Interventions to Reduce Intimate Partner Violence Perpetration by Men Who Use Substances: A Systematic Review and Meta-Analysis of Efficacy

Abstract

Introduction: Despite the high prevalence of intimate partner violence (IPV) perpetration by men who use substances, limited evidence exists about how best to reduce IPV among this group. Method: A systematic narrative review with meta-analysis determined the effectiveness of interventions to reduce IPV by men who use substances. Inclusion criteria were randomized and nonrandomized controlled trials; adult heterosexual male IPV perpetrators where at least 60% of participants were alcohol and/or drug users; the intervention targeted IPV with or without targeting substance use (SU); outcomes included perpetrator and/or victim reports of IPV, SU, or both. Methodological quality was assessed. Results: Nine trials ( n = 1,014 men) were identified. Interventions were grouped into (1) integrated IPV and SU interventions ( n = 5), (2) IPV interventions with adjunct SU interventions ( n = 2), and (3) stand-alone IPV interventions ( n = 2). Cognitive behavioral and motivational interviewing therapies were the most common approaches. Data from individual trials showed a reduction in SU outcomes in the short term (≤3months; n = 2 trials) and IPV perpetration at different time points ( n = 3 trials) for interventions compared with treatment as usual (TAU). Meta-analysis with integrated IPV and SU interventions showed no difference in SU ( n = 3 trials) or IPV outcomes ( n = 4 trials) versus SU TAU. Conclusions: Little evidence exists for effective interventions for male IPV perpetrators who use substances. Outcomes in integrated interventions were not superior to TAU in meta-analysis. Future trials should consider the nature of the relationship between IPV and SU in intervention design, duration of intervention, and type and timing of outcome measures.

A study protocol to assess the feasibility of conducting an evaluation trial of the ADVANCE integrated intervention to address both substance use and intimate partner abuse perpetration to men in substance use treatment

“…Few perpetrator interventions have been trialled amongst men who use substances [28]. A recent review of interventions to reduce IPA perpetration by men who use substances identified only nine trials, three of which were conducted in substance use treatment services and two of these amongst men who had been arrested for IPA or court-mandated to receive the intervention [28].…”

“…Few perpetrator interventions have been trialled amongst men who use substances [28]. A recent review of interventions to reduce IPA perpetration by men who use substances identified only nine trials, three of which were conducted in substance use treatment services and two of these amongst men who had been arrested for IPA or court-mandated to receive the intervention [28]. Initial reviews of IPA interventions conducted concurrently with alcohol treatment [29] or integrated interventions that address both IPA and substance use [28] show some promise but were not superior to treatment as usual [28].…”

“…A recent review of interventions to reduce IPA perpetration by men who use substances identified only nine trials, three of which were conducted in substance use treatment services and two of these amongst men who had been arrested for IPA or court-mandated to receive the intervention [28]. Initial reviews of IPA interventions conducted concurrently with alcohol treatment [29] or integrated interventions that address both IPA and substance use [28] show some promise but were not superior to treatment as usual [28]. Some interventions to address IPA in men who use substances present a simplistic model of inebriated physical violence and struggle to integrate issues of gender, non-physical abuse and to fully consider the impact of a substance use lifestyle.…”

Relation of Driving Under the Influence Laws to Access to Firearms Across US States

“…P revious studies indicate that there is an association between alcohol misuse and increased risk of firearm injuries and deaths. [1][2][3][4][5][6][7] Wintemute et al found that firearm owners in California with driving under the influence (DUI) convictions had a 4-to 4.5-fold increased risk of a subsequent violent or firearm-related arrest over a median 8year follow-up period compared with firearm owners without previous criminal convictions. 2 Similar results were found in an update of the previous study.…”

“…Another study found an association between conviction of DUI and increased risk to be arrested for intimate partner violence. 4 Alcohol misuse has been associated with intimate partner violence, 5,6 interpersonal assault, and firearmrelated deaths. 7 Individuals who misuse alcohol are at higher risk of dying by firearm suicide.…”