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Grief is quite possibly the most difficult emotion one experiences in life. It is particularly difficult for those in recovery from substance use disorders, given the brain’s circuitry is wired to avoid pain, even if a person has been in recovery for a long time. 

Like any other triggers, it is important for a person in recovery to have a plan, should they experience a traumatic event, so they don’t have to deal with grief and relapse (returning to use). 

This guide provides a detailed overview of grief, how it presents in a real-life example, how to cope with it, and how unresolved grief can impact addiction.

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Personal Insight on Grief and Addiction

I’ve experienced the grief of losing a sibling and a parent both within a few years of each other. Nothing quite prepares you for the experience of grief and loss. While we all experience the similar stages of grief (explained below), it is an entirely personal experience that one can only truly understand by exposure to it. 

I cannot emphasize enough how huge grief can be in our lives. I’d describe grief as the mother of emotion: an all-feeling, all-encompassing commotion that commands your attention. It has this innate presence in your life that takes up increasing amounts of space, like a demanding job.

Despite my own ingrained propensity to avoid this kind of pain, the unfortunate reality is that humans cannot avoid the deep reality and the searing pain of loss. If you do try to avoid it, grief will make room for itself as unrelenting anxiety, deep depression, or even addiction – I would know, as I personally tried to avoid it and ultimately experienced the worst anxiety of my life over the last 11 months. 

Last year, I lost my mother suddenly and unexpectedly. She was in her early 60s and had no signs of ill-health. We spoke just a few days before she had a heart attack, as we did most weekends. We had a lengthy conversation on the phone where she told me her wishes that I do everything I can to succeed in graduate school. I had no idea that would be the last time I would hear her voice. 

It has been nearly a year since she passed and I am a different person today. In some ways I don’t recognize who I’ve become – with a newfound assertiveness, a lack of capacity for other people’s drama and their expectations of me, and an innate desire to live my life purposefully. And while it has been the most difficult year of my life, I’m proud of the woman who walked through this shitstorm of grief with her recovery intact. 

I often wonder if I’d have made it through this past year if I didn’t already have a significant amount of time in recovery and work in the field of recovery. While I don’t think “clean” time is necessarily representative of emotional resiliency – the capacity to weather such huge life events – I have spent nearly ten years working on myself. That undertaking, during years of therapy, stood me in good stead to at least withstand grief without returning to use. 

For many people with substance use disorder, however, they may not be as fortunate to withstand the tsunami of grief and its unrelenting pain.

What is Grief?

Grief is a deep sorrow caused by loss. In this instance, we’re referring to the loss of a person, but grief can also be experienced in relation to the loss of a relationship, job loss, life in another country, the expected loss of life due to a terminal illness diagnosis, or loss of mobility due to an accident. 

Symptoms of grief include:

• Irritability
• Numbness
• Detachment
• Desire to use substances to numb
• Depression
• Fatigue
• Pain
• Difficulty sleeping
• Digestive problems
• Changes in appetite
• Loss of pleasure
• Withdrawal from social activities
• Isolating from friends and family

There is also another type of grief, called complicated grief disorder – affecting up to 20 percent of bereaved individuals – which refers to those whose experience of grief does not improve over time. In complicated grief, painful emotions are long-lasting and individuals struggle to recover from the loss and resume day-to-day life.

Anyone experiencing grief will find themselves dealing with a whole host of emotions from sadness, numbness, and a sense of being removed from everyday life. Unfortunately, you cannot control the grieving process or determine how long it will take. Although, it is said there are stages of grief that one cycles through.

The Stages of Grief

In the 1960s, psychiatrist Elizabeth Kübler-Ross explained in her book, On Death and Dying, that grief could be categorized into five stages. While these stages were originally designed to describe the grief of terminal cancer, her theory was widely accepted to describe other types of loss, like a person dying. 

The five stages of grief Kübler-Ross defined are: 

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

What’s important to note is that not everyone will experience all stages, or all stages in a defined order. Sometimes people may start with bargaining and move on to anger – this is particularly true for people with a terminal diagnosis. 

For me, I started with denial. I remember for the first month saying aloud, “my mum died” to my partner. I couldn’t quite believe it happened. I haven’t experienced anger or bargaining, but I have experienced deep depression and searing pain. It sometimes feels like someone has sliced through my heart. 

A year later, I am still shocked it happened. And I still tend to bounce between denial and depression. I am starting to believe it is true – perhaps acceptance does come next. But what I know for sure, from the loss of my brother, is that grief doesn’t go away. 

