Monday, January 17, 2022

Surviving A Sibling’s Overdose Death

Much like suicide grief, there is a complexity in overdose deaths in that people feel like the death was somehow preventable.  ~ Litsa Williams

A reader writes: My sister died unexpectedly from a drug overdose. She'd been off and on drugs since she was 13, but she was one of those very cool, very intelligent, very functional addicts (did I just call my sister an addict?). She got into some trouble last April and moved to live with other family so she could get clean. And--she DID! She was doing great! Had a great job, was enjoying life, it was all good! We had become close again and talked at least once a week.

 Two days before she died she called me and talked to me all the way to work. She sounded good and I was happy to talk to her. She was telling me about this great girl's weekend she had planned with some girls from work, and how they were going to party and see some friends.

This was a lie. What she did instead was to get a hotel room for the weekend with her ex-boyfriend. He arrived on Friday, and hours later she was dead from an overdose of Methadone.

I feel guilty, I feel abandoned, I feel angry that she did this, I feel angry because the people in the cubicle at work next to me are laughing, I'm devastated for my family because I KNOW they’re hurting so badly, I feel so unbelievably sad, I feel heartbroken....I've never had my heart shattered like this. I feel crazy, borderline insane. I don't concentrate on my work anymore which I used to take pride in, I'm late every day, I have no energy, and EVERYTHING reminds me of my sister. I love my husband but can't stand him, I just want to crawl into bed and sleep for the next 6 months. I have three kids and they seem to keep me distracted some of the time....I know I'm rambling but I can't stop. I'm sooo, soooo, soooo sad. I'm already on Prozac, which helps...but I shouldn't be so anxious.

Anyway, I’m writing to you because I need to know: Am I insane? When will the pain stop...or at least become manageable?....

I miss my sister soooo unbelievably much! I love her, why, why, WHY DID SHE LEAVE US????? WHY DID SHE LEAVE ME??? I'm an ONLY child now!!! Who will be there for me when our parents are ill and eventually pass? Who will I turn to???? I'm simply devastated.

My response: My heart just aches for you as I read your message ~ I am so very sorry for your loss, and I can only imagine the depth of the shock, anguish, hurt, anger, guilt, sorrow, anxiety, confusion and everything else you must be feeling in the aftermath of this horrible, unspeakable tragedy. 

I can only tell you that you are NOT “insane,” because everything you are feeling right now is normal. Surely if I were in your shoes, I probably would be feeling and reacting much the same as you are now. 

Your grief is complicated by all the circumstances surrounding your sister’s death, and as you continue to sort through all of this, it is extremely important that you don’t try to bear the burden of this loss all by yourself. In addition to seeking the help of your primary care physician, a qualified grief counselor, grief therapist and/ or an "in person" grief support group, you might consider joining our online Grief Healing Discussion Groups, which include a forum for Loss of A Sibling, to get your concerns and feelings validated, and to get some support as you struggle to make some sort of sense of all of this.

In addition to the assurance that this tragic death most certainly is not your fault, I want to suggest that you visit the Suicide Loss page on my Grief Healing Web site, which contains a number of links to relevant resources that you may find quite useful in this situation. See especially Grief Support for Survivors of Suicide Loss. Even though a death related to an overdose may be accidental, it is a suicide nonetheless, and the issues for the survivors of such a tragic loss are very much the same. You might want to explore some of the sites listed here as well: Coping with Traumatic Loss: Suggested Resources.

Afterword: Something you said is really giving me a hard time. We don't really consider my sister as having committed suicide... I guess "technically" yes she did, but I've never heard of an overdose without a note left behind as being ruled suicide. The medical examiner did not rule it as such, so why would we consider it that way? Your words here have brought on a new realm of thoughts for me. And why do you say that it's important to understand this death as a suicide? This perspective is intriguing to me and never crossed my mind until you stated it. I'm not responding to the suicide thought negatively because I don't think it's that far-fetched. Aparently more was going on with my sister than my mother or I could have EVER imagined for her to do this in the first place.

