title: The association between alcohol, medicinal drug use and post-traumatic stress symptoms among Norwegian rescue workers after the 22 July twin terror attacks.
abstract: BACKGROUND
  The aim of this study was to assess whether the use of alcohol and medicinal drugs among rescue workers as a consequence of the 22 July terrorist attack was associated with post-traumatic stress symptoms, and explore if there were differences between affiliated and unaffiliated rescue workers.
  
  
  METHODS
  Ten months after the bombing in the Oslo government district and the shooting at the youth camp on Utøya Island, a cross-sectional study of 1790 rescue and healthcare workers was conducted. The questionnaire included information on medicinal drug and alcohol use, experiences during rescue work and PTSS.
  
  
  RESULTS
  Few rescue workers reported alcohol (6.8% n = 119) or medicinal drug (5.5% n = 95) use as a consequence of participation in the 22 July terror attacks. Alcohol and medicinal drug use was associated with an elevated level of PTSS among the rescue workers who reported to use medicinal drugs (11.1 95% CI: 5.7-21.8) or alcohol (10.0 95% CI: 5.2-19.0) as a consequence of the terror attacks.
  
  
  CONCLUSIONS
  The study found a low level of post-traumatic stress symptoms (PTSS) and alcohol and medicinal drug use among the rescue workers after the terror attacks in Norway on 22 July 2011. There was a strong association between both medicinal drug and alcohol use and elevated PTSS.
authors.affiliation: Domain for Forensic Sciences, Norwegian Institute of Public Health, PO Box 4404, Nydalen, Oslo N-0403, Norway; Lovisenberg University College, Lovisenberggt. 15b, Oslo 0456, Norway. Electronic address: StigTore.Bogstrand@fhi.no.
authors.forename: Stig Tore
authors.initials: ST
authors.lastname: Bogstrand
authors.affiliation: Department of Acute Medicine, Oslo University Hospital, PO Box 4956, Nydalen, Oslo 0424, Norway; Paramedic Sciences, Oslo and Akershus University College, PO Box 4, ST. Olavs Plass, Oslo 0130, Norway.
authors.forename: Laila
authors.initials: L
authors.lastname: Skogstad
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, PO Box 4956, Nydalen, Oslo 0424, Norway; Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway.
authors.forename: Øivind
authors.initials: Ø
authors.lastname: Ekeberg
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000209:etiology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D055553:Prescription Drugs / Q000627:therapeutic use*; D018635:Rescue Work; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology; D011795:Surveys and Questionnaires; D023481:Terrorism / Q000523:psychology; D000078329:Workforce
chemical_list: D055553:Prescription Drugs
keywords: Alcohol; Exposure; Post-traumatic stress; Psychoactive medicinal drugs; Rescue workers; Terror attack; Trauma