This article was originally posted Nov. 20, 2019. It has been updated.
By Drew Prochniak, MA, LPC, LMHC
Despite the increased focus on first responder wellness and resilience in the past decade, little attention is paid to the significant, ongoing problem of substance abuse within these professional communities.
According to the Addiction Center, appoximately 30% of first responders develop behavioral health conditions, including depression, anxiety and PTSD, which put them at higher risk for addiction.
Sadly, real or perceived social, political or systemic obstacles often exist that preclude an individual from asking for help, acquiring appropriate treatment or returning to a supportive work environment. This article addresses these issues and provides some guidance for navigating these challenges.
Asking for help for substance use problems
Asking for help with an alcohol or substance use problem should not be an impossible task. However, shame, fear of appearing weak or concern that one’s reputation or career will be negatively impacted often keep individuals from reaching out. Those individuals suffer in silent isolation as the problem grows. Seeking treatment before the problem negatively impacts your career is the best hope for limiting consequences.
Trusted coworkers within your department or at a neighboring agency can be a good place to seek initial help. Departments with peer support teams recognize the need for first responders to have a helpful resource to obtain such support.
The Americans with Disabilities Act protects some individuals with alcohol abuse or dependence issues. According to the Job Accommodation Network, the same cannot always be said for illegal drug use, so it is important to be familiar with the limitations of your protection and your department’s policies. Being able to show a history of self-initiated treatment, and obtaining it sooner rather than later, can help demonstrate your recognition of the problem and your willingness to address it, especially if licensing or certification boards are involved.
Acquiring substance abuse treatment
Various levels of treatment are available for anyone willing to address a substance use issue. From group support meetings like Alcoholics Anonymous or Narcotics Anonymous to counseling, intensive outpatient programs or inpatient treatment, different levels of treatment may be necessary given a host of variables.
Often officers can be reluctant to attend support meetings for fear of running into “clientele.” To remedy this concern, consider attending meetings out of your district or in a neighboring city, if possible. When this is not an option, online meetings may be a helpful alternative. In larger cities, “first responder only” meetings may be available (these meetings are not usually listed on any public forum and are best found by asking around). Remember, you do not need to disclose your profession at these meetings.
Outpatient counseling can be a great benefit for any officer needing additional support and professional guidance. It is important, however, that these professionals be “culturally competent,” meaning they understand and know how to work with first responders, especially when it comes to honoring confidentiality.
Sometimes, inpatient treatment may be necessary to appropriately begin addressing one’s substance use. More and more treatment centers are advertising specialty programs for working with first responders and veterans. However, being with like-minded individuals may not suit everyone. Some important questions to consider include:
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Is a lower level of treatment necessary before my insurance will approve inpatient treatment?
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Will my insurance cover inpatient treatment at this facility?
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What is my projected out-of-pocket cost? Can my union help cover any expenses?
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Can coworkers donate sick/vacation/comp time to help cover while I am away?
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What about utilizing time under the Family and Medical Leave Act (FMLA)?
Returning to public safety after substance abuse treatment
Returning to work can often result in anxiety for first responders who have been away for any significant length of time. Knowing that there are likely to be questions about where you’ve been can cause some individuals a fair amount of stress. Remember that your experience is yours to share with whomever you wish, in whatever way you wish.
It is reasonable that not everyone who asks will get the same detailed response. Depending on your relationship with the individual, you may feel safe and comfortable disclosing where you’ve been and what has been going on, or you may wish to significantly limit what you share.
Here are some responses that may be helpful in planning your reply to others:
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“Thanks for your concern, but I’d rather not discuss it.”
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“I’ve been away taking care of some personal business.”
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“I’ve been addressing some health concerns I’ve had for a while.”
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“I was struggling with a drinking/substance use problem for a while, and I’ve been away at treatment.”
While the latter response may feel too honest to some, it takes courage and ownership to be completely truthful. Perhaps by acknowledging the issue openly and showing you’ve taken the initiative to address it, you are supporting other first responders who want to seek help for themselves. Choosing to challenge the stigma and secrecy of a substance use problem is a significant step toward being rid of both.
The role of administrators in first responder wellness
The cost to replace a veteran first responder is steep. It is astounding that agencies continue to demonstrate the propensity to address problems, not people. Consider how the implicit or explicit messages that administrators send about first responder wellness, mental health and substance use/abuse may be received by members of both rank and file.
Do the policies of your agency, and the way they are enforced, support the overall wellness of its employees and encourage individuals to seek assistance, or do these guidelines express a punitive tone? Support services must be made openly available and confidential in order to support any chance of a positive outcome for the officer. Dr. Jack Digliani’s Make it Safe Initiative offers a host of recommendations on how administrators can be more supportive of their members.
About the author
Drew Prochniak, MA, LPC, LMHC is a mental health therapist who specializes in the education, training and treatment of first responders and is the author of “Addiction and Recovery for First Responders.” With a background in wilderness medicine, he is a former search and rescue professional and comes from a family of law enforcement officers and other public safety professionals.
He has presented nationally on topics related to addiction, trauma and traumatic stress, work-life balance and resilience for public safety audiences. He currently is a sought-after trainer in peer support and CISM. Before establishing his private practice in Portland, Oregon, he worked as a clinician in the addiction treatment industry for nearly seven years.