DR. NEAL HOUSTON

Adult Integrative/Behavioral Health Specialist

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Monday, June 3, 2013

Connections Between Substance Abuse and Domestic Violence?


The effects of Domestic Violence

The meaning of Domestic Violence is the use of intentional emotional, psychological, sexual, or physical force by one family member or intimate partner to control the other. Violent acts include verbal, emotional, and physical intimidation: destruction of the victims possessions; maiming or killing pets; threats; forced sex; and slapping, punching, kicking, choking, burning, stabbing, shooting, and killing victims. Spouses, parents, stepchildren, children, siblings, elderly relatives, and intimate partners may all be targets of domestic violence.

In the United States, a woman is beaten approximately every 15 seconds. At least 30% of female trauma patients (excluding traffic accident victims) have been victims of domestic violence, and medical costs associated with injuries done to women by their partners total approximately more than 44 million annually. Much like patterns of substance abuse, violence between intimate partners tends to escalate in frequency and severity over time. 

“Severe physical assaults of women occur in 8% to 13% of all marriages; in two-thirds of these relationships, the assaults reoccur. For example, in 1992, an estimated 1,414 females were killed by “intimates,” a finding that underscores the importance of identifying and intervening in domestic violence situations as early as possible.

An estimated 3 million children witness acts of violence against their mothers each year, and many come to believe that violent behavior is an acceptable way to express anger, frustration, or a will to control. Some researchers believe, in fact that “violence in the family of origin [is] consistently correlated with the abuse of victimization of an adult”. Other researchers, however, dispute this claim. The rate at which violence is transmitted across generations in the general population has been estimated between 30 and 40 percent. Although these figures represent probabilities, not absolutes, and are open to considerable interpretation, they suggest to some that 3 or 4 of every 10 children who observe or experience violence in their families are at risk for becoming involved in a violent relationship in adulthood. 

Researchers have found that one fourth to one half of men who commit acts of domestic violence also have substance abuse problems.  A recent survey of public child welfare agencies conducted by the national committee to prevent child abuse found that as many as 80% of child abuse cases are associated with the use of alcohol and other drugs, and the link between child abuse and other forms of domestic violence is well except. Research also indicates that women who abuse alcohol and other drugs are more likely to become victims of domestic violence and that victims of domestic violence are more likely to receive prescriptions for and become dependent on tranquilizers, sedatives, stimulants, and painkillers and are more likely to abuse alcohol.

Clearly, substance abuse is associated with domestic violence, but it is not the only factor. Witnessing or experiencing family violence during childhood is a risk factor as is a history of childhood aggression. Another factor that must be acknowledged is societal norms that indirectly excuse violence against women. Some groups more than others accept domestic violence or intoxication as a way of dealing with frustration or venting anger. Though they range from subtle to blatant, sexist assumptions persist and are reflected by society’s different responses to the domestic violence and substance abuse among men and women.

So experts agree there is a connection between the two behaviors, its precise nature remains unclear. One researcher writes, “Probably the largest contributing factor to domestic violence is alcohol. All major theorists point to the excessive use of alcohol as a key element in the dynamics of wife-beating. However, it is not clear whether a man is finally because he is drunk or whether he drinks two reduces inhibitions against his violent behavior.” 

Within the societal of substance abuse as morally weak and controlled by alcohol or other drugs actually serves some batterers, rather than, taking responsibility for their actions, they can blame their violent acts on the substance(s) they are abusing. Although drugs or alcohol may indeed be a trigger for violence, the belief that the violence will stop once the drinking or drug use stops is usually not borne out. The use of alcohol or other drugs may increase the likelihood that the batterer will commit an act of domestic violence - because it reduces inhibitions and distorts perceptions, because alcohol is often used as an excuse for violence, and because both alcohol abuse and domestic violence tend to follow parallel escalating patterns - but it does not fully explain the behavior. The fact remains that non-drinking men also attack their partners, and for some individuals, alcohol actually inhibits violent behavior.

Domestic Violence batterers - like survivors - often turn to substances of abuse for their numbing effects. Batterers who are survivors of childhood abuse often frequently say that they use drugs and alcohol to block the pain and avoid confronting that memory. It is a self-perpetuating cycle. It has been documented and reported that batterers say they feel free from their guilt and others’ disapproval when they are high or under the influence of alcohol.
Though it cannot be said that substance abuse “causes” domestic violence, the fact remains that substance abuse treatment programs see substantial numbers of batterers and victims of domestic violence among their patient population and increasingly are compelled to deal with issues related to abuse.

As substance abuse treatment programs have grown more sophisticated, the treatment offered patience has become more comprehensive and more effective. Questions about vocational, educational, and housing status; coexisting mental disorders; and presence of Human Immunodeficiency Virus (HIV) and other infectious diseases are routinely raised during the assessment process. Treatment providers now recognize the importance of addressing issues that affect clients’ patterns of substance abuse and vice-versa so that these issues do not undermine their recovery. Today, mounting evidence about the very association between domestic violence and substance abuse attests to the need to add violent behavior and victimization to the list of problems that should be explored and addressed during treatment.

TIP 25: Based on their clinical experience, members of the Consensus Panel who developed TIP 25 concluded that failure to address domestic violence issues interferes with treatment effectiveness and contributes to relapse.

The battered women live in a war zone: she really knows what will trigger an abusive episode, and often there is little, if any, warning of its approach. She spends a great deal of time and energy trying to read subtle signs and clues in her partner's behavior and moods in order to avoid potential violence, but she is not always successful. Financial constraints and fear that the batterer will act on his threats to harm family members or continually harass, stalk, and possibly kill her often inhibit victims from leaving. If the batterer is also the victims drug supplier that further complicates the situation. Assuming all these issues can be resolved, the effects of continual abuse and verbal degradation can be so inherently damaging to self-esteem that the survivor may believe that she is incapable of “making it” on her own.

A key aspect of treatment for substance abuse is encouraging the client to assume responsibility for her addiction. For the survivor client, it is critical at the same time to dispel the notion that she is responsible for her partner's behavior. She is only responsible for her own behavior.

The survivor client must realize that she does not and cannot control her partner's behavior, no matter what he says. The Treatment should help her move toward becoming an autonomous individual who is not at the mercy of external circumstances. At the same, it is important to recognize that many survivors consciously keep the fact or extent of their battering concealed for good reason, such as fear for themselves, their children, or their family members. When a battered woman leaves her abuser, her chances of being killed will increase significantly. Furthermore, the batterer may be the primary source of income, so his incarceration could leave her without financial support.


What To Do If You Are a Victim of Domestic Violence:
  • 1. Call 911 and report the incident. Write down the police report/incident number and keep with your records.
  • 2. If necessary, seek medical attention. Have injuries documented and photographed.
  • 3. Go to a safe place such as a domestic violence shelter.
  • 4. Seek the support of caring people. Tell someone you trust about the abuse. They may be your friend, a family member, a neighbor, a co-worker, or staff members of support agencies. Talk to them in a private, safe place. You do not need to face abuse alone.
  • 5. Have a safety plan. If your partner is abusive, have a plan to protect yourself and your children in case you need to leave quickly. If you are abusive, be honest with yourself, think of the consequences, and get help.
  • 6. File for a Protective Order that will tell your abuser to stay away.
References – Research Material: [Gelles & Strauus][McLeer and Anwar][Bureau of Justice Statistics][Kaufman and Zigler; Egeland 88’][Gondolf; Leonard and Jacob; Kantor and Straus; Coleman and Straus; Hamilton and Collins] [LaBell][Pernanen; Leonard and Jacob; Steele and Josephs]