By Dr. Narine Arutyounian, M.D., Medical Director
Clinical contribution by Ritsa Fistes, LMFT, Clinical Director
Healthy Living Residential Program, Santa Clarita, CA
Every day, you run toward the things other people run away from. You pull strangers from wreckage, deliver lifesaving care on the side of the road, talk people back from their worst moments, and carry the weight of things most people will never have to see. You do it professionally, willingly, and with a composure that the rest of us can barely imagine. But strength has a cost, and for too many police officers, firefighters, paramedics, EMTs, dispatchers, corrections officers, and healthcare workers, that cost accumulates quietly until something gives.
If you have found your way to this page, something has likely already shifted. Maybe you know that alcohol or drugs have become a problem. Maybe someone close to you has said something. Maybe you are simply exhausted from fighting a war on two fronts: the one on duty, and the one inside yourself. Whatever brought you here, one thing is true: needing help does not make you weak. It makes you human. This article is about why first responders are so uniquely vulnerable to addiction, why so few ever ask for help, and how the right kind of treatment, private, medically sound, and built around who you are, can change everything.
Why First Responders Are at Higher Risk
The data tells a clear and sobering story. According to a 2018 SAMHSA research bulletin, an estimated 30 percent of first responders develop behavioral health conditions such as depression and PTSD over the course of their careers, compared with roughly 20 percent of the general population [1]. That elevated risk is not a coincidence. It is the direct result of repeated, cumulative exposure to trauma that the human nervous system was never designed to absorb on a daily basis.
The consequences can be devastating. A widely cited white paper from the Ruderman Family Foundation found that police officers and firefighters are more likely to die by suicide than in the line of duty, and noted that the average officer witnesses approximately 188 critical incidents over the span of a career [2]. That volume of exposure to death, violence, and human suffering leaves a mark, and for many, substances become the most available way to manage it.
Alcohol is often the first coping tool to take hold. A large peer-reviewed study of police personnel found that roughly one-third reported hazardous levels of drinking, and that those experiencing depression, anxiety, or PTSD were significantly more likely to drink at harmful levels [3]. What begins as a way to unwind after an impossible shift can quietly become dependency.
Why It Rarely Gets Talked About
If the risk is so well documented, why do so few first responders get help? The answer is cultural. These professions are built on toughness, self-reliance, and the ability to compartmentalize. Admitting to a struggle, especially one as stigmatized as addiction, can feel like a betrayal of that identity. There is a very real fear of being seen as unfit for duty, of losing credentials, or of being viewed differently by the people you rely on in life-or-death situations. Many first responders have watched colleagues hide their pain for years rather than risk the fallout of honesty.
But silence does not protect first responders. It isolates them. Treatment, the right treatment, is what actually protects a career, a family, and a life. And the features that make treatment work for first responders are specific and worth understanding.
What Makes the Right Treatment Different for First Responders
A Private, Intimate Setting
One of the most common fears we hear is the dread of walking into a large facility full of strangers, or of having one’s presence there become public knowledge. At Healthy Living Residential Program, that concern is addressed structurally: our Santa Clarita facility has just 12 beds. This is not a sprawling institutional campus. It is a quiet, private residential setting where every client is known by name and your presence stays exactly where it belongs.
Confidentiality That Is Absolute
For public-facing professionals, privacy is not a preference; it is a necessity. Beyond our internal standards, your confidentiality is protected by federal law. Under 42 CFR Part 2, federal regulations specifically protect the confidentiality of records for people receiving treatment for substance use disorders [6]. Your employer, whether that is a police department, a fire agency, a hospital system, or a corrections facility, does not have the right to the details of your medical leave.
Medically Supervised Detox
For those whose use has progressed to physical dependency on alcohol, opioids, or other substances, medical detox is the essential and safest first step. At Healthy Living, detox is supervised around the clock by our physician-led team, with Medication-Assisted Treatment (MAT) administered as part of a structured protocol. Withdrawal does not have to be dangerous or needlessly painful when it is managed with experience and care.
A Structured Daily Program
First responders thrive on structure. You are trained to operate within clear schedules, defined roles, and purpose. Our daily program mirrors that rhythm, a full schedule of clinical groups, reflection, and evidence-based therapy from morning through evening, channeling the discipline you already have toward healing rather than survival.
