Study Suggests High Rates of Violence among Substance Abusers
Violence is a common problem for individuals in substance use disorder (SUD) treatment, and has numerous costs with regard to physical, mental health, interpersonal, and occupational functioning. SUD treatment settings provide an important point of access for targeted violence prevention treatment, and offer an ideal context for incorporating therapies targeting violence-related problems. This study examined violence related to SUD, as well as potential violence prevention treatment needs for men and women patients in SUD treatment settings. Investigators looked specifically at violence resulting in injury toward partners and non-partners, as well as against individuals in treatment. Men and women (non-Veterans) currently seeking treatment for a substance use disorder were recruited for this study between 2006 and 2007 from one Mid-Western state. Participants (n=489) completed a pre-study screen (e.g., demographics, psychiatric symptoms, alcohol and drug use) in order to take part in a pilot study of a six-session violence prevention intervention. The authors report on data from the screening only.
Findings show that rates of injury across relationship types were substantial, with more than 54.8% reporting injuring another person, and 55.4% reporting being injured. Further, there was a strong association between injuring others and being injured. Overall, those reporting injuring others had significant psychosocial challenges in terms of low rates of employment, low household income, relatively few prior SUD treatment visits on average, and most participants did not have prior "anger-management/domestic violence" treatment. Moreover, those injuring or reporting injury by others had higher rates of problems (e.g., binge drinking, opiate use, depression) than those in the non-injury groups. These findings indicate the need for interventions or models of care that address general violence. The authors propose that such models of care should target motivation and treatment engagement for substance use, psychiatric issues, and violence-specific risk factors, in addition to ongoing clinical monitoring and case-management.
Chermack S, Murray R, Winters J, et al. Treatment needs of men and women with violence problems in substance use disorder treatment. Substance Use and Misuse 2009;44(9/10):1236-62.
Drs. Chermack, Murray, and Winters are part of the VA Serious Mental Illness Treatment Research Evaluation Center (SMITREC) and the VA Ann Arbor Healthcare System.