Addiction devastates lives and can severely damage relationships. People in recovery have often suffered many losses, and drug and alcohol use can delay feelings of grief related to these losses. This grief can then become staggering when substances are not being used, which can cause a person to want to use them more.
Grief can exacerbate addiction as well. Many of the same pathways in the brain that are involved with feelings of grief can also be impacted by substance abuse and addiction.
Grief can complicate addiction, and the reverse is also true. Both grief and addiction are best managed through a comprehensive treatment program that can address all the social, emotional, interpersonal, spiritual, and physical aspects of each condition.
Key Facts About Grief and Addiction
- Studies show that men who are bereaved for two years engage in problematic alcohol use and struggle with alcohol dependence at much higher rates (about double) than those who are not bereaved.
- Loss of a loved one, such as a spouse, can lead to negative behavioral changes, which can include increased alcohol use. Grief can therefore be a contributing factor in problematic substance abuse and addiction.
- People with a substance use disorder are more prone to also have complicated grieving symptoms and maladaptive coping strategies after the loss of a loved one than those without addiction.
- Addiction and social attachment share many of the same biological mechanisms and brain interactions, which can mean that grief and addiction can be very closely intertwined.
What Role Does Grief Play in Addiction?
Loss is something that people in recovery are very familiar with. Problematic drug or alcohol use can often lead to broken relationships, loss of friendships, and isolation, which can cause grief.
Grief is a deep sorrow that is commonly felt from the loss of a loved one. Addiction can cause loss and therefore grief. When someone dies, it can also cause a person to turn to drugs or alcohol as a coping mechanism.
Drinking or using drugs can serve as a temporary escape — a way to turn off negative feelings and put grief aside — although these feelings are often heightened after the drugs or alcohol wears off. The “crash,” or extreme low that can follow a “high,” can encourage a person to take more drugs or drink more alcohol repeatedly to avoid the negative feelings.
Repeated drug and alcohol use can cause drug dependence. It can lead to addiction, which is compulsive and chronic substance abuse.
Grief, Addiction & Depression
Substance abuse and addiction commonly co-occur with depression.
In a study of people with substance abuse, nearly all (93 percent) experienced some level of depression, with close to three-quarters (72 percent) having severe depression. Grief can increase depressive symptoms, potentially lead to depression, and therefore also be involved in substance abuse and addiction.
Studies also show that people with major depressive disorder (MDD) are more prone to have higher rates of complicated grief, which is similarly associated with a higher prevalence of lifetime alcohol dependence.
Social Attachments, Addiction & Grief
Social attachments and falling in love are likewise linked with addiction related to brain circuitry, chemistry, and function. Drug and alcohol use, for example, interact with the reward processing pathways and areas of the brain involved in motivation and pleasure. The same is true for falling in love and forming social attachments.
Drug addiction and love both involve the following:
- The mind continually invaded by thoughts of the love interest or substance
- Spending more and more time wanting to use drugs or be around the love interest
- Cravings for the substance or love interest
- Withdrawal symptoms, such as low moods and changes in sleep or appetite when the substance wears off or the love interest is removed
The loss of a loved one after the attachment is formed (grief) can then exacerbate drug or alcohol withdrawal symptoms, making them more pronounced. This can make it harder to stop taking the substance that seems to make you feel better, further compounding substance abuse and addiction.
It can then be difficult to feel pleasure without drugs, alcohol, or your love interest. When the person is gone, it can push you further toward drugs and alcohol to feel anything “good.” The brain will literally need to be rewired through specialized treatment to aid with recovery, enhance motivation, and find new ways to feel happiness.
What Treatment Options Are Available for Grief & Substance Abuse?
Since grief and substance abuse are often intertwined, and symptoms and biological responses can overlap, it is optimal to treat both at the same time. When two issues are present in the same person at the same time, such as grief or depression and addiction, they are said to be co-occurring. In these instances, dual diagnosis treatment programs are ideal.
With dual diagnosis treatment, both conditions are treated simultaneously, often with a team of medical and mental health professionals working together toward common goals. Treatment may include a variety of methods, such as counseling, therapy, medications, and support groups.
Treatment options for grief and substance abuse can be provided in a variety of settings, including both inpatient and outpatient. Inpatient treatment programs can provide care, support, and monitoring around the clock in a highly structured environment. In these settings, you can focus completely on healing as you work through structured programming on a set schedule.
Outpatient programs offer more flexibility, and they can range in their level of structure and offered programming. You will need to have a safe and supportive home environment to return to after completing treatment sessions. Some people opt to live in a sober living home during outpatient treatment to better support their sobriety.
With addiction, the first step in an addiction treatment program is often detox, which is commonly performed in a specialized treatment facility or detox center. Detox allows the drugs and alcohol to safely process out of the. Medications are often used to manage potential withdrawal symptoms and physical and mental health concerns that can arise.
