Substance Abuse and Intimate Partner Violence

Research indicates that substance abuse is a risk marker for intimate partner violence (IPV). This entry reviews the evidence for this association, possible explanations for it, and implications for theory and practice for professionals who work in this area.

Substance Abuse as a Risk Marker for Intimate Partner Violence

Studies using a variety of passive-observational research designs have established that substance abuse is a risk indicator for IPV. For example, population-based studies as well as studies of clinic- or court-referred groups, have examined rates of substance abuse in people with and without a history of IPV victimization, IPV perpetration, or IPV recidivism (i.e., repeated IPV following an initial incident). According to narrative and meta-analytic reviews of these studies, the association between substance abuse and IPV is moderate or even moderate-to-large in magnitude. About 20% to 50% of all incidents of IPV occur when one or both partners have consumed and are under the influence of alcohol or illegal drugs. Substance abuse increases the odds of IPV perpetration or victimization by a factor of about 2 to 4. The association tends to be strongest when (a) the substances of abuse are alcohol, cocaine (in various forms), or heroin; (b) substance abuse is defined in terms of problematic patterns of use, rather than frequency of use or amount consumed; (c) IPV is defined in terms of moderate or severe violence, rather than minor violence; and (d) substance abuse and IPV are defined in terms of a broad time frame (e.g., lifetime) rather than a narrow time frame (e.g., past year). The association does not appear to be influenced by the legal status of the intimate relationship (married vs. cohabiting vs. dating), the sexual orientation of the intimate partners (heterosexual vs. same sex), or the gender of the perpetrator and victim.

Explanations for the Association between Substance Abuse and Intimate Partner Violence

There are several possible explanations for the observed association between substance abuse and IPV. First, the association may be false—the result of perpetrators attempting to avoid moral and legal culpability by claiming that they were intoxicated at the time they committed IPV. But the substance abuse/IPV association is observed even in studies that relied solely on victims to provide information and even in studies where substance abuse was measured months or even years prior to the first occurrence of IPV.

Second, the association may be artifactual—the result of some third factor that is causally related to both substance abuse and IPV. Potential third factors could include mental disorder in the perpetrator (e.g., antisocial personality disorder or psychopathy) or severe conflict in the victim-perpetrator relationship (e.g., recent separation or divorce). But studies that attempted to control for potential third factors have found that they accounted for only a small part of the association.

Third, IPV may be a cause of (i.e., have a causal influence on) substance abuse. Longitudinal research supports this view, at least in part. People who experience IPV increase their use of alcohol or illegal drugs, which in turn leads to increased risk for (repeated) IPV.

Fourth, substance abuse may be a cause of IPV. The same longitudinal research that found that IPV increases substance abuse has also found that substance abuse increases risk for IPV, even when the substance abuse came months or years before the IPV. For example, substance abuse as a young adolescent predicts IPV as a young adult, and premarital substance abuse predicts IPV after marriage. In addition, treatment outcome research has found that reductions in substance abuse are associated with subsequent reductions in risk for IPV.

In summary, the association between substance abuse and IPV appears to be bidirectional in nature: Substance abuse is both a cause and a consequence of IPV. With respect to substance abuse as a cause of IPV, theory and research suggest that several direct or proximal and indirect or distal causal mechanisms may exist. Putative direct mechanisms focus on the psychopharmacological or psychological effects of substance abuse. Intoxication and withdrawal may impair cognitive functions, leading to reduced inhibitions against violence (e.g., underestimation of negative consequences, overestimation of positive consequences, failure to consider alternatives to violence) or misperception of social cues (e.g., misattribution of hostile intent in others). Putative indirect mechanisms focus on the destabilizing effects of substance abuse on social adjustment. For example, the short- and long-term consequences of substance abuse—such as problems with employment, finances, health, and family arguments about drinking patterns or the consequence of drinking on employment, finances, and relationships with family or friends—cause conflict between partners in intimate relationships, which in turn increases the risk that IPV will occur. Similarly, the consequence of substance abuse may impair one partner’s ability to cope with conflictual or aggressive behavior by the other partner (through the use of strategies such as deescalation, deterrence, or escape), thus increasing vulnerability to victimization and, ultimately, the risk that IPV will occur.

Implications for Research and Practice

It is clear that substance abuse is neither a necessary nor a sufficient causal factor for IPV but rather one of many contributory causal factors. Currently, researchers are trying to further understand the various causal mechanisms that may exist and how substance abuse interacts with other causal risk factors to cause IPV.

Professionals who work in the field of IPV need to be aware that substance abuse increases risk for IPV, and treating substance abuse mitigates risk. For these reasons, substance abuse is included as a risk factor in several IPV risk assessment procedures, including the Danger Assessment Instrument (DA) and the Spousal Assault Risk Assessment (SARA) Guide, and many intervention programs for perpetrators and vic-tims of IPV focus in part on decreasing substance abuse. The challenge for professionals is to determine what role substance abuse plays (i.e., which causal mechanisms are relevant) in a given case and then deliver appropriate services.

References:

  1. Klostermann, K. C., & Fals-Stewart, (2006). Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention. Aggression and Violent Behavior, 11, 587-597.
  2. Stith, S. M., & Smith, D. B., Penna, C. E., Ward, D. B., & Tritt, D. (2004). Intimate partner physical abuse perpetration and victimization risk factors: A meta-analytic review. Aggression and Violent Behavior, 10, 65-98.

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