Families and children who have experienced the death of someone important in their lives due to substance use disorder, have a unique set of needs. Along with the trauma of the death itself, the stigma surrounding both grief and the disease of addiction adds layers of complication to this life-changing event.
As many of us are aware, opioid use and substance use deaths are on the rise and overdoses more frequent.Therefore, the number of kids who are affected by a substance use death is rising as well.
No two families are the same: In some cases, children have witnessed addiction up close for many years and some adapt by becoming “adults” before their time. They may have adopted the role of caregiver to a parent who is struggling with the disease of addiction. Some children become overly responsible, goal-achieving and hyper-vigilant about potential risks in their environment. Sometimes their education is interrupted and learning challenges may become apparent including a broad array of symptoms from attentional issues to behavioral challenges. Some families develop a culture of secrecy which can make the death harder for children to talk about and understand.
Grief Response: Grief is not something to “get over” but something that we experience in different ways throughout our lifetimes. In my role as a grief support counselor, I have developed strategies that use a trauma-informed model based on the following R.I.C.E. method. It is important for the children and families in this situation to feel: Respected, Informed, Connected and Empowered.
The information below is meant to provide some insight and ideas on how to support a child who has experienced the death of a loved one from the disease of addiction based on this model.
This is a confusing and difficult time for you and the children. Even if they don’t have all of the information, they are most likely picking up on changes in routines, family interactions, and different displays of emotion. Here are some ideas for acknowledging these changes with respect.
- Practice patience and compassion and develop routines. Keep in mind that all children need limits, structure and boundaries, even in the most challenging of times.
- Understand their development: Children’s concept of death and response to grief changes as their brain develops. Understand their response to grief and ways to support them based on their age. Developmental Grief Responses & 10 things grieving children want you to know.
- Funerals: There are many age-appropriate ways to involve children in a funeral. Some families want to “shield” their children from the pain of a funeral. But many kids benefit from being included. Perhaps they could write something to be read or draw something to be shared. Maybe they could help select the music. More on Youth and Funerals
- Respect the Memory: Be open to talking about the person who has died and to keep the memory of that person strong in your hearts. Camp Erin can be transformative for children.
Respect Links: For more information on how addiction affects families: Family Roles and Family Rules
Many families struggle with how to inform their children about a substance use death. Again, there is no right or wrong way to do this, but the following guidelines may be helpful.
- Prepare: Take a moment for yourself before you talk with your child. Take a couple of deep breaths. Think about what you are going to say. Mindfulness S.T.O.P. practice for focus.
- Practice patience and compassion: Be prepared to repeat things several times. The concepts of death, addiction and substance use are challenging for all of us to comprehend. Most children will not “get it” the first time it is discussed. Think of these “repetitions” as opportunities to remind the child that he/she is loved, safe, brave and kind.
- The Truth: Always speak the truth, in an age-appropriate way. Remember that, often what a child has imagined or heard from others can be almost worse than the reality. Given the amount of information that is available from social media, they may know more than you think they do and/or they may be misinformed. Talk about addiction as a disease, just like cancer or heart disease. Blame the illness of addiction, and not the person, for the death. Use facts: “Daddy died from an illness. That illness is called addiction.”
- Answer questions: Children may ask about medicine and alcohol. What you can do:
- Teach children how to take medicine properly, how to follow directions and how to read the label.
- Do not tell children that vitamins or medicine are candy, to get them to take it.
- Make sure children know only to take medicine or vitamins from a parent or another trusted grownup.
- The National Association for Children of Addiction has a helpful question and answer resource here: NACOA
More Resources to Support this Conversation: Understanding addiction (site for kids) , 'The Highjacker' Video, How to teach children about the brain, That's Right: Addiction is a disease, How to talk with kids about addiction
Above all, children need to feel that they are loved, that they are safe and that they are important. As difficult, heart-breaking and unfathomable as this is, it is also an opportunity to build connections and reinforce what is important in your family. Perhaps taking the time to sit with a child will give you comfort as well.
- Lead with Love: Always reassure the child that they are loved, that the person loved them and that the illness and death isn’t their fault.
- Emotions are high: Tell your child that they may notice adults acting differently. You may say, “You may see me crying sometimes. I know you aren’t used to seeing me cry. I want you to know that everybody cries. I am OK, though, and crying helps us to release emotions.”
- Continue to connect: Begin and end each conversation by emphasizing that the child is loved and safe. This can’t be said enough! Check in with the child to see how they are doing after the conversation. “That was a really hard thing to talk about. I wonder how you are now? What might help you? Shall we take a walk, or just sit quietly for a few minutes?”
- Seek Support: Look for local support resources. Ask for help. Seek connections within your community. Support can also come from unexpected places such as school, places of worship, clubs or teams.
Connect Links: Eluna Resource Center(search for local programs) Addiction Resource Center, Grief Recovery After a Substance Passing (GRASP), Camp Mariposa, Grandparents raising grandchildren, Compassionate friends, Alateen
You are going through something that is difficult. You can give children and yourself the tools that you need in order to survive this situation. Here are some ways to empower yourself and your family:
- Mindfulness: Practice taking some deep breaths, or mindfulness exercises. Three Mindfulness Activities for kids.
- The Seven C's: Post the Seven C’s in your home or office. Children are not responsible for the family member’s substance use and they can focus on healthy coping skills. I didn’t CAUSE it…
- Model Self-Care: It is important that you are kind and patient with yourself and get support. Children will notice and learn from this! They will be encouraged to know that you are taking care of yourself. This will help them to feel safe. Try getting some fresh air everyday: walking or exercising. Stay hydrated. Practice some deep breathing exercises. Try These
- "You are safe" So much of the work with these kids is to make them feel safe. Reassure them that you are healthy and safe and that you will be there for them if they need you.
- Provide Tools: Children will be asked some tough questions. Give the child “scripts” so that they can be prepared in different situations when asked questions. Perhaps you can write some scripts yourself. We have created some scripts for children here: Scripts for Kids
- Prevention: Learn more about how you can break the cycle of addiction in your family. Prevention is an important part of this process for any child. Prevention Resources
Empower Links: Our Children are the Victims, Partnership for Drug-Free Kids