FACT SHEET ON FAMILY VIOLENCE AND
SUBSTANCE ABUSE
Purpose of the Overview Paper
The goal of this fact sheet is to provide some
basic ideas for understanding the connection between family violence
and substance abuse. Although a connection has long been observed,
there has been confusion and debate about its nature and its meaning.
Even the terms "family violence" and "substance abuse"
have different meanings for different people. If we can understand
the relationship between substance abuse and family violence, we
can help to create safety and support for the people affected by
these problems.
A Framework for Family Violence
Family violence is abuse of power within relationships
of family, trust or dependency. It can include many forms of abusive
behaviour:
emotional abuse
psychological abuse
neglect
financial exploitation
destruction of property
injury to pets
physical assault
sexual assault
homicide.
The primary victims are women, children, seniors
and including people with disabilities.
Females are more frequently victimized than males
and in most cases the perpetrators are male.
These abuses of power are reinforced by traditional
societal attitudes and maintained by existing barriers to social
equality based on sex, race, age, class and disability.
A Framework for Substance Abuse
Substance abuse refers to the inappropriate use
of any drug or mood-altering substance. It can result in personal,
family, health, social, legal and financial problems. Substance
abuse is use that occurs:
too frequently
in excessive amounts
over a long period of time or
in the wrong combination with other drugs.
Both legal and illegal drugs can be involved, including
alcohol, prescription and over-the-counter medications, illicit
drugs and solvents.
Substance abuse can result in physical and psychological
dependence or addiction.
Substance abuse or dependence can affect
a person's overall health and functioning - emotional, psychological
and physical. Therefore these problems must be addressed as specific
issues, rather than as mere symptoms of other problems.
The effect of a substance on a person depends on
more than just the drug. People's behaviour under the influence
of a drug can vary depending on factors such as age, gender, biology,
personal beliefs and expectations, and social context.
Making the Connections
Family violence and substance abuse are problems
that are complex and multi-faceted and this is further complicated
when they appear together. Two major concerns are the link between
the victim's experience of family violence and substance abuse,
and the link between the victimizer's substance abuse and abusive
behaviour.
As victims
Women abused in the past, or currently living with
an abusive partner may use alcohol or other drugs to deal with the
pain, anxiety and fear of their situation.
Adults who were abused as children may use substances
to deaden the pain of past memories.
Adolescents who have been abused or who have witnessed
abuse may resort to alcohol or other drug use as a coping mechanism.
As victimizers
Parents who abuse and neglect their children often
have problems with substance abuse.
Men who assault their partners often use alcohol
or other drugs prior to the assault.
Men who sexually exploit children have often engaged
in substance abuse before or during the sexual offence and may use
alcohol and other drugs as a way of luring and manipulating their
victims.
Victimizers may abuse substances to diminish their
feelings of guilt or shame or to assist in denial of their acts.
Those who care for seniors or persons with disabilities
may give them excessive medication or withhold medication in order
to control their behaviour.
Although they are often interrelated, not every
person who experiences family violence will use substances to cope.
Nor will everyone who abuses substances will perpetrate family violence.
When both problems occur together, each contributes to the other.
Families in which both violence and substance abuse occur are sometimes
referred to as dually affected families.
What Do We Know?
Family violence and substance abuse are often "hidden"
problems, and the association between the two has not been adequately
researched. Several recent studies do, however, highlight connections
between these problems.
• A survey of 2,099 women found that women
who had experienced abuse reported more frequent use of sleeping
pills and sedatives than women who had not been abused.
40%
more battered women reported sleeping pill use.
74%
more battered women reported sedative use.
50% more women physically
abused as children reported sleeping pill use and all
reported sedative use.
Women who were sexually abused as children reported
two times greater sleeping pill use and three times greater sedative
use.
• Research indicates that men who drink regularly are more
likely to abuse family members.
Parental child abuse was six times more frequent
among men who often drank to excess.
The national Violence Against Women Survey (1993)
indicates that alcohol is a prominent factor in wife assault. In
one-half of all violent partnerships, the perpetrator was usually
drinking. The rate of wife assault for women currently living with
men who drank regularly (at least four times per week) was triple
the rate of those partners who did not drink at all. Women were
at six times the risk of violence by partners who frequently consumed
five or more drinks at one time, compared to women whose partners
never drank.
