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Guide to Addiction in First Responders

First responders face very high rates of both substance abuse and addiction. Often, their issues are complicated by underlying mental health issues, including post-traumatic stress disorder (PTSD). Stigma and a culture of “keep it in the family” can stop people from getting the help they need. That’s unfortunate, as substance abuse treatment is very effective. People who are dealing with addiction should ask for help.

Struggling with Addiction? Get Help Now

First responders — including firefighters, police officers, and EMTs — are the people we call when we’re sick, hurt, frightened, or in pain. We rely on them to help us, no matter what happens. But sometimes, that work takes a terrible toll. 

Statistics on First Responders & Addiction

Key Facts

  • About 4.6 million people work as career or volunteer first responders. Each one faces intense challenges each time they report for duty.
  • Between 16 and 40 percent of first responders struggle with alcohol abuse. Many police officers, firefighters, and others connect and relax around drinks at the local bar after shifts.
  • Many first responders struggle with PTSD, and that mental health challenge is significantly linked to drug and alcohol abuse. First responders might use substances as a form of self-medication rather than getting the help they need.
  • First responders who don’t get help face high suicide risks. Researchers say first responders make up about 1 percent of all suicides.

What Substances Are Typically Abused?

While all first responders face high substance use and abuse rates, the drugs they use can vary by the community they’ve joined. These statistics can help you understand what types of drugs are linked to different careers: 

Police Officers 

For many police officers, sheriffs, and sheriff’s deputies, alcohol is a part of daily life. Sometimes, drinking turns into alcoholism. 

In a study of police officers, 18.1 percent of men and 15.9 percent of women said they’d experienced a problem due to alcohol abuse, and close to 8 percent met criteria for alcohol abuse or dependence. 

Correctional Officers

People who work in prisons and jails aren’t always considered part of the first responder community. But these professionals are on the front lines when terrible things happen and perpetrators need to be removed from society. 

In a study of correctional officers, stress was widespread. Many people deal with stress by drinking alcohol, but no clear connection between a specific substance was found. 


According to experts, alcohol is the most commonly abused substance among these professionals. People who must fight fires all day long may look forward to cool drinks at the end of their shifts, and one sip can turn into several very quickly. Once alcohol becomes a way to cope with the stress of the job, it’s easy for a cycle of abuse to deepen.

EMTs & Paramedics 

In a study of firefighters working as EMTs, 85 percent admitted to drinking alcohol, and about half were binge drinking. Some EMTs can access powerful drugs during their shifts, including opioid painkillers. They may take pills or injections while on the job, and that habit could become an addiction in time. 

Mental Health & Addiction

An underlying mental health problem could make addiction more likely. People may lean on substances to treat difficult emotions, memories, or triggers. And in time, they may find that they need the substances they once found helpful. 

Researchers suggest that 30 percent of first responders develop behavioral health problems, including depression and PTSD, compared to 20 percent of the general population. 

Using drugs can make these mental health problems worse. For example, some drugs (like opioids) impair the brain’s ability to regulate emotions and produce mood-boosting chemicals. As an addiction deepens, so does the depression. 

An underlying addiction can also cause a mental health concern. For example, people who abuse stimulants (like cocaine) can feel intense highs and very low lows. Some people who abuse these stimulants can develop deep depression over time due to the chemical depletion the drugs can cause. As feelings of sadness and hopelessness worsen, people often engage in more serious and chronic levels of drug abuse.

What Else Can Cause Addiction?

Several issues can convene and cause substance abuse problems in people working or volunteering as first responders. These are a few of the factors closely linked to substance abuse in this community:


Researchers know that stress is closely connected to both the development of addiction and the risk of relapse in those who are in recovery. It’s hard to think about the work first responders do without considering stress. 

First responders deal with people at their worst on terrible days. They put their lives on the line, as do their colleagues. And most of their work happens at high speed, where even a second can mean the difference between life and death. 

Without adequate support systems, people facing relentless stress may feel they must lean on addictive substances to cope. And they can develop an addiction if this use continues.

Lack of Outlets 

First responders are, as the name implies, the first on the scene of challenging or dangerous situations. They’re asked to put their emotions, thoughts, and feelings to the side to help others feel better. 

