As part of their benefits package, most companies offer their employees a specified number of days off for holidays, vacation, personal days, and sick time. In the event of an illness or injury that requires extended time off, hopefully, the employer offers the employee the chance to take an unpaid leave of absence to recuperate. Most employers, including entities that employ firefighters, recognize that circumstances occasionally arise that warrant more time off than they typically allow for within standard benefits.
This arrangement is a good compromise for the employer who wants to see the employee return to work as soon as possible, and the employee wants to keep his or her job. Of course, the downside for the employer is that they need to manage the workload in their employee’s absence. The downside for the employee is a short duration without pay. This type of arrangement typically works well because superiors and co-workers have sympathy for whatever ails the employee who is ill or injured. No one likes to see someone they care about sick or hurt!
What happens when the employer sees the reason for recovery as a poor personal choice rather than a disease—as in the case of a drug or alcohol addiction?
Employers Don’t Typically Classify Addiction as a Disease
Let’s say that the disease that caused the discussion for unpaid leave is alcoholism or substance abuse. Would the employer automatically offer the non-paid leave option? Would the employer stigmatize these particular diseases and unfairly discriminate against the employee? Would co-workers support their peer’s need to take time off to get healthy under these circumstances?
The National Center on Addiction and Substance Abuse says that addiction is a disease because it alters the brain. Unfortunately, much of our workforce still stigmatizes addiction. The reality is that many employees who need to recover from addiction might be concerned about losing their jobs because of the nature of the illness.
There is some validity about the concern about firefighters with addictions. Firefighters need to be able to respond quickly and think on their feet at the scene of every emergency call. When substance abuse in a firefighter causes compromised thinking, public safety is at risk.
The result is that firefighters who want or need to keep their jobs often hide their addictions which poses an undue risk for themselves and their communities. What we haven’t done well enough is to connect the high rates of job-related stress to addiction, and support our firefighters through addiction prevention and recovery.
Connecting the Dots Between Firefighting and Substance Abuse
For those who have worked in the firefighting profession for a long time, a peer who loses their job because of addiction will likely recognize some irony. Being a firefighter is one of the most stressful career choices. Firefighters have developed their own culture about how to deal with the personal stress of constantly being thrown into life and death situations. At the close of the shift, many of them hit the bar.
Firefighters are starting to realize the importance of combatting the high level of job-related stress. Many firehouses are taking a proactive approach and are making a conscious effort to change the culture that has historically existed within firehouses. Many of today’s firefighters are eating healthier group meals and working together to stay physically fit because they know that the nature of the firefighter career starts a cycle of stress. Chronic stress may lead to substance abuse, which can lead to personal losses including their jobs.
Being proactive is a good first step, but it’s causing some firefighters to question if they can be doing more to help their peers with substance abuse recovery once addiction takes hold.
Similar Problems in the Aviation Industry Spark a Potential Solution
The field of airline pilots is another industry that has a high rate of alcoholism and substance abuse. Pilots point to long hours, cost-cutting measures, and increased duties to enhance security as sources of stress that lead to addiction within their field.
Reports of alcohol-related aviation incidents where pilots had previous offenses led the aviation industry to look for ways to encourage sobriety among commercial pilots.
The Birth of the HIMS Program
The Air Line Pilots Association and a labor union joined forces and launched a medical research program in the 1970’s to test a program for dealing with the issue of alcoholism among pilots. The program was called HIMS (Human Intervention Motivation Study). The National Institute for Alcohol Abuse and Alcoholism (NIAAA) funded the project. HIMS was a pilot-specific model that included a peer identification and referral system.
A pilot who needs treatment needs a peer referral and a sponsor, which is an Aviation Medical Examiner (AME). The pilot must also commit to an aftercare program to ensure sustained sobriety. The AME sponsors the pilot through the recertification process. Pilots who are successful not only get access to recovery, but the aviation industry will help them to get their jobs back. Managers, pilots, healthcare professionals and the FAA work together in the HIMS program to preserve careers and enhance air safety. The HIMS program enjoys great success with returning more than 4,500 pilots to the cockpit since the program’s inception.
Could a Program Like HIMS Be Effective for Firefighters?
The success of the HIMS program in the airline industry may be an indication that a similar program could be developed for firefighters. This story about a fictitious firefighter named Mullins paints a picture of what a firefighter-specific program might look like.
Essentially, a firefighter’s peers would recognize signs and symptoms of alcoholism or substance abuse and refer the addicted firefighter to an addiction recovery program. Managers, firefighters, healthcare professionals and others within the industry would form a team to help the firefighter recover and establish a path for safely returning to work.
Firefighters enjoy a close-knit camaraderie because of the vast amount of time that they spend together in between emergency calls. They also develop a deep and abiding trust in each other because they are regularly working together on emergency scenes where they are placing their lives in the hands of their peers. Firefighter relationships are unlike pilot relationships where the nature of the airline industry causes pilots to be regularly isolated from their peers. The tight relationships between firefighters may enhance the success of a firefighter-specific program such as HIMS.
Thoughts to Ponder About a HIMS Model for Firefighters
Studies on firefighters and substance abuse, particularly alcoholism, have brought forth some concerning statistics about the high percentage of firefighters who turn to alcohol to destress on a regular basis. Addiction studies have brought to light that addiction is a brain altering disease that makes it difficult for someone to stop abusing substances once they get started. We have made some progress in getting society to accept addiction as a disease and to support recovery; however, we have a long way to go. The connection between job-related stress and addiction calls to question if we are doing enough to help firefighters prevent and recover from addiction.
The HIMS model suggests that a new model of a back-to-work recovery program could work not only for firefighters, but also for other careers where stress is high, as it did in the fictitious story of Firefighter Mullins. The only question that remains is, “What are we waiting for?”
Mark W Lamplugh Jr is a fourth-generation firefighter and former captain with the Lower Chichester (PA) Fire Company. He was the Chief Executive Officer of 360 Wellness Inc and currently the Vice President of Responder Services (www.frontlinerehab.com) with Advanced Health & Education and Cedar Point Recovery Lamplugh is also nationally recognized in Crisis Stress Intervention through the American Academy of Experts in Traumatic Stress. Lamplugh hosts a talk show called "Firefighter Wellness Radio" for Fire Engineering. He has helped hundreds of firefighters, police officers, veterans, EMS personnel, and civilians nationwide find help for addiction, alcoholism, PTSD, and mental health support. You can reach him for comment at email@example.com.