In 2022 and 2023, California employed 32,930 firefighters, 22,690 Emergency Medical Technicians (EMTs) and paramedics, and 68,010 police officers. Suppose 16% of them have a substance use disorder. In that case, approximately 19,780 of the 123,630 first responders in the state have developed this condition. This poses consequential risks to their well-being and impacts their ability to effectively execute their critical, life-saving responsibilities.
At Pacific Sands, we understand the unique challenges first responders face in addressing and overcoming substance use disorders while balancing the demands of their careers. Today, we will explore the connection between first responders and addiction and how achieving recovery empowers them to excel in their profession.
Substance Use Disorders and Emergency Responders: What Is the Relationship Between Them?
First responders, such as police officers, EMTs, paramedics, and firefighters, are professionals who respond to emergencies that threaten the lives of people and the community. Because of their jobs, they are at an increased risk of witnessing traumatic events like seeing an injury, being injured themselves, being threatened with a weapon, or seeing someone die. These events happen frequently in their daily jobs and pose a risk of creating mental health concerns.
As a way to cope with those concerns and events they experience as a result of their job, many turn to substances as a way to cope. In one study, researchers found that out of the 112 firefighters they surveyed, 80% drank alcohol, with 14% having hazardous drinking behaviors. Firefighters are not unique to this in the first responder community as they all are exposed to these circumstances, which might lead to a need for unhealthy coping mechanisms.
Potential Risk Factors for First Responders and Substance and Alcohol Use Disorders
Beyond the constant exposure to potentially traumatic events, other risk factors exist. First responder careers are a teamwork profession. As a result, people become close and might feel pressured to go out with their coworkers to decompress at a bar or other location after getting off work. It is important to remember, however, that not everyone who drinks alcohol will have an alcohol use disorder.
Still, in this type of environment, they might feel encouraged to continue their substance use to cope with the day’s challenges. Some might not recognize that there are any concerns with their alcohol consumption because everyone else in their profession is drinking. They might see it as just a regular part of their occupation.
Additional risk factors first responders are exposed to as a part of their job include:
- Mental health disorders, including acute stress disorder (ASD), post-traumatic stress disorder (PTSD), and depression – First responders have a 30% chance of developing a mental health disorder compared to the 20% in the general population
- Compassion fatigue or burnout – It is easy for first responders to experience a depletion in their capacity for empathy as they are often overworked and/or are not supported by their leaders
- Poor sleep conditions due to 24-hour shifts – These long-hour shifts of witnessing potentially traumatic events create disrupted sleep patterns and don’t allow them to process these experiences between exposures properly

PTSD’s Impact on Substance Use Among First Responders
PTSD may develop as a result of experiencing or witnessing a traumatic event. For first responders, there is a potential exposure every shift. A 2022 study found that firefighters had a higher rate of PTSD symptoms than military personnel. It was 57% for firefighters, while military personnel had 37.8%. Firefighters often risk their own lives while entering a burning building and witness the traumas of other people, which could be contributing factors to higher rates. The other first responder professions also experience similar events in their fields.
Individuals who have PTSD are 2 to 4 times more likely to develop a substance use disorder compared to those who do not. One reason this might be the case is because substances can alleviate specific PTSD symptoms like hyperarousal and avoidance symptoms. Avoidance symptoms might include not wanting to think or talk about the event. In contrast, hyperarousal symptoms might consist of concentrating or sleeping concerns. Substances may be seen as beneficial in reducing the intensity of these symptoms and making it temporarily easier for them to continue doing their jobs.
Signs of Substance and Alcohol Use Disorders in First Responders: How Can You Know If You Have Developed One?
As mentioned earlier, being exposed to traumatic events and drinking alcohol or consuming substances as a way to decompress from those experiences is typical for first responders. Still, not everyone will develop a substance or alcohol use disorder. So, how do you know if you have developed one?
