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First Responders Addiction Guide

Our first responders work hard to save lives, and as an unfortunate consequence, they are often emotionally impacted by the situations they are exposed to on the job. This exposure can often lead to substance abuse as a means of coping and self-medicating.

Fortunately, there are drug and alcohol abuse rehab programs available that are either exclusive to first responders or have specialized programs for first responders.

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How First Responders Fall Into Addiction

First responders, such as police officers, firefighters, EMTs, and paramedics, are exposed to high-stress and dangerous situations on a daily basis.

Not only are these brave individuals exposed to high levels of danger as part of their job description, but they are also under tremendous pressure. These professions hold a lot of responsibility and esteem in communities.

Sadly, the nature of their jobs places first responders at a higher risk for substance use disorders, as they may turn to drugs or alcohol to cope with their work demands.

Scope of Substance Abuse Among First Responders

As people who consistently face high-pressure situations and traumatic events, first responders are particularly vulnerable to the physical and emotional challenges that may contribute to substance abuse.

An estimated 25% of first responders are living with some form of addiction, whether involving drugs and alcohol, gambling, or sex.

Substance Use in EMTs

EMTs and EMS clinicians provide basic life support to people during medical emergencies and are often exposed to intense and traumatic situations where they must act quickly.

Add to this the fact that EMTs are often paid the least but work the longest hours compared to other emergency medical service responders, and it is not surprising that they may turn to drugs or alcohol to cope.

Substance Use in Paramedics

Paramedics have more advanced education and skills than EMTs and are exposed to high-stress situations often or even daily that put them under an immense amount of pressure.

One reason paramedics may be more prone to addiction than other types of emergency responders is that they often have access to addictive prescription medications such as opioids.

Substance Use in Firefighters

Working as a firefighter is one of the most high-stress and dangerous professions a person can participate in, often having to risk their own lives to save others.

Alcohol use and binge drinking are much more frequent among firefighters than any type of drug use or addiction, as firefighters are usually drug-tested regularly and frequently.

An estimated 1 in 3 firefighters abuse alcohol, while 1 in 10 abuse drugs.

Substance Use in Law Enforcement Officers

Substance use is common among law enforcement officers for similar reasons as firefighters. Research indicates that police officers are around 3 times as likely to abuse drugs and alcohol than the general population.

Law enforcement officers tend to have easy access to both drugs and alcohol, a factor that may also contribute to their level of substance abuse.

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Risk Factors for Alcohol & Drug Addiction in First Responders

While first responders are heroes in our communities, they must also live with certain risk factors for developing alcohol and drug addiction.

Stressors First Responders Face

Stressors first responders face that may become a risk factor for substance abuse:

  • Witnessing traumatic events
  • Responding to emergencies
  • Dealing with life-threatening situations
  • Working long hours or night shifts
  • Experiencing high levels of pressure and responsibility

Additionally, first responders may be exposed to violence, abuse, and other forms of trauma, which can lead to ongoing emotional distress.

They may also face challenges balancing work and personal life, leading to increased stress and burnout.

PTSD in First Responders

The high-stress nature of their jobs puts first responders at a greater risk of developing post-traumatic stress disorder (PTSD), a disorder often accompanied by symptoms like severe anxiety, depression, and intense nightmares.

To cope with these PTSD symptoms, many first responders then turn to alcohol or drugs, which can then lead to addiction.

Mental Health Issues in First Responders

The constant exposure to traumatic events and high-stress situations in the line of duty can lead first responders to develop mental health conditions such as anxiety and depression, in addition to PTSD.

Unfortunately, many first responders may feel stigmatized or ashamed to seek help for their mental health problems, leading them to turn to drugs or alcohol as a way to cope instead.

According to a 2018 study published by the Substance Abuse and Mental Health Services Administration (SAMHSA), up to 30% of first responders will develop a behavioral health or mental health disorder of some kind while in their profession.

Signs of Substance Abuse in First Responders

Substance abuse can seriously affect first responders’ job performance, personal relationships, and overall well-being.

