First responders are those responsible for taking care of the public in their worst moments. House fires, car accidents, violent home life, and medical emergencies are all situations first responders deal with. They are the firefighters, police officers, emergency medical professionals, and dispatchers. These services are necessary for any civilized community, but the importance of the job may overshadow the impact it can have on a person.

Constant exposure to terrible situations puts first responders at a higher risk of developing PTSD (Post-traumatic stress disorder) which, if not managed correctly, can lead to unhealthy coping mechanisms. While this could be as simple as an occasional drink, it has the potential to encourage more risky substance abuse including drugs and alcohol.

This article will outline the risks first responders face, the prevalence of substance abuse, and how to seek help.

Substance Abuse in First Responders

Many elements could fuel a substance abuse disorder in first responders. The culture itself creates silence when it comes to expressing the need for treatment or suspected abuse. For many in this field, developing any sort of mental health disorder from the pressure of the job implies they are not tough enough to handle the work. While this is false, it does not stop countless first responders from seeking unhealthy ways to unwind or manage the stress of the job.

Recreationally drinking in downtime could help manage the stress, pressure, or constant negative encounters a first responder has on the job. However, it poses several risks. When alcohol abuse ceases to work, an abuser may continue to consume more and more to find relief. This also puts them at risk of forming a physical dependence. Excessive drinking has many physical repercussions, such as liver disease, high blood pressure, stroke, and even various types of cancer. If the drinker is doing so to numb the pain of past trauma it is very likely they will not want to stop. It is important to recognize when abuse occurs and remember treatment is always available.

While drinking seems to be the more common route of many first responders, we should not discount those who use drugs as a means of coping. For some, they may have suffered an injury that is treated with pain killers. The relief could lead to continued abuse. In some instances, an abuser may even seek out illicit drugs to replace prescriptions if they develop a compulsive drug habit. If substance abuse is suspected there are a few signs family and friends can watch out for, such as:

• Worsening health problems
• Changes in personal appearance
• Lack of personal hygiene or altered grooming habits
• Hiding drug paraphernalia
• Memory loss
• Financial problems
• Behavior changes (including becoming withdrawn from others and change in work performance)

No matter the substance, first responders are at a higher risk of abusing it. While the culture of silence seeks to keep them self-medicating, it is completely possible to seek out supportive care. Many of the best ways of supporting a first responder come from understanding the root cause of the abuse.

PTSD in First Responders

PTSD can impact any first responder, from police officers to paramedics and everyone in between. They are twice as likely as the rest of the population to develop PTSD and other trauma-based mental health coditions. Given the intense situations first responders find themselves in over and over, it is not surprising some form of trauma is inevitable.

Whether it is witnessing horrible events, being put in life-or-death situations, or even physical trauma, first responders stand at a higher risk of seeking out substances to balance out the damage done to mental health. First responders with PTSD are 50-66% more likely to struggle with addiction for this reason.

For some, the use of alcohol or drugs could help numb the physical or mental pain. For others, it may act as a means of unwinding to get some rest. Whatever the case, PTSD is overly common among first responders. Those who suffer from it may show the following symptoms:

• Flashbacks or intrusive memories
• Avoidance
• Negative thoughts or mood
• Changes in reactions, physical and emotional
• Memory problems and amnesia

It doesn’t matter what causes the trauma, because once PTSD exists it can become increasingly severe if left untreated. Finding a healthy means of coping with it isn’t always easy. Many people with PTSD may not realize the extent of the trauma they suffer. It is important to try and understand trauma, as it can be the first step to find healthy methods of managing it.

Various types of PTSD manifest in different ways. Some of the most common types of PTSD experiences among first responders include:

• Re-experiencing a moment through flashback, night terrors, or delusions.
• Hyperarousal resulting in feeling on edge, intense anger, insomnia, or being easily startled.
• Avoidance by feeling guilt or depression, struggling to recall events, no interest in former hobbies, and avoiding places that might cause a reaction.

PTSD may seem daunting to manage, but it is possible through proper mental healthcare.

The Struggle with Mental Health

Mental health struggles affect more people than is commonly known. Due to several factors, such as culture, stigma, and social expectations, many do not seek out help to cope with mental struggles. While some face problems with money or resources, others refuse to admit there is a problem at all. This can not only lead to substance abuse, but also pushing away friends, family members, and other loved ones. For first responders, they may feel that their family members do not understand the struggles they face. Having this mentality can separate them from a crucial support system.

