The Opioid Epidemic Compounds Compassion Fatigue and Burnout Among First Responders

700,000 is the Center for Disease Control (CDC) number Harry Nelson uses in his book “The United State of Opioids: A Prescription For Liberating A Nation In Pain” to estimate the number of drug-related deaths between 1999 and 2017 in the United States (Nelson, 2019). The loss of life over these 18 years averages to 38,888 deaths per year. When you divide the number of death per year by 365 you get 106 people dying every day in this country from drug overdoses. According to the latest research, the CDC estimates that between 1999 and 2020 more than 932,000 have died from drug overdoses (CDC WONDER, n.

d.). The CDC estimates that between the years 2017 to 2020, nearly three-quarters of these overdose deaths were opioid-related. In 2020 alone, there were 91,799 drug overdoses in the United States (CDC WONDER, n.d.). This averages out to 251 people dying of an overdose every day in America. When someone dies due to suspicious circumstances (drug overdose) law enforcement has to be involved and must investigate the matter. Every day law enforcement officers (LEOs) must interact with individuals overdosing and dying or nearly dying.

Seeing death or near-death experiences every day can impact individuals in their professional and personal lives. This can have detrimental effects on law enforcement officers and first responders and lead to Compassion Fatigue (CF) or even Job Burnout.

Compassion Fatigue and Job Burnout affect many first responders (law enforcement officers, paramedics, and firefighters), frontline medical workers (ER and Clinics), and those in social services. All human beings are affected by emotions and feelings. Any time we ask individuals to put themselves in the position of helping others their personal feelings get involved.

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No matter how much training and preparation law enforcement officers receive, nothing prepares them to see humanity at its worst. Compassion Fatigue is very different from job burnout. Merriam-Webster defines Compassion Fatigue as the physical and mental exhaustion and emotional withdrawal experienced by those who care for sick or traumatized people over an extended period. Compassion fatigue can also be described as apathy or indifference toward the suffering of others as the result of overexposure to tragic news stories and images and the subsequent appeals for assistance. (“Compassion Fatigue,” n.d.)

Job Burnout can be derived from any work-related stress and can make individuals feel physically or emotionally exhausted. There is no medical diagnosis for burnout but some experts think there may be underlying conditions and factors involved with burnout, such as depression, personality traits, and family life that can influence individuals’ feelings (Police Compassion Fatigue, 2020).

Law Enforcement Officers and other first responders may not know that they are being affected by compassion fatigue, they may write it off as only small problems and changes in their lives. Recognizing the underlying signs and symptoms that lead to compassion fatigue is the first step to fully understanding this condition. Symptoms of burnout can include:

• Physical or mental exhaustion
• Changes in perceptions of safety, community, and trust
• Intrusive memories or thoughts about past traumas
• Excessive worry about loved ones or personal safety
• Unfounded doubts that you do your job well
• Increases in anxiety or arousal, or feelings of numbness and disconnection

Historically, law enforcement officers (LEOs) have always dealt with job burnout due to the daily stressors involved with their duties and responsibilities. Now added to this mix is the opioid crisis, which has brought misery and death to many thousands of people across the United States. The opioid epidemic has placed many law enforcement officers in the role of medical first responders, as well as social workers. Law enforcement officers are generally the first to arrive at any type of emergency, from bank robberies, armed assaults, and domestic violence situations, all the way to medical emergencies. They are generally the first on the scene of opioid-induced medical emergencies like accidental and intentional overdoses.

When individuals join law enforcement agencies to protect and serve, they are not given formal training to be medical first responders. Many times new LEOs may only receive basic first aid skills such as CPR. Now with the rise of Opioid Use Disorders (OUDs), many of the calls LEOs respond to are both criminal matters and medical incidents that involve individuals either intoxicated by an opioid or have overdosed and died.

Compassion Fatigue can set in when officers, first responders, and other criminal justice authorities see the same individuals repeatedly leave treatment and return to a life of drugs and crime, they can easily feel defeated and experience compassion fatigue. (Knight et al., n.d.) While these men and women work to save lives, they cannot force addicted people to accept recovery or make changes toward healing. Many crisis workers see the same people over and over or witness the effects of the opioid epidemic on the most vulnerable people: children and the elderly (DeMio, 2017). Over time this will take a toll on many first responders.

with the rise of opioid abuse, there is a rise in drug-related calls law enforcement officers respond to: from domestic violence incidences to individuals going through a mental crisis episode, with most of these incidents involving heroin and synthetic drugs like fentanyl. The trend lately has been for the government to utilize social service programs to give the first responders Naloxone. LEOs must be trained on the use of NARCAN, from how it can affect someone to how to properly administer it to someone in need. This can be an added stressor to many LEOs, them having a life or death antidote in their hands and ensuring it is administered properly.

Nelson goes into great detail in chapter 9 of his book when discussing his SEVEN NATIONAL PRIORITIES: O-P-I-O-I-D-S. Nelson uses the acronym OPIOIDS to stand for Outreach-Physicians-Innovations-Overdoses-Interdictions-Data-Strengthening Access and explains that the O is for Overdose and he says an effort should be targeted to reducing overdose deaths by the effective distribution of Narcan and other forms of naloxone into the hands of every first responder and law enforcement officer in the United States (Nelson, 2019 p203). This will add more pressure on law enforcement officers to not only be law enforcement agents for the government but now they are being tasked with being first responders and dealing with medical situations they did not expect when hired.

As law enforcement officers take on more social service responsibilities and medical first responder duties this can greatly impact that individual, the department, and the communities they serve. One of the greatest impacts of compassion fatigue and burnout is law enforcement officers leaving their jobs. There can be many ramifications when turnover occurs in law enforcement, such as the loss of experienced (seasoned) officers. These officers carry with them the knowledge of the law, community connections and relationships built up over time, and the maturity to handle highly stressful situations.

Another issue with turnovers due to burnout is the time and money spent to find and hire qualified personnel to fill these gapped positions. It may take weeks to months to find and train new officers. It can be costly to hire and train individuals by sending them to police academies for months then sending them out to be police officers, and then repeating this turnover cycle again and again.

Compassion fatigue and burnout have historically been issues with law enforcement officers and other front-line workers but the surge of the opioid epidemic over the last twenty-plus years has added to the job stress in ways never before imagined. There needs to be a better support system to deal with these front-line workers dealing with the situations that arise from the crisis. To help law enforcement officers and other first responders deal with compassion fatigue and burnout while fighting the opioid crisis we need to first be able to recognize and understand what compassion fatigue can look like. Second, practice self-care to deal with these stressors and the effects compassion fatigue can have, and thirdly, show support for those facing compassion fatigue and burnout.