Dangers of Prescription Drug Abuse In Firefighting

William Hatfield, a firefighter in the town of Hull, Massachusetts, was in uniform and had just stepped out of his fire truck. Surprisingly, he wasn't responding to a call or returning to his station.

Hatfield was buying painkillers with fraudulent prescriptions – while on the job

His addiction began, as many do, with an injury in the line of duty. Firefighters face a serious risk of this type of injury – the National Fire Protection Association estimates that 63,350 firefighters were injured in 2014, with the majority of those injuries (42.6%) taking place during fireground operations.

Hatfield's drug of choice was oxycodone, an opioid for treating pain. Used as prescribed, it doesn't pose a serious risk. When abused, however, there is a high risk of dependency as well as life-threatening respiratory distress when combined with other drugs, especially alcohol.

Unable to control his addiction, Hatfield claims he turned to his union for help. The union disputes this, saying Hatfield spent two weeks in a hospital, but turned down further treatment at a rehabilitation facility.

Speaking about the case, union spokesman Melissa Hurley told CBS Boston, “Prescription drug addictions are an epidemic in our society, and firefighters are particularly susceptible given their high injury rates, which is why we have an aggressive employee assistance program.”

Unfortunately, it wasn't enough for Hatfield. He was arrested for passing fraudulent prescriptions in 2014.

Risk Factors for Abuse

We already know that firefighters are at greater risk for prescription drug addiction because of the high rate of on-the-job injuries. But several other factors can put individuals at risk. According to the Mayo Clinic, these include:

• Past or present addictions to other substances, including alcohol and tobacco
• Family history of substance abuse problems
• Certain pre-existing psychiatric conditions
• Easier access to prescription drugs
• Lack of knowledge about prescription drugs and their potential harm

In a pill-popping culture, it's not surprising that so many people, including first responders, are addicted to prescription medication. Nor is it surprising that this addiction comes with both mental and physical consequences, in addition to legal and career-threatening ones.

Danger of Prescription Drug Abuse

In Hatfield's case, opioids were being abused. Opioids reduce the user's perception of pain. They can also produce a strong sense of euphoria. It is this feeling that spurs abuse, leading to an increased risk for addiction.

According to the National Institute for Drug Abuse, opioids can cause severe respiratory depression and death when taken in large quantities. Opioids also affect the amount of oxygen that can get to the brain. This can lead to a condition called hypoxia, causing brain damage and sometimes coma.

CNS depressants are another type of commonly abused drug. They work by increasing a neurotransmitter called gamma-aminobutyric acid. This has the effect of inhibiting brain activity and producing a feeling of drowsiness and calm in the user.

Used properly, CNS depressants are an effective treatment for anxiety and sleep disorders, but the abuse of these drugs can lead to addiction. Once a dependence has developed, the side effects of withdrawal can be life-threatening and include “restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements” as well as seizure, according to the National Institute for Drug Abuse.

Stimulants are prescribed to treat ADHD, narcolepsy and depression, but they are often abused for their energizing and euphoric effects. The National Institute for Drug Abuse warns that the side effects of stimulants include hostility and paranoia, as well as more dangerous complications such as overly high body temperature, irregular heartbeat, cardiovascular failure and seizures.

Clearly, abusing prescription drugs takes a toll on the mind and body, but the adverse consequences don't stop there. In emergency conditions, firefighters need to be mentally acute and physically adept. Prescription drugs can impair performance to the point that firefighters cannot carry out their duties or may do so in a way that endangers citizens, fellow firefighters or themselves.

Accordingly, Fire Engineering recommends medical evaluations for new members as well as annual medical evaluations for all members. Departments are also advised to “ensure members are knowledgeable of, and comply with, fire department requirements regarding reporting any medical condition that could interfere with their ability to safely perform essential job tasks. This must include all medications, prescription and over-the-counter.”

Treatment for Addicts

Generally speaking, withdrawal treatment for addiction to prescription drugs involves a period of time spent gradually tapering off the drug until the user is no longer physically dependent. Even with this gradual decrease, withdrawal symptoms will likely still be an issue – the body needs time to adjust. Withdrawal symptoms commonly include sleep, appetite and mood disturbances, according to the Mayo Clinic. While taking a drug to overcome drug dependency might seem counter-intuitive, drugs do exist that can alleviate some of the discomfort associated with withdrawal from opioids and depressants. No such approved drug exists for stimulant users, unfortunately.

Once the body adjusts lower and lower doses of the drug, attention must be paid to the mind. After all, overcoming an addiction isn't purely physical. A successful path to recovery must involve counseling or psychotherapy. In this way, the underlying issues that feed temptation can be identified and treated.

Given the nature of the job, first responders that are battling addiction to prescription drugs require special care. Coming to terms with an illness that jeopardizes careers and relationships isn't easy. But with your life and the lives of the public you serve at stake, proper treatment is essential. Remember: seeking help is an act of courage and strength.

At Station House Retreat, we exclusively help those whose job it is to help others. Most importantly, we do it in an environment that is both clinical and residential, meaning that our clients form close bonds and overcome similar underlying issues together. In our recovery model, everything is relevant. This is the basis of our peer support treatment – and what sets us far apart from a normal addiction treatment program.

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