Over 75,000 people died from opioid drug overdoses between April of 2020 to April of 2021, compared to 46,000 deaths in 2018 (CDC, 2021; Wilson et al., 2020). Left behind are family members, significant others and friends struggling with grief as opioid-related losses are highly stigmatized and disenfranchised. Theoretically informed by the model of resilience (Mancini & Bonanno, 2009), as well as the transactional model of stress, appraisal and coping (Lazarus & Folkman, 1984), this study examined the role of disenfranchised grief, social support, and coping in prolonged grief and posttraumatic growth among a sample (n = 159) of people bereaved by the loss of a family member, romantic partner or friend due to an opioid-related death. Together, disenfranchised grief, social support, and coping predicted 43% of the variance in prolonged grief and 36.6% of the variance in posttraumatic growth. Specifically active emotional coping predicted unique variance in both outcomes. Findings from this study have important implications for research and clinical practice to improve grief outcomes for this unique yet extensive population.