Research shows that intimate partner violence can cause physical and mental health problems for survivors. These can include chronic pain, injuries from abuse, post-traumatic stress disorder (PTSD), and suicide attempts. Sometimes these problems lead to the use of substances to cope with pain, trauma, and abuse. However, victims also report being forced into using substances by an abusive partner who wants to exert power and control. It is easier for someone to control their partner once they become addicted and if the partner relies on them to supply their substances. Also, when the abused person is ready to seek help and treatment, an abusive partner can try to sabotage their recovery efforts. This is called substance use coercion. Lack of access to treatment and recovery support, and the stigma of substance use disorder (SUD), can make survivors of abuse and their children unsafe.
Substance use coercion is a form of abuse that is important to keep in mind when working with survivors of intimate partner violence. In 2012, the National Center on Domestic Violence, Trauma and Mental Health (NCDVTMH), in partnership with the National Domestic Violence Hotline, conducted Mental Health and Substance Use Coercion Surveys; both organizations are funded by the Family and Youth Services Bureau’s Family Violence Prevention and Services Program. The surveys found that more than 60% of those who sought help for substance use said their partners tried to hinder treatment. Coercive tactics may include efforts to:
The Substance Use Coercion Survey (3,248 participants) found that 27% of respondents said a partner or ex-partner had pressured or forced them to use alcohol or other drugs or made them use more than they wanted. The survey also found that 15% had tried to get help for their use of alcohol or other drugs. Of those, 60% said that a partner or ex-partner had tried to prevent or discourage them from getting that help.
Following the surveys, the NCDVTMH developed the Coercion Related to Mental Health and Substance Use in the Context of Intimate Partner Violence Toolkit. This resource educates mental health and substance use providers on the coercive tactics abusers use and how to support the well-being and safety of survivors and their children. Knowing these tactics is the first step in helping survivors.
Substance use coercion remains a growing area of research. Given the many issues we face as we try to address the opioid epidemic, the NCDVTMH toolkit is an important tool for health professionals. Identifying coercion as an abusive tactic and then linking survivors to the appropriate supports will improve outcomes for survivors with SUD.
As part of Domestic Violence Awareness Month, the NCDVTMH is hosting a webinar on this topic, Substance Use, Trauma and Domestic Violence: Critical Issues, Promising Approaches on October 23 at 3:00 PM Eastern. This webinar will highlight 1) strategies for addressing the multiple factors that contribute to substance use in the context of domestic violence; 2) promising approaches to the opioid epidemic by rural domestic violence programs; and 3) an evidence-based intervention to increase safety for people dealing with substance use and trauma. A link to register is below.
For more information on the intersection of intimate partner violence, trauma, mental health, and substance use, see these resources: