Drawing on our sample of 106 bereaved individuals, this chapter explores the impact of a substance-related death. Such deaths were often experienced as traumatic due to distressing and sometimes unexplained/suspicious and complex circumstances surrounding the death. Interviewees reported complex feelings such as relief or guilt. Additionally, anger and resentment could arise towards others who were involved or present at the death. In the aftermath of the death, official processes and professionals could exacerbate interviewees’ distress. In navigating an unfamiliar and confusing system, many interviewees perceived themselves to be on the receiving end of insensitive, judgmental and abrupt responses from police, pathologists, coroner (England) or procurator fiscal (Scotland) and newspaper reporters. Arranging the funeral shifted the focus from deceased to bereaved, with those that provided funeral care, such as undertakers and clergy, commended by interviewees for their sensitive, discrete and respectful approach. Following the death and further down the line, interviewees received support for their bereavement from various sources, including family and friends, professionals, workplace colleagues, spiritualists, local or national organisations or community groups dedicated to the support of people affected by substance use. However, interviewees could also experience a lack of support, characterised by insufficient, insensitive or hurtful responses.