FMLA, State Disability, and Union Benefit Navigation
The fear of losing your job is one of the biggest barriers to getting help, and for first responders it is tied to identity, pension, and certification. The good news is that protections exist. The federal Family and Medical Leave Act (FMLA) entitles eligible employees to up to 12 weeks of unpaid, job-protected leave for a serious health condition, which can include treatment for a substance use disorder; eligibility generally requires having worked for a covered employer for at least 12 months and 1,250 hours [7]. For California workers, the state’s State Disability Insurance (SDI) program can provide short-term wage replacement during a medical leave, though it is worth understanding that SDI provides income support rather than job protection, which is where FMLA and the California Family Rights Act come in [8]. Our admissions team helps clients navigate these systems, including union Employee Assistance Programs, so you do not have to choose between getting better and protecting your career.
Technology Access After Stabilization
We know complete disconnection is not realistic for many active-duty or on-leave first responders. After the first five days of medical detox and stabilization, clients have access to personal devices during designated free time, so you can stay connected to your department, your union representative, or your family without compromising your recovery.
The Toll That Goes Unspoken
We want to name something directly: the mental health weight that first responders carry is real, cumulative, and it does not simply disappear when sobriety begins. Repeated exposure to trauma changes how the nervous system processes stress, and for many, substances became a way of managing symptoms that were never properly addressed. This is why trauma-informed care matters so much.
The clinical evidence is strong here. The VA’s National Center for PTSD reports that PTSD and substance use disorder frequently co-occur, and that treating both conditions at the same time, rather than one and then the other, produces the best outcomes [4]. This reflects a broader principle established by the National Institute on Drug Abuse: roughly half of people who experience a mental illness will also experience a substance use disorder at some point, and integrated treatment that addresses both together leads to meaningfully better results than treating either alone [5].
At Healthy Living, our clinical team of licensed therapists, LMFTs, and certified counselors approaches every client with this understanding. The substance use is treated, and so are the things underneath it. For most first responders, sobriety alone is not enough; the underlying weight has to be processed and given somewhere to go. You can read more about our approach to co-occurring disorders and how we treat trauma alongside addiction.
You Served This Community. Let Us Serve You.
The Santa Clarita Valley and greater Los Angeles area are home to thousands of first responders who give everything to the people they protect. If you are one of them, or you love one of them, and substance use has become part of the picture, help is available, close by, and completely confidential.
Healthy Living Residential Program is DHCS licensed and JCAHO accredited, serving first responders from Santa Clarita, Valencia, Newhall, the San Fernando Valley, Burbank, Glendale, and communities throughout Los Angeles County. We accept most PPO insurance plans, and our admissions team is available 24 hours a day, seven days a week. You have spent your career making sure other people get help in their hardest moments. This one is yours.
Call us today at (661) 536-5562, 24 hours a day, 7 days a week. We’ll take it from here.
Learn more about our First Responders program →
Are you a veteran? See our Veterans program →
Related reading: Traveling for Rehab: Why Leaving Home Can Strengthen Recovery →
Sources
[1] Substance Abuse and Mental Health Services Administration (SAMHSA). First Responders: Behavioral Health Concerns, Emergency Response, and Trauma (Supplemental Research Bulletin, May 2018). https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf
[2] Ruderman Family Foundation. Ruderman White Paper on Mental Health and Suicide of First Responders. https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/
[3] Irizar P, et al. The prevalence of hazardous and harmful drinking in the UK Police Service, and their co-occurrence with job strain and mental health problems. National Library of Medicine (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220482/
[4] U.S. Department of Veterans Affairs, National Center for PTSD. Treatment of Co-Occurring PTSD and Substance Use Disorder. https://www.ptsd.va.gov/professional/treat/cooccurring/index.asp
[5] National Institute on Drug Abuse (NIDA). Co-Occurring Disorders and Health Conditions. https://nida.nih.gov/research-topics/co-occurring-disorders-health-conditions
[6] U.S. Department of Health and Human Services (HHS). Confidentiality of Substance Use Disorder Patient Records – 42 CFR Part 2. https://www.hhs.gov/hipaa/part-2/index.html
[7] U.S. Department of Labor, Wage and Hour Division. Family and Medical Leave Act (FMLA). https://www.dol.gov/agencies/whd/fmla
[8] State of California Employment Development Department (EDD). Disability Insurance. https://edd.ca.gov/en/disability/disability_insurance/
About the Author
Dr. Narine Arutyounian, M.D. is the Medical Director at Healthy Living Residential Program in Santa Clarita, California, where she oversees the medical care of all clients in detox and residential treatment and leads the physician-led team providing 24/7 medical supervision.
Clinical contribution by Ritsa Fistes, LMFT, Clinical Director at Healthy Living Residential Program, who leads the facility’s trauma-informed clinical programming.
