Why It’s Harder for First Responders to Seek Help for Addiction

Their go-getter personalities make it hard to admit they have a problem.

First responders – police officers, firefighters, emergency medical technicians (EMTs) – experience higher rates of alcoholism, suicide, other mental health issues than the general public. Due to the nature of the job, first responders are more vulnerable to trauma, stress, and negative emotions. On average, they experience 188 critical incidents over a 20-year period, while the general public may experience one or two in a lifetime.

Unfortunately, despite being much more at risk, first responders are also much less likely to seek help. Their type-A, go-getter personalities often make them resistant to admit they have a problem. To them, it means they are not in control. They see themselves as helpers, not the ones who need help. They might think they are superheroes who can handle everything, but they are only human, after all. When struggles with life’s challenges or some need for help occurs, the compounded impact can really hit them hard.

All addiction carries an element of denial. Addiction is a disease that keeps people from recognizing how bad things really are – and first responders seem particularly prone to this distorted thinking. Because it’s important to “tough it out” like the culture of their profession often expects, many first responders deny (even to themselves) that they are emotionally compromised by the stress and trauma of their jobs. They may be drinking or using substances to deal with their unexpressed emotional pain; but when they put on the uniform, they feel 100% ready and they’re able to pull it together. While the rest of their lives may be falling to ruin, they feel that as long as they can work, they don’t have a problem and don’t need help. This distorted thinking pattern can be detrimental in getting help for first responders struggling with substance use disorder (SUD).

First responders with SUD often don’t recognize or admit there is a problem until they are nearing the brink of disaster. Even then, many still offer excuses about why their behavior isn’t problematic or why they don’t need help. Caron’s experts in the First Responders Program recognize these as red flags that are symptomatic of a problem that needs to be dealt with and requires professional help.

Excuses that are really, in fact, red flags

Distorted thinking is the rationalization and justification of continuing problem behavior, even in the face of evidence that what they are doing is harmful. If you find yourself or a loved one giving these excuses when asked about the use of alcohol and substances, take a step back and examine whether distorted thinking is at work.

  • I can't have a problem.

    Given the nature of their keen ability and training to solve others’ problems, many first responders abide by the notion that they aren't supposed to need help; they are the helpers. They take pride in their ability to have grace under pressure, whereas others may be overcome with emotion. However, first responders are still human beings who inevitably are affected by the emotional impact of what they experience. Ignoring it doesn’t make the issue go away; it just changes how it presents, such as problem behaviors resulting from substance abuse or self-medication. Denial is fueled by distorted thinking about their ability to handle everything and that needing help is a weakness.

  • My partner, Joe, drinks more than I do.

    Peer relationships matter a great deal to first responders, and they often judge their responses and behaviors against those of their peers. The reality is that individuals respond to situations differently and have varying thresholds based on their own biases and experiences.

    Trust is everything among partners – especially when dealing with a crisis. It can make it incredibly difficult to admit having a substance use problem, for fear of being perceived as weak, unreliable or untrustworthy.

  • It's not that bad.

    The sad truth is, if you are saying your use of alcohol or substances isn’t that bad, it probably is. It is certainly a warning sign that your behavior surrounding alcohol or substances has progressed and is being noticed by friends, family, and colleagues.

  • I'm not hurting anyone.

    Despite the serious potential health consequences of long-term or excessive use of alcohol or substances, there’s a myth that such use “doesn’t hurt anyone.” The behaviors associated with problem usage put a tremendous emotional and physical strain on spouses, children, family, friends, and colleagues.

  • It's not a problem. I still go to work. I never miss work.

    We hear this a lot in the First Responders Program at Caron. Work is often the last thing to be affected by substance use disorder. The rest of their lives may be crashing down around them, but they still manage to be functional at work. However, eventually, the problem is going to affect their work.

  • I don't drink at work. I've never gone in drunk to work or under the influence.

    For a lot of first responders, that will be true, until it's not true. Alcohol or substance use disorders are progressive diseases, which eventually can get to a point where they cross that line.

Distorted thinking about going to treatment

Much of the distorted thinking involves going to treatment. They may have gotten to the point where they know they need help, but they still find excuses that keep them from getting that help.

  • I can't miss work. I can't be away from work for 30 days.

    Although no one is irreplaceable, work will survive without that officer or firefighter. The reality is that the first responder’s job has become such a part of the individual’s self-identification, it is hard to imagine being away from it for 30 days. Getting healthy, however, will help individuals “show up” and be truly present at work – and home.

  • I need to be home. I can't be away from my family.

    Alcohol and substance use typically puts a huge emotional strain on the family. The long-term benefits of getting healthy both mentally and physically far out-weigh the short-term inconvenience of being away from home for a short while. The family will likely be healthier for it.

  • If I go to treatment, I could lose my job. If work knows I have a problem, they will take me off the job.
    This isn’t necessarily true. People can't be fired for having a substance use disorder; however, they can be disciplined or fired for the behavior that results from it. It is essential for first responders to get treatment before their behavior begins causing problems at work. Unfortunately, by waiting to reach this point, there are likely many factors forcing them to come to treatment, whether it's a significant other at home giving an ultimatum, trouble at work or legal trouble, or driving under the influence or an accident.
  • I need to work to pay my bills. I can’t afford treatment.

    Denying a problem or not getting help can have big – and even financial – consequences, like putting their jobs in serious jeopardy. The sooner a problem is addressed, the greater the chances of success.

    Treatment programs for first responders, like Caron’s First Responders Program, are often covered by the first responder’s health insurance. Other options also exist to help a first responder get the treatment they need and deserve.

  • I don’t need an in-patient program. I can do this on an out-patient basis.

    Out-patient programs can be less expensive and less disruptive to everyday life, but it is difficult to do the hard work of recovery while still in the midst of the stress and trauma that brought on the crisis in the first place. An in-patient program provides a safe, supportive environment, where people are given time to learn the tools they need to live in recovery. Getting sober is the easy part. Staying sober takes work.

There is help.

Distorted thinking is one of the major hurdles for getting first responders who may struggle with SUD to seek the treatment they need. Sometimes heroes need help too.

First responders are exceptionally adept and skilled in handling stressful and crisis situations, making it difficult to notice symptoms of struggling with SUD. Addressing these subtle signs and getting help is the first step. One successful approach is through peer-driven interventions, where a trained peer keeps an eye out for signs someone is having issues and refers them to the right help, or you can contact me directly to learn about the resources available. Hope is here.

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