Studies have shown that intimate partner violence, or domestic violence, commonly co-occurs with substance use disorders like alcoholism.1 If you suspect that someone you know is struggling with these issues, or if you are living in a situation that’s causing you distress and harm, it’s important to understand that you’re not alone and that help is available for victims of domestic abuse.
Keep reading to learn more about substance abuse and domestic violence, the potential risk factors for domestic violence and its consequences, how to identify domestic violence, and how you might be able to assist if someone is being harmed.
Substance Abuse & Domestic Violence
Domestic violence or intimate partner violence is any behavior or action in an intimate relationship that causes harm to the other person.1 This can mean sexual, physical, or emotional harm and includes behaviors like hitting or slapping, intimidating or belittling, forcing sexual intercourse, or controlling another person by monitoring them, isolating them from friends and family, or limiting their access to information and assistance.1,2
Although it’s difficult to determine the exact prevalence of the issue in the U.S. (the problem is often underreported), some research indicates that as many as 10% to 15% of American women experience domestic violence.2 Additionally, the link between substance abuse and domestic violence is complex.
Some theories of domestic violence explain that abusive behavior means that a person is using their actions to intimidate and control someone else and substance abuse is just a way they might try to justify their behaviors.3 People often think that drinking or using other substances leads to domestic violence, but this is a myth—not everyone who abuses substances becomes violent.
Many abusers use drinking or substance abuse as an excuse for their actions.3 For example, they might say they can’t help their behavior because they were drunk. The reality is that many abusers don’t become violent or lose their temper because of substance abuse, but substance abuse can exacerbate their actions.3
Furthermore, many studies have shown that the amount of alcohol a person has before engaging in abusive behaviors is usually one or more drinks, so alcohol may be linked to domestic violence just through the mere act of drinking alone rather than the state of intoxication. Again, it’s important to understand that alcohol is thought to influence a person’s behavior because it distorts their perception of reality, but it doesn’t cause their behavior.3
In some cases, the desire to commit sexual violence may actually cause alcohol consumption—in order to justify behavior.18 Alcohol can impact their judgment, perception, and ability to process what is happening; so, for example, this can mean that drinking may increase the chances that an abuser will misinterpret what his partner says or does and overreact or act out.3 An abuser may also experience an increased sense of power or control over their partner when they drink, which could exacerbate the risk of violent behavior. Finally, couples may have conflict over the abuser’s drinking habits, which could lead to increased episodes of violence.3
Alcohol Abuse & Alcoholism
To understand alcohol abuse, or misuse, and its effects, it’s helpful to get a better understanding of excessive drinking and alcoholism. The terms alcohol abuse and alcoholism are often used interchangeably, but they’re not the same thing. The NHS defines alcohol abuse as any pattern of drinking that is harmful or causes dependence.4
Alcoholism, known by the clinical term alcohol use disorder (AUD), is a pattern of drinking that causes significant distress and harm to oneself. If you have an AUD, you continue to drink alcohol despite the negative consequences it has on your life.5 AUD is characterized by cravings, or strong urges to drink, a loss of control over your alcohol use, and negative emotions when you’re not drinking.5
Alcohol is one of the most commonly used and misused substances in the U.S. The 2019 National Survey on Drug Use and Health reports that among 137.6 million current alcohol users aged 18 or older, 25.8% (29.7% men and 22.2% women) reported that they engaged in binge drinking in the past month, while 6.3% (8.3 % men and 4.5% women) aged 18 and older engaged in heavy alcohol use in the past month.6 In addition, 14.5 million Americans aged 12 and older struggled with AUD in the past year.6 This number includes 9 million men and 5.5 million women.6
According to the Centers for Disease Control and Prevention (CDC), binge drinking, heavy alcohol use, and underage drinking or drinking by pregnant women are considered to fall under the category of excessive drinking.7 Binge drinking is a pattern of drinking that means a man has 5 or more drinks or a woman has 4 or more drinks on a single occasion, whereas heavy drinking means a man has 15 or more drinks or a woman has 8 or more drinks per week.7
People who drink excessively do not necessarily have an AUD, but alcohol misuse over time, including binge drinking or heavy alcohol use, increases the risk of AUD.
