Retired Four-Star  Army General Barry R. McCaffrey sees a lot of similarities between fire fighting and military service.

He spoke as the keynote speaker at the IAFF John P. Redmond Symposium and Dominick F. Barbera EMS Conference in Denver, Colorado.

High-level training and knowing how to work as a team are important for both professions to produce  successful outcomes, he says.

In addition,  fire fighting and members in combat are connected because of the high risk and stress that exposes them to unimaginable human suffering each day.

Sometimes,  the  emotional trauma may prove too great and cause alcohol abuse and other substance abuse to help ease problems.

McCaffrey has seen and experienced trauma first-hand, winning four Purple Hearts for wounds sustained in combat. He served as the director of the White House Office of National Drug Control Policy from 1996 to 2001.

He has been outspoken about raising awareness of substance abuse among members in the military. He has partnered with CR  Health Group and other organizations to provide treatment to almost 30, 000 veterans.

There are more than 23 million Americans who need but do not receive drug and alcohol treatment, according to the Department of Health and Human Services.

“Alcohol abuse is the single  issue that drives spousal abuse, ill-health and other vices,” McCaffrey told IAFF members in an “Ask the General” session at the Redmond-EMS Conference. “If you have a buddy or employee who is indulging in self-destructive behavior, confront them.”

Fire fighters and EMS personnel are the first line of defense for the American people and have  a ferocious challenge when dealing with emotional trauma, McCaffrey says.

One moment fire fighters can find themselves in a life or death situation and a short time later have to interact with their families and deal with their needs.

After the September 11, 2001, terrorist attacks on America, a study found that 11 percent of first responders in New York City were at risk for a severe drinking problem, while only 5 percent of individuals reported they would seek treatment.

There is still a stigma associated with substance abuse  because fire fighters are concerned about how it will affect their career if they discuss their problems publicly, McCaffrey says.

“It is a lethal condition, ” he says.

Training, good leadership, and  support from the fire fighters union will continue to be needed to make a significant difference in substance abuse. If  left unaddressed, the effects can be devastating.