Grief Meets Stigma

Grief is difficult enough when your relationship with your loved one was generally healthy, you had a chance to say goodbye, make amends, or just say ‘I love you’ one last time. The pain of it is overwhelming; at times, unmanageable. 

When you add stigma to the experience of grieving it makes makes it exponentially more difficult to manage. 

Stigma can simply be defined as being ‘othered,’ or viewed negatively by people, systems, or organizations and is manifested in overt behaviors or subtle language. The stigmatization can be formalized for example, only given two days of bereavement time after the death of a spouse or parent or terminated from a job. Or informally expressed in language used by those who might think they are being supportive. 

Stigmatization of grief often results in disenfranchised grief which proceeds hand-in-hand with complicated grief; known to increase symptoms of depression, mental health illnesses, alcohol and/or substance use, as well as impact physical health, ability to perform at work and overall life satisfaction. 

Grief can be a tsunami in someone’s life and if they do not feel that they can reach out for help from people, organizations or systems then that will almost always worsen the impact of grief. 

Stigmatization affects people inwardly and outwardly.  It can translate into the inability to attend funeral services or have acknowledgment of the importance of that person in your life. For example, one member of a gay couple dies and the family does not want it known that their child was gay so introduces the partner as a “friend” or ignores the partner completely. 

Or a child or sibling dies from a drug overdose the parents or family might blame the child’s partner for the overdose (particularly if both had a history of use). If the couple lived together in the deceased house/apartment the family might refuse to allow the partner to take any remembrance, or have any of the ashes (if they are cremated) or even have access to the home to retrieve their own possessions. They might take possession over animals that were shared. 

A partner in an affair who loses their lover but who cannot outwardly grieve. Cannot attend any of the services, and might have difficulty explaining to people why they are unable to be part of the communal rituals. 

Stigmatized grief, disenfranchised grief and complicated grief are all difficulties often endured by those who are addicted to substances or are working towards their recovery. The opioid epidemic has created a grief epidemic that is mostly born by stigmatized people. The addict, the substance user, the one struggling in their sobriety needs a space to grieve their losses. And in the opioid epidemic the losses continue to rise. 

If one person you cared about died every year for 5 years it would be overwhelming; almost impossible to recover from. Imagine if almost every death was stigmatized — they were using drugs, opiates, heroin, fentanyl — ‘it was bound to happen.’ Imagine if every death was one you couldn’t share with family or friends because they would point to your own struggle with substances, maybe your own continued use of opiates. 

My goal is to give those struggling with addiction the safe place to talk about their grief and how it is affected by their addiction. In the next couple of months me and a colleague of mine will be starting a drop-in grief group in Niagara Falls, NY for those in addiction or in recovery from addiction in order to give them a safe and supportive space to process their grief. 

#griefepidemic

The fact that there is an opioid epidemic in the U.S. is not news. However, the grief epidemic that reverberates like aftershocks from an earthquake does not get much attention. 

Should it? 

The Center for Disease Control reports that over 702,000 people died in the U.S. from drug overdoses between the years 1999 and 2017. In 2017 alone, the estimate is 70,000 people died from overdoses of substances. 

Let’s assume an average of 5 people were significantly impacted by the death of each of those who died in 2017. That is approximately 350,000 that have been affected by those overdose deaths. 

That is a grief epidemic. 

Photo credit: Sydney Angove

Grief isn’t just about funerals, cemeteries, tears and sadness. Grief can negatively impact physical health, mental health, work productivity,and  relationships. 

Also, there is some research that supports the theory that experiencing grief increases the risk of addiction or relapse and while the understandable focus has been on how to stop the deaths, maybe we also need to provide assistance for this specialized grief both individually and as a community at large. 

I’ve tried to find some other historical phenomenon or event that is similar to this one. The only thing I can think of is the AIDs epidemic or war. The sheer number of deaths and the devastation on those left behind. 

Would a national memorial project similar to the AIDs Quilt Project help? Would it give people a public arena to express their grief? 

At this point in time I have more questions than answers. Do we make a grief group part of regular substance use treatment? If we did, what would it look like? If someone does not want to grieve in a traditional way, how can we encourage someone to do that, knowing that it helps so many others. 

What about the children? The highest rates of deaths from opiate overdose are between the ages of 25 and 54. I don’t have a source to support it but wouldn’t that be prime child-raising years? How many children have been left behind to grieve their mother or father from overdose? How will that affect them over the course of their life? 

So many questions…