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Injured on the Job and now Addicted to Pain Medication

Thomas Jefferson once said, “With great risk comes great reward.”  There are numerous rewards and incentives of being a firefighter. We are revered and respected members of our communities, the emotional rewards are boundless, and we are granted a lifetime membership into a brotherhood that is linked to firehouses all around the world.  But, as with most things in life, great rewards are often generated from great risk.  In order for something to be classified as a risk, there must be something at stake. For firefighters, this equates to our health and our lives. 

Firefighters are confronted with grave danger at every turn.  Aside from obvious life-threatening burn injuries, we are constantly exposed to carcinogens in smoke, increasing the risk of cancer. Firefighters are at elevated risk for falls, whether it occurs in an unstable structure, or on a ladder during a routine drill. We run the risk of having a structurally compromised building collapse upon us and in perpetual danger of smoke inhalation, which can either culminate in acute injury or long-term disease.  Cardiac issues can result from smoke inhalation, the physical strain from dealing with heavy equipment, and stress. 

Due to their pain relieving properties, opioids are prescribed by physicians to alleviate pain from injuries, surgeries, dental work, and chronic illness. Oxycodone, Vicodin, and Morphine are commonly known examples of prescription opioid medications.  Opioids refer to a group of drugs that pass through the blood and adhere to opioid receptors in the brain.  When this occurs, brain cells circulate signals, blunting pain perception and elevating pleasurable reaction.  Opioids decrease the number of pain signals that the body sends to the brain and fundamentally alters how the brain reacts to pain.  Opioids create synthetic endorphins, which makes one feel good. Excessive use can prompt the brain to depend on these artificial endorphins and may even cause the brain to stop producing them entirely.

Opioid medications are extremely effective in managing pain associated with injury, but can also be dangerous.  As opioids enhance feelings of calm and pleasure, dependence can easily occur, as individuals are pain-free and enjoy the gratifying sensations.  Opiate abuse occurs when prescription medication is used more often than prescribed or in larger amounts from increased tolerance.  

When drug use is stopped, withdrawal symptoms arise, thus impacting the entire body. An individual’s gastrointestinal system, body temperature, sleeping habits, pain experience, and emotions all become impacted.

Opioid dependence encompasses physical, emotional, and behavioral symptoms and occurs when the body’s natural mechanisms are altered from prolonged drug use. Some signs and symptoms of opioid dependence include:

  • Vacillations in the mood, ranging from depression to elation
  • Irritability and anxiety
  • Decreased motivation and poor decision making
  • Disrupted sleeping patterns and drowsiness
  • Gastrointestinal issues, including queasiness, vomiting, and constipation
  • Physical distress, weak coordination
  • Shallow or slow breathing


Due to increased risk of acute or chronic injury, firefighters are representative of a population at increased risk for the development of opioid dependence. With this knowledge, firefighters need to be especially vigilant to protect us from developing an addiction. Opioid medication should be used exactly as prescribed for brief lengths of time. We need to have awareness of any potential interactions with other medications and dosage should never be stopped or modified without speaking to a physician beforehand.       

Treatment options for opioid dependence seek to assist individuals in terminating drug use and avoiding use in the future.  A physician can assist in alleviating withdrawal symptoms via medications, such as methadone, buprenorphine, and naltrexone.  Once detoxification is completed, treatment will focus on how and why the addiction developed, will provide coping skills to avoid relapse, will work to repair damaged relationships, and will promote emotional well being.  Treatments can be conducted in the individual, group, or family modality and if there is a co-occurring mental health disorder, treatment will address both conditions simultaneously. 

If you or a firefighter that you know is struggling with opioid dependence, the Fountain Hills Recovery and Lionrock Recovery Program could be for you.  For more information, please visit the website and like them on social media. You can also look into Roscrance program which also helps firefighters struggling with addiction.   

As Thomas Jefferson wisely said, “with great risk comes great reward.”  In addition to doing everything possible to avoid injury and illness, firefighters need to mitigate the risks of addiction and dependence.  In doing so, it will allow them to focus more attention on great rewards instead. 



American Academy of Family Physicians (2017, July 24).  Opioid Addiction.  Retrieved from

Mayo Clinic.  (2018, Mar 21).  What Are Opioids and Why Are They Dangerous”.  Retrieved from

National Institute on Drug Abuse.  (2018, Jan). Misuse of Prescription Drugs.  Retrieved from

 WRSH. (2018, Sep 7).  Firefighters-Health Risks and Workers’ Compensation.  Retrieved from


Mark Lamplugh is a fourth-generation firefighter and former captain with the Lower Chichester (PA) Fire Company. Mark is the Board President of theInstitute for Responder Wellness. Mark also owns Influence Media Solutions which is a Marketing, Public Relation, Digital Marketing and Social Media firm with accounts nationwide. He consults Fountain Hills Recovery & LionRock Recovery. Mark is one of the top marketing executives in the United States and has revolutionized how addiction treatment centers reach potential clients thru influence marketing and traditional marketing. His expertise in Marketing, Social Media, Digital Marketing and Public Relations has generated millions of dollars of business to several national companies. Many of his techniques are documented in his book Beginners Guide to Digital & Social Media. He's also a professional advocate for the behavioral and mental health of firefighters and other first responders. Lamplugh hosts his own talk show called "Firefighter Wellness Radio" with Fire Engineering. Mark has been chosen as one of the Board of Directors at One World For Life (To head up Communication and the Health & Safety section). He can be reached for comment

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