THE NEWSLETTER OF THE BUREAU OF HEALTH SERVICES • COUNSELING SERVICES UNIT • FDNY Vol. 2 • No. 5 • March 2004

When Does Alcohol Use Become Abuse?

It's been a long week, the car broke down, your son made the baseball team, the family is getting together for an anniversary party. You reach for a drink, whether to celebrate good fortune or reflect on a misfortune BUT when does drinking become over the line drinking?

Roughly 90 percent of our population drink. Our FDNY members are no different in that regard. So how do we know when social drinking has extended beyond the barriers to harmful drinking to drinking as a disease ? These are issues we struggle with as we deal with relentless press coverage focusing on our drinking patterns. Though these newspaper articles do not reflect the true behavior of our members as a whole, it does provide an opportunity and incentive to reflect on the role alcohol and other substances can have on our lives.

Alcohol use does reflect cultural and familial patterns. We grow up with learned behaviors of "acceptable drinking” in our lives. At family gatherings, social get togethers, and parties we witness alcohol use at the earliest age, and may begin participating from the teen years on. Our own use of alcohol may follow the patterns of our parents or peers. Behaviors can be established or modified depending on the circumstances of our lives. A Saturday night out might mean a keg of beer with a few friends or a bottle of wine with a special someone. But the pattern of use can become abuse.

During stressful times people may turn to increased alcohol or substance use. With increased use of alcohol, inhibitions are lowered and actions that would be unacceptable when sober become acceptable. The pattern of drug or substance use begins most often with alcohol. Just as people under the influence of alcohol may make the bad judgements (ever exchange heated words or phone numbers with the wrong person?). People under the influence may make bad decisions, whether it is to drive home or try a drug like cocaine. It is a slippery slope that can lead from alcohol over use to illicit drug use.

Both alcohol and other substances cause tolerance which means that our systems require more of the substance to get the same effect because we process it better with time.

Alcohol and substance abuse affects not just the individual but those at home and those at work. The individual under the influence of, or withdrawing from these substances is adversely affected. Family disputes, domestic violence, or motor vehicle accidents are frequently the result of alcohol or substance abuse problems. In DWI cases, on the first offense, 25 percent of people have a alcohol abuse problem. On the second DWI offense, 50 percent have an alcohol abuse problem.

What can be the signs or symptoms that alcohol has become a problem? If you are drinking alone, drinking in secret, or planning and thinking about the next time you get drunk, you should examine your behavior. Assess your situation with the following questions: Do you lie about your substance use? Have you ever felt the need for an eye-opener or woken up wanting another drink? Do you feel guilty or bad about your substance use? An answer of 'yes' to two or more of these questions could indicate a problem.

How do you get help for yourself or some one you care about? Whether it is a relative or a friend, you can help that individual.

The Counseling Services Unit has many options available to you should you wish help with substance abuse. Counselors will work one on one with individuals to assess the situation and develop personalized treatment plans. Out patient treatment and in patient detoxification will be offered where appropriate. You can make a one time appointment with a CSU counselor specializing in substance use or obtain a referral to a counselor outside the department should that be a more comfortable route. Twelve step groups , such as Alcoholics Anonymous have proven useful and are offered in every community. Each group may have a different flavor to it, so trying different groups can be helpful. They are offered during the day, evenings and on weekends. Substance use does not usually necessitate hospitalization nor require a dramatic intervention. Discussing your use with a counselor does not have to be an embarrassing experience.

Unfortunately, sometimes people will not seek help until the legal system intervenes. Ideally help should be accessed when problems are beginning. Behavioral changes can help get lives back on track.

Here are ways we can help. Call for assistance, call for an appointment or call for the names and numbers of counselors. The first day of getting better starts with getting help today.

CSU Manhattan
(212) 570 1696/1693

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Fitness For Duty; Fitness For Life

As part of our commitment to our members, BHS continues to take a proactive role in helping our uniformed members maintain their optimum health and fitness levels.

It goes without saying that firefighting and emergency medicine is a strenuous job, carrying over 100 lbs of equipment, climbing stairs, carrying patients, working hose lines, pulling down ceilings, etc. The physical demands of the job command a workforce who is fit to carry out the task at hand.

Our current schedule details members to BHS for their annual medical on a 15-month schedule. Members who are ending a medical leave or light duty status and returning to full duty also need to evaluate their fitness levels after their medical conditions have been resolved.

To accomplish this, BHS will be identifying members who come to clinic and are in need of annual medicals and they will be directed to the Annual Medical area. The Automated Citywide Medical Leave System is another vehicle that checks Department records for a members' last annual medical; a prompt will then notify the caller that an annual is needed and the member should expect to spend 4 hours to fulfill this commitment.

Annual medicals are not used as punitive measures, nor are they used to 'catch' something and force a member to retire. In fact, quite the opposite; members have come forward to say that results from their annual medical brought to light changes that required follow-up by their own personal physician. Some of these changes identified problems that essentially saved the members' life. The goal of the annual is twofold, to raise the fitness level of our members through education and practice. A person with an optimum fitness level performs the rigorous demands of their job better and that fitness carries over to a better and healthier lifestyle.

The medical professionals at BHS are all too familiar with the demands of this job, and therefore our commitment to maintain our workforce at the greatest fitness levels possible remains our mission. A 'fitness for duty' is also a 'fitness for life'.
Stay healthy; stay safe.

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