• Studies about the use of alcohol and wife
assault show a difference between reports by victims and perpetrators.
Ten studies reporting chronic alcohol use, alcoholism,
or alcohol abuse reported that between 24% and 86% of battering
incidents involved alcohol abuse. When batterers reported, the result
was a combined average of 36% of battering incidents involving alcohol;
when victims reported, the combined average was 67%.
• A study of 712 street youth reported that
many came from troubled homes where family violence and/or substance
abuse were present.
2 out of 3 of the street youth were using alcohol
and/or other drugs daily or weekly, with the majority being moderate
to heavy users.
1 in 4 of the 321 female street youth described
their first sexual experience as rape, perpetrated by male relatives
or family friends.
87% of girls and 27% of boys who were introduced
to sex before the age of ten said rape had been their first sexual
experience.
• Only recently has attention been paid to
abuse of seniors. A telephone survey of 2008 seniors living in private
dwellings reported that about 40 persons per 1000 had recently experienced
some serious form of maltreatment in their own home.
Regarding substance abuse 1 in 7 abusers was identified
as having a drinking problem, and nearly 1 in 10 abusers was identified
as having some other drug problem.
Questions to Consider
What is the nature of the relationship between
family violence and substance abuse?
Although family violence and substance abuse frequently
coexist, the exact nature of the relationship is not well understood.
There are similarities between the two problems and the problems
add to each other. The relationship is not directly causal - substance
abuse does not cause family violence nor does family violence cause
substance abuse. There are a multitude of factors that influence
how a person will be affected by family violence and whether or
not that person will be susceptible to substance abuse and dependence.
However, the connection between the two problems
is sufficiently strong to cause concern:
Members of families in which one or both parents
abuse substances are considered to be at high risk for physically
abusing and particularly for neglecting their children.
Persons who have experienced family violence are
at greater risk for alcohol and other drug problems than those who
have not.
Evidence suggests that adolescents who run away
from violent homes are at risk of further victimization and substance
abuse as well as other problems.
Why does the relationship occur so frequently?
There are many ways of looking at the connection
between family violence and substance abuse. Here are some examples:
Self-medication - Alcohol and other drugs
may be used to cope with the physical, emotional or psychological
pain of family violence. It has not, however, been determined that
victims who abuse substances do so solely as a result of their victimization.
Disinhibition - Alcohol or other drugs are
seen as reducing behavioral inhibitions so that socially unacceptable
behaviour such as aggression is more likely to occur. However, this
does not adequately explain the choice of family members and vulnerable
populations as targets of this aggression.
Learned association - These theories focus
on the rules that regulate behaviour. We learn in our families and
social groups that certain events or behaviours are connected and
expected. For example, a person may learn to connect family violence
and substance abuse by growing up in a family where they both occur.
In addition, beliefs about the potential effects of a drug will
strongly influence a person's actual experience of the drug. A belief
that a drug will cause abusive behaviour will increase the likelihood
of abusive behaviour.
Disavowal - This explanation is related
to learned association. Often abusive individuals excuse their violent
behaviour, and are even excused by their partners and other family
members because they were drunk and "not in control".
It allows us to see the person as normal, but their behaviour as
deviant.
Each of these theories has assisted in exploring
the relationship of family violence and substance abuse. However,
they can also be used to avoid the issue of accountability. Social
attitudes and beliefs contribute to our tolerance of family violence
and substance abuse. To have a significant impact on reducing these
problems, we need a comprehensive understanding and a redefining
of what we will tolerate.
What do family violence and substance abuse
have in common?
While family violence and substance abuse can occur
either separately or together, researchers in both fields report
common characteristics. Regardless of differences of opinion among
workers in both fields over whether substance abuse is a symptom
of illness or a learned behaviour or whether family violence is
a mental health issue or social problem, agreement does exist on
many fronts.
Family violence and substance abuse
-
are pervasive social and health problems cut
across all demographic categories
-
are potentially life-threatening
-
are often intergenerational
-
tend to become progressively worse
-
affect all members of the family
-
typically involve denial by all parties
-
result in social isolation for individuals
and families
-
often lead to other kinds of problems (e.g.
health, legal and financial)
When family violence and substance abuse occur
together, the impact of each problem may be intensified. Despite
similarities we need to recognize that each problem needs to be
addressed separately, without assuming that addressing one will
take care of the other.
