Links Between Officer Trauma and Substance Abuse Butler Center for Research Update | November 1, 2015 For years, many professionals in the fields of research, counseling, public policy, and criminal justice have expressed concern over alcohol use and abuse among law enforcement officers. Despite the widely held assumption that police officers are at risk for higher-than-average rates of alcohol abuse, very little research has been conducted to investigate patterns of substance abuse within the law enforcement field.1 Recent research into the relationships among social and cultural factors, stress, trauma, and problematic alcohol use has finally been able to shed light on this special population, which is, in turn, opening the doors to new, empirically founded treatment strategies. Substance Use and Abuse Rates for Law Enforcement Officers In 2010, a study of police officers working in urban areas found that 11% of male officers and 16% of female officers reported alcohol use levels deemed "at-risk" by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).1 A 2007 survey of 980 American police officers found that 37.6% of the respondents endorsed one or more problem drinking behaviors.13 Researchers have long debated the reasons for elevated alcohol consumption among police officers, but most agree that underlying patterns include social and stress-related problem drinking behaviors.2 Among social factors, drinking to "fit in" with one's peers has been identified as a significant contributor to drinking for police officers who demonstrate hazardous alcohol consumption.2 A 2001 survey conducted among police officers provides some insight as to why officers may feel the need to drink in order to fit in: 31% of those who responded to the survey reported that they believed nondrinkers "were viewed as suspicious and unsociable people" by other officers.3 Social factors are particularly important to consider among the law enforcement population, as police officers spend a very large amount of their social time with other officers. Most police officers report spending at least 25% of their social time (outside of work) with their coworkers, and 10% of officers reported that they spent 75% or more of their free time with coworkers.3 Many scientists and clinicians fear that the combination of drinking to fit in and spending large amounts of time with colleagues could lead to a culture of problematic drinking behaviors among police officers.2 While social factors are certainly a major concern, perhaps an even more significant area of interest is the relationship between the stress and trauma faced by officers in the line of duty and subsequent increases in alcohol consumption. Links Between Officer Trauma and Substance Abuse Research linking trauma and substance abuse began to gain momentum during the Vietnam War, when large numbers of active and returning soldiers presented elevated rates of alcohol and other drug use.4, 5 Since then, scientists have learned a great deal about the effects of stress and trauma on mental and physical health. Exposure to traumatic events can result in stress disorders, which cause serious physical, emotional, cognitive, and behavioral changes that can be very unpleasant and can cause significant problems with productivity, social and family functioning, and overall well-being.6 One of the most commonly studied stress disorders is post-traumatic stress disorder (PTSD). Recently, researchers determined that nearly half of individuals (42%) who were diagnosed with PTSD also met the criteria for an alcohol use disorder.7 It is generally believed that people suffering from PTSD and other stress disorders have not developed appropriate coping strategies for processing the stress or trauma they experience and instead turn to alcohol or other drugs as a way of dealing with their symptoms.8 As the symptoms of the stress disorder worsen over time, they are also often made worse by substance abuse. This cycle can lead to addiction, as well as increasingly severe mental and physical health problems.9 As a result of their unique occupation, police officers face a great deal of stress and trauma much more regularly than the general population. In addition to the potential for physical harm in the line of duty, officers witness traumatic and disturbing events and images and also experience stress related to their roles and reception by their community. All of these elements contribute to significant overall stressors that can result in a pathological response (e.g., PTSD or other stress disorders).2, 10 Many officers demonstrate a great deal of psychological resilience in the face of disasters and traumatic events in the line of duty, even when compared with other rescue workers (an effect attributed to tighter screening procedures and effective training for coping after a traumatic event)11. However, when nontraumatic occupational stressors (such as workload, administrative problems, or poor community relations) are present, officers exposed to traumatic events demonstrate a high prevalence for psychological distress and pathological stress disorders such as PTSD.12 The lack of availability for training related to coping strategies for nontraumatic stressors only further opens the door to alcohol consumption as a maladaptive response.9 Indeed, researchers have uncovered a strong tie between police officers’ problem drinking and the anxiety and depression that occur as a result of combined organizational and traumatic stressors.13 Special Considerations for Treatment When available, critical incident debriefing with a trained professional has been shown to significantly reduce problem drinking behaviors following a traumatic event;14 however, research has indicated that day-to-day coping strategies aimed at reducing non-traumatic police work stressors are also critical to reducing stress-related alcohol consumption.13 Officers who seek treatment for alcohol abuse may consider exploring healthy and effective ways to address the anxiety and/or depression that may be present as a result of these daily stressors. Many police organizations offer employee assistance programs (EAPs) to facilitate treatment for alcohol use disorders. These programs are usually confidential and are also familiar with the unique struggles facing police officers, which can make them highly effective for reducing hazardous alcohol use.14, 15 Community-based self-help programs may also be of assistance to police officers, as many successful alcohol abuse treatment programs within police departments have been modeled after Twelve Step programs such as Alcoholics Anonymous (AA).14 The discrete nature of AA and many other Twelve Step programs can also offer police officers protection from any perceived or actual community stigma they may fear as a result of seeking treatment. Summary Police officers are a unique subset of the population as a result of their occupational culture and regular exposure to stressors and trauma. These issues culminate in an increased risk for problem drinking, either as a result of social pressure or as an unhealthy way to try to control anxiety or stress. Without professional treatment, officers who engage in hazardous alcohol consumption may be negatively affected by reduced productivity at work, increased mental health concerns, and dysfunctional family and/or social environments. It is critical that officers learn healthy coping strategies to minimize stress on a regular basis, rather than attempt to mask stress with alcohol. Download the Alcohol Abuse Among Law Enforcement Officers Research Update, plus read our Q&A interview with research scientist Bethany Ranes, PhD.