Substance Abuse by Men in Partner Abuse Intervention Programs: Current Issues and Promising Trends

Article excerpt

This article discusses key studies linking intervention for co-occurring substance abuse and partner abuse. Findings are grouped into three areas: (a) the effect of addictions treatment on partner violence; (b) application of transtheoretical, motivational, and culturally focused approaches to improve engagement and prevent attrition; and (c) assessment-based matching of services. Finally, the relative value of serial, coordinated, and integrated substance abuse programs and partner abuse intervention programs are considered. We reached three primary conclusions: (a) Addiction treatment alone reduces the risk for future domestic violence in a subset of men who batter, (b) screening and assessment for substance abuse by all men in partner abuse intervention programs is a standard of practice but needs to extend beyond "intake" and occur periodically, and (c) coordinated and integrated substance abuse and domestic violence programs probably offer more safety than traditional serial substance abuse treatment followed by partner abuse intervention.

Keywords: batterers; batterer intervention programs; substance abuse; substance abuse treatment

Alcohol and drug abuse are highly prevalent in partner abuse intervention programs (PAIP). In a multisite study of 840 men drawn from four geographically different U.S. PAIP, 56% of the participants scored in the "alcoholic tendencies" range on the Michigan Alcohol Screening Test, and 26% of the participants had a history of substance abuse treatment (Gondolf, 1999). Another study documented the prevalence of "hazardous drinking" by 68% of the sample of 150 court-ordered men in PAIP (Stuart, Moore, Kahler, & Ramsey, 2003). Both the acute effects of intoxication and the chronic effects of substance abuse have been linked to partner abuse. Several early studies compared physically aggressive couples with conflicted and satisfied couples and found that measures of alcohol abuse rather than quantity and frequency of alcohol use best differentiated these groups (Telch & Lindquist, 1984; Van Hasselt, Morrison, & Bellack, 1985), and population studies report similar findings (Leonard, Brommet, Parkinson, Day, & Ryan, 1985). In one sample of men from a domestic violence treatment program it was found that marital violence was eight times more likely to occur on a day when the man had used alcohol than on a nondrinking day (Fals-Stewart, 2003).

Drugs other than alcohol are also linked to partner violence (Kantor & Straus, 1989). In a study of 151 court-referred batterers, 53% had used marijuana and 24% had used cocaine during the past year (Moore & Stuart, 2004). A substantial number of these substance users were regular consumers, with almost one in four (23%) using marijuana at least four times a week. In addition to differentiating between substance use and abuse, the effect of alcohol needs to be partitioned from drug use since most users of illegal drugs also use legal drugs, including alcohol. Controlling for the effects of alcohol use, Moore and Stuart (2004) found that drug use behavior remained an independent predictor of partner violence.

In practice, alcohol and drug abuse have often been viewed as independent of partner violence-separate problems with different interventions (e.g., CSAT, 1997; IDHS, 2005). More recently, a case has been made for a causal link between substance abuse and partner abuse (Fals-Stewart & Kennedy, 2005). From a different conceptual framework, men's drunkenness may also be seen as instrumentally controlling a partner's behavior through instigation of fear (Hutchinson, 1999). These perspectives represent complementary views of the role of co-occurring substance abuse and partner violence. How these perspectives are applied to interventions will be the focus here.

SERVICES RESEARCH ON SUBSTANCE ABUSE AND BATTERER PROGRAMS

Research informing services to intervene with co-occurring substance use and partner abuse has been primarily epidemiological, estimating the prevalence of substance use and abuse by men in PAIPs and linking substance abuse and partner violence to other variables. …