Written by Granite Recovery Centers
Clinically reviewed by Cheryl Smith MS, MLADC
October 28, 2020

First responders experience an extremely high level of stress every day on the job. They are called to disastrous situations where they are tasked with putting their life on the line to ensure the safety of others. Not only is this incredibly taxing physically, but it is also mentally wearing. While training prepares them for the emotional wherewithal they will have to bring with them to work every day, over time the daily grind has a profound effect and can result in anxiety, depression, and PTSD.

With all these daily stressors, it’s no surprise that two such groups, Firefighters and EMS workers, are vulnerable to substance use disorders. As their professions call for them to be ready at any moment to run into a dangerous situation, they sometimes channel that same adrenaline into using a substance in an effort to alleviate the trauma and danger they have witnessed. The loss and heartbreak they witness are sometimes too much to take, paired with the long work hours and overnight shifts; and in order to cope, they turn to a substance. After a while, they can become dependent on it, their brain correlating relief with that drink or drug. Over time, it can turn into a vicious cycle and; later, an addiction they cannot control.

Studies have shown that firefighters deal with a large amount of sleep deprivation, which can change their thought processes and cloud their thinking. High-risk behaviors can stem from lack of proper rest, which can lead to binge drinking, excessive smoking, antisocial tendencies, and more. They are also pressured to exude the fearlessness that has been historically associated with their line of work, which includes masculine stereotypes that only serve to hinder their mental health. Rather than express their feelings of depression, exhaustion, anxiety, or symptoms of PTSD, they may not think they have any choice but to project confidence and well-being. This can result in even more subsequent substance use to keep afloat and to not appear tired or worn.

Addiction in Firefighters

About 58% of firefighters have reported to participate in binge drinking. Drinking usually stems from those who are seeking comfort, relief, or a way to relax and be social. When compared to the general population, the risks of binge drinking are much higher in firefighters. Not dissimilar to police officers, several social and psychological variables contribute to the increased rates of alcohol use; usually, acts of camaraderie and the idea of social gatherings to blow off steam involve alcohol, in some means or another. Typically, it will be described as a “cooling down” experience after the struggles of the day. According to a 2018 study, alcohol was the second most popular coping mechanism for firefighters.

Up to 10% of firefighters actively abuse prescription-only drugs, such as opioids. For those who turn to prescription drugs, it sometimes stems from a physical injury that occurred while working. Fighting fires is an incredibly dangerous pursuit, one that can result in burns, smoke inhalation, bodily harm from collapsing buildings. It may have begun as a safe, doctor-administered prescription for pain management, but it can quickly lead to purchasing illegal substances on the street as well as dependence, given the addictive nature of opioids.

The connection between sleep deprivation and the use of various substances is inextricably linked within the firefighting industry. Studies have been conducted to dissect their unhealthy and overworked schedules, showing that they have little time for rest. Essentially, a typical firefighter works a whole day straight (24 hours) and then has 2 days off (48 hours), which can be described as a chaotic schedule at best. They are constantly trying to correct their unnatural sleep habits, often reaching for substances that may either assist them in settling their mind to finally rest, or giving them synthetic energy to combat the sleepless days and nights.

Addiction in EMS/Paramedic Workers

EMS workers are exposed to many occupational stressors, similar to Firefighters. They are also known to work very long hours, resulting in lower quality of life and diminished physical health. They also experience severe trauma firsthand, such as child abuse, extreme acts of violence, and fatal injuries on the people they try to rescue. Just like Firefighters, the stressors of work seep into their personal lives and often result in anxiety, depression, and PTSD.

Roughly 80-100% of all EMTs and paramedics reported that they were exposed to these highly traumatic events, which is not surprising. Rates of PTSD among first responders are upward of 20%, according to this data.

It has been found that 40% of EMTs and paramedics have reported problems with drugs and alcohol. It should be noted that the study did not specify the degree of each individual’s drug problem. Nevertheless, the data proves that there is a causative link between stressful jobs and substance use disorders. In such a high-risk job, EMS and paramedic workers are expected to be “professional,” and to be able to remove themselves emotionally from the tragedies they will no doubt encounter. After witnessing so many, however, it is human nature that some will get to them.

In order to deal with the emotional and mental toll of bearing witness to these situations, they turn to drugs and alcohol to cope, just like Firefighters.

Signs of Addiction in Firefighters & EMS Workers

While it’s impossible to diagnose simply from speculating, there are signs you can look out for to help you determine if there is a problem. Some are behavioral, while others are physical signs that will be seen or witnessed firsthand.

Some behavioral signs to look out for:

  • Extreme mood swings
  • Depressed mood
  • Anxiety
  • Secretive behavior
  • Poor memory recall
  • Slurring speech
  • Falling short when on duty and neglecting responsibilities
  • Poor judgment
  • Impulsive behavior
  • Difficulty focusing
  • Antisocial behavior
  • Avoiding contact with superiors

Some physical signs that could be reason for alarm include:

  • Shaking of hands, tremors
  • Needle marks on arms
  • Slurring of speech or incoherency when speaking
  • Inability to hold a conversation
  • Difficulty making and/or maintaining eye contact
  • Jumpiness
  • Sleepiness
  • Notable mood swings
  • Stuttering or sudden disruptions in speech patterns

While firefighters and EMS do have more support in place now than they did 20 years ago, they are still considered high risk for substance abuse given the stressful nature of their everyday work. If gone untreated, coupled with the occupational hazards they endure, it can result in what’s widely known as “compassion fatigue.” This is when the EMS or Firefighter absorb the trauma they have witnessed so much that it impacts their perception of the world.

With environmental factors as well as the occupational stressors coming into play, firefighters and EMS responders will turn to substances also as a way to bond with one another or people outside of work in an effort to relieve stress. The team environment of these jobs can be beneficial in the case of an addiction, as the camaraderie will keep a support system in place. However, there is still a stigma around mental health, and if it could threaten a person’s job—even if it is threatening their ability to do their job—it sometimes goes unchecked.

Green Mountain Treatment Center’s Uniformed Professionals Treatment Program

Green Mountain Treatment Center is proud to offer specialized, tailored treatment for Firefighters and EMS personnel struggling with substance use disorders. Our drug and alcohol rehabilitation facility in Effingham, New Hampshire, offers extensive selections of therapies and program options that treat these individuals who have often experienced unique and traumatic experiences throughout their careers. Researchers have discovered that a profound number of First Responders suffer from debilitating depression, anxiety, and PTSD, which are often the link to substance abuse.

Our professionals are specifically trained to help guide Firefighters, EMS workers, and other uniformed service professionals in their pursuit of a life without drugs and alcohol. They will also delve into the other aforementioned challenges, such as anxiety, PTSD, and depression, to help you achieve a better and more fulfilling life.

Learn more about our Uniformed Professionals Treatment Program here.