Implications for Service Providers
Recognizing the link between family violence and
substance abuse is vital if front-line workers are to provide effective
services to families affected by both problems. That means service
providers, whatever their area of expertise, need to be willing
to work together. Philosophical and theoretical differences must
be secondary to safety and cooperation. Truly effective service
comes from knowing our limits and knowing how to network within
the community.
While service-delivery-issues related to family
violence and substance abuse are too extensive to be fully covered
here, the following points may stimulate further exploration and
discussion.
Safety planning must always be the first priority
when dealing with family violence and substance abuse. Workers must
continually assess the level of risk for suicide, homicide and recurring
violence.
It is important that service providers look for
both substance abuse and family violence and develop strategies
to address both problems. The impact of these problems on all
members of the family should be considered.
Although these problems may appear to be directly
linked, we must remember that they are distinct issues. Dealing
with one problem does not necessarily eliminate the other. Assumptions
of this kind will lead to continued risk for all involved.
Victims of family violence who have alcohol or
other drug problems may require additional support. Dealing with
both problems may make it more difficult for the victim to leave
a violent relationships and/or to stop abusing substances. Special
attention must be paid to safety issues.
The timing of various kinds of assistance is crucial
in addressing these problems. The first priority is to ensure everyone's
immediate safety and to address ongoing safety plans. Alcohol and
other drug- dependency-treatment should begin by putting supports
in place for family violence issues. Therapy for family violence
should not begin until the acute effects of substance abuse are
sufficiently diminished.
Family violence issues may influence decisions
about treatment in the addictions field. For instance, safety may
be enhanced by placing perpetrators of family violence in residential
programs. Women, especially those who have been abused, can benefit
more from specialized women's programs than from the traditional
male-oriented treatment programs.
Effective safety planning by family violence workers
can be enhanced when the impact of substance abuse as a risk issue
is fully appreciated.
Recognition of the mental-health-effects of child
abuse, wife abuse and abuse of seniors has increased greatly in
recent years. There remains a concern that medications are often
prescribed as the sole intervention for these problems. Unless underlying
family violence issues such as safety and victim trauma are dealt
with, drug dependency may result.
Older persons may become victimized if they are
not aware of the effects of unintentional misuse of drugs in combination
with other drugs.
Treatment approaches in the family violence and
substance abuse fields are sometimes so divergent that they are
barriers to communication and cooperation. These differences can
be tempered with the strength of similar backgrounds. Both fields
were launched by grass roots movements that stimulated the development
of programs and services. Their shared traditions of group support,
friendship and strong commitments to prevention, public awareness
and social policy development are foundations for collaboration
and understanding.
Some Thoughts for Family Violence Victims
If you have been a victim of family violence, there
are several issues about substance abuse that may be important for
you to consider.
Family violence does not necessarily stop when
the abuser stops abusing alcohol and/or other drugs.
Using alcohol or other drugs to cope with the effects
of family violence can lead to further problems, including drug
dependency and possibly increased vulnerability to violence.
Both family violence and substance abuse problems
often require assistance beyond the family for protection, support
or treatment.
Attempting to deal with one problem without addressing
the other can cause a false sense of security.
In a crisis, contact your local police, child welfare
agency or women's shelter for protection. For ongoing support or
treatment, contact a family service or counselling agency or addictions
program.
Some Thoughts for Those Who Behave Abusively
toward Family Members
If you have abused a family member, there are several
issues about substance abuse that are important to you.
If you have a history of abusive behaviour, intoxication
will increase the likelihood and severity of your violence.
Getting treatment for both substance abuse and
abusive behaviour is important, as treating only the substance abuse
is no guarantee that your abusive behaviour will stop.
Children growing up in families where substance
abuse or family violence is present, often repeat these problems
as adults.
Most people who threaten or harm others, especially
family members, feel upset about what they did. There are programs
that can help you stop behaving abusively and that can help you
feel better about yourself. Contact a counselling program for men
who batter, a family service agency, or an addiction treatment program.
