Some of the earliest memories of childhood are to meet a paramedic or firefighter. It’s a thrilling sensation to see the large trucks and hear the blaring sirens, but the pressure they face is a task children, and adults seldom see. It’s crucial for paramedics and other first responders to maintain optimum mental wellness as they treat an array of life-threatening injuries. Some shifts can last up to 24 hours, expose them to significant trauma, and increase their susceptibility to abuse drugs or alcohol. Paramedics are incredibly vulnerable to substance abuse.

Despite the risks and some of the heinous images paramedics must live with, aspects of the job contribute positively to their mental health, including meaningful and essential work, positive relationships with their coworkers, above-average wages, and benefits, and a positive atmosphere in the workplace. Sometimes it might be challenging to find a balance when the adversity begins to mount, but there are positives in the profession. However, you may wonder how drug and alcohol abuse affects paramedics.

Is There a Stigma Attached to Mental Health Issues?

One of the primary issues paramedics face is the stigma of mental illness in the United States. The U.S. Centers for Disease Control and Prevention (CDC) suggests that the stigma against those living with mental illness is significant. An estimated 24.6 percent of those living with mental illness believed people would care about their struggles, leaving 57.3 percent of those who were not struggling with mental health symptoms that were sympathetic to the topic. An estimated 77.6 percent living with poor mental health and 88.6 percent not living with mental health problems believed that treatment could assist in achieving a conventional life.

The findings suggest that people in need of treatment fear being judged by others and that individuals like paramedics are more likely to self-medicate their mental health symptoms with drugs and alcohol instead of therapy. Paramedics may see this stigma against mental health issues as a barrier to treatment. Instead of calling attention to their struggles, it may be complicating their ability to function.

Fortunately, there’s been a surge in education and prevention efforts for paramedics, firefighters, and retired veterans to diminish these stigmas and get the help they need. For example, the National Fire Protection Association is working to increase awareness about paramedics and firefighters’ mental health issues. It has led to an improvement in access to treatment.

The Most Common Health Issues for Paramedics

All first responders, including paramedics, are continually exposed to human suffering, which leads to a long-lasting toll on their mental health. The effects of fires, physical and emotional damage caused by abuse and accidents, constant stress, the threat of being attacked, and the inability to save everyone they encounter is a challenge to accept on a regular basis. In addition to all of this, working with others who are struggling with similar mental health issues, problems at home, long shifts, or other personal issues contribute to the extreme rate of mental health disorders among paramedics.

Retirement has been shown to exacerbate drug, alcohol, or mental health disorders masked during active duty. Retirement is a vulnerable period for paramedics and other first responders, and emotional issues they once suppressed come to the surface, leading to self-medication and abuse. Paramedics unable to transition into retirement from active duty in the first year are the most vulnerable to mental health disorders. The most common mental health disorders include:

Post-Traumatic Stress Disorder (PTSD)

paramedic-coming-out-of-back-of-ambulanceParamedics and first responders struggling with post-traumatic stress disorder (PTSD) will not exhibit all of the same symptoms. Those exposed to significant trauma, such as any experience that occurs on any given shift for a paramedic, is known to trigger different subsets of PTSD. The National Institute of Mental Health (NIMH) describes the three types of PTSD as:

  • Re-experiencing: Unexpected flashbacks of the event(s) that bring on sweating or rapid breathing, overwhelming fears, nightmares, and other intrusive symptoms describe this form of PTSD.
  • Avoidance: Intense feelings of depression and guilt, inability to remember traumatic events, no interest in former hobbies, and avoidance of places that trigger memories are signs of avoidance.
  • Hyperarousal: Intense anger, insomnia, feeling on edge, or being easily startled as examples of hyperarousal.


Symptoms of anxiety that persist for more than six months qualify for a generalized anxiety disorder (GAD) diagnosis. It includes panic disorder, obsessive-compulsive disorder (OCD), and social anxiety disorder. These symptoms will vary based on the condition but could consist of fear of specific places, obsessive thoughts, insomnia, or drug and alcohol abuse.


Depression is common in society, and the occasional feeling down or sadness is nothing to be concerned about. However, paramedics might suffer deep feelings of hopelessness, suicidal thoughts, insomnia, guilt, or other problems related to depression. The diagnosis could be mild or severe, or it could relate to other mental health disorders such as PTSD. It may be driven by substance abuse or addiction.

Drug And Alcohol Abuse

Drug and alcohol abuse is characterized by the compulsive use of substances despite adverse consequences that follow. It is a chronic disease causing discernible changes in the brain, leading to deteriorating mental and physical health. Paramedics diagnosed with addiction cannot stop drinking or using drugs by themselves and must seek professional addiction treatment for help.

Paramedic Drug and Alcohol Abuse Statistics

Due to the stigma attached to getting help, especially for first responders, statistics don’t paint an accurate picture of how drug and alcohol abuse affect paramedics. With that said, an estimated 9.1 percent of public safety workers reported heavy alcohol usage in the previous month. The rate of alcohol consumption in this category was slightly above the national average, but firefighters and paramedics had the lowest rate of illicit drug use among first responders. An estimated ten percent of firefighters may be abusing drugs, which is more than double the general population.

The Need for Treatment

There are significant barriers when it comes to getting treatment for paramedics. Some of which include:

  • Denial.
  • Stigma on the job.
  • Fear of losing their job.
  • Backlash from the community they serve.
  • A belief treatment won’t work.
  • Financial concerns.
  • Access to treatment.

Fortunately, numerous options exist when it comes to mental health treatment services for paramedics. The issue could be depression or anxiety or mental health issues exacerbated by drug and alcohol abuse. There’s a wide range of treatment services, but it must first begin with a diagnostic evaluation to determine the course of a tailored program. Treatment must be fit to the individual’s specific needs to be successful.

If you’re a paramedic or know one struggling with the effects of drug or alcohol abuse, it’s time to consider getting help. You should not worry about the stigma attached when your life’s on the line. Therapy will allow you to learn coping mechanisms, apart from drugs or alcohol, to deal with PTSD or other problems caused in the field. You don’t have to live another day with addiction.

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