Ask Dr. Bob: Substance Abuse Problems

BY: Robert Ballantine, MSW, DCC, D.MIN., LISW-S

CATEGORY: Grief and Loss

​Dr. Bob,

My wife died five years ago. This was the most painful experience I have ever had in my life. The depth of the pain and the duration of the pain made daily functioning unbearable. To handle the pain, I started to have a drink in the evening. This seemed to help. Soon it was two drinks, then, in a very short period of time it was a fifth-plus a day. What started out to be helpful ended up being harmful. All I wanted to do was numb the pain! I now have been clean for six months and I am ready to deal with the death of my wife in a positive way. -- Clean for Six Months


Dear Clean for Six Months,

Unfortunately, your story is not uncommon. You are so right when you described the intensity of the pain that accompanies a significant loss. As you mentioned, you were only trying to "numb" the pain. This is understandable, but caution needs to be taken on how we numb it. The American culture tends to grasp at anything that can provide a "quick fix," but using the wrong "fix" may result in long-term consequences. That is true with substance use. When substance use turns into substance abuse, it can complicate one's grief journey and one's life.

For many the journey with substance use started or increased after an intense loss. For others whose substance use already had control of their life, a significant death may not have seemed as important to them as its continued use. Therefore they did not feel the impact of the death when it happened. Also, it's not uncommon for families to avoid telling a user about a significant death because of how substance use has negatively affected the user's behavior and/or family relationships. As one becomes clean, the loss becomes real and a delayed or complicated grief can set in. The pain increases when other issues surrounding the death surface, issues such as feelings of guilt or the desire to restore relationships.

If an individual has been clean for a short period of time and their only coping method in handling pain has been substance use, we may want to consider delaying grief work until other ways to cope have been developed and they are involved in a substance abuse program. It is important to have developed positive coping skills and have a strong support system in place before dealing with the difficult issues of grief. For those who have been substance free for an extended period of time, they are at risk for a relapse when a significant loss occurs. Their grief journey should be monitored, and interventions set in place to help them maintain their positive coping skills.

You can cope poorly for reasons other than substance abuse, but, if you notice that your use is increasing or the pattern of use has change, don't ignore it. I can't overemphasize the importance of developing and using positive coping skills rather than relying on substance use or other efforts which hurt you rather than help. Assistance is available. Seek it out. Grief counseling is one way to accomplish this. A grief counselor will be able to help you in identifying and developing good coping skills.

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