Signs of substance abuse in first responders include:

  • Changes in behavior or mood swings
  • Frequent absences from work or frequent tardiness
  • Poor job performance or deterioration in work quality
  • Financial problems or borrowing money frequently
  • Unexplained injuries or accidents
  • Secretive or suspicious behavior
  • Neglecting personal hygiene or appearance
  • Isolation from colleagues or friends
  • Smelling of alcohol or drugs
  • Sudden weight loss or gain

Risks & Dangers of Substance Abuse in First Responders

Substance abuse among first responders poses various risks and dangers, not only to the individuals but also to their colleagues and the communities they serve.

Some of the key risks and dangers include:

  • Impaired judgment
  • Reduced response time
  • Increased risk of accidents
  • Emotional and mental health issues
  • Strained relationships
  • Declining job performance
  • Legal consequences
  • Financial strain
  • Health risks
  • Increased risk of suicide
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Specialized Addiction Treatment Programs for First Responders

Specialized treatment programs for first responders can be found in both outpatient and inpatient addiction treatment centers, though studies have shown that inpatient rehab programs offer the greatest benefit.

Here are some of the most common services and treatment options that you will find in specialized programs for first responders.

Trauma-Informed Therapy

Trauma-informed therapy includes acceptance and commitment therapy, cognitive behavioral therapy (CBT), narrative therapy, and eye movement desensitization and reprocessing (EMDR).

One of the benefits of trauma-informed therapy is that it can help first responders to reframe their traumatic experiences in a way they can understand.

Group Therapy

Group therapy is an effective treatment for substance abuse and addiction in first responders and the general population.

This type of therapy can create a sense of community and accountability. First responders may find it more comfortable to share their experiences and feelings with those with the same unique struggles.

Alternative Therapies

Alternative therapies for first responders include equine therapy, yoga, tai chi, meditation, art therapy, and adventure therapy.

These therapies allow people to tap into their creative, spiritual, and physical sides to address and heal from their addiction.

First Responder Clinical Psychoeducation

Clinical psychoeducation is a type of therapy designed to be structured and educational, teaching the person about their diagnosis and different coping methods.

With first responders, these programs can help them to understand the stressors they face in their profession that may lead to substance abuse.

These programs are also often done in group settings, helping to encourage first responder camaraderie to help support and foster recovery.

SMART Recovery

SMART Recovery stands for Self-Management and Recovery Training, and it is a type of group therapy and peer support based on science.

This type of therapy aims to help people understand their addictive behaviors, learn to manage their thoughts and urges healthily, and ultimately live more balanced and happy lives.

12-Step Support Groups for First Responders Only

Twelve-step support groups for first responders are becoming increasingly popular for these individuals to seek help for substance abuse and addiction.

These support groups are designed specifically for first responders and those who may be more likely to experience trauma and mental health issues due to their work.

By providing a safe and confidential space for members to share their experiences and struggles, these groups can help first responders connect with others who understand their unique challenges.

Gender-Separate Programs

Women make up a smaller percentage of first responders, with current data showing them making up about 35-40% of these professions.

This number is even smaller in specific professions, such as firefighting, of which they make up less than 10% of workers.

For this reason, some women may feel more comfortable in first responder programs that are also gender-specific, where they can be in an environment away from their male counterparts and vice versa.

Mental Health & Substance Abuse in First Responders

First responders face unique challenges and stressors on a daily basis. They are often exposed to traumatic events such as accidents, violence, and natural disasters, which can take a toll on their mental health.

Unfortunately, many first responders turn to substance use to cope.

How Does Mental Health Affect Substance Use Issues in First Responders?

Mental health issues and substance use disorders often go hand in hand. First, responders are no exception, as they are exposed to high levels of trauma and stress nearly every time they go to work.

For many first responders, substance use may initially serve as a coping mechanism to help them deal with this stress and trauma.

