Substance Abuse

Substance abuse is a serious problem that affects many people, but especially those who work in high-stress and traumatic situations, such as first responders. First responders are the professionals who respond to emergencies, such as firefighters, police officers, paramedics, emergency medical technicians, 911 dispatchers, and emergency room personnel. They are exposed to life-threatening situations, human suffering, and death on a regular basis, which can take a toll on their physical and mental health. According to some estimates, 30% of first responders develop conditions that include depression, anxiety, and post-traumatic stress disorder (PTSD), which put them at a greater risk for substance use disorder⁷. 

Substance use disorder is a condition in which a person has a problematic pattern of using alcohol or drugs that causes significant impairment or distress. Some of the common signs of substance use disorder are: 

- Craving or strong urge to use the substance

- Difficulty controlling or stopping the substance use

- Continuing to use the substance despite negative consequences

- Developing tolerance or needing more of the substance to achieve the same effect

- Experiencing withdrawal symptoms when reducing or stopping the substance use 

The most popular substances of abuse by first responders are alcohol, prescription opioids, and benzodiazepines¹. Alcohol is often used as a way to cope with stress, relax, or socialize with peers. However, excessive alcohol consumption can lead to various health problems, such as liver damage, cardiovascular disease, and cancer. It can also impair judgment, coordination, and reaction time, which can compromise the safety and performance of first responders. Prescription opioids are painkillers that are prescribed for injuries or chronic pain. They can be effective when used as directed, but they can also be addictive and cause respiratory depression, overdose, and death. Benzodiazepines are sedatives that are prescribed for anxiety, insomnia, or seizures. They can help calm the nervous system, but they can also cause dependence, memory loss, and increased risk of falls and accidents. 

One of the main reasons why first responders struggle with substance abuse is the exposure to stress and trauma. The repeated exposure to traumatic events can cause psychological distress, such as flashbacks, nightmares, intrusive thoughts, emotional numbness, and hyperarousal. These symptoms can interfere with the ability to function normally and enjoy life. Some first responders may turn to substances to escape, numb, or control their emotions. However, this can create a vicious cycle, as substance use can worsen the symptoms of trauma and increase the risk of developing PTSD⁸. 

Another factor that contributes to substance abuse among first responders is the lack of adequate recovery and support. First responders often work long hours, irregular shifts, and have little or no time to rest and decompress. They may also face stigma, isolation, and fear of losing their job if they seek help for their mental health or substance use issues. Many first responders do not receive adequate training, education, or resources on how to cope with the stress and trauma of their work. They may also lack access to affordable and effective treatment options that are tailored to their specific needs and challenges. 

The good news is that substance abuse among first responders can be prevented and treated. There are several steps that can be taken to help first responders cope with the stress and trauma of their work and reduce the risk of substance abuse, such as: 

- Increasing awareness and education on the signs and effects of substance abuse and mental health disorders among first responders

- Providing regular screening, assessment, and referral for substance abuse and mental health issues among first responders

- Creating a supportive and non-judgmental work culture that encourages first responders to seek help and support when needed

- Offering peer support, counseling, and debriefing programs that allow first responders to share their experiences and emotions with others who understand

- Implementing policies and practices that promote wellness, resilience, and recovery among first responders, such as flexible schedules, adequate rest, healthy diet, exercise, and hobbies

- Providing access to evidence-based and trauma-informed treatment options that address the underlying causes and consequences of substance abuse and mental health disorders among first responders 

Substance abuse among first responders is a serious and complex issue that requires attention and action. By recognizing the problem, providing the help, and supporting the recovery, we can help first responders overcome their challenges and live healthier and happier lives. 

Source: Conversation with Bing, 11/18/2023

(1) undefined. https://sobernation.com/addiction/first-responders/.

(2) Help For First Responders Struggling With Drug Abuse Or Mental Illness. https://liveanotherday.org/resources/first-responders/.

(3) undefined. https://www.addictioncenter.com/addiction/emergency-responders/.

(4) . https://bing.com/search?q=substance+abuse+among+first+responders.

(5) Addiction in First Responders & Firefighters - American Addiction Centers. https://americanaddictioncenters.org/rehab-guide/firefighters-first-responders.

(6) Substance Use Disorders in First Responders - NAADAC. https://www.naadac.org/assets/2416/aa&r_winter2020_substance_use_disorders_in_first_responders.pdf.

(7) First Responders & Substance Use Disorder | Bicycle Health. https://www.bicyclehealth.com/blog/first-responders-substance-use-disorder.

(8) Alcohol and Substance Abuse Among First Responders. https://bulletprooffirstresponder.com/alcohol-and-substance-abuse-among-first-responders/.