Chapter 2: Why your grief may be different
Lack of understanding
I knew they were having a lot of pain and trouble with their back, but I didn’t realize that they were taking such strong medication. I often wonder if they knew the risks of taking that kind of medication and what would happen if they took too much.
There needs to be more public education about drug use and addiction. No one gets up in the morning and says, “I want to be addicted to drugs.”
He started drinking at a young age. There was a lot of pressure to be cool, but then it became an everyday thing. It was a way of life for him until he got sick, but by then, he felt like he couldn’t stop.
When someone dies from their use of a substance, you may be left with many questions and a desire to understand what happened. You may find yourself struggling to understand why someone would use a substance in a way that is known to be harmful. You might wonder how something that can result in death could be so accessible. You might not understand how this could happen if it was the person’s first or only time. You may be dealing with questions about this yourself, or you may be facing other people’s lack of understanding or judgment.
People of all ages and from all walks of life can die from substance use. There are many reasons why people use substances and why death may occur as a result. These deaths are often traumatic for friends and family.
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People who are faced with challenges to their physical health may use substances. When suffering from a painful injury, for example, a person might be prescribed an opioid to treat the pain and then subsequently become dependent or addicted. Someone who is living with chronic or debilitating physical conditions may use substances to help manage or relieve their symptoms.
People who are faced with mental illness or other mental health concerns, including those that are undiagnosed, may use substances to help manage or relieve their symptoms. Someone who uses substances may also develop mental health challenges as a result of that substance use.
For some, experiencing trauma can be a contributing factor in substance use. For those living with the effects of trauma, substance use may be a way that they try to cope with or manage their experience.
The ongoing stress of being unhoused and without financial resources can contribute to a person’s use of substances. For some who are vulnerably housed or homeless, use of substances may be for reasons of safety to guard against increased risks of violence (e.g., staying awake at night to protect themselves).
Youth, in particular, may try or use substances out of natural curiosity or to “fit in.” There may be a sense that some substances are harmless because they are commonly used or easily accessible.
All substances have the potential to cause death. Sometimes, a combination of substances taken together causes a person’s death. For example, if alcohol is consumed with certain medications or “street drugs” or both, the combination can be fatal. The simplest explanation for why a death occurs is that the amount or strength of the substance(s) was more than the person’s body could manage.
The use of some substances has become the norm, and consumption is sometimes expected in modern culture. Alcohol, for instance, is legally available and advertised as a way to have fun, escape your worries, and relax with friends. Use of some substances has become common in different settings, leading many people to feel a sense of familiarity or comfort with the substance, although there is still a risk for harm.
A well-known class of drugs called “opioids” can be deadly because of their high potency. Opioids can sometimes be undetectable by taste, smell or sight and they have been found in many illicit or street drugs. With these highly toxic substances in the illicit drug supply, deaths are happening in greater numbers.
When someone develops a physical dependence on or addiction to a substance, they will continue to use a substance compulsively, despite the problems or harmful consequences that may result. This compulsion is often in order to avoid the unpleasant symptoms and the experience of withdrawal. Addiction can cause changes in the brain that impact thinking, personality, and behaviours.
The unsafe use of needles can cause diseases such as HIV, hepatitis B and C, and endocarditis (heart infection). Ongoing substance use may cause other life-limiting illnesses including cardiomyopathy and liver cirrhosis, which can eventually cause death.
Poverty, inadequate housing, social isolation, mental health concerns, and poor access to appropriate healthcare reduce a person’s life expectancy. These may have occurred because of the person’s ongoing substance use, or they may have contributed to it in the first place.
What may help
- Acknowledge the complexities involved in substance use. This can help you to understand that there was more than one reason for the person’s death.
- If you want to deepen your understanding about the challenges associated with substance use or about your grief, consider talking with associates and friends of the person who died or joining a bereavement support group specific to substance-related deaths. This can also be a valuable opportunity for you to talk about the person who died.
- Reflect on the circumstances of the person’s life and on ways these might be affecting your grief or that of others. For example, you might have become exhausted by your efforts to help the person over a long period of time.
- Try to recall parts of the person’s life apart from their substance use. What did you appreciate about them? Who were they to you?
- You may be feeling too overwhelmed right now to do much, and that’s okay. Give yourself time and allow yourself to try different strategies so you can find what works best for you. Keep in mind that what works now may not be what you need in the future.
