Firefighters and first responders experience stress and trauma each day. The chances of developing an addiction or mental health issues increase the longer they work. Although it may not seem to bother them at first, over time, the trauma they witness can pile up until they are struggling to cope with what they see. With training, it helps them deal more effectively but does not completely gloss over the challenging experiences they have on the job. Substance use disorder (SUD) is one way some first responders cope with work stress. Due to feelings of shame, they are less likely to discuss it and more likely to hide it from loved ones.
Why Addiction Happens
Alcohol is a substance misused by first responders. There is a relationship between occupational stress and substance use disorder for some people. Lawyers and doctors are top of the list, along with first responders. Alcohol and drug use increase with this profession because there is so much stress on their bodies and minds. They work shifts, long hours, and generally feel they are on call all the time. When they are off work, it is hard to rest. Though people see the effects drugs have on them, nobody is physically immune to the dependence opioid drugs create.
Mental Health Disorders
Mental health is a complex issue for first responders. They often struggle with depression, anxiety, and PTSD symptoms from working with trauma victims. They may witness violence or disasters and need time to rest their weary souls but are called upon to keep going day after day. People who perform rescue and recovery duties typically experience stressors that impact their mental well-being. A number of factors play into this, including childhood trauma or abuse, genetics, age, and other complications. Rescue workers typically see things most people do not and are trained to handle these circumstances but they still can struggle with it over time.
Substance Use Disorder Indicators
Alcohol and substance use can show up at any time. First responders may use them before they start work, during shifts when times are slow or after work when they are off-shift to download and process. There may be a culture of drinking among first responders as a way to unwind. Look for ways to identify the signs of abuse:
- Slurry speech or stuttering for no apparent reason
- Dilated or constricted pupils that do not change when exposed to light
- Hyperactivity or energy
- Lethargy or lack of energy
- Mood swings
- Fear or anxiety that seems unwarranted
- Highly irritable, flying off the handle, or getting angry and snapping at people
In addition to these symptoms, a person may experience behavioral changes including difficulties making choices, needing redirection, struggling to deal with their daily work or life, and needing help with basic functions like hygiene and getting up to go to work. While first responders are more likely to abuse alcohol, prescription drug abuse is also a major issue among firefighters and first responders. It is common for first responders to obtain prescriptions for addictive painkillers. With the demands of the job, injuries, and mental health concerns, they are at higher risk for developing addiction simply due to access.
Shame and Stigma
The stigma around mental health and addiction can keep first responders from getting help. While some coworkers deal with their stress in other ways, perhaps some get lost in addictive patterns. The social stigmas associated with seeking mental health help on the job have negative consequences. Some of these include their supervisor treating them differently or co-workers perceiving them as weak and being passed up for promotions. There is a great fear they may not be able to keep working in their career if they share the struggles. The belief a supervisor or superior will look down on them or colleagues will not view them the same can hold someone back from seeking help. Reprisals are also a fear among first responders. A team environment and approach to care is always better. A person needs to count on the team for support but shame keeps them hidden. They do not wish to be seen as the weaker link, so they do not talk about it.
The benefits of treatment for first responders depend on the individual and the ability to seek help. If they can take time off and afford treatment, they are more likely to get help faster. New options including intensive outpatient programs (IOPs) are providing support for first responders who need help but cannot leave their jobs to get it. They can still work to maintain a balance of being on the job with being in recovery. The goal is to provide a safe space to be vulnerable and feel heard. If they feel they are able to cope and manage with recovery while working, they may be encouraged to do so. If not, they may need to take a short leave so they can focus on recovery and deal with triggers and cravings that may pop up once they transition back to work.
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