The death of a loved one is one of the most difficult and painful human experiences, and one that almost everyone will experience during their lifetime. Some deaths, however, are particularly traumatic and difficult to heal from. For instance, when death is premature, unexpected, or occurs with a loved one you had a strained relationship with, the grieving process can be much more painful, arduous, and long. A particularly difficult type of grief is having a loved one die from a drug overdose.

Each year, more than 70,000 people in the US die from a drug overdose, and the vast majority of these involve an opioid drug like fentanyl, heroin, or prescription painkillers (1). Sadly, these numbers have been rising in recent months due to the secondary effects of social isolation, unemployment, stress, and other byproducts of the COVID-19 pandemic.

All grief is psychologically painful but losing a loved one to a drug overdose can lead to specific kinds of grief that are known to be especially hard (2, 3, 4). Psychologists have different terms to describe the different forms of grief that people who had a loved one die from an overdose might experience. These include anticipatory grief, complicated grief, and disenfranchised grief. Depending on the circumstances, a person who lost a loved one to a drug overdose may experience one, two or all three of these kinds of grief.

Anticipatory Grief

In some instances, a fatal drug overdose might not come as unexpected news. If a person was aware that their loved one struggled with a drug or alcohol problem, they might have even anticipated someday getting this news. They may even have mentally or emotionally rehearsed getting this news several times, intentionally or unintentionally.

Anticipatory grief is a form of premature grief that comes after a person has reason to suspect that their loved one will die but before the person actually dies. Anticipatory grief often generates conflicting emotions in a person. It might make them angry with their loved one, wanting to distance themselves or pull away from them, or blame them for not making certain changes. Anticipatory grief can also cause a person to feel helpless, depressed, and scared.

When a person actually does die, someone has been in a state of anticipatory grief can experience a wave of emotions. They might feel an immense sense of guilt, somehow believing that expecting or thinking about the person dying played some kind of causal role, even though they know this does not make logical sense. They might also feel a sense of numbness, after having repeatedly rehearsed this scenario so many times that they feel unable to even access any emotion at all.

While it is hard to accept, after having spent months or maybe even years dreading and worrying about getting the news, having it actually happen can even trigger something like relief. Feeling a sense of “relief” can trigger a lot of guilt in people because it feels “wrong” to have that emotion, but it is completely normal, and experienced by many other people who have lost a loved one to an overdose (2, 4).

Anticipatory grief is like a dress rehearsal for actual grief, and it is a way that people try to psychologically prepare themselves for a death that feels inevitable. Those most likely to experience anticipatory grief before a loved one overdoses are those who are aware that the person has a drug or alcohol addiction. They may have even tried a number of times to confront their loved one and tried to convince them to stop or get help before they reached this stage.

Complicated Grief

Complicated grief is a more generalized term that psychologists use to describe grieving processes that are abnormally long or challenging, often because of certain factors that “complicate” the ability of the person to accept the death. Complicated grief is prolonged and leads to significant impairment in a person’s ability to return to a “normal” baseline of emotional stability and functioning.

Complicated grief is more common when a death is sudden, unexpected, or premature, and is also more common in certain types of relationships. For instance, the death of a child or spouse is much more likely to result in “complicated grief” than the loss of a grandparent or even a parent (5, 6).

Complicated grief is common in people who have lost a loved one to a drug overdose, regardless of who the person was or how old they were. Unlike cancer or even a car accident or injury, drug overdoses are considered preventable deaths, a factual but also a complicated truth. In theory, it is possible for a person to avoid a drug overdose by seeking treatment, cutting down, or even moderating their drug use.

In this way, the deceased person was the only person who could have prevented their death, despite the ongoing guilt and self-blame loved ones often place on themselves (2, 4). This often complicates the grieving process because it leads people to either blame themselves or blame their loved one, or even alternate between the two. Either way, both paths make it difficult to accept, heal, and find closure after their loved one has died.

Disenfranchised Grief

Disenfranchised grief is another common type of grief that people experience when losing a loved one to a drug overdose, and describes feeling unentitled to feeling sadness, grief, or mourning the loss of the person. People who lose loved ones to overdose experience high rates of disenfranchised grief, largely because of the public stigma and negative view of drug use, and the idea that people who overdose are to blame for their death (3, 4).

Similar to the experience of people who lose a loved one to suicide, people who die from drug overdoses are often seen as being selfish, reckless, and fully accountable for their circumstances (3). Even if loved ones do not hold these beliefs themselves, the public stigma surrounding drug overdoses often leaves people feeling more isolated and without a support system to help them move through the stages of grief. Unfortunately, this makes it even harder for people to move towards a place of acceptance, heal, and even do their own work of reconciling their conflicting thoughts and feelings about their loved one and the circumstances of how they died (2, 3, 4).

Healing & Finding Closure After a Loved One Overdoses

While there are many factors that complicate the process of grieving a loved one who died of a drug overdose, there are also many paths towards healing and hope. Some of these involve more traditional treatments like therapy, while others may involve self-help resources, support groups, and even advocacy.

For those who are looking to heal and find closure after a loved one has overdosed, consider taking one or more of the following steps:

1. Seek counseling: A professional counselor who specializes in addiction issues, complicated grief, or traumatic loss can help people process through their conflicting thoughts and feelings, learn new methods of coping, and find closure. Therapy is often covered by health insurance plans, making it affordable and accessible.

2. Find a community: Connecting with other people who have lost loved ones to drugs or alcohol can be an incredible source of support to those struggling to grieve. Organizations like GRASP, SADOD, or Full Circle all specialize in connecting people affected by drug overdose to resources, information, and support networks.

3. Buy a self-help book: Self-help books can provide essential tips and strategies, often from people who have suffered a loss directly or who are experienced in helping others who have. Some suggested reading lists already exist, and I can also personally recommend Grief Diaries, It’s Ok That You’re Not OK and Finding Meaning.

4. Stay connected to memories: When possible, try to find ways to connect to memories that remind you of the best parts of the person and your relationship with them. These might have been dimmed in more recent years due to the person’s addiction, but even more distant memories can help you feel connected to who they were before the addiction took over.

5. Find meaning: Much like the book by the same title, the process of finding meaning has been added as a “sixth” stage in the process of grieving and involves not just making sense of the person’s death but finding a way to turn it into something meaningful. This might be advocacy work, building awareness, or even making a small lifestyle change or starting a yearly tradition on the person’s birthday. This sixth stage is a way to take the pain of grief and use it to build something meaningful in the place your loved one left in the world.

Sources:

  1. Center for Disease Control. Drug Overdose Deaths
  1. Templeton, L., Valentine, C., McKell, J., Ford, A., Velleman, R., Walter, T., … & Hollywood, J. (2017). Bereavement following a fatal overdose: The experiences of adults in England and Scotland. Drugs: Education, Prevention and Policy, 24(1), 58-66.
  1. Bereavement Following Substance Misuse: A Disenfranchised Grief.
  1. Dyregrov, K., Møgster, B., Løseth, H. M., Lorås, L., & Titlestad, K. B. (2020). The special grief following drug related deaths. Addiction Research & Theory, 28(5), 415-424.
  1. Newson, R. S., Boelen, P. A., Hek, K., Hofman, A., & Tiemeier, H. (2011). The prevalence and characteristics of complicated grief in older adults. Journal of affective disorders, 132(1-2), 231-238.
  1. The Center for Complicated Grief

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