Grieving my child’s addiction

Substance use disorder is an equal opportunity disease. It affects all genders, races, ethnicities, and socio-economic statuses. No one is safe, not even the daughter of an advanced practice registered nurse and loving mother.

I have been a registered nurse for over 35 years; I help people and change lives for a living. However, the one life I cannot change, I gave birth to 31 years ago. Despite my advanced degrees, how do I, an expert nurse, reconcile that my struggling adult child is not able or willing to receive my help?

Substance use disorder is a disease of despair, bad choices, and alienation. Individuals with substance use disorder avoid despair by using substances, make bad choices to find those despair-alleviating substances, and, as a result, are alienated from family, community, and society. The Centers for Disease Control and Prevention states that as of 2021, 45 people die each day nationwide of a drug overdose, with overdose deaths being the leading cause of injury-related death in the United States. Drug-related deaths have increased exponentially over the past two decades and are continuing to rise. These statistics are staggering; however, they are especially detrimental if your loved one is at risk of becoming one of these numbers. Is it possible that on any given day, my daughter will be one of those 45 individuals who take their last breath? The thought alone stops me from breathing.

Grief is an all-encompassing acute pain that is attached to loss. While navigating my daughter’s addiction and grieving for a child who has not died, I find myself referencing Elizabeth Kübler-Ross’s five stages of grief from “On Death and Dying.” I spend time in each stage periodically, in no particular order, as my grief is not linear. My grief is a never-ending cycle—always in my periphery as I am grieving my daughter even though she is very much still here.

1. Denial: I am not in this stage often, but I was in this stage frequently when I first found out about my daughter’s substance abuse. I do not consider myself naïve, but I wanted so desperately to believe that my daughter was either not addicted, handling her addiction, or was remaining sober. As I became an expert personally and professionally on the physiology, signs, and symptoms of a substance use disorder, it was harder to deny. Denial can be a protective emotion—a defense mechanism that allows more time to process what is happening. Moving away from this stage is complex as we begin to feel and acknowledge the sorrow, anger, and shame.
   
   
2. Anger: A natural stage of grieving, anger is also a protective measure that manifests due to losing control over what is happening. When denial is no longer working, anger takes over. This new reality is very emotional, uncomfortable, and hard to comprehend, and anger becomes an easy outlet for these problematic feelings. My education and knowledge of this disease are not able to combat these intense feelings. This aggression can often help the griever feel more in control and less helpless. I occasionally travel through this stage of grief as it is so incomprehensible, unfair, and unjust that my family, myself, and my daughter are enmeshed in a substance use disorder. Anger is not always pretty, and it is directly connected to shame—a distressful feeling caused by regret and disappointment. For quite some time, I was ashamed to admit that I had a child with substance use disorder. I kept the secret close, only sharing it with family and a few close friends. I felt as if it was my daughter’s story to tell, not mine. Over time, however, I began to more openly talk about my daughter’s struggles and its effects on my daughter and our family. The more I shared the sorrowful tale, the more people I met who were touched by substance use disorder, too, and who wanted to share their stories with me. Releasing anger and shame by telling my story allows me to manage my anger and lessen the pain.
   
   
3. Bargaining: The bargaining stage often becomes an opportunity to gain control or postpone grief. As you attempt to gain or maintain control, bargaining may briefly avert sadness. I used bargaining to try to explain what could have, should have, or can be done to change the outcome and manage my pain. In this stage, my mind wanders back to contemplate the past and what could have been done to change the current situation. Worrying, overthinking, ruminating, and wishing for a different outcome can be all-consuming during this phase of grief. When bargaining does not work (and it does not), depression occurs.
   
   
4. Depression: This is perhaps the most challenging stage and often the quietest. I work two fulfilling nursing jobs and build relationships with students, friends, patients, and their families daily. I love my jobs and family; laugh and smile often; raise and cherish my grandson; celebrate holidays; and feel joy daily. Nevertheless, at any given moment, depression descends. It is the over-arching umbrella that covers my existence. This is the most challenging stage of grief, as it can cause hopelessness and disconnection. I visit the depression stage most often, and it requires intense personal work, meditation, deep breathing, strength, and support from my family and friends to move through it each time.
   
   
5. Acceptance: The National Institute on Drug Abuse defines addiction as a chronic, relapsing brain disorder characterized by brain circuitry changes and compulsive drug seeking despite adverse consequences. Accepting this definition is an enigma to me—I am unable to accept that my daughter is in the throes of this life-threatening disease. What I can accept is that I cannot get well for her. My love, advanced degrees, nursing expertise, hopes, and dreams cannot heal or treat her. I can accept that this is her disease and not mine and that she must be ready to receive treatment and help. I can accept that my daughter’s substance use disorder is a part of my life, but I must still be able to live a life with joy and abundance despite the devastation that substance abuse can bring. The act of acceptance has helped me not to enable my daughter as she settles into her substance abuse. I want to save her, support her, and fix her. Acceptance is the acknowledgment of the facts of this disease and stops me from getting in the way.

As the mother of an adult child with substance use disorder, grief is an unending cycle. Being an advanced practice nurse with comprehensive knowledge of substance use disorder does not mitigate this sadness. Traveling through these five stages of grief helps to make sense of this devastating disease and provides guidance and understanding of the complicated emotions associated with it. Grief is a common human experience. However, the grief accompanied by substance use disorder is a loss unlike any other. It is the grief of my child living in a life-and-death situation with the possibility of dire consequences. It is complex, scary, frustrating, sorrowful, and hard to explain. It is driven by fear, sadness, loss, an unending mother’s love, and the hope of new beginnings.