You just have to learn to live with it and to make space for it. 

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Unresolved Grief and Its Impact on Addiction

Like any other stressful life event, grief increases the risk of both developing substance use disorder and can cause a relapse. 

There are several studies demonstrating the connection between grief and addiction, specifically:

• Substance misuse is associated with increased risk for complicated grief
• Among bereaved men, the risk of alcohol use disorder is twice as high
• Those experiencing complicated grief disorder and major depression are more likely to experience alcohol dependence in their lifetime.
• Grief can activate the brain’s reward center in those with complicated grief

Additionally, a recent study showed that grief interventions were beneficial for substance misuse. 

Given the risk factors for people with substance use disorders to develop complicated grief and increase the risk of substance use, it’s critically important to develop a strategy to cope with and process grief.

How to Cope With Grief and Avoid Relapse

There are countless ways to deal with grief, including grief counseling, journaling, spiritual development, reading, grief support groups, and medical/psychological support. 

While there are many different ways to recover from grief, there is one thing that has been really helpful for my grief recovery and that is the advice that there is no right or wrong way to grieve. No one gets to tell you how to process your loss, experience your grief, or when to move on. It is an entirely personal process. 

I have experienced and processed my grief through time with family, therapy (a lot of therapy), reading, journaling, peer support, and time. I have learned to befriend my grief. Some days are better than others, and I have learned that grief is an entity that I have to allow time for. 

Of some of the many books on grief I’ve read over the past year, one of my favorites is The Smell of Rain on Dust: Grief and Praise, by Martin Prechtel. What I loved about this book is how he described that grief doesn’t leave us. It’s a common misconception that with every other stressful event that we are expected to move on. Grief is different… it is here to stay. As Prechtel says, below, it can also have a profoundly positive impact on your life.  

“Grief doesn’t go away. It can change into many things and will, but as a substance and presence it never leaves. To have caused and witnessed suffering and loss of life means grief is eagerly awaiting your decision as to what direction it will take in your destiny: to make more life or to make more death and violence, internally or externally. The best decision is that all grief be turned into life-promoting grief-based beauty and usefulness. The willingness for violence-shattered soldiers to heal others makes their malady into medicine.” 

The way I experienced grief was a kind of metamorphosis. My grief changed me into a person I didn’t know a year ago. I can’t quite express what a disorienting experience it was. It’s like you turn yourself inside out. 

Grief made me critically examine who I was and what my purpose was in the world. It also really helped me to understand what was important and what to let go of given how fragile life is. It is now much easier to say what doesn’t work for me and what to avoid investing myself in. 

In the past year, I’ve let go of demanding and draining relationships – both personally and professionally. I also decided to get married because I no longer know how long I will get to experience the people I love. I now cherish the moments I do have, before they’re gone.

A List of Valuable Grief and Addiction Resources

Websites about grief: 

• Good Grief — Grief support center for children and families
• COVID Grief Network— for those who have lost loved ones to COVID
• What’s Your Grief — About the complexity of grief
• Mindfulness and Grief — meditation, yoga, and journaling for grief.
• Modern Loss — explores the taboo and the funny (and everything in between with loss)
• The Dougy Center — for children, teens, and young adults coping with grief
• The American Society of Suicidology — About suicide
• American Association for Suicide Prevention 
• The Tragedy Assistance Program for Survivors — offers support for people who have lost loved ones in the military
• Option B — stories of hope for those who have lost
• The American Counselling Association — extensive resources on grief

Books on grief: 

• • The Smell of Rain on Dust
  • Tools for the Trenches: Daily Practices for Resilience, Perspective and Progress
  • It’s OK That You’re Not OK
  • Being Mortal
  • The Grief Recovery Handbook
  • Nothing Gold Can Stay
  • Notes on Grief
  • The Art of Losing It: A Memoir of Grief and Addiction
  • Bearing the Unbearable
  • Option B

Videos on Grief

• • We don’t move on from grief. We move forward with it
  • How Grief Affects Your Brain and What To Do About It
  • How to Deal with Loss or Grief of Loved Ones
  • The Grieving Process: Coping with Death
  • Life After Loss: Why It’s OK to Not Just “Get Over Grief”
  • Grief Happens
  • Speaking Grief

Grief and Addiction Resources

• • The Effects of Grief in Addiction Recovery
  • The Grief of Addiction and Overdose
  • How to Find Treatment for Alcohol Use Disorder

If you, or someone you know, is experiencing grief and a recurrence of alcohol use, help is available. Call 800-948-8417 Who Answers? today.