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The purpose of this research was to ascertain the incidence, prevalence and severity of substance abuse among first responders as they relate to the general population, as well as determine existing variations that may be present between classifications of first responders (firefighters, emergency medical technicians and law enforcement officers). The present state of publicly available publications reporting on substance use by this population was assessed using key vocational terminology and found to be unsubstantial in journalistic quantity with diverse variations in statistical reporting according to differentiations of professional title, substance(s) of interest and geographic locale within the continental United States.

While tobacco use by firefighters (FFs), Emergency Medical Technicians (EMTs) and Law Enforcement Officers (LEOs) has declined 30% over the past 37 years,36 utilization of smokeless tobacco use among this population is still twice that observed within the general public; LEO use has remained steady but appears to be increasing among FF/EMTs, particularly when evaluated alongside problematic alcohol consumption.37-38,49 Two out of five from the aforementioned professions were deemed liable of experiencing alcohol dependency in the course of their lives, regardless of sociodemographic characteristics.34,44-50,53-54 Consumption of electronic “vape” products by FFs/EMTs was almost five times that of civilians.37,42 Data on recreational cannabis usage by LEOs was unobtainable, scantly assessed among FFs/EMTs,34-35 and overall frequently inaccessible due to rigid restrictions placed upon data retrieval.

Further probing into substance use for maladaptively coping with occupationally linked trauma exposures in this population is recommended, lest failing public faith progress into the crumbling of public safety systems at large.

Faculty Advisor(s)

Courtni Jeffers, MS, MPH, EdD Talmage Holmes, PhD, MPH

Publication Date

4-2-2026

Burning It At Both Ends: A Scoping Review of Trauma-Induced Substance Use Among American First Responders

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