What the Heck is a SUD—and Why Should You Care?
So, what’s your SUD?
Yeah, I know—if you’re a first responder, you’re probably thinking, “What the hell is a SUD and why should I care?” Great question.
Let’s start there.
SUD stands for Subjective Unit of Distress. It’s basically your internal pain scale. Not physical pain—mental pain. Emotional stress. Psychological weight. It’s used to gauge how overwhelmed you are in the moment. Think of it like this: “On a scale of 0 to ‘I want to throw my MDT out the window and live off the grid,’ how wrecked am I right now?”
This tool is one part of something called ASAP, or Acute Stress Adaptive Protocol—a no-nonsense, action-focused method used by peer support teams to help first responders and veterans rapidly reduce acute psychological stress. This isn’t traditional talk therapy. There’s no office, no couch, no hour-long introspection on childhood attachment issues. ASAP is designed for the person who’s in it right now, who needs help not weeks from now, but today.
So, What Exactly Is ASAP?
ASAP was created with military personnel and first responders in mind. The people who run toward trauma. Who carry other people’s worst moments long after the scene clears. It's not just “stress management.” It's a structured, step-by-step protocol that works directly with the body’s natural fight-or-flight system, helping reprocess traumatic material and lower the internal intensity tied to it.
It’s efficient, it’s portable, and yes—it’s been shown to work.
And here’s the part that really ruffles feathers: you don’t need a therapist with 27 letters after their name to administer it. You don’t need a clinical psychology degree, a $300-an-hour office, or a library of DSMs. You need training, accountability, and heart. You need peers who understand what it’s like to carry ghosts. You need people who’ve lived it and aren’t scared to face it.
Yes—Peers Can Be Trained
Contrary to what a few ivory tower critics like to believe, peer-led ASAP isn’t some back-alley, Wild West version of therapy. To become a certified ASAP peer support provider, you go through a multi-day, intensive training led by licensed clinicians certified in the protocol. This isn’t fluff. You’ll cover:
The science of how trauma impacts the brain and nervous system
How to assess SUDs accurately
How to administer the full protocol safely and effectively
When to refer someone for clinical care
Hands-on, supervised practice sessions
Strict ethical guidelines
Let me be clear: you earn that certification. This isn’t some 45-minute “self-care” training where you get a printable certificate and a granola bar. You’re trained, evaluated, and expected to uphold the standards of care just like any other professional.
And yet… despite the structure, success, and support this brings, some professionals still have an issue with it. Want to guess why?
It’s Free—and It Works
That’s right. Peer-led ASAP sessions are often free. No copay. No insurance denials. No two-month waitlist just to cry in a beige office. Just two humans sitting down with a shared mission: get through this storm, together.
And that terrifies some folks. Especially the ones making their entire living from hour-long therapy sessions or gatekeeping healing behind a wall of credentials. Some mental health providers will throw around terms like “unregulated,” “unsafe,” or “non-evidence-based,” when what they really mean is: “We don’t control it and we’re not getting paid for it.”
Let’s also not forget the pharmaceutical industry—another giant that doesn’t benefit when healing happens without a prescription pad. No pills? No profit.
Not Just Theory—Real Lives, Real Impact
Here’s the part they can’t argue with: lived experience.
I’ve used ASAP. I’ve delivered it. I’ve trained in it. And more importantly—I’ve survived because of it. Along with EMDR 2.0, ASAP helped me crawl out of the black hole of depression, grief, and survivor’s guilt. I have buried more people than I care to count in my 27 years as a first responder. The faces of those I couldn’t save used to follow me into every quiet moment. But through peer-led ASAP and EMDR 2.0, I found my way back.
And if you're wondering whether peers can really “handle it”—I am living proof that they can. That they do.
I’m not just some guy throwing around acronyms. I’ve been in the pit. I’ve fought demons that don’t show up in textbooks. So if someone wants to come into our corner of the state and challenge ASAP—they better come correct. Because while they were theorizing trauma in air-conditioned classrooms, I was surviving it in real life.
Final Thought
ASAP isn’t for everyone, and it’s not a one-size-fits-all miracle. It doesn’t replace therapists, chaplains, EMDR, or long-term care. But when it's used as part of a true, layered support system—where peers, clinicians, and community resources all work together—it becomes something powerful. It becomes a lifeline.
And for many of us, that lifeline was the difference between barely surviving—and finally starting to live again.
Watch over each other and stay safe, Dr. M
