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In 1997, the SAMSHA (Substance Abuse and Mental Health Services Administration) Treatment Improvement Protocol (TIP) guide for Substance Abuse Treatment and Domestic Violence declared the need for coordinated care in terms of treating co­occurring domestic violence and substance abuse. The guide notes that while there has been no direct cause/effect relationship established between them, that substance abuse is nevertheless a risk factor for domestic violence. Further, the panel of experts that created the guide conclude that “failure to address domestic violence issues among substance abusers interferes with treatment effectiveness and contributes to relapse.”

It would be easy to attribute domestic violence to the use of drugs and alcohol, particularly when abuse and addiction are co­occurring in the home. Although the presence of one of these conditions tends to increase the risk of the other, the direct cause is unclear. Research, however, indicates that these are two primary issues that need to be treated as such.


In a report by Larry Bennett and Patricia Bland for the National Online Research Center on Violence Against Women, the authors note certain key statistics:

  • 1/2 of men in batterer intervention problems also show substance abuse issues, and are 8x as likely to be violent when drunk
  • 1⁄2 of men entering treatment for substance abuse have battered in the previous year (when entering treatment in a relationship), and those men are 11x as likely to be violent when drunk
  • Between 1/4-1/2 of females seeking help for domestic violence have substance abuse issues as well
  • Between 67 and 80% of women in substance abuse treatment are survivors of domestic violence

Further, the belief that men are always the perpetrators of domestic violence is false. The National Domestic Violence Hotline reports that, “… one in seven men age 18+ in the U.S. has been the victim of severe physical violence by an intimate partner in his lifetime. One in 10 men has experienced rape, physical violence, and/or stalking by an intimate partner. In 2013, 13% of documented contacts to the Hotline identified themselves as male victims.”

So Which Leads to Which?

There is little evidence that substance abuse automatically leads to victimization. However, drug and alcohol use may contribute to abusive relationships in that intoxication impairs victims’ abilities to defend themselves. Further, many victims of domestic violence (whether in childhood or beyond) may reach to drugs and alcohol to cope. Bennett and Bland (2011) note that it is likely that there are multiple factors involved in the co-­occurrence of domestic violence and substance abuse (in both the victim and the abuser), and that it is important to examine the long-­term (chronic) effects of drugs and alcohol as well as the short-term (acute) dis-inhibiting effects. They note that over time, chronic substance abuse can diminish cognitive ability, damage social interactions and relationships, and contribute to loss of income; all factors which contribute to domestic violence. Further, outside factors that often surround substance abuse, such as poverty, drug subcultures, exposure to violence, early childhood experiences, and additional psychological issues (such as antisocial personality disorder) can all increase the risk for violence in the home.

Get Help: Where to Turn

If you or someone you know has been the victim of domestic violence, call the National Domestic Violence Hotline at 1-800-799-SAFE to receive immediate, confidential help. If you or a loved one would like to learn about treatment options for domestic violence and substance abuse, visit Serenity Acres and learn about our Dual Diagnostic treatments that can save you or your loved one’s life. Contact us today.