Alcohol Abuse Among First Responders
As the name suggests, first responders are the front-line men and women called into action to address a number of emergency situations. The “first responders” umbrella term typically includes: police officers, emergency medical technicians (EMTs), fire fighters, and dispatchers. By occupation, these individuals are traumatized daily which often leads to a progressive and problematic relationship with mood altering substances, in particular alcohol.
Trauma, Mental Health, And Alcoholism
Traumatic events and psychological well-being are closely linked. Experiencing trauma causes emotional, physical, and physiological symptoms known as acute stress reaction or “Flight, fight, or freeze.” Symptoms of acute stress reaction typically include increased heart rate, blood pressure, and respiration, sweating, and muscle tension. These symptoms are caused by a release of stress hormones like cortisol and adrenaline. Experiencing symptoms of acute stress reaction for a prolonged period of time can impair daily functioning and progress into the mental health disorder known as Post Traumatic Stress Disorder (PTSD). The symptoms of PTSD can be debilitating. Whether it’s an event early in life, military/combat experience, or trauma on the job as a first responder, PTSD can lead to unhealthy coping habits associated with alcohol.
Co-occurring PTSD And Alcohol Use Disorder
The extreme stress and trauma associated with first responder positions predisposes them to developing PTSD. Loss of life of someone you’re trying to save, a coworker who’s making an arrest, or the collapse of a building you’re trying to evacuate can all serve as catalyzing events for the formation of a trauma-based disorder.
Studies focused on PTSD and alcohol use disorder found that as many as 52% of males and 28% of females with PTSD meet the criteria for alcohol dependence. When an individual experiences a traumatic event, the brain produces chemicals called endorphins that feel good in order to soften the psychological blow of the event. If the trauma is enough to cause lasting psychological damage, eventually the brain stops releasing endorphins and people go into what is known as endorphin withdrawal. Without the extra production of “feel good” chemicals, people can resort to putting external chemicals in their bodies, like alcohol and other substances in an attempt to manage their emotions or to sleep or to just feel “normal.”
EMTs And Alcohol Use Disorder
Medical emergencies, stabilizing wounded people, and transporting them to the nearest hospital for treatment all fall under the responsibilities of EMTs and the emergency medical services (EMS). Any incident from car accidents to attempted suicide requires EMTs to race in and perform their duties. Frequent exposure to traumatic experiences like these puts the men and women of the EMS at high risk for an alcohol dependency.
Stress And Alcohol Use
Research shows that a job that exposes workers to consistent stress increase the likelihood that they will rely on alcohol as self-medication. These professionals pull long hours performing emotionally and physically draining work. EMT work provides consistent stress and the traumatic events that can lead to PTSD and another leap in risk for alcohol dependency. Pile on top of these health issues, the increased likelihood for depression and common occurrence of sleep deprivation, EMTs are a very vulnerable population.
EMTs in particular suffer with higher rates of substance abuse when compared to police and firefighters. No solid research has discovered exactly why, but some professionals speculate that the nature of medical emergencies is more consistently traumatizing than law or fire related issues. Also, with a stock of available drugs around, EMTs have easier access.
Firefighters And Alcohol Use Disorder
Similar to EMTs, firefighters struggle much more than average citizens with alcohol dependency. A survey in 2015 found firefighters:
- Drink more often than average
- Drink a higher volume than average
- Binge drink more than average
In each of these categories, the fire service drinks far more than the average person. Firefighters binge drink nearly double the national average. There’s no one explanation for why firefighters drink, but symptoms of trauma, like night terrors and sleep deprivation, are common complaints. Researchers also suggest that drinking is used as a means for building camaraderie between people in the fire service.
Police And Alcohol Use Disorder
The patterns of drinking present in the police force are similar to those of the fire department. Much higher than the national average, and due to job stress as well as social pressure. All first responders exhibit drinking due in some way to job stress and police are no different. Frequently navigating dangerous, sometimes life-threatening situations put them at risk for mental health issues, including alcohol dependency.
Surveys throughout the 2000s turned up a significant social factor as well. While firefighters drink to facilitate camaraderie for the most part, surveyed police officers reported feeling pressure to drink in order to fit in. Over a third of the officers included in the study reported an aversion in the force towards non-drinkers. Police that don’t drink are thought of as anti-social and untrustworthy.
This social dynamic within the police force reinforces problematic drinking social conformity. Officers report spending a significant portion of their free time socializing with coworkers because of the close bonds formed in the line of duty (shared trauma), the feeling that nobody else understands them, and being alienated by the friends and family that they had prior to getting on the force.
Treating First Responders
Unfortunately, even though these men and women sacrifice their health in order to help maintain the world we live in, the treatment available isn’t scaled to match the issue at hand. While some treatment centers offer first responder and veteran catered programs, the number of responders in need far outweighs their options. Given the necessity of their position, many people working these jobs may not feel like they can feasibly attend outpatient rehab, let alone spend a month in inpatient rehab. Expanding the conversation about early intervention and alcohol dependency in first responders could give people the options they need to lead a healthier life as an emergency worker.
Addressing The Issue
If you or a loved one identify with these issues, please reach out to a treatment provider for help. The issues faced when responding to emergencies can be singularly difficult to handle, but that doesn’t mean you have to face them as a single person.
Author: Michael Muldoon | Last Edited: August 4, 2021
Medical Reviewer: Dayna Smith-Slade