First Responder Addiction Treatment

First responders are the first to arrive and assist at the scene of an accident or emergency.¹ They include firefighters, police officers, emergency personnel, paramedics, correction officers, and others responsible for responding to medical, fire, hazardous material, or other emergencies.¹

People who work in these fields struggle with certain mental health issues (including depression and PTSD) at rates higher than the general population. Evidence suggests the nature of the job may contribute to ongoing symptoms of distress including depression, heavy alcohol consumption, anxiety, hyperarousal, and sleep disturbances.² This article will discuss substance use and mental health issues among first responders, and addiction treatment options.

Common Mental Health Issues Among First Responders

Certain mental health issues are more prevalent among first responders vs. the general population, and this is largely attributed  to the challenging, stressful, and dangerous situations they respond to, as well as being the first to provide emotional and physical support in disasters and other emergencies.² Common mental health concerns for first responders include:

• Depression. Around 15% of paramedics suffer from depression.³ Other research has found that EMS workers may be more likely than the general population to think about or attempt suicide.²
• Post-traumatic stress disorder (PTSD). Reports of rates of PTSD in first responders vary between 10 and 23.2%.³

PTSD & the Impact on Substance Use Among First Responders

As mentioned above, PTSD is something many first responders deal with. It is the most common mental illness experienced by people in the field. Research has found that the presence of PTSD symptoms and their severity are associated with increased substance use in first responders.⁴

For example, 52% of men and 28% of women police officers with PTSD have a history of co-occurring alcohol dependence or problematic alcohol use.⁵

Alcohol Use Among First Responders

Research suggests that the normalization of alcohol use is a large contributor to problematic drinking patterns among first responders. For example, one study found that drinking was highly ingrained in the culture of the U.S. Fire Service, with around 50% of career and volunteer firefighters believing that, at least in certain circumstances, drinking to intoxication was socially acceptable and the norm. 43.5% admitting to binge drinking in the past 30 days.⁶

Treating Addiction

Evidence-based addiction treatment can help develop healthy stress-coping mechanisms while abstaining from drugs or alcohol.⁷

Evidence-based addiction treatment often includes various forms of behavioral therapy, including:⁷

• Cognitive-behavioral therapy (CBT): Cognitive-behavioral therapy is an evidence-based treatment used for many mental health and substance use disorders. It helps patients identify situations that may cause relapse and avoid them or exercise healthy coping strategies.
• Motivational Interviewing: A treatment intervention to help patients overcome ambivalence about making changes toward sobriety and work to make lasting psychological and behavioral changes.
• Contingency management: Contingency management is a positive reinforcement program that rewards patients for remaining free from substance use and meeting other recovery goals.
• Family therapy: Helps address the family’s influence on drug use and helps the family unit function in a healthier way.

Other interventions used to treat addiction may include:

• Peer support groups: Peer support groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and SMART Recovery can help provide patients with the skills and connections necessary to sustain recovery.⁸
• Psychoeducational groups: Psychoeducational groups teach skills such as anger management, relapse prevention, stress management, and a variety of other topics related to living a substance-free life and managing mental health symptoms.⁹
• Medications for substance use disorder. Medications are an important part of recovery for many people. They may reduce withdrawal symptoms and cravings or block the effects of certain substances.¹⁰

Treatment Options for First Responders

Some rehab facilities provide specialized treatment programs for first responders. These programs are unique because they allow first responders to undergo treatment alongside peers who share many of the same experiences and can relate in ways that others can’t. In addition, the program may provide focus on topics specifically relevant to first responders in recovery, such as:

• Hypervigilance and stress management.
• Post-traumatic responses.
• Pain management.
• Grief & loss.
• Moral injury (events that threaten one’s deeply held beliefs and trust).

Treatment may be provided in a variety of settings, such as:

• Medical detox: Detoxification is a level of care in which the patient is stabilized and monitored through the symptoms of intoxication and withdrawal.¹¹ Not all addiction patients require detox; however, it may be necessary for patients with moderate to severe dependence on substances such as alcohol, benzodiazepines, and opioids. Detox without continued treatment is seldom effective in helping patients achieve long-term abstinence.¹²
• Inpatient/residential care: This level of care requires patients to stay at a facility 24/7 to receive treatment and around-the-clock supervision. People at this level of care may attend group therapy, individual therapy, family therapy, and educational sessions and recreational activities.¹³
• Partial Hospitalization Program (PHP): A PHP is the most intensive form of outpatient treatment, often involving 6–8 hours of group counseling, individual therapy, and other interventions per day, for a weekly minimum of 20 hours.¹⁴
• Intensive outpatient program (IOP): IOP is less intensive than PHP but offers similar programs. ^{7 IOP} IOPs require a weekly minimum of 9 hours per week.¹⁵
• Outpatient therapy: Standard outpatient treatment utilizes many of the same treatment approaches but requires less time in treatment, allowing for more flexibility in scheduling.¹⁶

Find Addiction Treatment for First Responders

If you’re a first responder seeking treatment, American Addiction Centers can help. We offer specialized treatment programs tailored to the needs of first responders.

You can find specialized treatment tracks for first responders at:

• Oxford Treatment Center.
• Desert Hope Treatment Center.
• Greenhouse Treatment Center.
• River Oaks Treatment Center.
• Recovery First Treatment Center.
• Laguna Treatment Center.

You can recover from substance use or mental health challenges. Don’t wait. Call one of our admissions navigators to get started with treatment today.