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Alcoholism and Domestic Abuse



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When a person finds themselves regularly drinking to excess to the degree that they are physically or mentally affected in a negative way, they are experiencing alcohol misuse.

It often gets to the point where they cannot control the amount or frequency of their drinking, which indicates an addiction. [1]

The National Health Service recommends that people not drink more than 14 units of alcohol per week. A unit is described as 8g or 10ml of alcohol.

You can get more information on specific types of drinks and alcohol percentages on the NHS official website. [1]

Risk Factors

While some things like a history of parental figures with substance abuse may make someone more at risk for alcoholism, it does not cause it. [5]

There are many possible factors that come into play, and not all of them are firmly understood.

Below are factors most commonly associated with alcohol abuse:

  • Drinking above the recommended limit
  • A family history of alcohol use disorder or other substance abuse
  • A family or personal history of mental health issues (e.g., depression, anxiety, bipolar, etc.)
  • Experiencing a high level of continued stress while also having low self-esteem has been known to contribute
  • Living in a place where excessive drinking is part of everyday life
  • Inability to express emotions in a healthy way (e.g., anger management issues, suppressing emotions, etc.)
  • Living in a traumatic environment

Long-Term Health Effects of Alcohol Addiction

Depending on the length of time a person has been drinking to excess, their body may be showing the first signs of organ damage, or they may have full-on organ failure and mental disorders caused by the toxicity of alcohol.

There are also many short-term health effects (e.g., alcohol poisoning, dangerous risk-taking behaviour, accidental injury, etc.), which can be mitigated by getting help as soon as possible.

Below are several of the most common long-term effects: [4]

  • High blood pressure
  • Heart disease
  • Stroke
  • Liver disease
  • Digestive issues
  • Various cancers, including breast, liver, mouth, throat, oesophagus, and colon
  • A weakening of the immune system which increases the likelihood of contracting highly contagious illnesses like Covid-19
  • Learning handicaps
  • Memory problems
  • Dementia
  • Mental health disorders (e.g., depression, anxiety, etc.)
  • Social issues (e.g., the strain on close relationships, an inability to hold down a job, legal problems, etc.)
  • Alcohol dependence

What is Domestic Abuse?

Any action meant to harm or control someone is a form of abuse. Manipulation as a means of controlling someone is the primary motivation in abuse. Violent actions are not the only ones that can be termed partner abuse.

They can include the following:

  • Emotional
  • Physical
  • Verbal
  • Social
  • Psychological
  • Sexual
  • Financial
  • Spiritual
  • Elderly
  • Image-based

By far, the most common is partner-on-partner violence. The Office of National Statistics reports 4.2% of men and 7.9% of women over the age of 16 have been subjected to some form of this type of abuse. These following are some common examples of domestic violence.

This is not an exhaustive list: [6]

  • Rape, molestation, or any form of forced sexual contact
  • Slapping
  • Hitting
  • Kicking
  • Beating
  • Intimidating or threatening actions, words, or behaviours
  • Continual belittlement
  • Purposeful humiliation
  • Isolation from family or friends
  • Excessive monitoring including a need for constant updates when physically separated via phone or text
  • Restricting access to information, people, places, or things
  • Controlling what they eat, wear, who to see, and what to do on a daily basis
  • Controlling finances
  • Using children in the relationship to assert dominance or control

 

A study in Iceland showed that 22% of domestic violence victims used alcohol as a way to cope after a traumatic event and 9% of them reported being under the influence of alcohol while being abused. A Swiss study revealed that 33% of abusers were under the influence at the time that they were harming their significant other.

The World Health Organisation reported that in a 26 year period, 11% of all homicides were the result of domestic violence. In 2004 it was discovered that in England, 32% of all domestic violence incidents involved a perpetrator under the influence.  These statistics show a substantial connection between the two issues, and treatment for both the substance abuse and the violence is required before healing and recovery can begin.

The following are some known risk factors for domestic partner violence: Personal or family history of domestic abuse Low self-esteem Being younger than your partner Low income Lower than average academic achievement Illegal behaviour as a young adult Drug or alcohol use Depression and other mental health disorders Suicidal thoughts or attempts

Many men and women who suffer from domestic abuse become diagnosed with various mental disorders stemming from the trauma (e.g., Post-Traumatic Stress Disorder, Anxiety, Depression, etc.). Therapy and counselling are recommended for anyone who believes they may be experiencing mental problems due to their abuse history. Most communities have support groups for anyone who has experienced domestic violence. For those who commit abusive behaviour, rehabilitation and counselling are also necessary to help them learn healthy ways to express their emotions so that no one gets hurt. There are anger management classes and family therapy that have been shown to make a difference in the ability of abusers to reform.

