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mental health
staff
evidence
paramedic

Alcohol/substance use and occupational/post-traumatic stress in paramedics

02 October 2020
Features
02 October 2020
Volume 12 · Issue 10

Abstract

Background:

Paramedics work in high-pressure environments and experience traumatic events, which contribute to high levels of occupational and post-traumatic stress. Such stress can result in alcohol and substance misuse in other health professionals, but this relationship has not been examined in paramedics. This review is the first exploration of the literature on this.

Methods:

A systematic literature review was conducted using PRISMA guidelines, with databases searched using terms relevant to paramedics and alcohol/substance use. Studies were analysed using descriptive statistics for quantitative data and thematic analysis for qualitative information.

Findings:

Eleven studies were identified. Nine studies examined alcohol use; seven examined substance use; five examined both. Alcohol and smoking may be linked to occupational stress.

Conclusions:

The nature and extent of alcohol and substance use in relation to occupational and post-traumatic stress among paramedics need further investigation to facilitate advice and support.

Exposure to traumatic events and working in pressurised environments are features of the paramedic role (Regehr et al, 2002; van der Ploeg, 2003). These contribute to high occupational stress levels (Donnelly, 2012) and result in higher levels of post-traumatic stress disorder (PTSD) than in the general population (Bennett et al, 2004; Donnelly and Siebert, 2009; Stanley et al, 2016; Wild et al, 2016). The risk increases with long working hours and irregular shift patterns (Jones, 2017).

Occupational stress in health professionals arises for multiple reasons, including poor organisational support, unrealistic demands and inadequate training to perform a role (Weinberg and Creed, 2000). Personal coping strategies also play an important part (Ruotsalainen et al, 2015).

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Paramedic
Emergency medical services
Post-traumatic stress
Occupational stress
Alcohol use
Substance use