There are several signs, as outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), that allow medical professionals to know if someone has a substance use disorder. These signs also let you know if you or a loved one might have developed one, enabling you to understand when you need help. These include:
- Having a strong desire to take substances or drink alcohol
- Being unable to stop taking substances despite trying in the past
- Being unable to fulfill responsibilities at work or home due to substances
- Substances have created concerns with interpersonal relationships
- No longer participating in social or recreational activities due to substances
- Taking substances despite the risks involved
- Consuming a large amount of substances
- Experiencing withdrawal symptoms
- Needing to increase consumption to get similar effects
The Impact of Substance Use Disorders in Different First-Responder Professions
While it is common for substance use disorders to impact first responders at a general level, they could manifest and present themselves in different ways when examining the individual professions of police officers, paramedics, EMTs, and firefighters. Below, we discuss the different complications each might face when balancing a substance use disorder with their career.
Understanding Substance Use Disorders in Police Officers
A recent study discovered that 37.2% of male officers and 36.6% of female officers participated in binge drinking. The study showed that high levels of work environment stress, the presence of PTSD symptoms, and general psychiatric symptoms resulted in a higher risk of alcohol-related concerns among law enforcement. Likewise, other substance use disorders are also possible to cope with trauma, mental health conditions, irregular sleep habits, or injuries they received while on duty. Common police officer injuries include car accidents, use of force incidents, wearing their duty belt, sitting in a car for extended periods, or standing in one location for long hours. Taking certain substances may provide a sense of relief.
As a result, if they develop a substance use disorder, it creates several concerns that might impact their ability to successfully complete their job. For example, they might become drowsy or fall asleep during their shift, have moments of forgetfulness, be late to or miss many days at work, or be unable to complete tasks. Sometimes, it might even result in them disappearing from their shift to hide their substance use and to satisfy cravings. Some might begin to make poor decisions or be more likely to take unnecessary risks that have legal or occupational consequences.
How Substance Use Disorders Impact Paramedics/EMTs?
Compared to police officers and firefighters, there isn’t as much research on the specific impact or prevalence of paramedics and EMTs when it comes to substance use disorders. This doesn’t mean that there isn’t one. After all, extreme stress and witnessing a traumatic event are risk factors for developing a substance use disorder, both of which are everyday experiences for someone in this field. As a result, anyone with this condition will have complications in their professional life.
When it comes to paramedics and EMTs, a substance use disorder might result in someone not making the right decision when it comes to providing life-saving care. They might have moments where they are unable to complete routine tasks or might become forgetful of what they are trying to do. Like police officers, they might disappear in the middle of a shift to consume substances, which could place more work or responsibilities on their coworkers at the scene of an emergency or delay transportation.
The Impact Substance Use Disorders Have on Firefighters
While firefighters can have other substance use disorders, alcohol use disorders tend to be the most common in this profession. One study showed firefighters have a 50% lifetime risk of developing this condition. This is often due to the unusual work hours and potentially traumatic events they might encounter, such as witnessing building collapses or severe injuries or deaths of children or people in general. They might feel it is necessary to use alcohol as a way to cope with the psychological pain quickly before their next call.
However, a substance use disorder makes it difficult for a firefighter to successfully perform their job. Excellent reaction time and coordination are essential to this profession as fires often risk their and their team’s lives. This condition results in an impairment of those skills, which could lead to an accident or decrease in job performance that endangers themselves, their team, and anyone they are trying to save.

Substance Use Disorder Treatment for First Responders Is Available in Santa Ana, CA
The good news is that recovery from a substance use disorder is possible for first responders. While trauma and stress are standard components of the job, and you might be in an environment that encourages substance use to cope with those elements, all hope for healing is not lost. Through drug rehab, you will learn and develop the necessary skills that will provide you with the strength to complete the job you love, manage the associated stress and trauma, and leave substances behind as you find a healthier way of living.
Pacific Sands has a maximum of 6 clients with private rooms. Our facility is solution-focused, ensuring that you will receive the treatment that guarantees your success in recovering. For more information, contact us today at 949-426-7962.
Pacific Sands – The first step towards a new life.