Addressing Specific Needs of First Responders Struggling with Addiction

Lilo H. Stainton | April 5, 2017 | Health Care
The traits that make first responders who they are can also make them very susceptible to high levels of psychological stress

First responder treatment services team (from left): Michael Bizzarro, director; Ken Burkert, peer support specialist/outreach coordinator; Jim Schneider, peer support specialist
First responders are known to share uncommon traits: the willingness to run toward danger; a first-hand relationship with violence and often death; and a profession that is inherently risky, but not necessarily well paid.

These characteristics enable police, firefighters, and corrections officers to survive — and even thrive — on the job. But experts agree they also make first responders highly susceptible to substance-use disorders and high levels of psychological stress.

But providers at Princeton House Behavioral Health have led an effort to address this need in New Jersey with a unique treatment model specifically designed to help those whose job it is to help others in emergency situations. The First Responder Treatment Program, launched in 2013, has treated some 650 first responders and veterans through approaches that involve inpatient care, individual psychological treatment, peer counseling, and support groups, including the popular “Bottles and Badges” meetings.

Peer-to-peer model

Princeton House, which provides mental health and substance-use disorder treatment for the Princeton HealthCare System, a comprehensive network of providers in central New Jersey, has a history of providing programs targeted to specific populations, like patients with eating disorders, women, and teenage girls, Princeton House President Richard Wohl explained. But what makes the first-responder program so successful is the peer-to-peer model.

“You want to be there with someone who’s worn the uniform and knows what it’s like to juggle chain saws every day,” explained Sean Sprich, a corrections officer and union leader with PBA Local 105 who went through recovery himself and now serves as a peer liaison to Princeton House’s program.

The familiarity provides comfort, Sprich said, but it also allows program leaders to get past the elaborate defense systems constructed by some first responders to protect themselves and their families from the brutal realities of their profession. “If you don’t have someone who knows how to navigate that and knows how to peel back that onion, you’re not going to get there,” he added.

Opiate addiction alone has claimed more than 1,500 lives annually in the Garden State recently and driven tens of thousands to treatment, while many more remain unable — or unwilling — to get the care they need. First responders are often on the front lines in dealing with the aftermath, responding to vehicle accidents, robberies, and other violence. They have also played a growing role in helping addicts, particularly through the use of naloxone, which often comes as Narcan in an injection or nasal spray that can quickly reverse the effects of an opiate overdose.

Contributing factors

But proximity to drug use is only one of the many addiction triggers first responders face. The very nature of their jobs — and the approaches they take to dealing with extreme stress — are also key factors that contribute to substance use disorders, according to Princeton House experts.

“The individual makeup of first responders tends to be somewhat different, or very different, from the average person,” Wohl explained, underscoring how they don’t just run toward disaster, but they see some terrible things when they get there — stressors that can spark addiction and psychic distress.

It’s not clear that these workers suffer higher rates of behavioral health issues than the public at large, he said. “But yes, we were surprised to find the need was much greater than we thought,” Wohl said.

“We knew there was trauma involved in this profession,” added Michael Bizzarro, a former police officer and Army reserve member who helped found the program and is now director of clinical services, “but we didn’t initially think we’d see it to this extent.”

Building credibility

Bizzarro said the program has grown each year and has built credibility by establishing strong relationships with the unions representing local and state police, corrections officers, and firefighters. “They know we are people who can be a point of contact,” he added, and the trust they can establish with patients can make all the difference in their recovery.

Ken Burkert, the senior outreach coordinator and a former corrections officer, said that while they may witness horrors every day, it can be hard to escape the pressures of the profession. “They’re basically sleeping with their firearm and that becomes their best friend. The job doesn’t end when you’re not on duty,” he said. “It’s so normal. And then when you come home and try and normalize your life, it’s very hard to shut off.”

Sprich, the corrections officer, agreed. “The treadmill in your mind doesn’t stop. You’re always trying to anticipate what’s next,” he said. “At any minute somebody could drag a razor blade across your face. But you work it like it’s a regular job. It’s insane.”

Protecting family members

Trying to protect family members from this reality adds another level of stress, Burkert said. For years, he made sure to remove his uniform and shower before letting any of his loved ones close, he recalled.

To relieve this stress, first responders often turn to their colleagues, Burkert and Sprich explained, relying on those who know the challenges first hand. But this comradery often leads to a bar and significant drinking, a patch that just compounds the problems for some. “You’re killing the pain, but it’s a quick fix,” Burkert said.

Eventually, things can spiral out of control. For Sprich, that involved an alcohol-induced car crash in a forest in his hometown, a painful but eye-opening experience that led him to the Princeton House program — and more than 500 days of sobriety.

Now he works to connect others with the help that turned his life around. Last week Sprich was contacted about two colleagues who were suicidal; one got into another treatment program designed for law enforcement, but the other he found handcuffed to a bed in an empty hospital room with a guard sitting outside.

Role reversal

“It’s complete role reversal” for a corrections officer whose job involves monitoring inmates, he said, “on top of all the shame and guilt and all the other reasons why you’re there.” For many first responders, the hardest part about treatment is “letting someone else drive,” he said.

Wohl agreed, employing the same analogy. “Letting someone else be the driver and surrendering to that” can be very hard for first responders, he said. “They’re used to helping other people and it’s a huge shift to let them be helped.”

To help this particular colleague, Sprich shared his own story, freed the patient from his restraints, and helped him transfer to Princeton House. “That’s two less funerals, hopefully,” he said.