Domestic Violence and Addiction: Do Addiction Treatment Programs Need to be Concerned?

The past several months have been filled with headlines about domestic violence. To what extent should addiction treatment programs be concerned with spouse, partner, and child abuse? Certainly alcohol and drug abuse is involved in many abuse cases. Although there is no direct causality established with addiction and domestic violence there is a strong correlation (SAMHSA, 2008); addiction is a major risk factor for domestic violence. For example, read the following research outcomes (NCADV, n.d.):

Alcohol abuse is one of the leading risk factors for spouse/partner abuse.
Physical abuse associated with alcohol abuse may be more severe and result in greater injury.
Alcoholic women are more likely to report a history of childhood physical abuse and emotional abuse than are nonalcoholic women.
Alcoholism treatment, in and of itself, does not stop abusive behavior.
Abused women are fifteen times more likely to abuse alcohol and nine times more likely to abuse drugs than nonabused women.
In 2002, 36 percent of victims in domestic violence programs also had substance abuse problems.
Fifty-one percent of domestic violence program directors agree that a woman’s use of alcohol can be a barrier to leaving a violent relationship and 87 percent agree that the risk of partner violence increases when both partners abuse alcohol or other drugs.
Sixty-nine percent of women in treatment for substance abuse indicate they were sexually abused as children.
Sixty-one percent of domestic violence offenders also have substance abuse problems.
Children of substance-abusing parents are more likely to experience physical, sexual or emotional abuse than children in non-substance-abusing households.
As many as 80 percent of child abuse cases are associated with the use of alcohol and other drugs and 50 percent of men who frequently assaulted their wives also frequently abused their children (Straus & Gelles, 1989).
Children who have experienced family violence are at greater risk for alcohol and other drug problems later in life than children in nonviolent families.

The following is a true story about Erin that best reflects the problems of addiction and domestic violence (Ackerman, 1995):

Living with an alcoholic is one of the worst situations in a marriage. If the man you’re involved with is violent and abusive to begin with, alcohol only makes it worse. It seems you can’t win with an alcoholic. I tried to do everything possible not to upset my husband or cause him to drink. I know I don’t cause him to drink or not drink, but that still doesn’t stop me from trying everything possible.

I would try getting even by going places he didn’t like or doing things to make him mad, but I was only hurting myself. I would try the opposite; doing everything I could to make him happy. I wouldn’t go anywhere, thinking he would stay home with me. I was what I thought the perfect housewife should be. The house was always clean, supper was always on the table and the kids were well-behaved. I always tried to look my best. He was never happy, he always complained and he drank constantly. The kids and I were always miserable.

A couple of times I tried leaving him. I took nothing, hoping he would leave me and the kids alone. It was really hard to go. I always had a reason for leaving. I was either tired of the abuse or just fed up with his constant drinking. The kids would often say, “Mommy, why don’t we leave Daddy?” and that’s what made me realize things were not right. I thought it was worth it to get the kids out and live a normal life.

The first time I left, I went to my parents’ house, which was a block away from our house. He came to the door and begged me to come back and promised he would stop drinking. I went back, but with a week the drinking started again. He would beat me up pretty bad when he got drunk.

The next time I left, I went to live with a friend. She had three kids, and with me and my two kids it was crowded. My husband, John, called the house all the time and would talk to my friend when he couldn’t talk to me. She didn’t know how to keep him away and neither did I.

The third time I left, I went to a shelter. We got some counseling and the kids and I talked about the problem and decided to get a place of our own.

Staying away from family, friends, and home was harder than I thought it was going to be. I felt I couldn’t be around friends or family for fear John would show up or bother them. Being cut off from everyone was just too hard. The kids started to blame me because they missed their dad and blamed me for taking them away from their friends and relatives. The kids were eleven and six and knew what was going on at home. They were both excellent students and, like me, tried to do everything right, thinking they could make it better.

While we were away from home, they put me through hell. I needed to get a job to support us, but they wouldn’t let me out of their sight because they were afraid I would leave them, too. The wanted to go home and hoped their dad had stopped drinking. Finally, I couldn’t take anymore and went back to John with his promise to quit drinking. I thought I was doing the best thing for the kids, but soon John had broken his promises.

Now I realize that staying with John is the worst thing for the kids. Being raised in an alcoholic home where they feel no love will affect them for the rest of their lives. I feel there is no way out and I will have to spend the rest of my life with a man I can’t stand. I thought I loved John and in some ways maybe I do. I realize I feel pity for him and don’t want him to be alone. I would do anything or give up anything if John would just stop drinking. I’ll probably have to spend the rest of my life waiting for things to get better.

I feel like a prisoner in my own home. He sees to it that I can’t go anywhere or see anyone. My leaving didn’t accomplish a thing. We did to Al-Anon and AA for two weeks, but then he decided he could do it on his own and wouldn’t let me go to Al-Anon.

I only wish I hadn’t come back. It never gets better; it only gets worse. Now I can’t tell my family or friends how bad it is because I will have to admit I was wrong to come back. The hardest thing to deal with is that I promised the kids I would not take them home to the same bad situation and to an alcoholic father.

I will always be afraid to love someone again. I tried to love John, but my love just made him more comfortable and able to drink more. I want to get the courage to leave him and never go back, but I don’t think I can do it. I feel I am weak and can’t do anything to help myself.

Final Thoughts

Alcohol abuse and domestic violence have some common characteristics (CDC, 2012):

They both can be passed from generation to generation
Both involve denial and minimization of the problem
The both impact the entire family
Both may involve isolation of the perpetrator/abuser and the victim and the family
Both revolve around power and control

What Can Be Done

At a minimum cross-training is needed by both the clinical staffs of addiction treatment programs and domestic violence programs.
Integrated treatment services for addiction and domestic violence need to be available in both addiction treatment programs and domestic violence programs.
Addiction treatment programs need to consider having a domestic violence counselor on staff and domestic violence programs need to consider having an addiction counselor on staff.
Both types of treatment programs need to maximize referral services to each other.
Social policies need to be improved to provide better services for victims of domestic violence especially when alcohol and drug abuse is involved.

References

Ackerman, R. J. (1995). Before it’s too late. Deerfield Beach, FL: Health Communications.

Center for Disease Control and Prevention (CDC). (2012). Understanding intimate partner violence: Fact sheet. Retrieved from http://www.cdc.gov/violenceprevention/pdf/ipv_factsheet2012-a.pdf

National Coalition Against Domestic Violence (NCADV). (n.d.). Domestic violence and substance abuse. Retrieved from http://www.ncadv.org/files/Domestic%20Violence%20Stylized–GS%20edits.pdf

Straus, M. A., & Gelles, R. J. (1989). Physical violence in American families. New Brunswick, NJ. Transaction Books.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2008). Substance abuse treatment and domestic violence: Treatment improvement protocol (TIP) series 25. Washington, DC: Author.

Robert J.Ackerman PhD

Website | + posts

Formerly Professor of Sociology at the University of South Carolina, Beaufort. Dr. Ackerman is a co-founder of the National Association for Children of Alcoholics and the Chair, Advisory Board of COUNSELOR: The Magazine for Addiction Professionals. He has published numerous articles and research findings and is best known for writing the first book in the United States on children of alcoholics. Twelve books later, many television appearances, and countless speaking engagements, he has become internationally known for his work with families and children of all ages. His books have been translated into thirteen languages.