Domestic Violence and Substance Abuse in Intimate Relationships

Domestic Violence and Substance Abuse in Intimate Relationships

Domestic Violence and substance abuse are severe psychosocial problems that affect thousands of families globally. Individually, domestic violence and substance abuse are critical healthcare issues resulting in mental, physical, or psychological challenges. Arguably, intertwining the challenges in one family can result in severe implications for all members of the affected social unit. A recent study by United Kingdom Drug Strategy established a link between substance use and intimate partner violence (Radcliffe et al., 2019). In that study, the evidence found that women reporting experiences of physical and sexual intimate violence tend to have drug or alcohol problems and a higher prevalence of intimate violence perpetration by men abusing drugs (Radcliffe et al., 2019). Also, various studies have reported fewer domestic violence incidents among families with no report of substance or alcohol abuse. It suffices to say that there is a link between domestic violence and substance abuse mandating the need for healthcare practitioners, psychologists, and other concerned professionals to develop support structures to address the problems linking the societal misfits. The report analyzes the link between domestic violence and substance abuse within the intimate relationship spectrum, aiming to develop evidence-based interventions to resolve and treat associated conditions. 

Literature Review

Defining Domestic Violence and Substance Abuse 

Before analyzing different aspects of domestic violence, it is crucial to define the term. The APA task force defines domestic violence as a pattern of abusive behaviors involving a range of physical, sexual, and psychological maltreatment used by one party of the intimate partner’s power to gain power and control against another one (Rakovec-Felser, 2014). In most cases, the abusive partner misuses their dominance to subject their partner to a physical or verbal altercation, a behavior that is harmful to the victim’s overall health. Domestic violence can result in bodily injury, psychological harm, or death when the perpetrator or victim loses control of the situation (Cafferky et al., 2018). The world today is defined as a multi-phased trait of intimate relationships. For instance, a close relationship can comprise same- or opposite-sex partners. It can also be made up of individuals sharing a familial link but are not intimate. It is crucial to note that all these intimate relationships are prone to experiencing domestic violence fueled by substance abuse. Domestic violence includes violence between a husband and wife, boyfriend and girlfriend, or gay or lesbian partners (Rakovec-Felser, 2014). In this case, the study on the link between domestic violence and substance abuse comprises all identifiable intimate relationships. 

In terms of gender, any person can be a victim or perpetrator of domestic violence, but the magnitude differs. According to Rakovec-Felser (2014), domestic violence can occur in any intimate relationship. Still, most of it is perpetrated by men against women, making it a significant public health problem. When it comes to higher victimization of women in domestic violence occurrences, different studies have adopted a sexist approach to identifying the problem. Most studies conducted in the United States refer to domestic violence as women abuse, wife abuse, partner abuse, and battered women (Rakovec-Felser, 2014). Also, children in the affected family emerge to be severe victims of domestic violence. They are either directly or indirectly implicated in intimate partner violence. However, it is important to stress that any person, despite their gender identity, is prone to becoming a victim of domestic violence. Still, women and children are at a higher risk of victimization. Thus, domestic violence can affect any member of the family. 

On the other hand, substance abuse primarily entails the misuse of drugs that can alter the ability of a person to act normally. The course material describes substances as any ingested material that can result in temporal alteration of a person’s behavioral, cognitive, and physiological state. The most abused substances include alcohol, tobacco, and caffeine. When used within the prescribed amount, a substance like caffeine can result in a relaxed state of mind. However, overusing the substance will alter the brain’s information processing capabilities slowing down the cognitive functions of other biological roles. In this case, a person who abuses drugs is prone to making irrational decisions, which they may regret when they become sober. It is the ability of the abused substances to corrupt an individual’s decision-making drug abuse process, a danger to domestic violence-prone people. A critical aspect of drug abuse is that continued substance intoxication can result in drug abuse and addiction, creating severe health problems for the user. Combining substance abuse with domestic violence can cause a menace to most families. 

Theoretical Conceptualization of Domestic Violence and Substance Abuse 

Different psychological theories create a cause-effect relationship to link intimate partner violence to substance abuse. Goldstein’s tripartite approach identifies three essential concepts; psycho-pharmacologically, systematically, and economically compulsively associating drugs and intimate partner violence (Radcliffe et al., 2019). The psycho-pharmacologically model directly correlates consuming or withdrawing from alcohol and other drug substances to violence perpetration (Radcliffe et al., 2019). Although the study does not explain the model’s suggestion, rationalizing the link between drug abuse and intimate partner violence helps expound on the psycho-pharmacologically recommendation on the issue. For instance, a close partner who engages or is withdrawing from drug abuse is likely to develop other aggressive behavioral symptoms exposing their partners to abuse. As a result, most perpetrators of domestic violence use their partners as a scapegoat to escape the damaging effects of drug and substance abuse on themselves and the broader societal environment. 

