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How Unresolved Grief Can Lead to Substance Use Disorder
Everyone experiences grief at one point or another. Grief is a heavy emotion associated with the loss of a loved one. We tend to express our loss through sadness or shock. You can also experience grief when you lose something you value and have relied on. You might experience grief over the loss of a relationship, a home, a career or even your health.
Some individuals find grief overwhelming and unbearable. These folks might try to cope by turning to alcohol or narcotics to numb their pain. Researchers have shown a strong correlation between substance use disorder and persistent grief disorder. Women who’ve had unresolved grief have a higher chance of developing chemical dependencies.
The 5 Stages of Grief and Loss
Psychiatrist Elizabeth Kubler-Ross describes the five stages of grief and loss in On Death and Dying. In her book, she identifies common grief responses among people whom she interviewed. While grief is usually experienced in stages, these stages may occur in no particular order, may not happen at all, or can be repeated, thereby creating a grief and loss cycle. These stages are denial, anger, bargaining, depression, and acceptance.
- Denial is often the first stage of grief. Those who are in the denial phase have difficulty accepting that the loss is real. This does not mean that the individual doesn’t understand what has happened but denial becomes a defense mechanism to cope with the intense shock and pain of the situation.
- Anger refers to the stage where individuals experiencing grief direct their negative feelings about the loss toward other people, God, themselves or the world and the situation in general. During this stage they have accepted the reality of the loss and have intensely negative feelings when they try to process that loss.
- Bargaining refers to the stage where individuals may experience “what if” thinking. Those in the bargaining phase may imagine making deals with themselves or to a higher power to somehow “undo” the loss or to avoid the pain of it. They may promise to do something, change something or give up something valuable to them to feel less sad or create a different outcome.
- Depression refers to the stage where individuals feel intense emotions related to the loss. These include physical and emotional symptoms that are a normal part of the grief process. They may include sadness, loss of interest in activities, changes in sleep and weight, an inability to concentrate or feelings of agitation, restlessness or guilt.
- Acceptance refers to the stage where the individual is finally able to accept the reality of the loss. While this is generally acknowledged as the last stage of grief, the process of grieving is different for each person. Often the stages of grief recur. Few people ever move through the stages linearly and systematically. You may move back and forth through the phases as you process your loss.
Coping with Grief, Loss, and Addiction
For people with co-occurring addiction and unresolved grief their alcohol or substance use disorder treatment plan should include grief centered therapy. This may consist of motivational interviewing or group processing to focus on how the loss impacts their well being. Engaging in 12 Step programs is also useful when working on grief and loss through peer support and understanding.
The connection between grief and addiction must be considered during recovery. Individuals in treatment also continue to face grief and loss. This is compounded by the absence of drugs as a coping mechanism.
This includes missing the substance and how it made them feel and how it may have helped them avoid the hurt and anger associated with their grief. They may also miss rituals that are associated with alcohol or substance use such as specific places, certain people, or predictable behaviors.
The loved ones of individuals with drug and alcohol substance use disorders face their own feelings of grief and loss. These feelings stem from watching their loved ones negatively impacted by their addictions. This may include the effects on relationships, finances, employment and health.
Impact of Substance Use and Mortality
Recent research has shown a decline in life expectancy in the United States. According to The Centers for Disease Control, from 2020 to 2021, nearly half of all unintentional injury deaths were due to drug overdoses.
From March 2021 to 2022, more than 109,000 people died as a result of drug overdose. While individuals with mental health disorders have higher rates of premature mortality, people with substance use disorders have the highest mortality rates.
How Do I Know if Someone Has an Addiction?
The signs and symptoms of addiction look different from person to person and depend on factors such as the substance used, the duration of use and its impact on one’s wellbeing.
Individuals with addictions tend to have intense urges to use numerous times each day. They need greater quantities of the substance to get the desired result. Without the substance they suffer negative physical and psychological withdrawal symptoms.
Family and friends often notice changes in their appearance. This may be weight loss or gain, changes in behavior including severe mood swings, a lack of personal hygiene and energy level changes. They may also neglect work or family obligations.
Where Can I Find Information on Substance Abuse Treatment?
The first step toward recovery begins with acknowledging there is a problem and being willing to make changes. You also need to find a treatment program that fits your needs. For individuals with a history of grief and loss, finding a treatment program that offers grief centered therapy is important.
US government agencies can aid in your search. The Substance Abuse and Mental Health Services Administration (SAMHSA) is a resource that can help you find an appropriate treatment program.
The Veterans Administration provides case management services that help military personnel, veterans and eligible beneficiaries connect to a program that’s a good fit for your needs.
The national 988 Suicide and Crisis Lifeline can help you navigate the process and find treatment programs locally or across the country.
Medical providers are another good resource when looking for alcohol and substance use disorder treatment. Local support groups such as Alcoholics Anonymous or Narcotics Anonymous can also be good starting points when looking for a treatment facility.
Finally, Rehab.com can help you to locate treatment facilities and programs in your area.
What are the Treatment Options for Drug Addiction?
The appropriate treatment for drug addiction depends on factors including the duration of the addiction, severity of the addiction, medical condition, family or work commitments, financial concerns and relapse risk. Working with medical and addiction professionals to complete a thorough assessment is the first step toward determining the appropriate level of care.
Levels of care range from the most intense care including inpatient medical detox and residential treatment to outpatient partial hospitalization or intensive outpatient programs, followed by outpatient counseling and aftercare support.
When grief and loss contribute to addiction, it’s important to consider a program that includes therapies to help you to work through the process. This may include programs that utilize a variety of modalities including eye movement desensitization and reprocessing (EMDR), motivational interviewing, or peer support that focus on evidenced based and trauma informed care practices.
