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The Complex Relationship Between Grief & Addiction 

Grief and addiction are often connected. People who are dealing with grief may turn to substances in an effort to escape their sadness and to cope with life. This can quickly lead to the formation of a substance use disorder (SUD).

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The Connection Between Grief & Addiction

Grief is the anguish and emotional distress people experience following a significant loss. That loss is usually the death of a loved one. 

Symptoms of grief include anxiety, depression, obsessive thoughts about the past, and nervousness for the future. Grief affects individuals on a scale. At its most intense, it can cause life-threatening conditions, such as a weakened immune system, neglect of self-care, and suicidal thoughts.[1]

SUD is a mental health condition that impacts how a person thinks and behaves. Someone struggling with addiction is unable to control and stop their use of drugs or alcohol despite experience negative consequences in their life related to that use.[2]

Conditions like grief and addiction do not necessarily cause the other to occur, but they can be closely related. Grief may lead someone to misuse substances, especially if they already have a history of substance abuse. Substance abuse can lead to situations, such as overdose or damaged relationships, that cause grief.[3]

Since 1980, mortality rates for people with substance use disorders have increased by more than 600% in large part due to the opioid overdose epidemic. More than 63,000 people died in 2016 from a drug overdose. People struggling with addiction are more likely to be surrounded by others who misuse drugs, which increases the likelihood of exposure to death and subsequent grief.[3] 

Collective Grief & the Opioid Epidemic 

Collective grief occurs when many individuals belonging to a group grieve at the same time. At some point, the grief becomes so widespread that the sense of what is normal changes. It becomes challenging for the members of the group to imagine a future that is different.[8]

The opioid epidemic has created the stage for collective grief in the United States. Between 1999 and 2018, nearly 450,000 Americans died from an opioid-related overdose. The epidemic was declared a national health emergency in 2017. 

One in 100 adults meet the criteria for an opioid use disorder (OUD), yet 88% of adults in the U.S. with OUD have not received treatment. Both the individuals struggling with opioid abuse and their loved ones witnessing the negative impacts belong to the pool of those affected by collective grief that is caused by the opioid epidemic.[9]

Grief & Substance Use 

Studies have identified a positive relationship between grief and substance use. That is, people struggling with grief (particularly complicated grief) are at an increased risk for substance abuse. 

Complicated grief is a disorder that affects approximately 10% of adults missing a loved one who passed away. Symptoms are persistent and affect mood, sleep, and quality of life. The condition can lead to low self-esteem as well as high-risk behaviors and substance use.[3]

The connection between grief and substance use is bidirectional. Individuals with a preexisting SUD are at risk of increased substance abuse when faced with grief. People with a substance use problem are less likely to have coping strategies that allow them to deal with grief in a healthy way.[4]

Links have been identified between losing a significant person in one’s life, complications of grief, and substance abuse. Grief is a normal response to a significant loss, but complications arise when a person does not have effective ways to handle it. Someone with a history of substance abuse is more likely to have difficulty recovering from a loss and may develop complicated grief, in which grief lasts longer and is more intense than traditional grief. An estimated 34.2% of people with SUD are affected by complicated grief.[4]

Grief & Gender

Everyone experiences grief differently, and certain patterns have been observed among men and women. Men, for example, who have lost a loved one, are more likely to abuse alcohol. Young adults who experience the deaths of multiple loved ones within a short period are at an increased risk for a substance use disorder.[3] 

Grief is also a risk factor for SUD in women. Many women with substance abuse have experienced the loss of a family member, and grief may become a driving factor for further substance abuse. To improve treatment outcomes, grief support groups within treatment programs can help women better understand the link between their grief and addiction.[6]

To better tailor interventions to specific genders, more research is needed on the relationship between bereavement, substance use, and gender differences. Gaining a better understanding of the tendencies of men and women to use substances when they are grieving will allow for the development of more effective treatment options. 

Interventions for Grief & Addiction

Effective interventions for grief and addiction target both conditions at once. If one condition is left untreated, the person is likely to fall back into a cycle of mental health challenges and substance abuse. Studies have found when both grief and addiction are treated simultaneously, the treatment outcomes are far better than when only one condition is addressed.[3]

For people whose grief does not resolve in time on its own, treatment may be necessary. Complicated grief treatment incorporates multiple therapeutic approaches, such as cognitive behavioral therapy, to help the individual accept and adapt to their loss. The goal is to help the individual find satisfaction in life without the presence of the person they lost.[7] CBT is also a widely accepted treatment method for addiction, as it can help individuals develop healthy coping skills instead of turning to substance use.

Another approach, the Family Bereavement Program (FBP), was designed to support children and adolescents who lost their parents. Losing parents as a child or adolescent is a risk factor for future mental health and substance use problems. The FBP aims to build resilience in children and increase their adaptive capabilities. Youth who have participated in the FBP have shown increased coping skills and improved mental health.[5] 

Participating in such treatment programs can help prevent grief from developing into complicated grief and increasing the risk of addiction. Grief interventions like these for people struggling with both grief and addiction offer many potential benefits, including developing resilience for facing challenging situations and reducing the impacts of substance abuse.

Updated February 17, 2024
  1. Grief. American Psychological Association. Published August 2022. Accessed January 30, 2024.
  2. Substance use and co-occurring mental disorders. National Institute of Mental Health. Published March 2023. Accessed January 30, 2024.
  3. The relationship between substance misuse and complicated grief: A systematic review. Parisi, A., Sharma, A., Howard, M., and Wilson, A. Journal of Substance Use & Addiction Treatment. 2019;103:43-57.
  4. Coping strategies and complicated grief in a substance use disorder sample. Caparros, B. and Masferrer, L. Frontiers in Psychology. 2021;11.
  5. The family bereavement program: Description of a theory-based prevention program for parentally-bereaved children and adolescents. Ayers, T., Wolchik, S., Sandler, I., Twohey, J., Weyer, J., Padgett-Jones, S., Weiss, L., Cole, E., and Kriege, G. Omega (Westport). 2014;68(4);293-314.
  6. Women, addiction, and grief: A quality improvement initiative. Groh, C. Archives of Psychiatric Nursing. 2020;34(4):224-229.
  7. Prolonged grief disorder. American Psychiatric Association. Published May 2022. Accessed February 2, 2024.
  8. Grief. Cleveland Clinic. Published February 22, 2023. Accessed February 2, 2024.
  9. Opioid misuse: A global crisis. Hornberger, J. and Chhatwal J. Science Direct. 2021;24(2):145-146.
  10. Coping strategies and complicated grief in a substance use disorder sample. Caparrós B, Masferrer L. Frontiers in Psychology. 2021;11.
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