• First Responders & Addiction: How Addiction Affects First Responders

First Responders & Addiction: How Addiction Affects First Responders

Table of Contents

Firefighters, Policemen, EMTs, Emergency Room Physicians, and other emergency personnel and first responders can experience stress and trauma in their day-to-day lives. Being exposed to accidents, responding to overdoses, and witnessing traumatic events can become mentally and emotionally draining. This can lead to high rates of substance misuse and addiction within the lives of these honorable men and women.

According to the US Firefighters Association, as many as 10% of firefighters may be misusing substances. It’s also estimated that alcohol misuse among firefighters is more than double that of the general population. Another study conducted by the National Institute on Alcohol Abuse and Alcoholism found that of police officers working in urban areas, 11% of male officers and 16% of female officers reported alcohol use levels deemed “at risk.” Findings from another study found that 36% of EMS workers suffer from depression, while 20% of EMTs suffer from PTSD. This can increase the risk of developing a substance use disorder.

What Substance Use Disorder Looks Like in First Responders

There are often times that first responders who are suffering from substance use disorder show signs of stress in the way they communicate, act, and interact. These symptoms may present as hyper-vigilance, emotional detachment, and irritability. Additional signs and symptoms can include:

  • Decreased interest in family life or social settings
  • Heightened depression or anxiety
  • Disregard for protocol and work duties
  • Difficulty submitting paperwork or reports
  • Decline in work performance
  • Unable to accept one’s own responsibilities for his or her actions
  • DUIs or other legal troubles

Drugs of Choice for First Responders


Alcohol is the most widely used drug among first responders. Drinking can be a way of relieving stress and coping with exposure to traumatic situations at work. Drinking can also become a way to develop camaraderie. If drinking becomes the primary way of coping with stress or connecting with others, it can increase the risk of developing a use disorder.


Tobacco is the second most widely used drug among first responders, with 18.4% of firefighters using smokeless tobacco. In addition, 16.7% of police officers smoke tobacco, which is higher than the 13.5% of the general population who smoke.

Prescription Medications

Prescription drug use is also a major issue among first responders. Due to the increased physical demands of their careers, first responders can often be prescribed medications with high risk of dependence or misuse. These may include opiates for pain or benzodiazepines such as Xanax or Ativan for anxiety or sleep. While appropriate use of these medications can be helpful, there is risk in relying solely on medication to address underlying mental health issues. If opiates or benzodiazepines become the primary way of coping with stress or trauma, it can increase risk of developing a substance use disorder.

Addiction Risk Factors for First Responders

Experiencing Trauma

One of the highest risk factors for addiction in the first responder community is the experience of traumatic incidents. Being a first responder means confronting violence, injuries, and even death. This can lead to feeling overwhelmed, stressed, and isolated. Substance use is a common way of coping with trauma.


For firefighters and EMTs especially, on-the-job injuries can occur on a regular basis. An estimated 58,250 firefighter injuries occurred in the line of duty in 2018. Oftentimes after these injuries, doctors will prescribe opiates to relieve short-term pain. When not taken as prescribed, first responders may be at risk of misusing opiates as a way to find psychological or emotional relief from stress or trauma experienced at work.

Family History

Genetics can play a large role in contributing to substance use disorder. First responders, therefore, maybe be at higher risk of developing a substance use disorder if there is a family history of addiction.

Mental Health Issues

Being a first responder is considered a “high-risk” occupation, in that the risks of physical and mental health issues are greater. With frequent exposure of traumatic events, emotional and mental health can be significantly impacted. It is estimated that 30% of first responders develop conditions that include depression, anxiety, and post-traumatic stress disorder (PTSD), which put people at a greater risk for substance use disorder.

First Responder Addiction Treatment

It can be difficult for first responders to accept help. Fear of judgment, refusal to show perceived weakness, and the mistrust of medical professionals can create barriers to asking for and accepting help. The stigma of mental health and addiction issues can also be an obstacle to seeking treatment, and lead people to minimize substance use or mental health issues in order not to draw attention.

Being a first responder is an incredibly honorable and courageous profession. As the first one on the scene helping those that are suffering, who is helping you? Reaching out for help can be hard, but one of the most courageous things you can do.

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Addiction Resources for First Responders

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