Culture and Mental Health

Culture refers to the views, beliefs, and values that form a society. These powerful forces can influence where a person seeks treatment when faced with addiction, mental illness, or substance abuse. For some it has to do with their religion, while for others their gender, race, or even profession can influence their choices.

While some first responders recognize the benefit of seeking help, some find it preferable to suffer in silence. This “silence culture” is formed around the thought that being tough for a tough job means never needing help. Some first responders may also think seeking help makes them less able to support the community they work for.

It is important to break this stigma of mental illness. It can prevent first responders from seeking help that may save their life in the end.

Mental Health Stigma in the U.S.

There seems to be a divide in the United States that implies many are supportive of those with mental health struggles, however, there are those who also think those problems wouldn’t bother a close family or friend. So, while much of the public thinks and supports people seeking help to manage their mental health, some don’t see the issue ever coming so close to their own lives. This stigma makes it difficult for those with mental health challenges to come to family or friends for support. Or at least it can seem that way.

Due to self-judgment and even depression, a person suffering from a mental health disorder may believe that if they reach out for support, they won’t get it. This feeds the negative stigma.

However, the Substance Abuse and Mental Health Service Administration (SAMHSA) aims to rid the U.S. of this stigma through peer support and inclusive social services for first responders. The hope is to increase understanding of mental health struggles and how they relate to addiction. This is done by providing individuals with a safe place to share experiences as well as a place for families to connect with others. All of this can help create a support system for substance abusers and those who struggle with mental health.

Mental Health Stigma and First Responders

While the stigma exists for much of the general population, first responders find that it is especially present for them. Whether it is self-imposed or the result of culture, mental health stigma in first responders can severely impact how well they do their jobs. Whether they see it that way or not, mental health is a burden that requires treatment. Many first responders want to simply focus on the job rather than their struggles. Some may believe that pulling the attention from the work they do is harming the community they serve.

What many should understand is this mentality could harm how they perform in their job by not operating at their full potential. It is important to break this stigma and encourage first responders to seek help with mental health and addiction.

Improvements Made in the Field of Mental Healthcare for First Responders

All hope is not lost for many first responders who feel like help isn’t accessible or easy to get. Some improvements have been made to support first responders and their struggles. The National Fire Protection Association (NFPA) has improved safety protocols for firefighters by adding a behavioral health chapter to supportive literature. While the move isn’t massive, it is a step in the right direction. The increased education and improved access to care and treatment for active and retired first responders can have important results down the road.

Common Mental Health Struggles for First Responders

This article has discussed various reasons why first responders may struggle with mental health. They see the worst of the human experience, from how humans interact with each other to how natural disasters can devastate lives. These experiences are not something many can just walk away from without carrying some part of that trauma home with them.

When you add long shifts, potential complications at home, and other personal issues, these mental health troubles can make life difficult. As a means of coping with struggles, many will abuse drugs and alcohol to help with a wide spectrum of mental health conditions, such as:

• Anxiety
  • If anxiety symptoms occur for longer than six months it can be diagnosed as a generalized anxiety disorder. This could be invasive to the sufferer, disrupting sleep or eating habits and encourage substance abuse.
• Depression
  • Can mean feelings of hopelessness, being lost, suicidal thoughts or behaviors, and other issues. Depression can range from mild to severe and can be made worse by substance abuse.
• Substance Abuse
  • Compulsive or recreational use can give the user temporary relief from the pressure they face, but the risk for forming a dependence is high. Making it difficult or impossible to stop use without intervention.
• Co-Occurring Disorders
  • Sometimes known as comorbid or dual diagnosis conditions, co-occurring disorders are diagnosed when a person is suffering from a mental health condition and a substance abuse disorder simultaneously.

High Rates of Mental Health Disorders in First Responders

In general, the rates of mental health disorders are higher than many know. While around 43.8 million Americans live with a diagnosable mental health disorder, the rate is far higher for first responders. While the data shows there are many other jobs with a higher rate of mental health disorders and substance abuse, first responders rank highest for suicide rates.

Repeated exposure to horrible events can trigger suppressed, or active, PTSD in many first responders that put them at risk of abusiong substances or even considering suicide. For these reasons, it is important to not only spread awareness about what first responders go through but also find means to support them.