However, over time, substance use can become a problem in and of itself, leading to addiction, health problems, and other negative consequences.

Dual Diagnosis Rehab Programs for First Responders

Dual diagnosis programs are designed to provide specialized treatment for people battling addiction and co-occurring disorders, such as depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).

For first responders, who may be exposed to high levels of pressure and stress on a regular basis, dual diagnosis programs can be especially beneficial.

These programs typically involve therapy, detox, medication management, and support groups to help people address their addiction and underlying mental health issues.

How to Help a First Responder Who’s Battling Substance Abuse

If you have a loved one or family member who is a first responder facing substance abuse, here are some steps you can take to offer your support.

1. Make a Plan to Talk to Your Loved One

A spontaneous conversation with a loved one about substance abuse is usually not ideal.

Make a plan about what you want to say, and try to stick with it and not veer off course at all while speaking.

2. Listen to the First Responder’s Concerns

Remember that this is a conversation that goes both ways, and your loved one has a right to speak and be heard in response to your intervention.

One of the best ways you can help your loved one is by attempting to understand them as best you can and how their profession led to abusing substances behind the scenes.

3. Offer Your Support for their Recovery

Make sure your loved one knows they have your full support regardless of their decision.

Offering your support can mean anything from listening when they need support to offer to drive them to therapy appointments or rehab.

4. Provide Information on Treatment Options

To improve your chances of offering help to a first responder battling substance abuse, it may help to research treatment options before your conversation takes place.

Offer multiple options to your loved one, so they can choose the treatment program that makes the most sense.

5. Help the First Responder Seek a Rehab Program

Your loved one may have difficulty locating a rehab program or treatment facility on their own. Helping them find one or more treatment centers is another important way you can provide support.

If you are able to, you may consider providing transportation and support for therapy appointments or visiting your loved one while they are in a residential rehab program.

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Benefits of Substance Abuse Treatment for First Responders

Seeking addiction treatment can be a difficult decision for first responders, as they may fear stigma and negative consequences for their careers.

However, the benefits of seeking addiction treatment far outweigh the risks.

Some benefits of substance abuse treatment for first responders include:

  • Improved physical health: Substance abuse takes a toll on the body and can lead to health problems, but treatment can help first responders return to a healthier state.
  • Improved mental health: Treatment can help first responders cope with any issues that were made worse by their substance use, such as depression, anxiety, or PTSD.
  • Improved job performance: Substance abuse among first responders can lead to poor job performance and put the public and fellow first responders at risk. Treatment can help first responders get back on track and perform their duties more effectively.
  • Reduced risk of injury or death: Substance abuse can impair judgment and coordination, worsening the risk that first responders already face for accidents and even death.
  • Support from peers: Programs for first responders often involve group therapy, providing a supportive environment for first responders to connect with others who understand their unique challenges.

Cost Rehab Programs for First Responders

Rehabilitation programs for first responders are crucial in addressing the unique mental health and substance abuse challenges these individuals face.

However, the cost of such programs can often be a significant barrier to accessing the help they need.

Fortunately, there are payment options for addiction treatment for first responders.

First Responders’ Health Insurance

Many full-time first responders can get health insurance through their employers, including coverage for mental health services and treatment for work-related injuries or illnesses.

These plans often also include coverage for prescription medications, medical equipment, and substance abuse rehabilitation services.

Those first responders who volunteer, such as firefighters, may also be eligible for treatment coverage through their volunteer insurance plan, particularly if substance abuse can be linked to stressors caused by their work.

COBRA insurance may also kick in if a first responder loses their job and insurance. Talk to your rehab center of choice to learn which types of coverage they accept and if they will work with your insurance.

Scholarships and Treatment Discounts

Some rehab facilities or programs will offer their treatment services at a discounted rate for first responders to thank them for their service to the community.

Some of these programs are even offered to first responders at no cost at all.

In some states, it may also be possible to find scholarships or grants available to help first responders who have been affected by substance abuse.

