Work Pressure During COVID-19 Pandemic Increased Problematic Substance Use Among First Responders


Problematic substance use was highest among firefighters, followed by emergency medical technicians, and police officers.

Work pressure and other factors related to the COVID-19 pandemic were associated with an increase in problematic substance use among first responders, new research published in the International Journal of Drug Policy found.1f

First responders, such as law enforcement personnel, emergency medical service providers, and firefighters, were on the frontlines of the COVID-19 pandemic response. This put them at a high risk of developing stress at work, which may lead to the development of problematic substance use. However, there has so far been a lack of research on this subject.

“While…studies highlight a potential risk for first responder substance use, they do not identify the role that work pressure, burnout, general workplace support strategies, and COVID-19-related support strategies play in progressing or mitigating problematic substance use,” the authors wrote. “These are important aspects to understand as they can help develop appropriate interventions within work settings.”

Investigators from Florida Atlantic University conducted a study to understand the relationship between work pressures, workplace support strategies, and problematic substance use during the early stages of the COVID-19 pandemic. Data was gathered from a nationwide online survey of first responders.

The study cohort included 2801 participants who worked in police departments, fire stations, and emergency medical service agencies. The survey asked questions on problematic substance use, work pressure, general workplace support strategies, COVID-19 support strategies, and burnout.

Investigators found that around 61% of respondents reported no concerns with substance use, even though nearly 40% said they used substances to relieve emotional discomfort. Of those who used substances, 22% said they used more than they meant to and 21% said they could not cut down on their use. Only 7.2% of respondents said their substance use resulted in neglecting work responsibilities.

Problematic substance use was highest among firefighters at 12.7%, followed by emergency medical technicians at 11.4%, and police officers at 8.1%. Additionally, general workplace strategies were not associated with problematic substance use. However, COVID-19-related strategies, such as providing compensation during quarantine, were positively associated with problematic substance use.

“Although intended to reduce stress associated with the job, organizations should be mindful that not all support strategies will have their intended impact, and some may even unintentionally increase stress, burnout, and problematic substance use,” Kaila Witkowski, senior author on the study, said in a release.2 “While we are not contending that compensation during quarantine is a negative workplace strategy, our study highlights the nuances of the COVID-19 quarantine measure, suggesting that additional stressors may have been placed on first responders throughout this process or that other beneficial workplace strategies were not easily accessible or used during this time.”

1. Witkowski K, Lofaro RJ, Headley AM, Contreras S, Remington CL, Ganapati NE. Understanding problematic substance use among first responders during the COVID-19 pandemic: A survey of law enforcement, fire, and EMS workers in the United States. Int J Drug Policy. 2024;123:104261. doi:10.1016/j.drugpo.2023.104261
2. Galoustian, G. Study examines substance use in first responders during the COVID-19 pandemic. News Release. Florida Atlantic University. January 18, 2024. Accessed January 19, 2024.
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