By Murphy Vestute, MS, RMHC, CGRS, and Jodi MacNeal


Losses are more than just deaths.

People in active addiction lose far too many friends to drug overdoses. We would never let that painful fact go unacknowledged. But for so many people entering treatment for addiction, grief from a lifelong string of losses fueled the need to drink or use in the first place.

People in recovery face subtle, unrecognized losses every day:

  • Loss of the drug itself
  • Loss of the rituals around getting and using the drug
  • Loss of the people you drank or used with, and loss of sober friends and family
  • Unresolved losses from the past

Adding grief therapy to the treatment plan addresses what Mark Sanders, LCSW, CADC, calls a “long, unwritten legacy in the field of addiction treatment, which suggests that clients should leave all other problems at the door until they have dealt with their addiction first. As the field matures, we are discovering that many clients cannot recover unless we are able to address a number of their problems simultaneously. Grief is often one of those problems, as acute pain around losses seems to resurface as soon as clients stop using.”

It’s frightening and uncomfortable to confront loss and grief while in treatment without the numbing effect of drugs or alcohol. In many cases, it’s the first time in years – maybe the first time ever – a recovering addict examines a life’s worth of losses and the accompanying emotions. It’s brave and courageous work.

And while you don’t have to do grief work to get better or to stay clean or sober, those who’ve done the work often come back later and report that it helped. In grief recovery work, we’re trying to say goodbye to the pain related to the loss, so the wounds don’t keep reopening. Success means resilience, and the ability to navigate new losses as they occur.

Loss of the drug

In her book, Addiction and Grief, Barb Rogers writes: “My friend is gone – the friend who got me through all the bad times, who was there for me whenever I needed help. Tears run down my face. Great sobs wrack my body… Can I really be grieving a bottle of whiskey?”

You can. Even though you’ve willingly walked away from that bottle, or that needle, or those pills, it’s still a loss. You still feel the pain of that grief, and you still mourn.

The substance has been the constant. It’s been there to provide escape or pleasure. It’s been like a lover, preoccupying your thoughts and filling your days and nights. Its absence leaves a profound sense of loss and grief, including the realization that you no longer have that escape to look forward to.

One young therapist had each person in her small group write a goodbye letter to their drug. “It was so moving,” she said. “It felt like they were letters to people. One person wrote, ‘I needed you. It felt good, and comfortable. You made me feel like everything was OK, but I didn’t realize how much damage you were doing. Now I have fatty liver and I’m dying, and I realize how much you hurt me, inside and out.”

Loss of rituals

People in active addiction spend hours every day acquiring and using their drugs. For some, it means planning ahead so they can shoot up before getting out of bed. For others, it means getting through the day at work by looking forward to getting drunk at night. Once in recovery, those rituals have ended and they’re faced with this daunting question: “How am I going to fill my time?”

Part of the loss of rituals involves the loss of freedom, the freedom to do whatever they want with whomever they want, whenever they want. This can feel stifling for a person who’s become unaccustomed to having little or no responsibility. Grief work helps that person see that freedom is available in other healthier ways.

Loss of people

People are powerful triggers. Very often, the only way to escape relapse is to avoid contact with the friends you drank or used with or the boyfriend or girlfriend who got you hooked. As once-addicted people step away from the drug community, it’s natural to mourn the relationships that must end if the person is to remain sober. Often, we meet people who have experienced family losses – through death or estrangement. Even the pain of romantic breakups can linger, causing the person to get stuck in their grief and turn to drugs or alcohol to numb the pain. As they complete their loss inventories, clients often are astounded at the number of personal losses they’ve experienced. One young man’s list was so long, he laid it out on the floor endto- end and looked up in disbelief. “This explains so much,” he said. “No wonder I’m using.”

Losses from the past

Why revisit old losses – like sexual trauma, abandonment, and abuse – in grief work? Rebecca Williams and Julie Kraft address the question in their book, The Mindfulness Workbook for Addiction: “Loss compounds loss… It’s as if those old wounds are simply covered over with a thin layer of scarring, only to reopen as soon as another loss hits, and then they begin throbbing and bleeding all over again. Lasting recovery requires healing at the source.”


Grief is a normal and natural reaction to loss. It is not a pathological
condition. It is not a personality defect. Grief comes to us all. As
a culture, we’re given so little education about how to handle loss.
Time does not heal – only what you do with that time does. That’s a
powerful message for people in recovery to hear.

Murphy Vestute, MS, RMHC, is a Certified Grief Recovery
Specialist, a primary therapist at Desert Rose Palm Beach, and
owner of A Place to Heal Counseling, LLC


Jodi MacNeal is creative director at Desert Rose, a gender-specific,
long-term outpatient treatment center in Palm Beach Gardens,
Florida. Soul-Centered Treatment™ at Desert Rose addresses past
hurts and losses. Learn more at or
call 561.459.8951.