The Dangers of Domestic Violence and Substance Abuse

According to the late former US Surgeon General C. Everett Koop, domestic violence is the leading cause of injury to women ages 15 to 44. It is, in fact, more common than automobile accidents, muggings, and rapes combined.

Is All Domestic Violence Defined by Men as Perpetrators and Women as Victims?

No, although men – being more prone to violence by nature – predominate, and heterosexual couples more commonly experience domestic violence than homosexual couples. Some studies actually show, in fact, that women may be as prone to actually hitting their partners as men are. The difference lies primarily in the degree of the assault and of the resulting injury. Ordinarily, a woman will be smaller and therefore less able to bring harm to her victim if that victim is a man who is larger than she is, compared to the damage done by him to her with the same level of anger and force. A man’s blow to a woman’s body is likely to be much more injurious – unless she uses a weapon.

This is a very controversial issue, and some experts believe that the incidence of men being battered by their wives, girlfriends, or male partners may be underreported. The Bureau of Justice Statistics’ National Crime Victimization Survey, found that men were considerably more likely to follow through on a violent inclination as compared to women. The speculation is that the difference lies in the different methodologies employed by the different surveys.

Is There a Common Denominator Among Domestic Abuse Cases?

Yes, and it is the use of drugs or alcohol by one or both of the participants. In up to half of all cases, alcohol is involved. Even when the abuser is sober, if he (or she) is an alcoholic, the abuse is (1) much more likely to occur and (2) likely to be much more violent. Alcoholics, even when sober, are more likely to commit spousal or partner abuse. The Department of Justice states that about 61% of domestic violence offenders also have problems with alcohol or drug abuse.

Is It Always Only the Assailant Who Is a Drug or Alcohol Abuser?

No. Often, both parties are alcoholics or drug users. Sometimes, only the victim is a substance abuser. In such cases, the abuser may be likely to claim that violence is employed in an attempt to deal with the substance-abusing person. When a victim is abusing substances instead of or in addition to their partner, the situation becomes all the more dangerous. For example:

• The victim may be unable to resist the attacker or to accurately assess the level of danger and inadvertently remain in or exacerbate a dangerous or even deadly situation.
• The victim may be unwilling to report the attack, for fear the authorities may arrest him or her for criminal substance abuse.
• The victim may be driven by the violence to even more extreme drug or alcohol abuse in an effort to deal with the resulting feels of anger, depression, fear and shame.

Often, victims of domestic violence are substance abusers themselves. Additionally, a very common scenario is where both parties are high. In a North Carolina study, described in “Influence of Alcohol and Drugs on Women’s Utilization of the Police for Domestic Violence,” a total of 419 women were interviewed following calls placed to the police reporting domestic violence. More than half (52.8%) of the assailants were habitual users or bingers. One-third of the assailants habitually drank 10 or more drinks per day.

About 30% of the victims reported that their partners used cocaine habitually as well. As for the victims, about 20% of them were reported to be habitual drug users or binge drinkers, and about 30% were drinking on the day of the assault. About 25% admitted to drinking more than usual on that day, but less than 10% admitted to being drunk. It’s important to note that these accounts by the victims were self-reported and that many of them may not have been aware of how much they drank that day or were otherwise unable to correctly recall the event due to the trauma.

What Substances Other Than Alcohol Are Frequently Involved in Domestic Violence?

Perhaps surprisingly, prescription drugs – particularly antidepressants and anti-anxiety medications – are often involved in cases of domestic violence.

Experts often, for example, point to the so-called “Prozac defense,” a tactic used by attorneys to blame a defendant’s violence on his or her use of prescription drugs. The report of the UNC study mentions Prozac, Paxil, Lexapro, and Celexa as examples of antidepressants known to sometimes unleash violent behavior. Also discussed are the benzodiazepines, or “benzos,” a class of anti-anxiety drugs with a similar history of causing violent behavior. These include such drugs as Xanax, Klonopin, and Ativan.

