For firemen, police officers, EMTs and combat veterans, death, violence and seeing horrific images are often all part of a day’s work. Many cope by using drugs and alcohol to mask their fear and pain.

You’re at your job. You aren’t having a good day at work. You are hearing gunshots. Bodies are lying on the ground. There is blood everywhere. Lots of it. You have just a few seconds to react, to do what has to be done, you need to save others, and possibly even save yourself, and those seconds go by quickly. You do your job. You do it well. Later that night you go home from work. Then it’s over.

But is it?

For firemen, police officers, EMTs and combat veterans, death, violence and seeing horrific images are often all part of a day’s work. People that work at these jobs all deal with a kind of stress that the rest of us could never imagine. Especially when they are first responders—those that are first on the scene of an accident, a horrific crime or a natural disaster.

It isn’t like most first responders have a comfortable place to talk about these things either. To show that you are affected by witnessing horrible acts, death, and chaos could make one appear weak and could affect your future and career goals.

“Jeff” a police officer that I know in my city, was recently the first to arrive at a particularly nasty death scene, this one was a suicide. How did he handle it? “I joked around and pretended it didn’t bother me. You don’t want to be saying to the other guys that you are having a hard time dealing with stuff like this. It kind of goes against the code. Everyone would call you a baby.”

So how do a lot of first responders deal with such things? Many cope by using drugs and alcohol to mask their fear and pain.

Experiencing these terrible things day after day can often lead people, even without prior addiction problems, to seek solace by using substances, and those that already have issues with drugs and alcohol often go farther down a path of destruction. And when they do go down that path, a lot of first responders just keep their problems inside and hidden, as many feel there is no place to get help that can help them.

However, there are such places. There are rehabs out there that offer specialized programs for law enforcement, firefighters, EMTs/paramedics, corrections officers and combat veterans that combine peer support with clinical, evidence-based treatment.

What first responders see can range from mundane to horrific at a moment’s notice. Every violent, disturbing, scary story that you read in the paper or see on the news, first responders were there, whether it be child abuse, death, violence or rape.

“Tim” a 35-year-old fireman, has been addicted to some form of mind-altering substance since high school. In his teens and early 20s he was into what he thought of as “party drugs”—alcohol, marijuana and cocaine. He didn’t feel like an addict, and thought he was keeping it under control at his job because he could stop using for long periods of time, usually for one or two months at a time, before he would pick up again. When things got bad he could always pull it back for a bit.

He was injured on the job and became addicted to pain meds. He tried to stop numerous times but the longest he could go was about a week before he would be back to taking them again.

When asked about this time Tim said: “Once I realized that by taking the opiates I could minimize the physical pain I was in and that they could help drown out the mental issues too, I began to abuse them a lot more. I started believing that by taking them every day, I wouldn’t have to relive the tragic events that happened at work. I really thought by continuing to abuse them that the pain of what I saw and experienced would just go away. After a substantial period of time and more added traumatic stress, they not only didn’t take either the physical or mental pain away anymore, my addiction actually made them worse.”

Finally, things became unmanageable and Tim went to an inpatient program specifically designed for first responders at Livengrin. “I really needed to talk about my underlying problems as well as my addiction. With the graphic and traumatic events I saw and experienced at work, I don’t think I would have felt as comfortable to talk about these specific situations at a typical treatment center. Having other addicts and counselors familiar with my job and the stressors that come with it, this provided a very comfortable setting to be able to talk about much more than just my addiction.”

While there are some progressive departments out there that have mandatory “debriefings” after major incidents, many do not provide any support at all for those who are struggling. As a result, many first responders do not address the horrific amount of cumulative stress that they are under, or figure out how to deal with their constant exposure to traumatic events. Because of the unwritten code for such professions, first responders often don’t trust outsiders, especially mental health professionals. The fear is that if they admit to needing help, they will be found unfit for duty and have their gun or badge taken away and they will be put out of work indefinitely. This lack of trust coupled with their training that teaches them that they must always be in control is a pretty solid foundation for not seeking help. Read more “the fix”…