The Relationship Between Alcoholism and Domestic Abuse

The mixture of alcohol and violence or emotional manipulation feed into one another and create a toxic environment. They do not directly cause one another. Alcohol will not turn someone into an abuser, and a victim or abuser will not automatically turn into an alcoholic. There are many factors at play.

However, there is no denying that these two issues are closely linked to a large swathe of the population. There is a strong likelihood that the cause of this is an overlap in the many risk factors that are shared between addiction and abuse. [2]

It is not uncommon for children to be caught in the middle of these unhealthy relationships. They can be used as pawns by perpetrators of abuse. Many people who would otherwise leave a toxic partnership stay behind because they are afraid of losing custody of their children or having no way to leave with them.

This can also make it harder to get treatment because private facilities do not allow children to stay with their parents while they are in recovery, and there may not be a safe place for them during that time. This might stop some people from seeking help.

Alcoholism and Abusers

In America, up to 55% of all domestic violence instances involved an abuser under the influence of alcohol. This number is slightly less in the UK, with 32-39% reported. [9] [8] One study showed that the average person was less likely to blame a husband abusing his wife if he was intoxicated.

The social acceptance of this excuse is perpetuated in the media (e.g., TV shows, movies, books, etc.) and makes it more likely that abuse victims will also be more likely to excuse the perpetrators’ actions. Domestic violence is highly dangerous and can lead to permanent physical injury or even death. [8]

Alcoholism as a Way to Cope With Abuse

A percentage of abuse victims use alcohol as a way to cope with their circumstances. These are usually individuals with more than one target factor for addiction. Being a victim with a substance abuse problem makes it much more difficult to get help in dealing with addiction symptoms because they may not be permitted to get medical assistance if their abuser fears discovery.

In these cases, the best course of action is residential rehabilitation, where they can get medical treatment through their withdrawal, counselling, and distance from their abuser.

How the Combination Can Affect Recovery

The combination of being addicted to a substance while also living in an abusive relationship involves many overlapping risk factors that can impede treatment and recovery.

In addition, some women’s shelters do not accept those with addiction or mental health disorders. [9]

Some other ways that the combination can affect recovery include the following:

  • Not having the finances necessary to attend private rehabilitation
  • Not having transportation to get to local resources (e.g., therapy, refuges, etc.)
  • Being unable to qualify for certain help due to having substance abuse issues
  • Resulting mental disorders that make it harder to ask for help or utilise resources (e.g., anxiety, depression, physical illness due to addiction, etc.)

Getting Past the Denial

The denial of the person involved characterises both alcohol abuse and partner violence. This can be due to ignorance, societal pressures, low self-esteem, or psychological response to stress. One of the first steps that must be taken in the journey towards recovery is removing all of the excuses that have been built up to deny the existence of a problem.

These are usually unhealthy coping mechanisms and are notoriously hard to breakthrough. If you have a loved one going through addiction and abuse, then intervention might be necessary.

If you have recognised signs of either in yourself, then it can be hard to accept that you need help, but it is the only way forward. You are not alone, and there is hope for a full recovery and a healthy life.

Where to Find Help

Finding help and resources to escape a dysfunctional or abusive situation is not always easy despite a concerted effort in communities to make this a higher priority. The Institute of Alcohol Studies reported that only 61% of women’s refuge locations in England boroughs allowed in women with alcohol addiction.

This severely limits the options of some people who live in areas that are not as prepared to assist them. [9]

There are private treatment centres in addition to local community programmes. By far, these are the safest and most successful way to treat the co-occurring symptoms that come with alcohol withdrawal and mental disorders that may be caused by the trauma of abuse.

Social support from friends and family is also going to be integral to treatment.

If someone going through alcohol detox and withdrawal is also the victim of domestic violence, then residential treatment in a facility will allow them to get therapy that may have been out of reach due to their partner's influence.

It will also provide a supportive and encouraging environment for healing. A treatment plan can be configured with aftercare that may include community refuge or one-on-one counselling once the programme is complete. Circumstances will determine whether family therapy will be useful or not.

