First Responders

Police officers, firefighters, EMTs, dispatchers, and corrections officers often share the hardest moments of other people’s lives. 

Even in the best of times, working as a first responder can be stressful. Challenging schedules, emergencies that can arise at any time, physical demands and job-related trauma all add up to a heavy burden.

First Responders, Work Stress, and Substance Use

It’s understandable that many first responders turn to alcohol or drugs in an attempt to manage stress, PTSD, or simply to get some sleep. 

First responders living with substance use disorders do recover. But, their chances of success are greatly increased if they can attend a program designed to meet their unique needs. 

Excel’s addiction treatment center in New Jersey recognizes how this work shapes substance use. Alcohol use among first responders is a common concern, and prescription pain medication adds another risk. These problems often come with PTSD, depression, or anxiety.

Treatment works best when it fits your job, your schedule, and your history. 

Let’s look closer at how first responders are uniquely affected by their line of work.

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What Substances Do First Responders Most Often Become Dependent on?

Alcohol

Alcohol is legal, easy to find, and part of the social side of the job. It’s also a depressant which can take the edge off anxiety, quell anger for some and help you fall asleep (although not restfully). All of these factors make alcohol the common substance first responders use. 

But even a casual, social habit can quickly spiral into an alcohol use disorder. Warning signs include drinking alone, drinking to fall asleep, and needing more to feel the same effect. Specialized alcohol addiction treatment covers both the drinking and the stress behind it.

Opioids

Many responders get a first prescription for opioids after an on-the-job injury. Short-term pain relief can turn into dependence. When opioid painkillers like oxycodone become the solution not only for physical pain, but depression, anxiety or trauma, it can feel like an inescapable dilemma. 

The good news is that treatment for prescription pain med dependence is more effective than ever and when it’s combined with comprehensive mental health support, it delivers real hope. 

Benzodiazepines and Sleep Aids

Anxiety and trauma are unfortunately common among the first responder population. When the symptoms become unmanageable, they may come to rely on controlled substances simply to calm their nerves, function and sleep. Sometimes they’re prescribed. Sometimes they aren’t. 

Overnight and on-call shift work can compound stress and sleep troubles leading many to take habit-forming sleep aids like Ambien (zolpidem). Sleep aid and benzodiazepine treatment can help them gently and safely discontinue use over time while providing effective care for anxiety or PTSD. 

PTSD, Trauma & Co-Occurring Mental Health in First Responders

PTSD can develop after a person lives through or sees a shocking or dangerous event. For first responders, those events can add up over years. Symptoms can include flashbacks, nightmares, constant tension, and trouble sleeping. Depression and anxiety often follow.

Research on firefighters describes PTSD, depression, and alcohol use disorder as common concerns. Researchers link them in part to repeated trauma and job stress. In one Texas study of first responders in counseling, nearly 40% screened positive for a possible substance use disorder.

Trauma and substance use make each other worse, so treating only one leaves the other in place. Integrated care for PTSD and addiction treats both together.

Occupational Risks in First Responder Substance Use

Three parts of the job raise the risk of substance use for first responders.

Shift Work and Sleep Disruption

Night shifts, rotating schedules, and forced overtime disrupt sleep. Poor sleep worsens mood and stress. Some responders use alcohol to wind down after a shift. Alcohol then cuts into sleep quality, and the cycle continues.

Repeated Trauma Exposure

Most people face a handful of traumatic events in a lifetime. First responders can face several in one month: crashes, fires, assaults, overdoses, and deaths. The memories build up. Alcohol or drugs can dull them for a while, but the relief fades and the use often grows. PTSD cannot be resolved with a drink or a drug. 

Chronic Pain, Injury & Access to Medications

Lifting patients, restraining suspects, and wearing heavy gear lead to injuries. A pain prescription can start as real medical care, and some people develop dependence. EMS staff also handle controlled medications on the job, which can put opioids within reach.

Barriers First Responders Face in Seeking Help

Even when someone sees the problem, several barriers get in the way:

• Stigma. The job rewards toughness, so many responders fear that asking for help looks weak.
• Career fears. Worry about losing a badge, a certification, or an assignment keeps many people from speaking up.
• Peer culture. When heavy drinking is normal in the crew, a problem is easy to miss or hide.

Confidential Treatment Options for First Responders

Outpatient care lets you live at home, and sessions can fit around shift work. A Partial Hospitalization Program (PHP) offers the most structure, with daytime treatment most days of the week, which likely requires you to step away from shifts. 

An Intensive Outpatient Program gives you structure several times a week, and you can return home or to supportive housing the same day. Standard outpatient treatment meets less often. It suits people with steadier schedules or those stepping down from higher care. Some people start with detox or residential care at a licensed partner facility, then move to outpatient treatment.

Telehealth sessions add privacy and flexibility. You can attend from home, which cuts out the commute and the waiting room. Telehealth works well as a next step after in-person treatment begins. Federal privacy laws protect your treatment records in both settings.

Take the Next Step Toward Recovery

When you spend your days taking care of everyone else, reaching out for yourself can feel unfamiliar. Contact our team to talk with someone at Excel Treatment Center about your situation and begin a conversation about treatment.

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Common questions

Frequently Asked Questions About First Responders and Addiction

Will seeking treatment affect my job or certification? +

No, treatment alone doesn’t end a first responder’s career, and the rules vary by agency, role, and state. Many departments offer employee assistance programs, and some offer leave for treatment. Federal privacy laws limit who can see your treatment records. Check your agency’s policy or talk with a union representative before you decide.

Can I get treatment that fits my shift schedule? +

Outpatient programs and telehealth let many first responders plan treatment around their shifts. Every schedule is different, so ask an admissions counselor to walk through your shift pattern and the options that fit.

Is PTSD common among first responders with substance use issues? +

Yes, PTSD and substance use often appear together in first responders. Repeated trauma exposure raises the risk of PTSD, and some responders drink or use drugs to quiet the symptoms. Treating both conditions together is usually the strongest approach.

Sources:

1. Possible Substance Use Disorders Among First Responders During the COVID-19 Era: A Quasi-Experimental Study of Personal and Residential Vulnerability — CDC/NIOSH
2. Alcohol Use and Mental Health Symptoms in Female Firefighter Recruits — PubMed/NLM
3. Post-Traumatic Stress Disorder (PTSD) — NIMH