Addiction Treatment for Firefighters: What Are the Rules & Considerations?

Firefighters and first responders struggle with substance abuse at higher rates than the general population. 

Specialized treatment is available to address trauma and other issues that are unique to firefighters in recovery from addiction.

A FIREFIGHTER’S JOB

Firefighters are among the heroes of our nation. They courageously protect families and homes, treasured lands, businesses, individuals, and even animals — all without any guarantee of their own safety. 

Many people may not realize how vital the work of a firefighter is until their home, life, or community is in danger and saved by the selfless men and women who dedicate their lives to fighting fires and stopping disasters.

Firefighters face great risk every day on the job. Whether reporting to a house fire, traveling to an out-of-control wildfire, or responding to another type of emergency, a firefighter never knows what they’ll encounter. They may be hurt on the job, or even lose their life. They may suffer smoke inhalation, witness the death or injury of a colleague or civilian, or be unable to stop a disaster from occurring. 

In addition to these risks — perhaps, in part, due to these risks — many firefighters face another danger as well: substance addiction.

FIREFIGHTERS & SUBSTANCE ADDICTION: STATISTICS

• According to a 2013 study published by Occupational Medicine, approximately 58 percent of career firefighter participants, and 40 percent of volunteer firefighters reported drinking heavily at least 10 days out of the month (about half of their off-duty days). A similar percentage reported binge drinking on the days they consumed alcohol.
• A 2012 study reported that of firefighters who drank, approximately nine percent of career firefighters, and 10 percent of volunteer firefighters, reported driving while intoxicated in the previous month.
• In 2017, a study published in Women’s Health Issues indicated that nearly 40 percent of participants (all women firefighters) reported binge drinking in the previous month, and 4.3 percent reported driving while intoxicated. Problem drinkers were 2.5 times more likely to have been diagnosed with depression or PTSD, and they were 40 percent more likely to have been injured on the job in the previous year.
•  In 2017, more firefighters died as a result of suicide than in the line of duty. It is also estimated that firefighter suicides are severely underreported.

WHY ARE FIREFIGHTERS AT RISK OF STRUGGLING WITH DRUG ADDICTION?

Just as each individual is unique, each individual’s struggle with substance abuse and addiction is unique as well. Of course, firefighters are no exception. Certain aspects of a career in firefighting, or even ongoing volunteer work as a firefighter, may make this population more vulnerable to addiction and substance problems. 

Some factors that may make firefighters at higher risk for substance use and addiction include:

Post-traumatic stress disorder (PTSD)

PTSD is a psychiatric disorder that sometimes occurs after someone experiences a traumatic event and is then left with long-lasting symptoms that interfere with their ability to function in everyday life. Symptoms of PTSD include recurring and/or involuntary memories or nightmares, avoidance of trauma-related thoughts, and persistent negative emotions. Because of the nature of their jobs, firefighters are exposed to high levels of trauma.

They may  witness violent crime scenes, provide medical support to severely injured children and infants, and see victims of a disaster or crime die in front of them. The frequency of these incidents may explain why firefighters are more likely to experience PTSD than those in many other professions.

Repeated exposure trauma (RET)

Although there have been studies examining the connection between PTSD and firefighters, many feel more research should be done on the effects of repeated exposure trauma (RET) on firefighters. While PTSD is linked to one traumatic event, RET is the effect of continuously and repeatedly being exposed to trauma and stress.

Depression

According to the U.S. Fire Administration, levels of depression are higher in firefighters than in the general population, perhaps due to job stress and trauma exposure.

Tough work conditions and burnout

Many firefighters have an irregular work schedule, and they often work long hours in rough conditions. Firefighters battling a wildfire, for example, may work in poor air quality, through long shifts without needed breaks.
These factors can make firefighters susceptible to “burnout,” a condition the Federal Emergency Management Agency (FEMA) defines by the following characteristics:

• Exhaustion
• Withdrawal from workplace and coworkers
• Cynicism and unhelpful attitude toward the goal of the work and the people being served

SIGNS & SYMPTOMS A FIREFIGHTER IS STRUGGLING WITH ADDICTION

Because PTSD is so often part of the equation when dealing with a firefighter who is struggling with substance addiction, understanding the symptoms of PTSD may help to identify a potential problem. 

Signs of PTSD include:

• Being emotionally distant and avoiding places and people that are reminders of trauma
• Withdrawing from coworkers, friends, and loved ones
• Acting jumpy and easily becoming irritated or angry
• Difficulty falling asleep or staying asleep throughout the night
• Loss of interest in usual activities

Signs that a firefighter may be struggling with substance use and addiction include:

• Developing an increasing tolerance or obsession with a substance, including alcohol
• Being secretive or defensive about substance use
• Participating in risk-taking activities
• Behaving in an out-of-character manner, such as becoming more irritable and angrier
• Sleeplessness
• A loss of interest in normal activities or loved ones

Coworkers may notice:

• Sleepiness on the job
• Decreased hygiene
• An increase in on-the-job mistakes
• Mood swings
• Difficulty concentrating and problems with memory
• Taking longer than usual to complete tasks

COMMON DRUGS OF ABUSE FOR FIREFIGHTERS

Most studies involving firefighters and substance addiction have focused on alcohol use. More research may be needed to determine which drugs and substances are most commonly used. 

Because many firefighters suffer from injuries, for example, some may use painkillers, which can be addictive. Many prescription anxiety medications may also be addictive.