Treatment for addiction and grief is going to vary from person to person significantly. What works best for you might not be the same thing that works as well for someone else. Treatment should be specific and individual.
With both grief and addiction, group and individual counseling sessions are usually part of the treatment plan. Counseling can offer new and effective ways for dealing with difficult emotions and triggers and finding new coping mechanisms.
Trained counselors meet with you one on one and in a group setting to work through unresolved grief and issues related to substance abuse and addiction. They may offer advice and give you “homework” of things to try in between sessions.
In a group setting, you can learn from other members of the group about methods that worked for them. The counselor will generally guide these sessions with a specific topic or goal.
Counseling is typically considered a short-term intervention that can help to shape lifestyle changes and aid in recovery.
Behavioral therapies are some of the most commonly used evidence-based treatment methods for addiction treatment.
Behavioral therapies, such as cognitive behavioral therapy (CBT), can identify negative thoughts that can often lead to self-destructive behaviors, such as problematic drug and alcohol use. CBT can also help to create new and healthy habits and responses, helping to regulate and reshape thought processes and emotions that drive actions.
CBT can help you to better process your grief. In sessions, you may gain understanding and insight into negative thought patterns that may be keeping you from fully experiencing emotions related to your grief. This can be particularly useful if you have used substance use as a coping mechanism to avoid grief.
Therapy sessions are led by a trained mental health professional who can help you to identify specific triggers and your subsequent reactions. Therapy can help you to be more self-aware and bring about positive changes that can improve your mental health. You can learn tools for managing difficult emotions and keeping your moods balanced without drugs or alcohol.
Medications are a common aspect of a complete addiction treatment program. This can include medications for specific mental health and medical symptoms as well as medication-assisted treatment (MAT).
With grief, mood-balancing medications like antidepressants can often be beneficial during treatment. These medications can help to balance brain chemistry that is often impacted by chronic depressive emotions.
MAT includes the use of FDA-approved medications, such as Suboxone, which contains both naloxone and buprenorphine. Suboxone is considered a front-line treatment for opioid use disorder (OUD).
The buprenorphine component of Suboxone is a partial opioid agonist, which means that it can still activate some of the same parts of your brain in the same way that other opioids do. This can help to alleviate drug cravings and withdrawal symptoms. It does not fully activate them, so it does not get you high.
Buprenorphine also has a ceiling effect, meaning that taking more of it does not increase the effects or cause intoxication. The naloxone component of Suboxone further acts as an abuse-deterrent feature, as it is an opioid antagonist that remains dormant unless the medication is abused through injection. Then, it can serve to precipitate uncomfortable opioid withdrawal symptoms, so there is little point in misusing Suboxone.
Suboxone, and the use of medications, is an important part of opioid addiction treatment. MAT can minimize the odds of relapse, reduce drug use, and help to create physical stabilization, so you can focus on processing grief and other issues related to substance abuse and addiction.
In addition to group and individual counseling, behavioral therapy, and medications, support groups can play an important role in helping to process grief and addiction recovery.
There are support groups for grief, which can be specific in regard to how you lost a loved one, such as loss due to a certain illness or loss from violence. Some groups may also cater to certain types of loss, including loss of a spouse, partner, or child.
There are a variety of support groups to help with alcohol and drug addiction. These can also be tailored to specific demographics, such as age, gender, ethnicity, or faith.
Support groups can be a vital component during treatment and recovery for a variety of conditions, including grief and addiction. These groups are made up of similar individuals — peers who can offer encouragement and support.
In these mutual self-help groups, members can find a wide range of advice and encouragement, helping members to see that they are not alone in their struggles. Support groups are often free and private, so they are accessible to most people. Group members often find that they find gratification in helping others in the group as well.
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- Changes in Routine Health Behaviors Following Late-Life Bereavement: A Systematic Review. (July 2013). Journal of Behavioral Medicine.
- Coping Strategies and Complicated Grief in a Substance Use Disorder Sample. (January 2021). Frontiers in Psychology.
- On Mourning and Recovery: Integrating Stages of Grief and Change Toward A Neuroscience-Based Model of Attachment Adaptation in Addiction Treatment. (Winter 2017). Psychodynamic Psychiatry.
- Assessment of Anxiety and Depression Among Substance Use Disorder Patients: A Case-Control Study. (June 2020). Middle East Current Psychiatry.
- Complicated Grief Among Individuals With Major Depression: Prevalence, Comorbidity, And Associated Features. (November 2011). Journal of Affective Disorders.
- Treatment Approaches for Drug Addiction DrugFacts. (January 2019). National Institute on Drug Abuse.
- Information About Medication-Assisted Treatment (MAT). (February 2019). U.S. Food and Drug Association.