First Responders & Substance Use Disorder

First responder at the scene of an incident

Medical professionals (firefighters, police officers, and emergency medical technicians) are 10% more likely to have mental health and substance abuse issues compared to the general population [1]. First responders are exposed to highly stressful situations, including witnessing violence, death, injuries, natural disasters, and pain.

These exposures are often in addition to threats to their personal safety, long work hours, and increased time spent away from friends and family. These factors place first responders at an increased risk of struggling with substance dependence and mental health conditions [1].

Research shows that mental health conditions can lead to substance abuse issues [2]. Common mental health conditions include depression, posttraumatic stress (PTSD), and suicidal thoughts or actual suicide attempts [1].

Employers and loved ones of first responders need to be aware of the signs of these mental health conditions. Signs of depression include:

  • Chronic fatigue
  • Irritability
  • Loss of interest in pleasurable activities
  • Issues concentrating
  • Changes in appetite
  • Sad mood
  • Suicidal thoughts or attempts
  • Sleep difficulty
  • Oversleeping

PTSD is a mental health disorder that occurs after someone has experienced or witnessed a traumatic event. This can include violence, natural disaster, serious accidents, or sexual violence. All of these things are events that first responders are responsible for responding to.

First responders suffer from PTSD and substance abuseSigns of PTSD include flashbacks of the event, avoidance of things that are reminders of the event, negative changes in beliefs and mood, and being on high alert for danger. While depression and PTSD can range in severity, these conditions can make it difficult to function in social, academic, and professional settings.

These disorders also can decrease quality of life. Individuals may rely on substances in order to cope with these symptoms [2]. It is important to be aware of the risk for these conditions and the symptoms so that you or your loved one can get support.

While it is important to get mental health treatment if someone is struggling with a mental health condition, it’s also important to implement prevention strategies [1]. There are certain prevention techniques to decrease the likelihood of first responders developing mental health conditions as a result of work. These include:

  • Adequate training to support an individual’s confidence in handling emergencies and disasters
  • Regular time off
  • Competent leadership
  • Good relationships with coworkers and supervisors
  • Access to mental health care following exposure to crises [1]

It is important to be aware of the unique vulnerabilities that first responders have to substance abuse disorders as a result of the high stress that comes with their job. Providing adequate support for these community members is crucial in reducing the rate of substance abuse [1].


[1] Substance Abuse and Mental Health Services Administration (2018, May). First responders: Behavioral health concerns, emergency response, and trauma.

[2] (2019, March 22). Mental health and substance use disorders.

About the Author:

Samantha Bothwell PhotoSamantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on September 25, 2020
Reviewed by Jacquelyn Ekern, MS, LPC on September 25, 2020
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About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.