Stress, Addiction, and EMS Responders

First responders such as EMS (emergency medical services) responders, police officers, and firefighters swear oaths to protect the public from danger. But what happens when they need help themselves? What happens when they might be dangerous themselves?

First responders have extremely stressful jobs. During the course of their work, they might witness traumatic events that happen to others or experience trauma themselves.

What Does Stress Do to First Responders?

It is not surprising, then, that some first responders experience post-traumatic stress disorder (PTSD), an anxiety disorder caused by experiencing or witnessing trauma. People with PTSD might:

• Feel frightened and stressed
• Experience flashbacks about the event(s) that caused the trauma
• Have nightmares

People often say that PTSD is disorder of the body’s fight-or-flight response, a response that temporarily readies the body for a potentially stressful event but fades after the event ends.

But, for people with PTSD, their fight-or-flight responses don’t end. Their brains are in a constant state of tension as they wait for stressful events.

PTSD occurs in women more than men. In addition to first responders, people who struggle with PTSD might include people who have survived physical and sexual abuse and assaults, accidents, or military combat, or have witnessed those incidents. Other events, such as the death of a loved one, might also trigger PTSD.

As with other areas of mental health, researchers are discovering more about PTSD all of the time. Like drug and alcohol abuse, researchers believe that people might also have genes that predispose them to develop conditions such as PTSD.

PTSD and stress affect different people in different ways. Some people might experience or witness trauma but not experience PTSD or stress afterward. Some people might recover from PTSD and other forms of stress on their own. Some might recover after a while, while others might deal with the condition for a long time.

Sadly, this trauma can take its toll. A Journal of Emergency Medical Services article notes that 6.6 percent of 4,000 first responders who responded to a survey admitted that they had attempted suicide. This EMS suicide rate for attempted suicides is more than ten times the rate of attempted suicides in the general population.

The statistics for police officers are also startling. “Nationally, about 300 police officers kill themselves each year, about twice as many as are killed in the line of duty,” reports Alan S. Brown in EHS Today.

How Do First Responders Deal with PTSD?

Like others experiencing PTSD, some first responders use alcohol or drugs to try to cope with the symptoms of their stress and anxiety. But using such substances make the condition worse. If people become addicted to the substances, they can develop a condition known as a dual diagnosis.

How many first responders have a drug or alcohol problem? Writing in Police magazine, Mark W. Clark notes that “Statistics show that 20% to 25% of working police officers are chemically dependent on either alcohol or drugs.”

If this many first responders are indeed struggling with substance use disorder, this could create a number of problems. First, of course, are the ill effects that drugs and alcohol can create for the people using them as well as their families, friends, and colleagues.

But first responders with drug and alcohol problems can also create additional problems for others. First responders’ jobs require them to make quick decisions and sometimes make equally quick actions in highly stressful situations.

It’s difficult enough to make these decisions and actions with a clear, sober mind. Under the influence of drugs and alcohol, people might

• Find it more difficult to think or act
• Think or act more slowly than before
• Make the wrong decisions and actions

Instead of helping the people they’re sworn to protect, first responders who are drunk or high could be putting people in even more danger, hurting them, or even killing them.

If first responders hurt someone, this could also be traumatic and stressful, which could intensify the first responders’ stress, PTSD, or other conditions. This intensification could lead to further substance use disorder or other behaviors used to cope. These behaviors do more harm than good and contribute to the complexities of a dual diagnosis.

This vicious cycle threatens both first responders and the public they’ve been sworn to help. If addicted first responders find assistance, they can better assist themselves and the public.

How Can First Responders Address Stress?

How can they assist themselves? Well, it turns out that a particular therapeutic approach might help first responders. This approach is called critical incident stress management (CISM). It uses first responders as peer counselors.

These peer counselors understand what first responders encounter on the job as well as the expectations surrounding their careers. Peer counselors reassure people that what they’re feeling is normal. The peer counselors check up with them after their meetings. They deal openly with emotions and encourage people not to hide them. They also refer people to mental health professionals, if needed.

CISM and other approaches acknowledge that addressing the problems of first responders is better than hiding them. The approaches acknowledge that different approaches work for different people but are worth exploring.