My response: Please forgive me if anything I’ve said has added to the “hard time” you’re already having ~ that was certainly not my intention. I hope you'll permit me to have another go at what I was trying to say to you in my earlier response. When I said that “even though a death related to an overdose may be accidental, it is a suicide nonetheless, and the issues for the survivors of such a tragic loss are very much the same,” I wasn’t speaking as a medical examiner determining the official cause of your sister's death, or from a legal standpoint. I was speaking as a grief counselor hoping to explain why this kind of death may be especially difficult for survivors to process. 

My point was that your sister did not die of natural causes (e.g., of a heart attack, of a stroke or of cancer, or of some other terminal disease), nor as a result of homicide, or a natural disaster, or anything else that was outside herself or completely beyond her control. Rather, your sister took a more active part in whatever may have caused her death. This is what sets your loss apart from other kinds of loss, and may serve to explain what could be fueling your anger and complicating your reactions to it now. My comment was meant only to help you begin to make some sense out of this tragedy and your reactions to it, and to explain why I would point you (and anyone reading this) to resources aimed specifically at helping with suicide and traumatic loss.

Read this author’s comments about complicated grief associated with substance abuse: 

If there was a problem of alcohol or drug abuse in the life of the deceased, you may have added issues to deal with. Substance abuse often creates discord within a family that will negatively affect relationships. Given time, your loved one might have gained control over his or her addiction and resolved the problems created by it. Deprived of that time, this person may have died with the problems unresolved, leaving you with conflicting feelings of anger, perhaps, and sorrow, not really knowing how you should feel . . . In cases like this grief is certain to be complex. If you are mourning the death of a loved one under such circumstances, think for a moment of the extra issues you have to deal with in addition to the death. Write your issues down so you can look at them, one at a time. Getting them down on paper will help you become more objective about them, and it also will make those issues less powerful and more manageable for you. If you have enlisted the help of a therapist, he or she can be more helpful when you have these particulars clearly in your mind . . .   Helen Fitzgerald, "Complicated Grief: Substance Abuse," in The Mourning Handbook  

The anger that you feel toward your sister is certainly understandable, but it can eat you alive unless and until you find an outlet for it, and a healthy way to process it. Anger is sheer, raw energy, and it can be put to good use or bad. If it’s used to hurt yourself or others, it’s bad. On the other hand, if all that anger-energy is used in a positive way, it can be harnessed and channeled to change things for the better. You can use the energy of anger to push yourself to change things and find better ways of coping. But if you don’t express it, if you let it build up inside of you, as the saying goes, "like cement, it can harden and become very hard to break." 

You can let your anger out in healthy, non-destructive ways that will bring no harm to yourself, to others, or to anybody’s property. Find a safe place, space, activity and time where you can let your anger out (through physical exercise, hobbies and crafts, music, writing, talking with someone you trust who won't judge you, asking others for support rather than expecting them to know what you need from them, etc.) 

As I think you've already discovered, pounding out your anger on your computer keyboard can be an extremely helpful and appropriate way to discharge some of that energy. The online forum I mentioned above is there for you to do just that, 24 hours a day, seven days a week. Use it to rid yourself of some of that rage. You will be harming no one, and there is not a person there who will judge you for doing it.

Afterword 2: Marty, I appreciate your guidance on the suicide perspective. I've done some research and I do relate to some of the things I've read. My sister did take an active role in her death, even if it was accidental...and of course we don't know that to be true. Her death certificate did say "drug abuse, Methadone and indeterminate intent."

Your feedback is welcome! Please feel free to leave a comment or a question, or share a tip, a related article or a resource of your own in the Comments section below. If you’d like Grief Healing Blog updates delivered right to your inbox, you’re cordially invited to subscribe to our weekly Grief Healing NewsletterSign up here


Image by Steve Buissinne from Pixabay
© by Marty Tousley, RN, MS, FT, BC-TMH

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