One of the prominent theories in explaining how families are affected by a relative’s substance misuse is the ‘Stress-Strain-Coping-Support’ (SSCS) model. This proposes that when someone misuses alcohol and/or drugs, families are exposed to common but extreme stress, which can have a major impact on them and which can be influenced by a number of factors such as understanding, coping and support. However, this model has not yet considered those who are subsequently bereaved through substance use. This chapter explores how the model can be applied to, first, family members and friends who experienced the subsequent death of their loved one and, second, their bereavement experience after the death. In both cases we also consider how the model needs to account for diversity through reference to a number of groups in our sample. There are two main conclusions to the chapter. First, that before the death of their loved one our interviewees were usually exposed to multiple stressors, often over long periods of time, as a result of their relative’s or friend’s substance use. These experiences align closely to the wider literature in this area and confirm that the SSCS model can be extended to describe the experiences of those who are subsequently bereaved through substance use, although we suggest some additional components to the model. Second, the SSCS model can be used to describe the post-death bereavement experiences of our interviewees, which were often a natural and inevitable extension of the difficulties they faced before the death. Although much of what we suggest here are new ideas that require further investigation, enhancing understanding in these ways is critical in considering the most appropriate support which is needed by those who are bereaved through substance use.