Alcohol Misuse and Correlates with Mental Health Indicators among Firefighters

Background: Stress and repetitive exposures to potentially traumatizing events are inherent to first-responder professions. Firefighters and other crisis responders are often exposed to incidents in their work environments and are at risk of developing acute or posttraumatic symptomatology, depression, and anxiety, as well as harmful patterns of alcohol consumption. Most prior research and theory suggests that many firefighters use alcohol to cope with past and current stressors, and that increased drinking accompanies ongoing exposures to stressful occupational hazards. Objectives: The primary aim of this research was to examine alcohol consumption and mental health variables associated in the literature with alcohol misuse. Participants included 546 predominantly male career firefighters in the U.S. Using a cross-sectional design, we examined alcohol misuse in the context of self-reported depression, generalized anxiety, PTSD, and suicidal ideation using previously validated measures. Results: Based on the AUDIT's recommended cut score of 8, 38.8% of our sample reported drinking at hazardous levels. Hazardous alcohol use was also significantly associated with several mental health indicators with correlations ranging from .28 to .34. Regression analyses revealed that over 14% of the variance in AUDIT scores could be explained by psychological symptom measures, and 29% of the variance in suicide risk was explained by a model using both alcohol and mental health measures. Conclusions: Findings suggest that psychological distress is associated with hazardous drinking, and that more consistent screening and referral for these issues, as well as multi-level interventions, are needed to effectively address these behavioral health concerns among firefighters.