It gets more complicated when children are in the picture. Children in the relationship might be used to make it impossible to attend a residential facility if they are threatened as a manipulation tactic. This is something that keeps many people from trying to reach out for help that they know they need to get sober.

It is harder to get the necessary counselling that comes with outpatient alcohol withdrawal treatments when someone is living with their abuser. A few women's shelters will provide a place to stay during detox, but many are not set up to accommodate this kind of assistance. [9]

Support groups and women's shelters are located in virtually every city. With the presence of Covid-19, there has been an increase of online and telehealth options, making it easier for people with no access to transportation or who are kept under very controlled circumstances (e.g., not allowed to leave the house alone, etc.).

There are online forums and groups for all types of abuse and those fighting addiction while experiencing co-occurring disorders, including trauma-related mental issues.

You can reach out for help and find local resources using such sites such as Refuge, which has site features to keep you safe while you find out more about what exists to help for addiction and abuse recovery in your community. They have information on identifying abuse, finding a local refuge, and tips for coping.

In severe cases, it might be necessary to leave your local city and find another location to ensure that the perpetrator cannot follow. Intake specialists will be able to assist in creating a safety plan.

Treatments for Addiction and Trauma

Addiction and partner abuse trauma have separate fixes, and recovery for both is dependent on getting the right type of treatment. If you go through rehab for withdrawal and then go straight back to an abusive environment without addressing the trauma, then the likelihood of relapse is extremely high.

Likewise, getting counselling for the abusive relationship will not progress if the addiction is not treated. Once intertwined, it takes hard work to get them untangled to achieve long-term sobriety and mental recovery.

1. Medications

There is a high risk for subscription medication abuse among people who have been victimised while also going through addiction. This is due to the overlapping factors. It is very common for mental disorders like anxiety, depression, bipolar, and PTSD to require some form of medication to lessen the symptoms. Still, many of these are also addictive in nature.

2. Psychotherapy

Both addiction and trauma need psychotherapy treatments in order for a healthy recovery to take place. Cognitive-behavioural therapies are the most common though community-based programmes like 12-step groups are also encouraged as they will have an aspect of social support that might otherwise be lacking for survivors of partner abuse.

One-on-one therapy is essential. It might be necessary to see multiple professionals who specialise in domestic violence or substance abuse, though some counsellors are trained for both.

Co-Occurring Disorders

Both substance abuse and domestic violence are high-risk factors for co-occurring mental health disorders such as depression, anxiety, and PTSD. Dual diagnosis will make it even more difficult to get into a treatment programme that can do the most good.

Some co-occurring disorders include the following:

  • Eating disorders such as bulimia or anorexia nervosa are fairly common, especially in cases where the partner abuse involves controlling the looks or eating habits of the victim
  • Depression, major depression, and generalised anxiety disorder are frequently developed during or after traumatic events and highly stressful situations
  • Post-traumatic stress disorder can occur in anyone and is the direct result of experiencing a highly traumatic event or events

Opportunities for Prevention

The WHO has several recommendations based on research into the subject for reducing community risk and preventing alcohol addiction and domestic violence. [6]

They include the following and have all been scientifically proven to reduce physical partner abuse while under the influence:

  • Making it more difficult to obtain alcohol
  • Increasing the cost of alcohol
  • A focus on treatment for alcohol use within the community

In addition, though there is no research to back up the treatment, it has become more common in the United States and some other countries for alcohol abuse screenings to take place in healthcare facilities followed by brief interventions and the presentation of resources. [6]

References

[1] https://www.nhs.uk/conditions/alcohol-misuse/

[2] https://opdv.ny.gov/professionals/abusers/excuse2.html

[3] https://opdv.ny.gov/professionals/abusers/excuse1.html

[4] https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

[5] https://psycnet.apa.org/record/1989-15968-001

[6] https://www.who.int/violence_injury_prevention/violence/world_report/factsheets/fs_intimate.pdf

[7] https://www.cdc.gov/violenceprevention/intimatepartnerviolence/riskprotectivefactors.html

[8] https://eric.ed.gov/?id=ED209593

[9] http://www.ias.org.uk/uploads/IAS%20report%20Alcohol%20domestic%20abuse%20and%20sexual%20assault.pdf

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