Another concept identified in the tripartite theory is the systematic model, “which suggests the conventional patterns of interaction within the drug distribution and use system” (Radcliffe et al., 2019, p. 10287). In this case, the systematic model places violence, aggression, and other co-occurring behaviors within the drug distribution and use of the network, affecting users. The perpetrator of violence who uses drugs may be replicating the aggressive behavioral traits present in the drug distribution and abuse system. It is difficult for a sober and drunk partner to have a healthy relational tie, and the aggression from the perpetrator may be a product of their indulgence in drug and alcohol abuse. Also, the economic-compulsive attribute of Goldstein’s tripartite theory “states that some drug users carry out violent crimes to support their drug use habits” (Radcliffe et al., 2019, p. 10287). Perpetrators of domestic violence will engage in the habit to protect and facilitate their drug-abusing needs. For instance, a violent intimate partner abusing drugs may become aggressive to prevent their partner from asking them to account for the money used to buy alcohol or any other medicine. In that case, the drug abuser views their habits as an investment that should be protected at all costs, including becoming violent and aggressive towards their intimate partner. 

The Prevalence of Domestic Violence 

The prevalence of domestic violence varies depending on the type of aggression involved. Source) identified primary forms of domestic violence to include psychological, social, physical, and sexual assaults. A victim may experience some or all forms of the identified intimate partner abuse. Some victims are simultaneously exposed to verbal abuse and physical aggression by their drug-abusing partners. According to Duncan et al. (2018), “prevalence rates of life experience of any form of intimate partner violence ranges from 29.7% to 78.0%” (p. 292). The statistic reveals that out of 10 people, at least two and eight have experienced any form of intimate partner violence. The higher number of domestic violence partners is likely to be influenced by alcohol and drug abuse. The number might be increased if the different forms of domestic abuse were categorized into their affiliate types. For instance, there is a likelihood for an intimate to experience psychological or physical assault from their drug-abusing partner in their lifetime. Addressing drug abuse as a causative factor can help reduce lifetime experiences of domestic violence of non-drinking or drug-abusing partners. 

Still, on the occurrence of domestic violence, lifetime experience of physical IPV varies from 13.0% to 38.1% (Duncan et al., 2018). Out of ten victims of intimate partner violence, one to three of them has reported experiencing physical assault in their lifetime. The physical form of domestic violence can have catastrophic outcomes. For instance, cases of people stabbing and killing their partners have risen in recent years. A drunk person may not be aware of the physical damage suffered by their partner until they become sober.

Moreover, the occurrence of sexual IPV ranges from 12.0% to 30.0%, while that of emotional or psychological IPV range from 5.4% to 73.2% (Duncan et al., 2018). All the data indicate a high prevalence of different forms of intimate partner violence in our families today. The situation may be worse given the recent restrictions imposed on the government regarding social gatherings forcing couples to spend a lot of time together. Addressing the alcohol and drug abuse cause of IPV can help reduce its occurrence in society. 

A reverse form of domestic violence where the victim turns to alcohol and substance abuse to cope with IPV is expected in society. The reverse effect of IPV victimization concerning alcohol and substance abuse occurs when the victim turns to drugs to cope with abusive relationship dynamics (Duncan et al., 2018). Drugs effects such as hallucination encourage victims of intimate partner violence to adopt them as coping strategies in managing their abusive relationships. The coping strategy creates more psychosocial effects than solutions. For instance, the victim may become addicted to the drug abused, prompting their partner to be more aggressive. Also, the victim is likely to engage in the irrational decision while on the drug, making them prone to engage in risky physical or sexual behaviors. Moreover, increased victimization and engaging in alcohol and substance abuse reduce the victim’s probability of reporting any depression-like symptoms (Duncan et al., 2018). In such cases, alcohol and other abused substances play a therapeutic role to the victim. The IPV victims end up damaging their life through alcohol and substance abuse. 

The Impact of Domestic Violence and Drug Abuse 

According to Abdo et al. 2020, substance abuse is categorized as a neuropsychiatric disorder characterized by the chronic urge to take the drug despite severe health consequences. Rugs like alcohol may damage the consumer’s liver if excessively consumed. Substance abuse is the primary cause of intimate partner violence among many families. Dysfunctional alcohol use has critical health and socioeconomic effects on the victim (Abdo et al., 2020). It is challenging for an individual to take care of their family’s fundamental needs while at the same time fulfilling their substance abuse desires. Alcohol and drugs are expensive to acquire and may result in intimate partners conflicts, mainly if only one person is abusing alcohol—the addictive trait of drug abuse fuels intimate partner violence. 