Chronic use of alcohol can also cause dependence, which is one of the diagnostic criteria of AUD. Dependence is a state in which your body has adapted to the presence of the substance, and you need it to feel normal and function. If you stop drinking and you are dependent, you will experience withdrawal symptoms, and you may resume drinking to ameliorate these symptoms.8 This can fuel a cycle of alcohol abuse which may in turn lead to an AUD.5,7
Prevalence of Domestic Violence and Alcoholism
Research has shown that a high percentage of people who abuse their partners also abuse substances, but not everyone who abuses substances is abusive to their partners. According to a paper by the American Society of Addiction Medicine (ASAM), different studies have found that substance abuse is involved in 40% to 60% of the reported incidents of domestic violence.9
Additionally, more than 20% of male offenders report using alcohol prior to their most recent and severe violent acts.9 It’s not just abusers who are affected by alcoholism and drug use: women involved in violent relationships are often coerced into using alcohol or drugs by their partners.9 In fact, substance abuse among women involved in abusive relationships is more common than among women who are not involved in intimate partner violence.9
The New York State Office for the Prevention of Domestic Violence reports that violence against female partners was 2 to 4 times more common in men with alcohol problems than among other men.10 Further, abusive men who engage in severe alcohol abuse, especially binge drinking, or illicit drug use were found more likely to have an increased risk of their violent behavior resulting in death to their partners.10
More than 80% of men who killed or abused female partners were problem drinkers in the year preceding the incident, and more than 2/3 of men who tried to kill or killed their partners were drunk at the time of the incident, with more than 1/4 using both alcohol and drugs at the same time.10 The World Health Organization (WHO) reports that in the U.S., victims of domestic violence believed that their partners were drinking prior to a physical assault in 55% of cases.1
Risk Factors for Alcohol-Related Domestic Violence
Although there are certain risk factors for alcohol-related domestic violence, it doesn’t mean that experiencing a risk factor is a guarantee that you will become involved in violence. These risk factors aren’t necessarily direct causes, but they may increase the risk of intimate partner violence.
Some of these factors include:1,11,12
- Low income, unemployment or excessive financial stress.
- Childcare problems.
- Family stress.
- Using alcohol to cope (sometimes referred to as “self-medication”).
- Heavier or more frequent drinking.
- Poor mental health.
- Antisocial personality traits and conduct problems.
- Traits associated with borderline personality disorder.
- Unplanned pregnancy.
- Differences in levels of alcohol consumption among partners where only one drinks excessively.
- Violent victimization in childhood.
- Aggressive or delinquent behavior as a youth.
- Observing threats or violence between parents in childhood.
- Low socioeconomic status.
- Neighborhood poverty.
- Tendency toward impulsive behavior.
- Anger and hostility.
- Depression and suicidal attempts.
- Insecurity and emotional and financial dependence.
- Having few friends or being socially isolated.
- A history of physical abuse or being physically abusive.
- Frequent conflict or fights in the relationship.
- Jealousy or possessiveness.
- A belief in traditional gender norms and inequality (such as believing women should stay at home).
Consequences of Domestic Abuse on Women
Domestic violence can also cause a range of short- and long-term effects in women such as causing negative emotions such as fear, anger, numbness, shame, or guilt.13 They also have a risk of isolating themselves from others, avoiding activities they once enjoyed, feeling like they can’t trust anyone, and developing low self-esteem.13,14
The Office on Women’s Health (OWH) reports that being the victim of domestic violence can cause short-term physical effects, such as:13
- Broken bones.
- Injuries to organs or other body parts.
- Vaginal bleeding.
- Pelvic pain.
- Unwanted pregnancy.
- Sexually transmitted infections like HIV.
- Difficulty sleeping or nightmares.
OWH reports that domestic abuse can also result in long-term physical effects, including chronic pain, migraines, stress, immune system problems and trouble sleeping.13 Concussion and traumatic brain injury (TBI) are also potential and serious consequences of physical domestic violence.13 It can be caused by a heavy blow to your head, or if you fall and hit your head. TBI may not cause any symptoms at first, but symptoms can appear after a few days, including:13
- Feeling pressure in your head.
- Slurred speech.
- Sleep difficulties.
- Memory loss.
- Loss of consciousness.
