Blog - Beach House Rehab Center
Substance abuse options for firefighters
May 18, 2018

Firefighter’s Substance Abuse Rehab Options: Understand Your Needs and How to Find Help

Substance abuse options for firefightersAs a firefighter, you have an extraordinarily demanding, dangerous and stress-filled occupation. Not only do you put yourself in harm’s way every time you respond to an emergency call, you also experience accumulated mental and physical health assaults that can lead to a substance use disorder (SUD), co-occurring disorders and even post-traumatic stress disorder (PTSD). When you’ve reached a critical turning point and want to find help, first understand your needs so you get the specific rehab and treatment options designed to assist you in overcoming these conditions. You have come to the right place, as Beach House provides these types of treatments.


Misusing substances such as alcohol and drugs, or a combination of alcohol and drug use, is a common, though ineffective, coping measure for trying to deal with life’s problems. As firefighters, exposed to constant danger, you may turn to alcohol and drugs to forget about what you’ve gone through, the horrific scenes of carnage and death you’ve witnessed, the charred destruction left behind. Once the behavior pattern of drinking or doing drugs goes from casual use to regular use, however, it often progresses rather quickly to everyday use. When other negative aspects arising from the constant use of substances accumulate, addiction is often the inevitable result.

Addiction, says the American Psychiatric Association (APA), “is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence.” The APA goes on to say that people with severe SUDs can be so intensely focused on the substance of alcohol or drugs that it takes over their lives. Even though they may know they have a problem, they continue to use. In fact, they’ve become incapable of discontinuing substance use because their body and mind have been rewired to respond to the intense cravings.

Symptoms of Addiction

While many symptoms have been described in literature as characterizing addiction, the APA groups them into four main categories:

four main categories of addiction symptoms

Substances of addiction include not only alcohol, but also prescription drugs like painkillers and sedatives used for nonmedical purposes, marijuana, illicit drugs such as heroin, cocaine, methamphetamine, inhalants, and hallucinogens such as PCP and LSD.

Treatment for a SUD should be comprehensive and tailored to meet specific needs. At Beach House, treatment includes detox from alcohol or drugs, residential treatment, long-term residential treatment, intensive outpatient care, aftercare outpatient care, and an active alumni program.


Besides constant vigilance exacting a toll on firefighters, there’s mounting evidence that such a demanding job wreaks havoc on emotional well-being and mental health. When someone has a problem with alcohol and/or drugs and a mental health disorder, such as anxiety, depression, and PTSD, among others, it’s called co-occurring disorder or dual-diagnosis disorder. Each disorder or condition has its own set of symptoms, many unique, some overlapping. Each requires concurrent, comprehensive and tailored treatment to meet the individual’s specific needs. At Beach House, continuum of care treatment provides evidence-based therapies for co-occurring disorders that include medication, cognitive-behavioral therapy (CBT), eye movement desensitization reprocessing (EMDR), mindfulness meditation and yoga, peer support and life skills groups, and family therapy.


According to the American Psychiatric Association (APA), PTSD “is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape, violence or other personal assault.”

7.7 million Americans over the age of 18 suffer with PTSD. Among them: firefighters, men and women who risk their lives to rescue and protect the populace in the event of fires, disasters, and other crises. The high-stress nature of the work of these public servants amplifies their risks of a PTSD diagnosis. Even just one exposure to a natural disaster correlates with higher rates of PTSD. (For example, 67 percent of people exposed to natural disasters – whether the victims themselves or emergency responders who rush in to help them – will develop PTSD.) Repeated exposure to trauma in the line of duty only adds to the likelihood of PTSD developing.

Symptoms of PTSD

The National Center for PTSD identifies four types of symptoms for PTSD:

  • Reliving the event. Called flashbacks, memories of the event can occur anytime, flooding the consciousness with unwelcome and unavoidable vivid images of the traumatic episode or experiences. Flashbacks generally follow a trigger, hearing or seeing something that reminds you of the event. Such reliving of the event can be frightening, feeling as though it is happening again in the present.
  • Avoiding things that are reminders of the event. Those who have PTSD go out of their way to avoid encountering people, places and things that remind them of the event. Firefighters, though, do not have that option, as they are duty-bound to go into harm’s way to assist those who need their help.
  • More negative feelings and thoughts than before. Like symptoms of a SUD, someone suffering from PTSD may experience a cascade of increasingly negative thoughts and feelings. He or she may be alternately sad or numb, find no interest in being around people or doing activities they once enjoyed. Feeling guilt or shame about not being able to do more to help or save people during the event is also common with PTSD.
  • Feeling keyed-up or on edge. This is a state known as hyperarousal, during which the individual with PTSD may be quick to anger, is easily irritated, finds it tough to relax or concentrate, has difficulty sleeping, and is constantly on the lookout for danger. When firefighters, who encounter danger every time they respond to a 911 call, also have PTSD, it’s only going to get worse without treatment.

Trying to cope with these symptoms often leads to unhealthy behaviors, including abusing drugs and alcohol, smoking, driving aggressively and taking other risks. In fact, about 50 percent of those with serious mental health issues have high rates of substance abuse, and about 37 percent of those abusing alcohol and 53 percent of drug users also have a serious mental health issue.

The emotional weight of PTSD symptoms can lead to other problems, including substance abuse and addiction, depression, anxiety, insomnia, difficulty functioning daily. Indeed, firefighters and others with PTSD find that their basic needs fall apart. They become super hyper vigilant, have night terrors and other sleep-related difficulties. Trying to cope by self-medicating with alcohol, a depressant, only makes depression worse over time.

