What Do You Say at the Funeral of Someone Who Struggled with Opioid Addiction?

I’m reading a Chicago Sun-Times column entitled “What I’ll Tell My Kids Someday About Drug-Addicted Uncle They Never Knew.” Author Stefano Esposito’s brother, James, died in a car accident at age 28. Stefano’s sons are ages six and one. He wonders how he will describe his brother’s death to them when they are older.

James’ death was caused by a collision into a concrete embankment. Stefano believes the accident was influenced, or perhaps caused, by James’ substance abuse. James had a history of heroin abuse. It sounds as if James made a good effort to stop his opiate addiction. He relocated out of state to start a new life, without easy access to drugs. We can’t know by the news story if James had found sobriety. However, the implication is that he had relapsed because he was in contact with his ex-girlfriend and that another presumed drug addict attended the funeral.

James was described as a sweet kid who made friends easily. He was well loved. At the funeral their mother said trembling “He was my son, and I loved him.” Stefano will tell his sons that he loved James, but wonders whether he could have done more to help him. He is angry for the pain James caused. He is also angry that his brother will not be available to help Stefano when he grieves their mother’s death. Stefano will tell his sons that James never met him, never hugged them, and would never know the joys of being a father because of drug addiction. Stefano’s greatest fear is that drugs will take his son’s lives.

Could Stefano have done more to help him? I don’t have knowledge of what efforts were made. I do know that he can do more to honor James’ memory.

So, what could Stefano say of his brother’s death? I would encourage Stefano to say that his brother was a wonderful young man. I’d recommend that Stefano tell the stories they shared as brothers, as is common in a celebration of one’s life. I would say that he was not only sweet, but resourceful, brave and motivated for change. James went to great lengths to find sobriety by moving out of state where he presumably had few friends or family.

I would recommend that he tell his sons that James had a disease, not unlike other diseases like diabetes or cancer. I would explain the nature of addictions and describe an automatic feedback loop in his brain that causes cravings for more drugs, against his better judgment. In fact, addiction impairs judgment, memory and reasoning skills. I would tell them that there are medications to treat opioid addictions, like Methadone and Suboxone. When coupled with counseling, countless people find sobriety.

I would educate his sons on opioids, which include heroin, as a class of drugs that are different from other substances. Other substances, such as cocaine and methamphetamine, are easier to stop. Those drugs are primarily psychologically addictive, whereas opiates are physically addictive. Withdrawal from opiates can be so severe that the user will do just about anything to avoid the symptoms. I would explain the swift progression of opiate dependence, in that someone can quickly become addicted from medically prescribed pain killers. I would tell them that if a patient is abruptly cut off from their prescription, they may turn to heroin which is cheaper and easier to access.

I would tell the story of the expansion of opiate use in the US when drug manufacturers heavily marketed pain killers to the medical system, falsely claiming that they are not addictive. I would say that 115 people a day are dying of an opioid overdose, partly due to this false misrepresentation.

I would talk about sadness over the loss but I would not be quick to express anger. No one sets out to become addicted. I would also tell his sons that sometimes accidents are just accidents, and correlation is not causation, and we’ll never really know what happened to cause James’ death.

I would ameliorate the stigma of addiction and celebrate a life that was more than one dimension. There was much, much more to this young man than a substance abuse problem. He deserves the same respect at death as one who dies of diabetes or cancer.

I would talk about James’ death with love and respect and utilize it as a learning tool for his sons.