Another type of drug known to accompany violent behavior is Chantix, a drug prescribed to help smokers stop smoking. All of these drugs, under the right circumstances, when used by the batterer or the victim, can exacerbate the violence and the resulting injuries.

TIME published a list of the prescription drugs most likely to inspire or induce violent behavior. It is led by Chantix, mentioned above, and includes various benzos and antidepressants, among others:

1. Varenicline (Chantix). While this drug does work to reduce the craving for nicotine, it is 18 times more likely to be linked to violent behavior than any ordinary drug.
2. Fluoxetine. This is the famous Prozac, which gave rise to the “Prozac defense” mentioned above. It is 10.9 times more likely to inspire violence.
3. Paroxetine. Known by its trade name Paxil, this drug is 10.3 times more likely to be linked with violent behavior.
4. Amphetamines. Amphetamines are legal drugs that are similar in effect to crystal meth or “speed.” They are often prescribed for the treatment of attention deficit and hyperactivity disorder (ADHD) and are 9.6 times more likely to be linked to violence.
5. Mefoquine. This one is a little different. Known by the trade name Lariam, it’s an anti-malaria drug. Its “violence index” is 9.5.
6. Atomoxetine (Strattera). This is a non-stimulant alternative treatment for ADHD. Nevertheless, its violence index is 9.
7. Triazolam. This is a benzodiazepine, known better as Halcion, used to treat insomnia. It is 8.7 times more likely to be linked with violence that ordinary drugs.
8. Fluvoxamine (Luvox) An antidepressant, this drug rates an 8.4 on the violence index.
9. Venlafaxine (Effexor). Another antidepressant, this drug comes in at 8.3 on the index.
10. Desvenlafaxine (Pristiq). Rounding out the top 10 with a violence index of 7.9 is this antidepressant.

Does Substance Abuse Cause Domestic Violence?

The statistical linkage between alcohol and drug use and domestic violence would strongly suggest that there must be a cause-and-effect relationship there somewhere. Yet, experts are reluctant to say so. For one thing, while heavy drinkers are often abusers, the heaviest drinkers aren’t. Furthermore, the majority of alcoholics overall are not abusers.

A book published by the Substance Abuse and Mental Health Services Administration (SAMHSA), Substance Abuse Treatment and Domestic Violence, examines the issue, concludes that while substance abuse was a factor in domestic violence, it was not the only factor. Another important factor is having experienced or witnessing domestic violence as a child. In addition, the book points out that batterers will often blame their behavior on alcohol or drugs in an effort to explain away their violence and avoid responsibility. The book also discusses how non-substance abusers are sometimes batterers and that the worst substance abusers (in this case, the most severe alcoholics) do not batter.

Domestic Violence and Mental Health Disorders

Those who are the victims of domestic violence are more likely to struggle with a wide range of mental health disorders and require treatment in order to overcome the abuse. Two of the most common among both men and women are substance abuse and eating disorders. In an effort to regain control over their lives and to drown out the pain and fear that comes with chronic violence and attack, many attempt to micromanage their eating choices, binge eat, or overindulge in alcohol or other substances. In addition to substance abuse and eating disorders, other commonly diagnosed mental health disorders among domestic violence victims are depression, anxiety, and post-traumatic stress disorder (PTSD).

Treatment That Addresses Substance Abuse and Domestic Violence

Many perpetrators of violence quickly find themselves on the wrong side of the law, and as a result, are remanded to drug rehab and/or to anger management classes that focus on providing them with crucial information about the impact of domestic violence. The goal is to help these patients get both issues under control because if both are in evidence, both must be addressed in order to provide the person with better coping skills going forward.

Additionally, the trauma experienced by victims of domestic violence can lead to a wide range of mental illnesses that will require treatment.

It’s important that the trauma and any co-occurring disorders are addressed effectively through treatment. At Futures, we can help. We can help you or your loved one take the first step toward healing. Survival of abuse is possible, and it starts with an intensive treatment program that provides everyone involved with the coping mechanisms necessary to move forward in life. Contact us today to learn more about how we can help you or a loved one.