Firefighters with PTSD

In partnership with the International Association of Firefighters and NBC-owned stations anonymously surveyed firefighters and found firefighters across the nation are struggling with mental health issues and PTSD. More than 96 percent of survey respondents said they experienced critical stress on the job. More than 77 percent said the stressful experiences they had as a firefighter “caused lingering or unresolved emotional issues.” Of these, the breakdown was as follows:

  • Recurring/unwanted memories of incident(s) – 75.13%
  • Sleep problems – 70.84%
  • Easily angered or withdrawn – 64.22%
  • Family/relationship problems – 59.03%
  • Change in view of job or future – 51.70%
  • Substance abuse – 31.48%
  • Thoughts of suicide – 13.60%

stigma of mental health issues for firefighters

When asked if they believed these behavioral issues resulted from PTSD, more than 77 percent indicated yes. Also, more than 77 percent said that stigma exists that creates a barrier to asking for help for emotional or behavioral health issues. Among the concerns contributing to this stigma about asking for help were being considered weak or unfit for duty (78.14%), overall cultural stigma regarding behavioral/mental health issues (69.03%), colleagues won’t trust your judgement under pressure (46.99%), and putting the job at risk, potential impact on family, and services not relevant to firefighters (35.88%, 33.52% and 30.24%, respectively).

Treatment for PTSD includes medication to help control some of the recurring symptoms, psychotherapy (individual and group), CBT, various forms of CBT that include EMDR, exposure therapy and cognitive restructuring, coping methods, relaxation methods such as yoga and mindfulness meditation, self-help and support groups. New treatment modalities that appear to help PTSD sufferers include surfing, service dogs, parrots, equine therapy, and virtual reality.


Firefighters experiencing extreme worry and fear that fails to subside may be diagnosed with anxiety disorder. When symptoms increase in both intensity and frequency and interfere with daily functioning, it’s time to seek professional help. The good news is that there are effective psychological treatments for anxiety disorder, including CBT, and with appropriate treatment, firefighters can regain control of their thoughts and feelings and resume normal life.

Symptoms of Anxiety

Those suffering with anxiety disorder may experience one or more of the following symptoms:

  • Extreme fear
  • Shortness of breath
  • Racing heartbeat
  • Insomnia
  • Nausea
  • Trembling
  • Dizziness


The American Psychiatric Association (APA) defines depression, or major depressive disorder, as a serious medical illness affecting the way a person thinks, feels and acts. Overall, depression affects one in 15 adults in any given year. Yet effective treatment can reduce or eliminate the overwhelming and debilitating symptoms and help speed return to everyday life. Treatment for depression generally includes psychotherapy, CBT, and sometimes antidepressant medication.

Symptoms of Depression

The APA lists the following as symptoms of depression:

  • Feelings of sadness or being in a depressed mood
  • No interest or pleasure in activities once enjoyed
  • Appetite changes – weight loss or gain not due to dieting
  • Sleep difficulties – sleeping too much or too little
  • Increased fatigue and loss of energy
  • Feelings of worthlessness or guilt
  • Increase in purposeless activity – such as hand-wringing, pacing
  • Increase in slowed movement or speech
  • Problems with thinking, making decisions or concentrating
  • Thoughts of suicide or death


If you want to get your life back on track, take the first step toward healing. Ask for the support of your loved ones and contact one of our specialists to find the best treatment program for you, including treatment for any other mental health issues you may be experiencing. Life can and will get better.



American Psychiatric Association. “FYI: Understanding Anxiety Disorders and Effective Treatment.” Retrieved March 13, 2018.

American Psychiatric Association. “What Is Addiction?” Retrieved March 10, 2018.

American Psychiatric Association. “What Is Depression?” Retrieved March 13, 2018.

American Psychiatric Association. “What Is Posttraumatic Stress Disorder?” Retrieved March 10, 2018.

Anxiety and Depression Association of America. “Posttraumatic Stress Disorder (PTSD).” Retrieved March 10, 2018.

Missourinet. “Mizzou study finds horseback riding helps veterans coping with PTSD.” Retrieved March 13, 2018.

National Center for Biotechnology Information. “Management of persons with co-occurring severe mental illness and substance use disorder: program implications.” Retrieved March 15, 2018.

National Center for PTSD. “Understanding PTSD and PTSD Treatment.” Retrieved March 10, 2018.

National Council on Alcoholism and Drug Dependence. “Alcoholism, Drug Dependence and Co-Occurring Disorders. Retrieved March 10, 2018.

National Institute of Mental Health. “Post-Traumatic Stress Disorder.” Retrieved March 13, 2018.

NECN. “Survey: Firefighters Struggling With Mental Health and PTSD.” Retrieved March 10, 2018.

Neuroscience News. “Understanding Addiction and Dual Diagnosis.” Retrieved March 15, 2018.

The Exponent (Perdue). “Study shows service dogs can help PTSD patients.” Retrieved March 13, 2018.

The Wall Street Journal. “How Virtual Reality Can Transform PTSD Treatment.” Retrieved March 13, 2018.

Washington Post. “Riding the waves to better health: Navy studies the therapeutic value of surfing.” Retrieved March 13, 2018. “Unique Manatee Co. PTSD treatment program uses parrots.” Retrieved March 13, 2018.