Helping First Responders with Addiction

The first step in helping first responders with addiction is attempting to break the stigma of mental health complications. Whether it is culturally impressed upon them or simply the result of self-influenced doubts, the stigma present can prevent many who need help from reaching out.

Understanding, or even attempting to understand, to the struggles first responders face can help encourage them to seek help by showing them it is okay to do so. First responders should be encouraged to talk it out with their support system. After listening and encouraging the idea of treatment, the support system should find a way to participate in the process of recovery. This can be done through educating themselves or even seeking out others who are in similar situations. From there, seeking professional help might come easier to a first responder who is struggling.

Factors that Might Prevent Treatment

For many, the “silence culture” might stop a first responder from seeking help, but there are other clear examples of what could stop them from getting help. Some first responders may tell themselves they do not have a problem, or not outright recognize the symptoms of addiction. For others, there are various concerns such as:

• Denial
• Fear of job loss
• Community stigma
• Effectiveness of Treatment
• Finances
• Access to treatment

All of these factors are understandable, but should not stop a first responder from seeking help. By refusing to get the treatment they need, a first responder could be putting the safety of themselves, their community, and their teammates at risk. By not allowing themselves to perform to the best of their abilities it can cause larger problems in the long run. It is important to look into resources to help find affordable, flexible, and even anonymous treatment if needed.

Knowing When to Seek Treatment

Seeing the signs of substance abuse or severe mental health struggles is important for both first responders and their support system. If a first responder refuses to seek or acknowledge signs it could make a dangerous situation for everyone around them. In some cases, intervention is needed to take a step forward. Some signs are:

• Increased conflict at home
• Poor work performance
• Health problems developed as a result of substance abuse
• Sudden and possibly violent mood changes
• Risky behavior relating to a substance (drinking and driving, suicidal behaviors, etc.)

If any or all these signs are present, but the addicted individual does not think help is needed the responsibility may fall to the support system to seek further help.

Addiction Treatment for First Responders

If there is uncertainty about treatment it should be comforting to know many facilities offer hotlines where a support system or an abuser can speak with a professional. Here they can receive counseling or have questions answered.

When the decision to seek treatment is made, the abuser should understand the many options for treatment plans that are available to help them recover. These plans include all levels of care, so that first responders suffering from addiction at different severity levels can get the help they need.

Some plans may require the addict to be stabilized if they are admitted in the middle of a crisis. After stabilization, medical detox may be necessary. After this, an evaluation and diagnosis can be made to help create an effective treatment plan. Some plans include therapy and 12-step programs, but a patient may also find alternative methods of therapy work best for them.

Treatment centers can not only help manage substance abuse, but also provide patients with the tools to function through PTSD, stress, and other mental health complications. These life skills can help a first responder become an even better public servant than before.

Many treatment centers will also cater to support systems by offering groups where family and friends can learn as much as they can to support the success of a first responder’s recovery.

Long Term Recovery for First Responders

An important aspect of recovery is continued support for an addict. Many treatment centers will offer aftercare services which allow an addict to thrive with their new life skills. Before learning these skills, a first responder must take the first steps to recovery. If they cannot do so themselves, it may be the responsibility of the support system to stage an intervention.

Whatever method is used to seek treatment. Recovery for any first responder who suffers from mental health struggles or substance abuse is achievable.

Addiction Recovery at NuView Treatment Center

NuView Treatment Center, a rehab located in West Los Angeles, has a wide range of outpatient treatment programs for first responders and other individuals who aim to escape from the arduous cycle of drug or alcohol dependence. Our up-to-date facility, highly trained staff, and evidence-based treatment methods can help anyone, regardless of the severity of their drug or alcohol use disorder.

Our rehab offes every level of care, including:

• Partial hospitalization programs (PHPs)
• Intensive outpatient programs (IOPs)
• Outpatient programs (OPs)
• Aftercare planning

At NuView Treatment Center, we are committed to approaching substance use disorder treatment on a whole-person basis. Compassion is prioritized above other considerations. We never promote a one-size-fits-all approach to addiction treatment. Our staff members believe that our clients are all individuals with unique needs, underlying issues, and one-of-a-kind strengths. Our team members work hard to develop individualized treatment plans for each person who walks into our rehab so that they can develop the coping tools and skills that they require to stay sober over the long term and live quality lives that are joyful, meaningful, and substance-free.

If you are a first responder and you desire help with a drug or alcohol abuse problem, help is available. Contact us today to talk with a member of our staff about treatment options that meet your unique needs.