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The Unique Grief Around Substance Use Disorder

By: Liz Falstreau, Community Education and Advocacy Manager
September 16, 2026

Nearly 19 million children were estimated to be living in a household with at least 1 parent with Substance Use Disorder, accounting for one-quarter of all US children in 2023. That is 1 in 4 children in the U.S. navigating the nuances and uncertainties that can come with witnessing your loved one or caregiver struggle with addiction. The pain and fear of “what if?” is what makes the grief around substance abuse so unique.

“Will mom get up from her nap today?”

“I hope grandpa doesn’t forget to pick me up again.”

“My brother is doing so well, I hope he doesn’t relapse and go away again. I miss him when he is gone.”

Young people in these situations have to grow and learn at school while navigating a world where they have to grow up faster than the rest of their peers. Conversations on social media and the news around substance use disorder can also weigh on a child’s mind­, with the comments and anger from strangers overloading their thoughts. This complex and nuanced disorder can be difficult to talk about even between compassionate adults. So how do we support the kids who are facing this reality?

In our Rainbows groups, we see the toll these situations can take, and the blame that a child can internalize if not given the chance to talk and work through their feelings. There are many resources out there, but we have seen the most valuable are community and comradery. These children may not have lost someone, but they know what it feels like to be angry, sad, loved, confused, embarrassed, and even guilty the way a child who has experienced the death of a loved one might feel.

May we all seek ways to assure these youth that they are not alone and embrace families who are navigating the nuanced journey of substance use disorder.

To help families and young people living through this experience visit Prevention First for many helpful resources.

Here we have outlined a few resources to get you started:

Sesame Workshop Video- Parental Addiction

Healing Through Art NOCoA’s Guide for Supporting Children and Teens Impacted by Family Addiction

Lessons Learned: Talking to Young Children about a Loved One’s Substance Use

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