We all live our lives knowing there is the potential for things to go wrong. We all know that life has its ups and downs, that accidents happen, and health emergencies come up.
Our police officers, EMTs, firefighters, doctors, are the first line of defense when these potential emergencies become a reality.
They walk into the burning building, they walk into the ER, they walk into the home of an overdose, they defend us in crisis, and they do it all, with no thought of themselves. They walk into our tragedies, providing us with a sense of relief and oftentimes saving our lives from catastrophic outcomes.
However, there are times when they walk into our tragedies, they walk out with them too. When this happens, after a significantly tragic or traumatic event has occurred, our first responders carry the event home with them. This “taking their work home,” may be the result of PTSD (Post Traumatic Stress Disorder).
Knowingly or unknowingly, first responders with PTSD can easily be led down a dark road towards self-medicating, and at the end of that road, addiction is waiting.
First Responders and PTSD
Research studies have suggested that the rate of PTSD among first responders may be between 15% and 30%. As an overall figure, it is estimated that about 20% of all individuals with the diagnosis of PTSD will also have a co-occurring substance use disorder.
Some of the symptoms of PTSD include:
- Experiences where the person actually relives the traumatic event, such as experiencing vivid memories, recurrent dreams, or even flashbacks
- Experiencing anxiety when reminded about aspects of the traumatic event
- Attempts to avoid reminders of the event (e.g., not watching television shows about emergency situations, avoiding driving for fear of getting in a car accident, etc.)
- Developing hypervigilance to potential or imagined similar types of events
- Depression, anxiety, loss of motivation, becoming overly pessimistic, or isolating oneself from others
- Cognitive issues, such as problems with attention or memory
- Feeling detached from reality or from other people
- Self-destructive behaviors that can include self-harming behaviors or significant substance abuse
First Responders and Addiction
Addiction can take a hold on anyone. Our first responders included. When it does, it has devastating effects regardless of the job description.
Alcohol is one of the most common substances of abuse in individuals who develop PTSD due to its central nervous system depressant effects (it deadens feelings or memories), its availability, and its acceptance across nearly every level of society. Moreover, the relationship is bidirectional, such that developing PTSD is a risk factor for developing a substance use disorder, and having a pre-existing substance abuse problem or substance use disorder is a risk factor for the development of PTSD in all individuals.
Other substances of abuse that are commonly used by individuals with PTSD include benzodiazepines (as these are often prescribed for anxiety), opiate drugs (often prescribed for issues with pain), cannabis products, and illicit drugs. It should be noted that first responders are far less likely to abuse illicit drugs than other individuals.
First Responders and Addiction Treatment
It is important that first responders have treatment tailored to them and their unique experiences in the field. Because it has been demonstrated that Cognitive Behavioral Therapy methods (CBT) are the preferred treatment methods for both PTSD and substance use disorders, some form of CBT will often be the main component of treatment.
Some of the specific goals of treatment for first responders are:
- Helping the person express their own needs in a manner that does not result in them feeling inadequate or exposed (frequent issues with first responders)
- The development of a strong social support system, including family members and coworkers that can assist the person
- An integral part of the social support system should be the person’s family members, potentially strengthened through family therapy
- The development of interests outside of work, to deal with the stress associated with the intensive nature of their work
- Continued participation in group therapy and psychoeducation classes to help the individual recognize the signs of traumatic stress and substance abuse
At RECO, we provide a tailored approach that includes our specialty services. Our clinicians are well-equipped with different backgrounds, specializing in the treatment of PTSD. This approach allows us to get the source of the substance abuse disorder in our first responders and help them begin to heal from the inside out. This is where the journey begins.