Author: Carole Trottere (source)
Thirty-three.
That’s how many friends, acquaintances, and clients Kurt Hall, 33, a former heroin user now in recovery for eight years, has known who have died from overdoses. Hall is now the Director of Operations at Hope House in Mt. Sinai, New York, a faith-based human services agency that offers residential and outpatient care for people in crisis.
How does such tremendous loss get processed? Or does it?
“It definitely felt like I couldn't talk about it with certain people,” Hall says. “I felt like I couldn't be open about it or grieve. It was almost like you had to pretend. By pretending, it did some weird thing in my head where I kind of switched it off.”
“People tend to compartmentalize and treat the grief separately,” says Dr. Victor Fornari, Vice Chair, Child & Adolescent Psychiatry and the Director of the Division of Child & Adolescent Psychiatry at Long Island Jewish Medical Center, including the Zucker Hillside Hospital & the Cohen Children’s Medical Center.
Hall, who has been in therapy for about eight years, says that grief and loss have been a common theme throughout all of it.
“A collective grief has befallen the country as a result of the decades-long American opioid crisis,” says Steve Chassman, LCSW CASAC, Executive Director of Long Island Council on Alcoholism and Drug Dependence.
Matthew Hubbard, 36, now in recovery, after 15 years of substance use, says he has known over 40 people who have died from overdose, including his best friend, Alex. Matt says he dealt with the grief and loss by getting high.
Now in therapy and living at Hope House, Matt is facing his grief and trauma. In the past, when he was in a rehabilitation facility, he says he found he had more in common with veterans and police officers.
“I've been through so much trauma that I found I had more in common with an Iraq veteran or a police officer than I did with a normal person,” he said. “I didn't realize I was that deeply psychologically affected.”
Not since the HIV/AIDS epidemic of the 1980s has a community of young people been so devastatingly hit by death among their peers.
Litsa Williams, MA, LCSW-C, and co-founder, along with Eleanor Haley, MS, of the online grief community What’s Your Grief?, thinks that both epidemics share many similarities.
“I think the HIV/AIDS epidemic and the opioid crisis share the fact that they have both affected a community of people who already felt stigmatized. They feel ‘othered,’ like people look down on them. Often, many of the people who are most impacted by the grief and loss of the opioid epidemic are people who are also using substances," Williams says.
The processing of grief among those “opioid epidemic survivors” can be a complicated one, as many of them were users and participated in very risky behaviors, or they may even be currently using. The stigma associated with drug use, either past or present, may inhibit grievers from sharing their feelings.
“One of the things that is unique about these losses is that people feel the stigma and they don't feel like they have the right to mourn as publicly or in the same way,” says Williams. “Their grief isn't seen, which translates to a huge number of people who just aren't connecting with services.”
Chassman adds, “It is vital that we extend these healthier opportunities as a means of offering support and acknowledging the collective grief and loss we are all experiencing as a result of 15-plus years of an opioid crisis.”
If a person with substance use disorder (SUD) shares their grief with a medical professional, there’s a good chance it may be ignored and overshadowed by the patient’s addiction, according to Williams.
One might think that losing a friend or loved one to an overdose or fentanyl poisoning would shock someone into sobriety. But that is not the case, she adds.
“When someone who is using loses someone, it often fuels them even further into that addiction because it is the way that they cope,” says Williams. “They feel so much shame because it should have been a wake-up call. They may think ‘How can I be out here using the day after my best friend died? What does that say about me?’”
“When I was shooting heroin, I did not care if I lived or died,” Hall recalls. “But I didn't want to die. I just wanted to escape how I was feeling. Now I have such a fear of dying and I don't know if that's attributed to everybody dying around me. There's definitely a part of me that asks, ‘Why did I make it and why didn't they?’”
Hall lost his good friend Jay two and a half years ago. Jay had been in and out of recovery for many years but shocked all those around him when he overdosed.
“I think about him every day,” he says. “Jay had a son named Reign, born after he died, so he never met him. I try to live the life that he will never be able to live. I don't know if you actually ever fully grieve at all. I don't think that there's a timeline for it.”
“I think people who've had serious adversity have to find a way to say, OK, I'm going to transform my adversity into a strength instead of denying it,” adds Dr. Fornari. “Instead of pretending, I'm going to wear it like a badge of honor. I'm going to try to help others. I think people can get enormous strength and meaning out of doing things that can be helpful to save other people who couldn’t be saved."
Hall says he finds gratitude in the fact that he is “one of the people that made it through.”
“I feel like it's my duty to share my story and to be somebody who doesn't get caught up in stigma and won't hide behind that. Rather than mourning the people that I've lost, I try to live the lives that they couldn't live,” Hall says.
“Moving forward, our responsibilities lie in our ability to acknowledge our collective grief and adequately respond by creating services to support our citizens, our families, and our neighbors,” Chassman says.