Domestic violence can result in severe long-term health implications for the victim. Several long-term health effects of drug abuse include anxiety, mood disorder, posttraumatic stress disorder, eating disorder, and alcohol and substance abuse (Abdo et al., 2020). Domestic violence victims are likely to suffer reduced quality of life in the long term, making them prone to other pathogenic conditions. Furthermore, exposure to domestic violence for years, actively or passively, is detrimental to the person’s mental health, increasing the odds of self-harm and suicide ideation (Abdo et al., 2020). It shows that domestic violence can result in the death of the victim or the perpetrator in extreme circumstances. IPV victims should be treated and offered long-term psychological support to prevent imminent mental disorders. 

Research Findings Implications of Clinical Intervention on IPV and Drug Abuse

The research findings are vital in eliminating the structural barriers in healthcare that make it challenging for caregivers to identify and treat IPV and drug abuse symptoms among the affected population. Challenges such as insufficient time or skill by health practitioners or lack of identification and screening tools have been barriers to the healthcare system when addressing domestic violence and substance abuse (Hegarty et al., 2020). Such research findings are crucial in reconstructing the professional training of health practitioners with the duty of addressing IPV and drug abuse. Nursing schools, psychology institutes, and other relevant medical training colleges should use this information to improve their curriculum to efficiently cover up-to-date interventions on intimate partner violence linked to drug abuse. Most healthcare practitioners have failed to engage patients with discussions concerning drug abuse and domestic violence due to feeling overwhelmed by the emotional outcome of the work (Hegarty et al., 2020). Some practitioners are victims of domestic violence and may find it discomforting to speak about it. As a result, the research findings on the topic are crucial in improving the professional curriculum used to train health practitioners, equipping them with the requisite skills and knowledge to address the issues associated with IPV and drug abuse effectively. 

Also, the study findings can help improve the patients’ willingness to disclose IPV experiences to a healthcare provider. Evidence has established barriers to patients disclosing domestic violence victimization, such as shame, confidentiality issues, and fear of being judged or not believed, among other challenges (Hegarty et al., 2020). It is the role of healthcare providers to build trust with the patient so that they may be willing to disclose if they are experiencing IPV victimization, drug abuse, or co-occurring issues. Existing literature on the problems has revealed low disclosure rates, with one-third of women who have experienced domestic violence disclosing to a practitioner (Hegarty et al., 2020). The statistics can be worse for men victimized by IPV and drug abuse. Also, the same findings have established a low inquiry rate by practitioners on patients regarding intimate partner violence and drug abuse ranging between 10-30 percent (Hegarty et al., 2020). there is a healthcare efficiency when one to two health practitioners are willing to inquire from the patient if they are experiencing domestic violence and drug abuse. The study finding will be used to develop health promotional campaigns on IPV and drug abuse to help sensitize the public on the significance of disclosing to a caregiver when subjected to domestic violence. 

Another clinical intervention generated from the study findings is putting in place a supportive healthcare system. Health practitioners’ readiness to address IPV and drug abuse-related issues involves a robust healthcare system equipped to manage the condition (Hegarty et al., 2020). The healthcare institutions should be supplied with enough health practitioners and sufficient resources to treat and manage IPV patients and drug addicts. As part of a supportive healthcare system, policymakers should implement laws to enhance the safety of IPV survivors (Hegarty et al., 2020). Domestic violence survivors can develop posttraumatic stress if they relive their IPV experiences. The literature review revealed different forms of intimate partner violence associated with alcohol and drug abuse, necessitating a policy-based response to protect the victim. Besides the healthcare regulations, policymakers can also regulate the alcohol and beverage industry by prohibiting the distribution of a high percentage of alcoholic drinks from helping the drinking population maintain a rational mind needed to avoid 

Besides, the literature findings are crucial in enhancing a collaborating healthcare environment needed to address intimate partner violence, drug abuse, and co-occurring behavioral challenges. Health practitioners have identified readiness to address domestic violence and drug abuse by instituting a multidisciplinary team of internal members of the facility and external experts to enhance the clinical outcomes of IPV patients (Hegarty et al., 2020). Treating a domestic violence victim requires pharmacological and non-pharmacological treatment intervention to efficiently care for the patient and provide the needed support to the survivor. “The interdisciplinary team provides emotional support and collective care strategies in the primary care settings” (Hegarty et al., 2020, p. 16). A team of doctors, nurses, psychologists, and social workers will ensure the patent receives the needed treatment and support to overcome the trauma resulting from IPV and drug abuse. The team will also help change perpetrators of IPV by subjecting them to a series of psychological treatments and support. Thus, the research findings can be used to enhance collaborative efforts within the healthcare system to address IPV and drug abuse problems. 