HOW CAN SUBSTANCE ADDICTION AFFECT A FIREFIGHTER’S JOB PERFORMANCE & SAFETY?

Substance use and addiction can be incredibly dangerous for a firefighter’s safety on the job. Substance abuse can severely and negatively affect their job performance.

An office worker may be able to get away with “zoning out” at the office, but a firefighter must be fully alert and engaged every moment they are on the job. Their lives, and the lives of their colleagues and the people they’re trying to save depend on it.

Substance use and addiction can lead to dangerous on-the-job mistakes, slower response times, and bad decision-making. These factors can be the difference between life and death when it comes to a burning building or other disasters.

HOW CAN DRUG ADDICTION AFFECT A FIREFIGHTER’S CAREER?

Many firefighters struggling with addiction may be able to hide their problem better than most. After all, the job requires an extraordinary level of control over one’s emotions and actions. 

Eventually, however, the physical and psychological toll of addiction will catch up with even the most disciplined and skilled professionals. Work performance will decline. The behaviors associated with addiction may cause the individual to develop a reputation for unpredictability, poor judgment, and suspicious personal habits. These are all traits that can stop a firefighter’s career right in its tracks.

There is an increasing awareness of the stress and demands placed on a first responder. A firefighter who genuinely wants to stop their substance abuse and completes a comprehensive treatment program should be able to expect the support and respect of their colleagues and leadership. 

CAN EMPLOYERS HELP WITH DRUG REHAB & RECOVERY?

There are many different types of firefighters in this country. Some may be employed by their city’s fire department; others may work as contractors or volunteer firefighters in their community.

Some are also trying to erase the stigma often associated with firefighters seeking help for psychological or substance problems.

After the devastating fire season of 2018, for example, CalFire, labor organizers, counselors, and fire chiefs throughout California worked together and committed to offering more resources and support to firefighters. 

TAILORED HELP

Firefighters face continual stress and trauma in their work life. Without tools to process and cope with these events and feelings, substances like alcohol can seem like an appealing escape from unwanted thoughts and memories. 

But using substances and battling addiction can lead down a dangerous path that can put their own lives, as well as the lives of others, at risk. It can also cost firefighters their career. 

Fortunately, there is a greater understanding today of the struggles firefighters face. More resources are available to help firefighters fully recover from addiction and mental health issues. These offerings address the unique challenges firefighters face, treating associated issues like PTSD in conjunction with substance abuse.

Firefighters face higher rates of addiction and suicide than many other populations. If you suspect a firefighter you know is struggling with mental health problems or substance use issues, point them toward treatment resources and offer your support. It may save their life.

Sources

(August 2014) Covariates of Alcohol Consumption Among Career Firefighters. A.K. Piazza Gardner, A.E. Barry. Occupational Medicine. Retrieved August 2019 from https://academic.oup.com/occmed/article/64/8/580/1430793

(November 2017) Alcohol Use and Problem Drinking Among Women Firefighters. Women’s Health Issues. Retrieved August 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694370/

(December 2012) Alcohol Use Among Firefighters in the Central United States. Haddock C.K. Occupational Medicine. Retrieved August 2019 from https://www.ncbi.nlm.nih.gov/pubmed/23064207

(April 2018) 'Silence can be deadly': 46 officers were fatally shot last year. More than triple that — 140 — committed suicide. USA Today. Retrieved August 2019 from https://www.usatoday.com/story/news/2018/04/11/officers-firefighters-suicides-study/503735002/

(January 2017) What Is Posttraumatic Stress Disorder? American Psychiatric Association. Retrieved August 2019 from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

(August 2019) Symptoms and Diagnosis of PTSD. Verywell Mind. Retrieved August 2019 from https://www.verywellmind.com/requirements-for-ptsd-diagnosis-2797637

(June 2019) Development of PTSD in Firefighters. Verywell Mind. Retrieved August 2019 from https://www.verywellmind.com/rates-of-ptsd-in-firefighters-2797428

(January 2018) The Effect of Repeated Exposure Trauma on Firefighters. U.S. Fire Administration. Retrieved August 2019 from https://www.usfa.fema.gov/current_events/011718.html

(March 2018) Firefighter Burnout and Workplace Safety. U.S. Fire Administration, FEMA. Retrieved August 2019 from https://www.usfa.fema.gov/current_events/072618.html

Symptoms of PTSD. Anxiety and Depression Association of America. Retrieved August 2019 from https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/symptoms

(October 2018) What are the symptoms of addiction? Medical News Today. Retrieved August 2019 from https://www.medicalnewstoday.com/articles/323459.php

(March 2019) 8 Signs Your Co-Workers are Struggling with Addiction. USA Today. Retrieved August 2019 from https://www.usatoday.com/story/money/2019/03/29/addiction-work-8-signs-co-worker-struggles-drugs-alcohol/3244622002/

(September 2017) Firefighters and Addiction: The Value of Peer Support. Fire Engineering. Retrieved August 2019 from https://community.fireengineering.com/profiles/blog/show?id=1219672%3ABlogPost%3A640288#gref

(March 2019) Must Reads: Firefighter Suicides Reflect Toll of Longer Fire Seasons and Increased Stress. Nina Agrawal. Los Angeles Times. Retrieved August 2019 from https://www.latimes.com/local/lanow/la-me-ln-firefighter-suicides-20190302-story.html