Love shouldn’t hurt

Domestic Violence, Mental Health and Substance Abuse
by Rebecca Hieronymi

Domestic violence can have devastating effects on a person’s mental health and those effects can be amplified when the victim also struggles with substance use. When an individual is experiencing a mental health crisis or substance use disorder, they are at greater risk of being controlled by an abusive partner. Abusive partners may try to undermine a victim’s mental health or substance use disorder treatment and recovery by preventing or discouraging them from getting help or taking prescriptions. These abuse tactics can increase a victim’s depression, PTSD symptoms, substance use, and suicidality.
Many survivors (especially women) are introduced to substances by their partner. Abusers also play a large role in the escalation from initial substance use to problematic substance use. Substance use coercion is a tactic used to exert greater power and control over a person. This can look like forcing a person to use drugs or alcohol (or use in a way that is unsafe or unwanted) and sabotaging recovery efforts.

Survivors may also use in order to numb emotional and/or physical pain related to domestic violence, other traumatic experiences, or health conditions. Withdrawal can range from mild to severe to life-threatening depending on the substance involved and history of use. People who experience moderate to severe withdrawal are likely to continue using if they don’t have access to withdrawal management services. Survivors may also experience barriers to accessing effective treatment. In general, treatment is a scare resource in many communities and can be even more difficult to access when a person doesn’t have health insurance or other financial resources. On top of those barriers, survivors also have to deal with interference with treatment and recovery and added threats to safety.

Being under the influence of drugs or alcohol can seriously hinder a survivor’s ability to accurately assess the level of danger they are in, or it may give them a false sense of power (believe they can defend themselves against physical assaults or that they have the power to change the abuser). Substance use can also impair a victim’s ability to make and keep safety plans and they are reluctant to call police for fear of their own arrest or referral to the Department of Human Resources. Quitting can be especially hard or seem unrealistic in an abusive relationship. There are feelings of shame and blame and the added anxiety of not knowing where to go or how to get help. Remember, “domestic violence survivors are never to blame for their alcohol or drug use but understanding how drugs and alcohol affect your relationship can be key to staying safe.” (Susan Bernsteing, LSW).

Crisis Services of North Alabama has locations in four counties (Jackson, Madison, Morgan, and Limestone County) where survivors of domestic violence and sexual assault can receive free and confidential services without fear of judgement. Advocates often provide trauma-informed care and resources to people that struggle with sobriety because of their violent or traumatic relationships.

We believe that individuals do not lose their right to safety and self-determination just because they use substances. We can all help save lives by actively listening to survivors and building safety into our conversations about substance use. This can mean learning the risk factors for overdose, learning to recognize overdose, and how to reverse overdose due to opioids (having naloxone on hand in case of an opioid overdose). The best prevention plan is one that is realistic and doable for the individual, so even if it is not what you think is the “ideal” plan, you should strive to offer unbiased and non-coercive information to survivors. With the support of family, friends, and advocates, survivors can begin to untangle these the complex dynamics between substance use, mental health, and domestic violence and realize their personal path towards healing. If you or someone you know has experienced intimate partner violence or image based sexual abuse, Crisis Services of North Alabama can help. Please contact us locally at 256.574.5826, on our 24/7 HELPline at 256.716.1000, or at our website

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