Remember to tell them about both the family violence and the alcohol
or other drug abuse.
Suggested Readings
Canadian Council on Social Development. Vis-
-vis, national newsletter on family violence, particularly the
issue on addictions and violence, winter 1991, Vol.8, No.4.
Canadian Panel on Violence Against Women. Changing
the Landscape: Ending Violence - Achieving Equality. Minister
of Supply and Services Canada, 1993
Health Canada, Overview Papers on child
sexual abuse, child abuse and neglect, wife abuse, wife abuse and
the impact on children, elder abuse, adolescent sexual offenders,
and dating violence. National Clearinghouse on Family Violence,
Ottawa.
Health Canada, Straight Facts About Drugs
and National Alcohol and Other Drugs Survey - Highlights Report.
Minister of Supply and Services Canada, Ottawa, 1990.
Interdisciplinary Project on Domestic Violence,
The Mountain and Beyond: Resources for a Collaborative Approach
to Domestic Violence. Ottawa, 1993. For information on where
to borrow copies, contact National Clearinghouse on Family Violence.
A useful resource for aboriginal communities is
A Resource Guide on Family Violence Issues for Aboriginal Communities
available from the National Clearinghouse on Family Violence.
Addiction Research Foundation. Link - An educational
program on the link between psychoactive drug use and domestic violence.
(Available summer 1994 from Addiction Research Foundation, Toronto,
Ontario.)
Audio-Visual Resources
The National Film Board (NFB) of Canada manages
a family violence film and video collection on behalf of Health
Canada. Films and videos can be borrowed from regional offices of
the NFB.
Endnotes
1. Daily B. "Dually Affected Families: Substance
Abuse and People Abuse" in Martens, T., ed. The Spirit Weeps.
Edmonton, Nechi Institute, 1988, pp. 188-122.
2. Groeneveld, J. and Shain M. Drug Use Among
Victims of Physical and Sexual Abuse - A Preliminary Report.
Addiction Research Foundation, Toronto, 1989.
3. Groeneveld, J. Domestic Violence Study.
Addiction Research Foundation, Ontario, 1989.
4. Statistics Canada. Wife Assault: The Findings
of a National Survey Juristat (Vol. 14, No. 9). March 1994,
Ottawa.
5. Tolman, R.M. and Bennet, L. W. A Review of Quantitative
Research on Men who Batter. Journal of Interpersonal Violence.
March 1990.
6. Radford, J.L. et al. Street Youth and AIDS.
Social Program Evaluation Group, Queen's University, Kingston, 1989.
7. Podnieks, E. and Pillemer, K. National Survey
on Abuse of the Elderly in Canada. Ryerson, Toronto, 1990.
8. Shainess, Natalie (1977) cited in Wright, Janet
M. Chemical Dependency and Violence: Working with Dually Affected
Families. Wisconsin Clearinghouse, 1981.
9. Lang, Alan R. Effects of alcohol on aggression
in male social drinkers. Journal of Abnormal Psychology. October
1975.
10. Gelles, Richard J. The Violent Home: A Study
of Physical Aggression. Sage Publications, California, 1974.
This fact sheet was prepared by Colin Campbell
with assistance from Julie Devon Dodd. Contributions of the following
people are gratefully acknowledged - Rick Browning and Rick Morris,
Institute for Human Resource Development, Newfoundland; Wayne Skinner,
Addiction Research Foundation, Ontario; Alayne Hamilton, Family
Violence Project, Victoria, British Columbia; and Katalin Kennedy,
Vera Lagasse, Barbara Merriam, Gordon Phaneuf, and Kathy Stewart,
Health Canada, Ottawa. This fact sheet was based on earlier work
by Linda Graham, The McCreary Centre Society, Vancouver, British
Columbia.
For further information on family violence issues,
contact:
National Clearinghouse on Family Violence
Family Violence Prevention Unit
Health Programs and Services Branch
Health Canada
Ottawa, Ontario
K1A 1B5
Telephone: (613) 957-2938 or toll free 1-800-267-1291
Fax: (613) 941-8930
TDD: (613) 952-6396 or toll free 1-800-561-5643
For further information on substance abuse, contact
your provincial or territorial department of health or community
services.
Date: December 1993
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