An often overlooked yet essential component in the first responder system, emergency medical service (EMS) providers responded to almost 49 million emergency medical service (EMS) calls in 2021, routinely facing infectious disease exposure, intense work environments, and repeated exposure to trauma as they provided care in uncontrolled settings. As a result, several adverse health effects experienced by EMS providers including obesity, sleep disorders, musculoskeletal injuries, and mental health concerns have been documented. Despite the emergence of known adverse health impacts, research has not focused much attention to other well-known health issues such as alcohol use. This dearth of information is particularly concerning given the potential for risky alcohol consumption among EMS providers as a result of their stressful profession. Additionally, several known adverse health outcomes have been associated with alcohol use (e.g. occupational or accidental injuries, physical violence, sleep issues, substandard fitness, liver disease, and neurological impairment). Therefore, understanding the role of alcohol in EMS culture is essential to the development of health and wellness programs. The role of EMS providers has become invaluable, recently highlighted by the pandemic, making understanding alcohol use a priority to not only the quality of emergency services provided to the public but to the health and safety of EMS providers. Using a multi-method approach, this study will use a national sample of EMS providers to provide a foundational understanding of alcohol use within the EMS provider culture. Interviews with providers will provide insight into the role of alcohol consumption in EMS culture, factors which promote or moderate alcohol misuse, and workplace-focused policy interventions. A randomly selected sample of EMS providers will identify baseline prevalence of alcohol use providing a cross-sectional evaluation of sociodemographic and occupational risk factors. A prospective 2-year component will allow for the examination of associations between alcohol use and behaviors, and occupational, physical, and mental health outcomes.