October 14th, 2022
I started my career working for and interning at a local domestic violence agency. 14 years later this is a client population that has stayed near and dear to my heart.
October is both Domestic Violence Awareness Month and Substance Abuse Prevention Month. During the month of October at Clarity Clinic, we have been using our platforms to bring more awareness to various aspects of substance use prevention, recovery, and treatment.
Substance use amongst people who are also victims of domestic violence brings about a number of unique challenges both within the context of being able to leave the abusive relationship and as a barrier to moving into a place of recovery from substance abuse.
People who experience being victims or survivors of domestic violence are 15 times more likely to abuse alcohol than those who do not and 9 times more likely to abuse drugs.
My clients often ask me the “what came first” question. “Do I have an eating disorder because I struggled with my body image or do I struggle with my body image because I have an eating disorder?” “Do I have social anxiety because I fear being judged by others or was I judged by others early in life and developed social anxiety?”
I often have to explain that it’s difficult to pinpoint that answer, especially because it can be a little bit of both in most cases. This question also often varies from client to client and a lot of times these problems started so long ago that it is hard for them to even remember.
So, if you are wondering, “do people abuse substances because they are being abused, or does abusing substances make people more vulnerable to domestic violence?” The answer is, it’s often a mix of both.
In this article I am focusing mainly on substance use and prevention in victims of domestic violence, but I do think it is important to mention that men who abuse alcohol are 2-4 times more likely to abuse their partners than men who do not. In a study done by the New York State Office for the Prevention of Domestic Violence, they found that 92% of men who assaulted their female partner had used either drugs or alcohol on the day of the incident.
The CDC also has released stats on male perpetrators of abuse and found that 2/3 of men who attempt to kill their partners used alcohol that day. While using substances is in no way an excuse for abusing your partner, the correlation is staggering and speaks to the need for the prevention of substance use within the context of any romantic relationship.
For victims of domestic violence, substances play a different role. Often substances are being used as a way to cope with the physical and emotional pain brought on by being in an abusive relationship. This adds an additional barrier when attempting to move into recovery because if the abuse continues and this is the person’s only way to cope then it is often too difficult for them to navigate life in an abusive relationship without drugs or alcohol.
On the other side of this, people who are abusing substances are also less likely to report their abusive partner to authorities out of fear of being found out that they themselves are abusing illegal substances. This gives the abuser an additional advantage in the relationship in that their abuse is more likely to be kept a secret. Perpetrators of abuse often encourage and facilitate (or participate in) substance use with their partners as a way to keep them controlled and isolated.
In a study done on women entering substance abuse treatment facilities, it was found that 67% had experienced partner violence within the last 6 months. In another study of women who attended a methadone clinic it was found that 90% of them had experienced intimate partner violence (IPV) within their lifetime.
Young women ages 18-24 experience the highest rates of IPV. In general, the bodies of research that have been done refer to substance abuse as both a risk factor for being a victim of IPV and as a consequence of being a victim of IPV.
The answer to why these rates are SO much higher in people who experience IPV lies in the trauma of it all.
Being abused, whether physically, sexually, emotionally, or verbally, often results in significant trauma for the victim. Unlike other forms of more acute (single incident) trauma where we might see someone quickly present to therapy and mental health treatment (witnessing a traumatic event, losing a loved one, a singular event of sexual trauma like rape, a natural disaster), IPV is ongoing and chronic trauma.
The impact on the brain can include mental health disorders like PTSD and depression, there can also be physical trauma to the brain (TBI) that can cause cognitive impairment. Exposure to high levels of cortisol (the stress hormone) can also impact a person’s hippocampus which is our brain’s center for memory functioning. IPV often results in trauma and the trauma is a risk factor for substance abuse.
I usually like to end my articles with a solution, a way to wrap up whatever I have just presented with some closure. Unfortunately, the complexity of this topic doesn’t allow for a linear approach to resolution.
Substance use, in general, is concerningly high in the US and the pandemic has only served to increase those rates. Prevention of both domestic violence and substance use starts in a multitude of places; at home, at school, and in the community.
Education on both of these topics and continued advocacy not just from mental healthcare professionals but everyone in our community is of utmost importance. Supporting local agencies that do this work either via donations or volunteering is a way that people outside of healthcare can contribute to prevention.
In the month of October, Clarity Clinic is partnered with Haymarket, a substance abuse treatment center to help bring awareness to the need for Substance Abuse Prevention in our community. To learn more about how you can get involved or support their work please check out their donations page.
Author’s note: The majority of studies that have been done on victims of domestic violence focus specifically on women as the victims and males as the perpetrators. Therefore, many of the statistics given in this article are in reference to women who are experiencing interpersonal violence within the context of their romantic relationships. While we do know that males are the victims of domestic abuse with women as the perpetrators the stats are so low that it is difficult to gather participants for those studies. Additionally, many studies either do not include or do not specify if they included members of the LGBTQ+ community.
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