First Responders, Trauma and Addiction

First Responders and Ambulance at Hospital - 3323385_1920

Thanks to frequent exposure to traumatic events and life-threatening situations, plus the taxing demands of a high-stakes, fast-paced job, first responders are at a much higher risk of developing behavioral health conditions and substance use disorder than the general population. Unfortunately, first responders face numerous barriers to treatment and are one of the least likely to seek help for mental illnesses and addictions.

The Relationship Between First Responders, Trauma & Addiction

An estimated 30 percent of first responders live with a mental health condition like post traumatic stress disorder (PTSD) and depression compared to only 20 percent of the general population [1]. A recent study by the Ruderman Family Foundation on police officers and firefighters reveal even more alarming rates.

According to the study, rates of PTSD and depression are nearly five times higher among firefighters and police officers than the general public [2]. And as numerous research shows, substance use disorder and addictions commonly co-occur with trauma-induced disorders like depression and PTSD. In fact, individuals seeking treatment for PTSD are 14 times more likely to be diagnosed with a substance use disorder [3].

Addiction Rates Higher Among First Responders

As numerous studies show, first responders often turn to substances like alcohol and drugs to cope with the trauma-induced challenges of the job. According to a 2007 survey, 37 percent of police officers reported one or more problem drinking behaviors [4].

Another study found that approximately 50 percent of male firefighters engaged in heavy or binge drinking in the past months [5], while a study on female firefighters found that over 60.5 percent drank more alcohol than the 2015-2020 Dietary Guidelines for Americans and 39.5 percent engaged in binge drinking compared to only 12-15 of females in the general population [6]. This same study also found that female firefighters who abused alcohol were around 40 percent more likely to have been injured on the job in the past year and were over 2.5 times as likely to have symptoms of PTSD than other firefighters, highlighting the connection between trauma and addiction among first responders.

Another study on police officers and alcohol use after Hurricane Katrina found a significant connection between hazardous drinking and officers’ involvement in hurricane relief work [7], while further research showed that following Hurricane Katrina, the number of alcoholic drinks increased from 2 to 7 per day, once again showing the connection between trauma and substance use/addiction [8].

Barriers to Treatment are Encountered

Although research shows first responders suffer from higher rates of trauma-induced behavioral health conditions and addictions than the general population, they are, unfortunately, some of the least likely to seek and receive treatment for mental health illnesses and addiction. Some of the barriers that keep first responders from seeking help include:

  • Denial
  • Stigma (both on the job and in the community)
  • Cost of treatment
  • Fear of job loss
  • Difficulty taking time off from work
  • Lack of access to treatment
  • Belief that treatment doesn’t work

First Responders at a Car Crash Using Jaws of Life - 4894770_1920In a 2018 University of Phoenix survey of United States military personnel and first responders, researchers found that 47 percent of respondents believed they would experience job repercussions if they sought professional counseling. Of the 47 percent who felt this way, 53 percent believed they would receive different treatment from coworkers, 52 percent were afraid of receiving different treatment from supervisors, and 46 percent cited concerns over being seen as weak by their peers and colleagues [9].

The good news is, studies show that first responders are more open to seeking professional help if their close friends, family, and colleagues open up about their own experiences with mental illness and addiction. For example, a University of Phoenix survey found that 82 percent of first responders said they would be more willing to seek help if a team leader spoke up, while 89 percent said they would feel encouraged to seek help if a friend, close colleague, or family member talked about their experience [10].

“As a community, there are steps we can take to erase the stigmas associated with receiving professional counseling,” says Sam Dutton, Ph.D., LCSW, the program director for University of Phoenix College of Humanities and Sciences. Dutton goes on to say, “There is no shame in seeking treatment for the flu or visiting the dentist. The same should be true of taking care of our mental well-being. Organizations and individuals that support first responders need to change the conversation about mental health, share their experiences, and encourage others to seek help if they need it” [11].


[1] Abbot, C., Barber, E., Burke, B., Harvey, J., Newland, C., Rose, M., & Young, A. (2015). What’s killing our medics? Ambulance Service Manager Program. Conifer, CO: Reviving Responders. Retrieved from http://www.
[2] Merit. Study: Police Officers and Firefighters Are More Likely to Die by Suicide than in Line of Duty. Ruderman Family Foundation.
[3] McCauley, J. L., Killeen, T., Gros, D. F., Brady, K. T., & Back, S. E. (2012). Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment. Clinical psychology: a publication of the Division of Clinical Psychology of the American Psychological Association, 19(3), 10.1111/cpsp.12006.
[4] American Psychological Association. APA PsycNet. American Psychological Association.
[5] Haddock, C. K., Poston, W. S. C., Jahnke, S. A., & Jitnarin, N. (2017). Alcohol use and problem drinking among women firefighters. Women’s Health Issues, 27(6), 632–638.
[6] ibid.
[7] First Responders: Behavioral Health Concerns, Emergency Response, and Trauma. SAMHSA. (2018, May).
[8] McCanlies, E. C., Mnatsakanova, A., Andrew, M. E., Burchfiel, C. M., & Violanti, J. M. (2014). Positive psychological factors are associated with lower PTSD symptoms among police officers: Post Hurricane Katrina. Stress & Health, 30(5), 405–415.
[9] University of Phoenix Survey Finds 93 Percent of First Responders Say Mental Health is as Important as Physical Health. University of Phoenix.
[10] ibid.
[11] ibid.

About the Author:

Sarah Musick PhotoSarah Musick is a freelance writer who specializes in eating disorder awareness and education. After battling with a 4-years long eating disorder, she made it her mission to help others find hope and healing in recovery.

Her work has been featured on numerous eating disorder blogs and websites. When she’s not writing, Sarah is off traveling the world with her husband.

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

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published November 24, 2020, on
Reviewed & Approved on November 24, 2020, by Jacquelyn Ekern MS, LPC

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.