TBI can also lead to depression and/or anxiety and cognitive problems, which might make it more challenging for you to leave your partner or to be able to carry out a plan to leave.13
Women who experience all types of intimate partner violence can also have an increased risk of developing alcoholism, as well as psychiatric disorders like posttraumatic stress disorder (PTSD), anxiety, and depression.13 Women who develop these mental health problems may turn to alcohol as a maladaptive way of coping with their symptoms, which can lead to alcohol abuse or AUD.13
Signs Domestic Violence May Be Occurring
For some victims of domestic violence, it can be hard to admit that you are being abused or they may be scared of the repercussions of speaking up. You may doubt your feelings and intuition and find it hard to believe that this is happening to you or that your partner is abusive. OWF explains that some of the signs that you are involved in an abusive relationship can include:15,16
- Feeling controlled. You might notice that your partner keeps track of what you do, everywhere you go, and any person you talk to. Your partner demands that you are always available; you need to answer or reply to texts, emails, and phone calls right away.
- Your partner demands sex, controls your birth control or demands that you get pregnant.
- They make decisions for you, in terms of what you wear, how you eat, or where you spend money.
- They act jealous, even in obviously harmless situations. Your partner may react irrationally or constantly accuse you of cheating.
- Your partner has angry outbursts that seem to come from nowhere and then blames you for them.
- They put you down or insult you.
- They hit, push, shove, punch, kick, or beat you.
- They threaten you with a weapon.
- Your partner destroys your possessions.
- Your partner threatens self-harm or suicide as a way of controlling you.
- They threaten to report you to authorities for imaginary crimes, especially if you threaten that you’re going to report the abuse.
- They say things like “If I can’t have you, no one can.”
Same-sex female partnerships may also display additional signs of abuse, such as:15
- Threatening to “out” you.
- Telling you that you’re not entitled to help if you’re not legally married.
- Telling you that women can’t be violent.
- Trying to convince you that authorities won’t help a gay, lesbian, bisexual, transgender, or other nonconforming person.
- Wanting you to prove your sexuality by trying to coerce you into doing things you don’t want to do.
How to Help If Someone is Being Harmed
You should never put yourself in harm’s way or involve yourself in a violent situation. However, there are certain steps you can take if you’re concerned that someone you know is involved in a domestic violence situation, such as:15,17
- Educating yourself about bystander intervention.
- Staying in touch with the person and asking how they are doing.
- Establishing a safe communication channel, as their partner may be controlling their communications (so you might ask if there is a specific platform of app they would prefer to use).
- Being supportive and believing what they tell you.
- Avoiding taking action without their consent, unless you believe the person’s life is in danger.
- Respecting their privacy and avoiding sharing anything you know without their consent.
- Offering assistance. This could include practical help like providing a safe place to stay or transportation or connecting them to resources, such as the National Domestic Violence Hotline.
. World Health Organization. (2006). Intimate partner violence and alcohol.
. Zilberman, M. L., & Blume, S. B. (2005). Domestic violence, alcohol and substance abuse. Revista brasileira de psiquiatria, 27 Suppl 2, S51–S55.
. Minnesota Advocates for Human Rights. (2003). Alcohol and domestic violence.
. NHS. (2018). Alcohol misuse: Overview.
. U.S. National Library of Medicine. (2021). MedlinePlus: Alcohol use disorder.
. National Institute on Alcohol Abuse and Alcoholism. (2021). Alcohol Facts and Statistics.
. Centers for Disease Control and Prevention. (2021). Alcohol Use and Your Health.
. MedlinePlus. (2019). Alcohol Withdrawal.
. Soper, R. American Society of Addiction Medicine. 4(2014). Intimate Partner Violence and Co-Occurring Substance Abuse/Addiction.
. New York State Office for the Prevention of Domestic Violence. Information for Professionals: Understanding Domestic Abusers.
. Centers for Disease Control and Prevention. (2020). Risk and Protective Factors for Perpetration.
. Caetano, R., Schafer, J., & Cunradi, C. B. (2001). Alcohol-related intimate partner violence among white, black, and Hispanic couples in the United States. Alcohol research & health, 25(1), 58–65.
. Office on Women’s Health. (2019). Effects of violence against women.
. Sullivan, T. P., Ashare, R. L., Jaquier, V., & Tennen, H. (2012). Risk factors for alcohol-related problems among victims of partner violence. Substance use & misuse, 47(6), 673–685.
. UN Women. (n.d.). Frequently asked questions: The signs of relationship abuse and how to help.
. Office on Women’s Health. (2018). Signs of domestic violence or abuse.
. Office on Women’s Health. (2018). Help end violence against women.
. National Institute on Alcohol Abuse and Alcoholism. (2001). Alcohol and Sexual Assault.