Substance Abuse Issues Among First Responders 

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Substance Abuse Issues Among First Responders 


Most people do not encounter real disasters at work every day. However, first responders deal with disasters all the time. Firefighters, police, paramedics and other paramedics are the first to arrive at traumatic scenes. 

Because of their unique job duties, first responders face unique mental health issues. For example, many emergency room patients may have symptoms of opioid addiction or another drug or alcohol use disorder. Substance abuse is a major problem for emergency workers, and many factors contribute to this problem. 

Stress and PTSD  

Perhaps the most important risk factor for addiction in emergency room patients is stress and post-traumatic stress disorder (PTSD). These professionals often witness fires, violence and medical emergencies, and these emergencies can result in trauma. 


Not all ED patients experience PTSD, but they are at greater risk for the disorder than the general population. Symptoms of PTSD may include: 


Reliving traumatic events with flashbacks and nightmares 

  •  easily agitated 
  •  insomnia 
  •  guilt 
  •  Depression 
  •  anxiety 
  •  panic 
  •  persistent stress disorder 
  •  constant exposure to stress 
  •  persistent irritability. causes unpleasant physical and mental symptoms. 


The effects of stress can increase over time. 


Both PTSD and chronic stress can increase a person’s risk of substance abuse, as some people use drugs and alcohol to self-medicate or to avoid symptoms. 


Injuries and Chronic Pain 


Many first responders deal with chronic pain from work-related injuries, and their doctors may prescribe opioids for relief. Although opioids work well for pain, they are not intended for long-term use because they can become addictive. 


Long-term or even permanent injuries are possible for the paramedic. Using opioids to treat this long-term pain can lead to physical dependence on these drugs, which in turn can lead to substance abuse and addiction. 


Wakefulness and rest 


In addition to chronic stress, a paramedic must be awake for long periods of time. When first responders are on call, even if they are not responding to an emergency, they must always be prepared for the possibility of disaster. 


Because of these constant “alert” feelings, first responders can have difficulty fully relaxing, even when they are not on duty. Although the logical side of the brain knows when work is done, the nervous system can remain awake and unable to let its defenses rest or sleep. 


As a result of this vigilance, some first responders may turn to drugs or alcohol to relax. 


Additionally, because they are often expected to work long shifts, first responders may be at high risk for stimulant abuse. Studies have found links between amphetamine abuse and working long hours, especially when the long hours involve a lot of physical work. Some people use stimulants to stay awake and focused during shifts, and many develop addictions as a result. 


Mental Health Stigma 


Although first responders face many mental health issues, they also deal with the stigma associated with mental health issues. Many first responders expressed fear in the survey that seeking mental health help could negatively affect their work. 


In the case of mental illnesses such as depression and anxiety, this stigma can lead to people abusing alcohol or illegal drugs instead of seeking treatment. As with PTSD, emergency room patients may use drugs and alcohol to treat other mental health symptoms. 


In particular, addiction has been associated with strong stigma even outside the first aid workplace culture.


Availability of drugs 


Availability of drugs is one of the many risk factors for addiction. Those who have easy access to drugs are more likely to show signs of drug addiction. Many first responders come into contact with medications on a regular basis. 


Police officers can, for example, confiscate illegal drugs at work or find drugs in evidence storage. However, it is easy for EMS workers and other medical professionals to obtain prescription drugs. 


Coping with Addiction as a First Responder 


If you are a first responder dealing with addiction, finding treatment is the most important thing you can do for your health. Since your work is focused on helping others, you may struggle to seek help for yourself. But remember, the healthier you are, the more effective you will be at work. 


Some treatment centers have programs specifically for emergency patients, and many programs deal with PTSD and other mental health issues besides addiction. Start by talking to your doctor about your concerns or searching for treatment centers in your area.

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