First responders, like soldiers exposed to combat, may be exposed to many traumatic experiences. They are present at all natural disasters in our country and other crises, suffering high rates of burnout because of the intensity of their jobs. Treating domestic violence, shootings, and overdoses from addiction, such as opioids, is part of their job, and yet, they are falling prey to the habit themselves. Who are our first responders: police, firefighters, emergency medical teams, paramedics, 911 dispatchers, ER personnel, and rescue workers, to name a few.

The rate of PTSD among first responders is growing as the intensity of their jobs increases without a break. They are called on to move from one crisis to another without a break. For example, first responders can answer four overdose calls in some areas daily. Indeed, the “rate of PTSD among first responders have remained higher than the rates in the civilian population for the past decade….”

Alcohol use and substance use are ways first responders try to manage their feelings, exhaustion, fear, sleeplessness, anger, depression, anxiety, and more. “It is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and [PTSD], as compared with 20% in the general population. In a study about suicidality, firefighters reported more serious attempt and ideation rates than the general population. In law enforcement, the estimates suggest between 125 and 300 police officers commit suicide every year.”

Conditions associated with First Responders

  • Depression: Mental health disorder characterized by persistently depressed moods or loss of interest in activities. This affects how you feel, think, and handle daily activities, such as sleeping, eating, or working.
  • Post-traumatic stress disorder (PTSD) or symptoms: Disorder where you have ongoing feelings of stress or fear, even when not in danger. Symptoms that last more than a month and interfere with relationships or work may be considered PTSD.
  • Suicide ideation: Thinking about, considering, or planning suicide.
  • Substance use disorder (drug addiction): A disorder affecting a person’s mind and behavior, leading to an inability to control the use of a legal or illegal drug or medication. The continued use of these substances changes normal behaviors and interferes with your ability to work or have good relationships with friends and family. Note: Substance use disorder does not require that a person be physically or psychologically dependent on a substance

What is an Opioid?

An opioid is a chemical compound that resembles opium. Opioids can be natural compounds or synthetic. The natural blend of opium comes from the poppy plant. It is found in morphine, codeine, oxytocin, and heroin, to name a few. These drugs are used as painkillers. These drugs are highly addictive. Today there are synthetic opioids that are many times more powerful than the natural compound.

How Opioids Work

The brain sends messages throughout the body utilizing different proteins called receptors. These receptors are on the nerve cells in the brain and are also used to send messages to the body. Opioid drugs attach to the opioid receptors on nerve cells in the brain, the spinal cord, and other body parts. The opioid receptors can block the pain messages. The drug can produce a sense of euphoria or a high; over time, more of the drug will be required to reach a sense of euphoria first experienced.

Ways in which opioids are consumed:

  • Pills
  • Inhaling powder
  • Injecting it into the veins

Because opioids are so highly addictive, it is never a good idea to take a family member or friend’s prescription to self-treat pain or affect a mood disorder. While the number of prescriptions for opioids has gone down over the last seven years, the number of opioid deaths remains alarming.

In the first responder culture of “tough,” mental health disorders is a sign of weakness. First responders regularly are exposed to drugs but also deal with exposure to death, near death, violence, etc. Additionally, for a first responder to admit to a problem with substances leaves many first responders fearful for their careers. As a character trait, first responders do not look at mental health help as a positive.

Firefighters, police, and emergency medical teams are often at significant risk of injury when responding to a crisis. Injuries and various other issues facing first responders can leave them vulnerable to substance abuse, especially opioids that relieve pain.

Signs of Opioid Abuse

  • Constipation
  • Nausea
  • Feeling high
  • Slowed breathing rate
  • Drowsiness
  • Confusion
  • Poor coordination
  • Increased need for a high dosage of pain medication
  • Increased sensitivity to pain with a higher dose
  • Lack of work performance
  • Mood changes
  • Accidents
  • Poor judgment
  • Dry mouth
  • Vomiting

Treating First Responders for Opioid Use Disorder (OUD)

The culture of first responders can be challenging to break through because people in these roles see themselves as “tough.” Proper diagnosis of the mental health condition and the SUD (OUD) is crucial. Generally, most individuals who have PTSD also have co-occurring disorders in alcohol use or drug use or both.

Moving into a detox facility where the medical and clinical staff work together to get the correct diagnosis and provide the proper medications is essential to help stabilize a mental health disorder and detox successfully from substances. This process must happen before the first responder can move into treatment. If only one of the co-occurring conditions is diagnosed (drugs or mental health disorders), treatment will not work.

Once a person completes the detoxification process and has been stabilized and a plan for moving to treatment arranged, he/she/they need to move immediately into a treatment program equipped to address issues relating specifically to first responders. Research has shown that when first responders are in groups with other similar professionals his/her/their recovery has a better chance.

Additionally, treatment protocols must include trauma-informed care, such as trauma-informed cognitive behavioral therapies or EMDR (eye movement desensitization and reprocessing) and group counseling, to name a few. Other treatments are also needed, such as mental health disorder education, medication management, coping skills, healthy stress-relieving activities, and family counseling.

The treating facility should always be licensed and staffed by licensed medical professionals and clinicians with expertise in addiction and mental health disorders who operate as a team and utilize best practices. The client must be regularly evaluated, and the treatment plan adjusted to address issues as they arise. Finally, there needs to be a formal aftercare plan that will help the first responder during the transition from treatment to work. Support groups that support the first responder are a necessary part of recovery to address stresses as they arise.

If you or a loved one is a first responder suffering from co-occurring disorders, which include opioid addiction and mental health disorders, call and speak to one of our trained staff. We can answer all your questions and get you on the road to recovery today.