Substance Abuse Treatment System
Despite the significant correlation between domestic violence and chemical dependency, very little research has been conducted and even less has been done to assist victims with chemical dependency problems to meet their dual need for both safety and sobriety. Similarly, little has been done to develop intervention strategies that address both the domestic violence and substance abuse problems of chemically dependent men who batter, and even less to address the needs of battered gay men and lesbians in alcohol/other drug treatment programs. As a result, workers in both systems are often ill-equipped to provide the range of services needed by battered women, lesbians and gay men, and abusers who are affected by chemical dependency.
For women, revictimization is predictive of relapse. Many victims begin or increase their use of alcohol/other drugs in response to the violence, as a way to medicate the physical and emotional effects of victimization. In fact, many chemically dependent victims are addicted to sedatives, tranquilizers, stimulants, and hypnotics, drugs that were prescribed by health care providers from whom they sought help. Elder victims may be at particularly high risk for prescription drug and alcohol interaction. About 2.5 million older persons (65-plus) have alcohol-related problems (24) and older people account for approximately 25% of all prescriptions filled, although they comprise only 12% of the total U.S. population. (25) In addition, many victims' use of substances is coerced by their partners as a mechanism of control. As a result, victims' recovery efforts are often directly sabotaged by their partners. Effectively addressing the safety needs of chemically dependent victims is an essential part of a successful recovery strategy.
Alcohol and other drug use and addiction do not cause men to perpetrate abuse in their intimate relationships, (26) and substance abuse treatment alone is unlikely to stop the violence. Victims with drug-dependent partners consistently report that during their partner's recovery the abuse not only continues, but often escalates, creating greater levels of danger than existed prior to their partners' abstinence. In the cases in which victims report that the level of physical abuse decreases, they often report a corresponding increase in other forms of coercive control and abuse-the threats, manipulation, and isolation intensify. (27)
Abusers who are also alcohol or other drug-involved need to address the alcohol/other drug problem separate from, and in addition to, being subject to appropriate criminal or civil justice sanctions for their abusive behavior. Not only is this a critical strategy to enhance victim safety, but abusers' continued use of coercive and violent acts against their partners is often a precipitant to relapse. Addictions self-help groups and substance abuse treatment programs were not designed to address battering and are not equipped to enforce abuser accountability, a role more appropriate to the