Pushing feelings away can become a habit, and drugs make this easier. People who drink to excess can forget — even if just for a moment — the things they’ve seen at work that day. Rather than processing their emotions, they drown them. Since substances are an effective means to avoid feelings in the moment, it can become a go-to coping mechanism for some.


A painful problem can facilitate an addiction. Painkillers such as Vicodin are often used to address sprains, muscle tears, and swollen limbs. People who use these drugs can become addicted to them with repeated use. And some people drink instead of working with a doctor to get pain relief.

Researchers say paramedics face nonfatal injuries at rates five times higher than the national average Other first responders can get injured on the job too. Without proper care and follow-up, these problems can increase addiction risks. 

Why Don’t First Responders Get Help for Addiction?

Addiction is a very treatable condition, but it’s also a silent one. Some types of addiction come with no physical warning signs, making them very easy to hide for long periods. But delayed treatment can make an addiction much worse. And unfortunately, the problem is very common among first responders. 

Researchers say first responders face these challenges in getting treatment:

  • Culture: Relaxing and easing stress with alcohol is common among first responders. Someone who has a problem with drinking may worry they’ll be left out of the comradery if they stop drinking.
  • Legacy: Some types of first responders rely heavily on the “way things have always been done.” Since some types of addiction treatment are relatively new, they may fear they’ll be shunned for engaging in them. 
  • Silence: First responders are encouraged to keep quiet about traumatic experiences. 
  • Stigma: Some first responders believe that discussing their problems is a sign of weakness that could cost them their jobs. They may believe they are stronger if they stay silent about their distress.

Some organizations are trying to change the culture. They’re holding classes to help people understand how addictions work, and they’re offering treatment forms that are held right at work. 

But ongoing stigma and shame could keep people from getting the help they need, even when it’s readily available. 

What About Relationships?

A solid connection to someone who listens, supports, and understands can be critical for a first responder. If someone who faced a difficult shift can come home to someone who wants to listen, that could mean staying sober. But unfortunately, being a first responder is very difficult on relationships. 

The divorce rate for first responders is between 60 and 70 percent compared to the national average of 50 percent. On-the-job stress can fracture relationships beyond repair, making people even more isolated. 

Divorce is also very stressful, working as yet another trigger for substance use and abuse. Since most breakups often mean moving, the stress can build. 

Some first responders have other sources of social support. Friends, parents, and siblings can all be excellent resources, capable of listening and helping people to find the treatment they need. 

But those without additional support may dig deeper into substance abuse and addiction. Without a safe place to turn, they simply return to substances more frequently and often at higher doses over time.

Getting Help for First Responders

Addiction is a chronic condition, meaning that people with it often struggle with triggers for the rest of their lives. But addiction can be treated, even in first responders. The following elements might be included in a care plan:


Some people benefit from medications to help them manage alcohol use disorder. Prescriptions can make alcohol less attractive or cravings less intense. With their help, people may find it’s easier to quit drinking.

Similar medications are available for people who are addicted to opioids, including prescription painkillers. These therapies, such as buprenorphine-based medications, can help people manage triggers, avoid withdrawal symptoms, and move forward with therapy.

Co-Occurring Conditions

People with mental health challenges underlying their addictions often need a special kind of therapy. They may benefit from medications to ease symptoms of depression or anxiety. They may also need therapy to learn how to manage the complex emotions these illnesses can cause. 

While some addiction treatment programs offer therapy for co-occurring conditions, not all of them do. It’s very important for first responders to find a qualified program that can help.


Psychotherapy, sometimes called talk therapy, is an important part of most addiction treatment programs. Sessions are sometimes held individually, and they’re sometimes held in group sessions. 

Psychotherapy is designed to help people both discuss their issues and learn how to cope with them. For some first responders, that means learning how to tell other people about the difficult things they see at work every day and how to deal with their emotions without using drugs or alcohol. 

How to Help Someone in Need

If someone you love is working as a first responder and struggling with substance abuse, help is available. Ask the person to tell you what’s happening and commit to finding a treatment program together. Your kind support could help the person to quit using substances for good.

Updated June 8, 2023
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