Addiction is a disease that preys upon our vulnerabilities and is often born of and feeds on pain. There are few times in life when we are more vulnerable, when we are more hurt, than when we are grieving the loss of a loved one.
It’s not only in the loss of a dear one through death that we may find ourselves grieving and, consequently, at an increased risk for substance abuse or addiction relapse (1, 2). We may also find ourselves grieving the loss of relationships through divorce, estrangement, or separation. We may mourn the absence of a beloved family home to natural disaster, the loss of a promising career to a global recession, and even the loss of health following a medical diagnosis (3, 4, 5, 6).
Indeed, there are many reasons and occasions for grieving in the ordinary span of a human life. And that means that there are many periods in life when we must be particularly vigilant in protecting and preserving sobriety through self-care, social support, and therapeutic interventions. This article examines the relationship between grief and substance use disorder (SUD) and describes strategies you can use to maintain your sobriety while you navigate the grieving process.
(Dis)Comfort in a Bottle: The Dangers of Self-Medicating
There are few life events more stressful than grief. Studies show that when you are in mourning, your brain triggers the body’s stress response, flooding the body with cortisol and adrenaline and, in essence, entrapping you in a state of fight or flight. This, in turn, substantially increases your risk of potentially life-threatening illnesses, including heart attack, within the first two years of bereavement (7, 8). Thus, when you grieve, you are not only inevitably experiencing heartbreak, the deep sadness borne of your loss, but you’re also likely to experience intense anxiety and the symptoms associated with it, ranging from insomnia to loss of appetite to anger and irritability.
When you are in mourning, you are almost inevitably contending with one or more of the mental health challenges–depression, anxiety, and post-traumatic stress disorder (PTSD)–that are often the catalyst for the development of a new substance addiction or the relapse of an existing condition, as it is common for those who are grieving to look to alcohol or drugs to ease their pain and cope with their anxiety (2, 9, 10, 11).
Loss of Motivation Following the Loss of a Loved One
If you have ever been in recovery, you know that getting well requires grit, determination, and endurance. You have to be deeply committed to your recovery program. For that, you need motivation; you need a reason to resist temptation, to conquer the cravings, to face the physical and emotional pain that recovery requires you to confront and resolve. For many of us, our family and beloved friends give us a reason to get sober and remain that way, even when we can’t find the reason within ourselves (12, 13). When someone you love is lost to death, illness, or some other kind of separation, it can feel as if your reason and your purpose for getting well have gone with them.
But that’s not the only mechanism at play. The disease of addiction can also undermine your recovery in this most vulnerable of moments by playing on your worst instincts, your insecurities, self-doubt, and self-recrimination. There’s evidence, for example, that people become particularly vulnerable to substance misuse and relapse following bereavement because, first, the use of drugs and alcohol gives them a sense (albeit misguided) of control that the loss of the loved one has taken away (11). The same studies have also found that men, in particular, are more likely to turn to alcohol as a conduit for expressing their feelings of pain, grief, and anger following a loss (11).
Unfortunately, when you’re in mourning, the rage and hurt you often feel easily turn inward, becoming self-destructive. Indeed, when you are experiencing SUD or are at risk, the evidence suggests that you’re also highly vulnerable to what psychologists have termed non-suicidal self-injury (NSSI) (14, 15).
You may, for example, abuse drugs or alcohol as a means to punish yourself, particularly in response to the survivor’s guilt that so often accompanies the death of a loved one. This is an especially significant threat for caregivers who have lost a loved one to cancer or another prolonged illness, as well as for those who have experienced sudden loss to homicide or suicide (16, 17). In response to complicated and prolonged grief, you may, for instance, “give yourself permission” to relapse because doing yourself harm, especially the physical damage inflicted by overconsumption, feels “better” than the emotional pain of mourning.
Healing and Sobriety
Grieving never really ends. If you’ve lost someone, you know that you never stop missing them, that their loss leaves a void that can never be filled. But you do them no honor by compounding the loss, by lying down in the grave, literally or figuratively, beside them.
And you don’t have to. No, the pain of the loss will never entirely go away. But that does not mean that there can be no joy on the other side of mourning. It does not mean that there can be no fulfillment in the aftermath of grief. And it does not mean that attending to your own health and recovery is a sign you’ve forgotten them.
Quite the contrary. In fact, just because you have said goodbye does not mean that you can’t still find in your loved one the motivation to push through to sobriety. Indeed, there’s perhaps no better way to uphold their memory than let your life be an example of all that love, devotion, and commitment can achieve. Rather than throwing away the precious gift of life, you can learn to nurture and cherish your own.
What that means, in practical terms, is recognizing and addressing your particular needs as one who is navigating both grief and recovery. The good news is that there are proven therapies available to support your sobriety through the darkest of days. Indeed, mental healthcare providers and addiction recovery experts alike are increasingly recognizing the role of complicated grief in the progression, exacerbation, or relapse of SUD and are developing highly effective protocols for helping patients deal with complicated grief while maintaining their sobriety (1, 18, 19).
Depending on the needs, circumstances, and goals of the individual patient, treatment options might include combined pharmacotherapy and psychotherapy, including the short-term use of antidepressants and/or anti-anxiety medications to manage grief symptomatology, as well as talk therapy, cognitive behavioral therapy (CBT), and related approaches to facilitate behavior change (20, 21, 22). There is evidence that psychotherapeutic treatments can help those experiencing prolonged or complicated grief to grow from their loss (22), developing new resilience, improved emotional regulation, and better coping skills. In other words, patients learn to cope with their feelings of pain and loss in ways that honor the memory of their loved one, without resorting to alcohol or drugs to make it through the day.
How Bayshore Can Help
At Bayshore, our multidisciplinary team of addiction recovery experts is highly experienced in addressing complicated grief among those facing addiction. We also specialize in tailoring treatment protocols to the unique needs and goals of our clients, including offering, as appropriate, short-term pharmacotherapy in conjunction with individual, family, and group counseling.
Our caring team of physicians, counselors, nutritionists, and wellness experts is deeply committed to helping our clients find health, happiness, and healing on the other side of mourning. Contact us today to discuss how our Bayshore family can help you or someone you love.