Why overdose deaths or substance abuse deaths feel so different?

Substance abuse and mental illness are often stigmatized. When an individual experiences stigma as a result of their addiction or mental illness, they are seen as less than because of their health status. What happens then when a loved one dies as a result of an overdose death or substance abuse death? When your loved one died (dies) as a result of an overdose or substance abuse death, grief and loss become complex. This is often referred to as disenfranchised grief, the pain and loss that may not be socially validated or supported.

Mental health and substance abuse therapist also grieve the death of their clients. Most therapists report feeling shocked, guilt, shame, fear, blame, and self-doubt. As a substance abuse therapist, I, too, have had clients die as a result of overdose and suicide. My go-to reaction is self-doubt, what did I miss, what intervention did I not use, what signs were there, what could I have done differently? As I go through these emotions and thoughts, I am not alone.

Grief can be a very deeply personal response. Varying emotions are felt when someone dies, yet when death is a result of an overdose or substance abuse death, frequently, people feel the most difficult emotions. Substance use-related deaths are sudden, even if you sat by the phone each day just waiting for “that call.”  Often people feel alone, who can relate to what I am experiencing as this is something I have never experienced, or possibly I am ashamed to talk about how my loved one died as others may judge me or not understand. It is not uncommon to have these feelings, thoughts, or reactions.  Often the emotions that appear on the surface are sadness, anger, guilt, shame, isolation, loneliness, relief, frustration, self-blame, fear, anxiety, depression, and the stigma. After these initial questions, comes, how will I feel better or different, when will this pain ease?