Rehab Center Payment Plans

Payments plans are designed to make drug and alcohol rehab more affordable for people who cannot pay for their entire program upfront, especially if they have no health insurance.

These payment plans may or may not charge additional interest as they are paid off.

Barriers to Addiction Treatment for First Responders

Despite the risks involved and the need for support, many first responders still face barriers when seeking addiction treatment.

These barriers can have serious consequences, not only for the first responders but also for the communities they serve.

Some barriers that prevent first responders from seeking addiction treatment include:

  • Fear of job loss: First responders may fear seeking treatment will lead to job loss or disciplinary action.
  • Stigma: There is often a stigma attached to substance abuse, which can prevent first responders from seeking treatment due to fear of judgment or negative consequences.
  • Lack of resources: Access to substance abuse or mental health treatment can be limited in certain areas, making it difficult for first responders to get the help they need.
  • Lack of confidentiality: First responders may be reluctant to seek treatment if they believe their personal information will not remain confidential and they or their families may be at risk.
  • Denial: Some first responders may not recognize or acknowledge that they have a problem with alcohol or drug abuse, which can prevent them from seeking treatment.
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Resources for First Responders Seeking Addiction Treatment

Many credible and non-profit organizations recognize the special needs of first responders and provide mental health and behavioral health services to them.

First responders may also want to check with their employers or healthcare providers for resources in their local community.

Resources for first responders seeking addiction treatment include:

  • For the Frontlines: This non-profit organization offers free crisis counseling for first responders via text messaging and is available 24/7. Simply text 741741 from the U.S. for help dealing with anxiety, fear, stress, isolation, and other stressors.
  • Disaster Responder Assets Network: DRAN is a network founded and run by emergency and disaster responders. They work to provide information and communication resources to first responders and emergency crisis victims in Northern California.
  • Yoga For First Responders: This non-profit organization offers yoga training and critical stress management classes for first responders specific to their line of work. YFFR also trains first responders to become yoga instructors for their peers/
  • Substance Abuse and Mental Health Services Administration (SAMHSA): A national organization, SAMHSA provides treatment information on mental health and addiction services, including location information and educational resources.
  • National Volunteer Fire Council (NVFC) First Responder Helpline: The NVFC helpline is available to all NVFC members and their families. It can provide up to five free counseling sessions for crisis and mental health support, consultations, and treatment referrals from master’s degree-licensed counselors.

Find Help for First Responders Battling Addiction

First responders with substance use disorders must remember they are not alone in this battle. Recognizing the signs and getting help when needed is crucial, as numerous resources and support systems are available.

Whether through therapy, support groups or reaching out to co-workers and loved ones, finding the courage to share your struggles and seek assistance is the first step toward recovery.

Remember, you have dedicated your life to helping others—now it’s time to allow others to help you. Contact the SAMHSA hotline for treatment assistance or the National Volunteer Fire Council first responder helpline for immediate help.

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Kent S. Hoffman, D.O. is a founder of Addiction HelpReviewed by:Kent S. Hoffman, D.O.

Chief Medical Officer & Co-Founder

  • Fact-Checked
  • Editor

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of and ensures the website’s medical content and messaging quality.

Jessica Miller is the Content Manager of Addiction HelpWritten by:

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

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  2. Donnelly, E., & Siebert, D. (2009, October). Occupational risk factors in the Emergency Medical Services. Prehospital and disaster medicine. Retrieved April 21, 2023, from

  3. Identifying Substance Misuse Responders. SAMHSA. (2014). Retrieved April 21, 2023, from

  4. The Substance Abuse and Mental Health Services Administration. (2018, May). First Responders: Behavioral Health Concerns, emergency … – samhsa. SAMHSA. Retrieved April 21, 2023, from

  5. Tiesman, H. M., Elkins, K. L., Brown, M., Marsh, S., & Carson, L. M. (2021, April 6). Suicides among first responders: A call to action. Centers for Disease Control and Prevention. Retrieved April 21, 2023, from

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