Treatment Plan

Client Name: John Clayton    

Presenting Problem:   Alcohol and substance abuse, domestic violence perpetration

Primary Goal: To treat substance abuse and IPV symptoms. 

Supporting Goals and Interventions

Early Goals	Interventions
Identifying the IPV and substance abuse symptoms.	1. Behavioral experiment.  2. Diagnostic therapy. 3. Medical screening.
Outline the dominant risk factors contributing to domestic violence perpetration and substance abuse.	1. Exposure therapy. 2. Roleplaying.  3. Thought channeling through journals.
To provide a brief treatment intervention.	1. Screening and identification. 2. Counseling therapy. 3. Medication
Middle Goals	Interventions
Develop healthy stress management practices.	1. Reduce stress triggers.  2. Physical exercise  3. Adhere to the dietary recommendation.
Abstaining from alcohol and other substances gradually.	1. Activity scheduling to eliminate alcohol-related plans.  2. Train the patient on how to capitalize on personal strengths.  3. Developing patient-based coping strategies like gradual withdrawal.
Adhere to treatment and medication plan.	1. Induce patient self-care strategies.  2. Schedule medication follow-up sessions.  3. Collaborate with pharmacists.
Late Goals	Interventions
Utilize social support from caregivers and family members.  Repairing the broken relationships.	1. Propose new socialization patterns between the patient and family members.  2. Point out the expectation of every family member.  3. Outlining the strength of every family member.
Finding new habits to replace the unhealthy ones.	1. Behavioral restructuring  2. Introduce new behavioral patterns.  3. Cognitive restructuring.
Staying committed to avoiding relapse.	1. Routine counseling therapy.  2. Progress tracking. 3. Introducing support group intervention

Supporting Goals:

1. Help the patient find new constructive social groups. 
2. Guide the patient in exploring new interests in life, mainly hobbies and fun activities. 
3. The patient to stabilize their economic status y find new income ventures to facilitate the lost resources.
4. Become an ambassador and support the population affected by domestic violence and substance abuse. 

Other Treatment Interventions:

1. 1. Use of group therapy. 
   2. Practicing active listening 
   3. A collaborative treatment approach that involves a multidisciplinary team of experts.
   4. A patient-centered approach where the client is given the responsibility to manage treatment. 
   5. Building on the patient’s progress.

• The feedback strategy. 

 

Conclusion

Research evidence has established a link between domestic violence and substance abuse. Domestic violence manifests in the form of verbal and physical abuse that affects the overall health of the victim. Although any person, irrespective of their gender, is susceptible to intimate partner violence, women and children form the majority of the victimized group while men are the most perpetrators. Domestic violence manifests in numerous ways, and it is evident that many people have experienced it once or twice in their lifetime. Clinicians and the healthcare system should devise strategies to minimize the incidence of IPV and drug abuse to support the stability of the affected family units strategically. Providing long-term support for domestic violence survivors improves their overall quality of health. Thus, researchers and practitioners within the healthcare system should develop evidence-based interventions to address domestic violence and substance abuse. 

References

Abdo, C., Miranda, E, P., Silva, C., Junior, J, B., & Bernardo, W, M. (2020). Domestic violence and substance abuse during COVID-19: A systematic review. Indian Journal of Psychiatry, 62(3), S337-S342, https://doi.org/10.4103/psychiatry.indianJPsyachiatry_1049_20 

Cafferky, B, M., Mendez, M., Anderson, J, R., & Stith, S, M. (2018). Substance use and intimate partner violence: A meta-analytic review. Psychology of Violence, 8(1), 110-131. 

Duncan, D, T., Goedel., W, C., Stults, C, B., Brady et al. (2016). A study of intimate partner violence, substance abuse, and sexual risk behaviors among gay, bisexual, and other men who have sex with other men in a sample of Geosocial-Networking Smartphones. American Journal of Men’s Health, 12(2), 292—301, https://doi.org/10.1177/1557988316631964 

Hegarty, K., McKibbin, G., Hameed, M., Koziol-McLain, J., Tarzia et al. (2020). Health practitioners’ readiness to address domestic violence and abuse: A qualitative meta-synthesis. PLoS ONE, 15(1), https://doi.org/10.1371/journal.pone.0234067 

Radcliffe, P., Gadd, D., Henderson, J., Love, B., Danielle, S., Johnson, A, Gilchrist, E, & Gilchrist, G. (2019). What role does substance use play in Intimate Partner Violence? A narrative analysis of in-depth interviews with men in substance use treatment and their current or former female partners. Journal of Interpersonal Violence, 36(21-22), 10285-10313, https://doi.org/10.1177/0886260519879259 

Rakovec-Felser, Z. (2014). Domestic violence and abuse in an intimate relationship from a public health perspective. Health Psychology Research, 2(3), https://doi.org/10.4081/hpr.2014.1821