave a return to routine.

Outpatient Addiction Treatment

Outpatient addiction treatment takes place during the day, with participants returning to their homes during non-treatment hours.

Outpatient care has varying levels of intensity. For example, partial hospitalization programs (PHP) provide treatment for six to eight hours per day, while some outpatient programs may provide therapy for an hour each week.

This type of care may work well for people who heal best in familiar environments. Falling asleep in one’s own bed can provide a source of comfort during recovery.

Grief Counseling

Grief counseling is a type of therapy that helps people cope with bereavement and loss. Grief counselors help their clients accept their loss and work through the associated pain.

For grieving people in addiction therapy, addressing a loss can help them find the root of their substance abuse and cope with potential relapse triggers, which are situations that may cause a person in recovery to use drugs.

Group Therapy And Support Groups

Group therapy and support groups, especially those that focus on SUDs and grief, may mitigate feelings of loneliness for people who experience these struggles.

As group members share their experiences, they can also offer support for other members of the group.

This type of support can prove especially valuable for people who lack support from friends and family members.

Trauma-Informed Therapy

Because grief and trauma have such a strong connection, and because trauma is linked to substance abuse, people dealing with SUDs and grief may benefit from trauma-informed therapy.

This form of therapy establishes a sense of safety and examines how trauma impacts the client’s life. Addiction treatment also examines how the client’s trauma and addiction intersect.

Therapists can help their clients identify trauma-related addiction triggers and find healthy coping strategies.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a therapy that has proven effective for SUDs and co-occurring disorders. It has also demonstrated benefits for people dealing with grief.

CBT operates from the understanding that thoughts, emotions, and behaviors impact one another.

It helps clients identify their unhelpful thought distortions and maladaptive behaviors, and it teaches more sustainable coping methods.

Motivational Interviewing

Motivational interviewing (MI) was developed for people experiencing addiction. It is a therapy modality that helps clients find their motivation for changing unhealthy behaviors.

More research is needed on the effectiveness of MI for grieving individuals with SUDs, but the available research shows promising results.

Identifying one’s motivations can help people maintain sobriety, even when faced with painful circumstances.

Resources For People Experiencing Grief And Addiction

Grief and addiction are both complex and difficult, but resources are available for those who need help.

These resources can help people find grief counseling and support groups:

• SAVE Support Group Directory — Suicide Awareness Voices of Education maintains this directory of support groups for people who have lost a loved one to suicide.
• Grief Support Directory — Evermore, a nonprofit organization that provides support for bereaved people, offers a directory of grief counselors and programs.
• Tragedy Assistance Program For Survivors — TAPS connects families of fallen military members to grief support services.

The following resources are available for people experiencing addiction:

• Alcoholics Anonymous — AA is a support group network that uses a 12-step approach.
• SMART Recovery — This support group program is a non-spiritual alternative to 12-step programs.
• FindTreatment.gov — This directory from the Substance Abuse and Mental Health Services Administration (SAMHSA) helps people find substance abuse care and other mental health treatment options in their area.
• Start Your Recovery — This organization provides information and support for people experiencing substance abuse.
• Opioid Treatment Program Directory — This SAMHSA directory connects people to opioid addiction treatment providers.

Here you’ll find guides and other helpful information for supporting grieving loved ones:

• Ten Ways To Support The Newly Bereaved — Evermore provides this guide for friends who want to support their loved ones through a loss.
• Helping Someone Who’s Grieving — This HelpGuide.com article provides guidance for people with grieving loved ones.
• After A Loved One Dies — This booklet from Children’s Hospital Los Angeles provides guidance for parents and other adults who want to help a grieving child.

These resources are available for people whose loved ones are experiencing addiction:

• Al-Anon Family Groups — Al-Anon is a network of support groups for the loved ones of people with alcohol addiction.
• SMART Recovery Family And Friends — SMART Recovery provides support groups for friends and family members of people with SUDs.
• Encouraging A Loved One To Seek Treatment — This guide from Start Your Recovery explains how to encourage a loved one to seek care for an SUD.

Written by the Addiction Resource Editorial Staff