Grief, Loss, and Substance Abuse

Any discussion of relationships between and among grief, loss, and substance abuse must first begin with an overview of loss and the resulting grief. While grief is most commonly defined as an emotional response to loss, there are more wide-reaching consequences in one's life. Beyond emotional responses, there are [Page 431]social, physical, psychological, cognitive, and spiritual dimensions to consider. Significant loss affects holistic health, including the ability to manage emotions, to function within the social environment, to make sound decisions, and to engage spiritually to uncover or find meaning in precipitating loss.

Many discussions of grief, loss, and substance abuse take place within the context of death. Although death may be the most commonly referenced event leading one to grief, most people's lives are affected by grief and loss from a multitude of sources. In addition to the loss suffered through death, there is a broad range of adverse circumstances, life events, and transitions that often result in grief. The source of loss ranges from loss of employment (either voluntary or involuntary), loss of friendships, loss of beloved pets, loss of socioeconomic state, and loss of socioeconomic status through financial hardship or social isolation or ostracism.

Individual responses to loss are varied and unpredictable, depending to a large extent on a person's support system, coping skills, and life situation. An individual's grieving process is equally complex, influenced by such factors as personality, family, culture, and spiritual and religious beliefs and practices. Each of these elements plays an important role in how someone responds to loss and the grief that frequently accompanies the loss. The relationship between job loss and individual, social, and psychological problems is well documented by counselors and researchers. The potential for loss of income, socio-economic status, social network, and sense of purpose are numerous and potentially painful for many people. For people who lack resources and appropriate coping skills, the trauma of loss may lead to substance abuse.

In addition to personal loss, loss occurs on a larger, more public scale. Increased substance abuse sometimes results from the reaction of many people to disasters, armed conflicts, and other forms of mass violence. In a study following the September 11, 2001, attack on the World Trade Center, researchers estimated that within 5 to 8 weeks after 9/11, 265,000 people experienced increased use of alcohol and other drugs, with 226,000 consuming more alcohol and 29,000 abusing more marijuana.