Grief and Substance Use: A Thematic Synthesis of Qualitative Research

People who use substances are disproportionately affected by both death and nondeath losses and have vulnerabilities that can hinder the processing of the associated grief. While there is an established and growing quantitative research base demonstrating the complexities between grief and substance use, the qualitative literature remains fragmented. This study aims to systematically review the grief experiences of people who use substances to enhance understanding and inform service delivery. A systematic search of four electronic databases identified 18 studies, which were quality assessed using the Critical Appraisal Skills Program. A thematic synthesis was conducted which involved line-by-line coding of findings, development of descriptive themes, and generation of analytical themes. This process identified three themes: Locked in Loss and Addiction, Defeated and Defended, and Routes to Recovery. Findings highlight the reinforcing relationship between grief and substance use, identify grief responses relevant to people who use substances, and offer an aggregated insight into their grieving experiences. This has important implications regarding the integration and provision of grief-informed support in clinical practice.