Losing Someone to an Overdose: Grief, Stigma, and Finding Support

If someone you love died of an overdose, you may be grieving a person who struggled, a relationship that had its own history, and a loss that some people around you don’t know how to speak about. You may also be facing judgment you don’t deserve. This guide explains what research shows about this kind of grief and where to find support. It doesn’t discuss substances, amounts, or how anyone died, and it uses language that respects the person who died.

If you are having thoughts of ending your life, please call or text 988 (the 988 Suicide & Crisis Lifeline), or call 911 in an emergency.

How common is this loss?

Very. A nationally representative survey led by Johns Hopkins researchers, fielded in spring 2023 and published in JAMA Health Forum, found that about 32 percent of U.S. adults knew someone who had died of a drug overdose, and 18.9 percent said the person was a family member or close friend, an estimated 48.9 million adults. A separate nationally representative RAND survey, published in the American Journal of Public Health, (a survey of 2,072 adults, published in February 2024) found that 42 percent of U.S. adults said they had known someone who died of an overdose. Surveys word their questions differently, which is why the numbers differ, but both show that millions of people are grieving.

The lead author of the RAND study told PBS NewsHour that overdose bereavement is neglected in scientific literature and in conversations about the broader overdose crisis. PBS reports that stigma, along with a lack of resources tailored to survivors’ sometimes complex grief, continues to shape the experiences of the people left behind. A Johns Hopkins researcher noted that although large numbers of adults are bereaved by overdose, they may not be as visible as groups who have lost loved ones to less stigmatized health issues.

What does research say about grief after an overdose?

Less is known than it should be, but some findings are clear. One Norwegian cross-sectional survey of 234 bereaved family members, including parents, siblings, and children, after drug-related deaths found that 26 percent had high levels of prolonged grief symptoms, using a cutoff the authors describe as preliminary: 31.2 percent of parents, 21.8 percent of siblings, and 20.9 percent of children. The authors note that stigma surrounding this kind of death may complicate bereavement.

Researchers at Stanford and RAND describe this grief as compounded by guilt, shame, stigma, and isolation, along with adverse substance use and mental health outcomes. That is a reason to look after yourself and to accept help, not a prediction. They are also testing a peer grief support model for overdose bereavement. It’s described as a promising practice that hasn’t yet been rigorously tested, so there is no proven treatment to promise you, but support can still matter.

Why is there so much guilt and stigma?

Because many people ask “could I have done something?” and because society often judges both the person who died and their families. NIDA explains that stigma about addiction can portray people with a substance use disorder in a shameful or negative way, and that it can prevent them from seeking treatment. Families can feel those judgments too. You may have spent years trying to help, and still be asked what you did wrong. Guilt, anger, sorrow, and love can coexist.

If you’re unsure whether you could have prevented the death, a counselor can help you carry that question. See complicated grief and the glossary entry for prolonged grief disorder if your grief feels stuck.

What language respects the person who died?

NIDA recommends person-first language, which focuses on the person and not their illness. It suggests saying “person with a substance use disorder” and avoiding terms such as “addict,” “drug abuser,” or “clean,” which can carry shame. You can say your loved one “died of an overdose.” You get to decide how to describe the person you lost, and you can gently correct others who use words that hurt.

What should I tell people?

It’s your choice. Some families speak openly about an overdose, hoping to reduce stigma; others share only with people they trust. Neither is wrong. You don’t owe anyone an explanation. Our guide on what to say to someone grieving a suicide loss includes a lot that applies here too, including not asking for details and not disappearing.

Where can I find support?

• GRASP (Grief Recovery After a Substance Passing). Weill Cornell Medicine’s program for substance use and stigma describes GRASP as created to offer understanding, compassion, and support for those who have lost someone to addiction and overdose, and notes that anyone who has lost a loved one this way knows society treats the loss differently
• A counselor or grief therapist experienced with traumatic or stigmatized loss; see finding grief support
• SAMHSA’s National Helpline: 1-800-662-HELP (4357), free, confidential, 24/7, in English and Spanish, for individuals and family members facing mental and/or substance use disorders; TTY 1-800-487-4889
• 988 Suicide & Crisis Lifeline: call or text 988 if you’re in distress or thinking about harming yourself

If you’re unsure whether the death was intentional, or you think it may have been, suicide loss resources can help too, including AFSP and Alliance of Hope; see why suicide loss feels different.

What if I use drugs, or I’m in recovery, and a friend died?

You’re grieving too, and you may be overlooked. A qualitative study of people who use opioids found a high prevalence of overdose deaths in their social networks, yet only one participant reported receiving grief support. Please consider reaching out: SAMHSA’s helpline can refer you to support and treatment, and 988 is there if you’re struggling. The Stanford and RAND researchers note adverse substance use outcomes among the bereaved, so getting support early matters.

HHS notes that naloxone is a safe medication that can reverse an overdose from opioids, and it points to where to get naloxone and how to use it. If someone in your life uses drugs, it’s worth knowing where to find it.

What happens in the first days?

The process resembles other unexpected deaths. In Texas, for example, an inquest is required when a person dies an unnatural death (Code of Criminal Procedure Art. 49.04), and a county medical examiner may produce a report, including a toxicology report if ordered. Texas’s death registration handbook says that if the cause of death is pending investigation, the certificate is filed marked “Pending Investigation,” so final paperwork can take time. See what families face in the first days after a suicide for a fuller description of police and medical examiner procedures, which are similar, and coping with sudden or traumatic loss.

See also support groups for suicide and overdose loss, writing an obituary after a suicide or overdose, and life insurance after a suicide.

This is general educational information, not medical or mental health advice. Research on overdose bereavement is still developing, and the processes described for investigating a death vary by state and county. If you are in crisis or thinking about harming yourself, call or text 988 or call 911.