Substance use and partner violence among urban women seeking emergency care.

Abstract

Growing evidence suggests intimate partner violence (IPV) and substance misuse are co-occurring problems that disproportionately affect low income urban women seeking care in emergency departments (EDs) and represent leading causes of injuries that result in ED visits. This paper examines temporal bi-directional associations between different types of drug and alcohol use and different types of IPV in a longitudinal study of a representative sample of 241 low income, urban women receiving emergency care from an ED in the Bronx, New York. After adjusting and matching for socio-demographics and potentially confounding multi-level risk and protective covariates, women who reported using heroin in the prior six months at Wave 1 were twice as likely as non-heroin using women to indicate any physical, injurious or sexual IPV at subsequent waves and were 2.7 times more likely to indicate experiencing an injury from IPV at subsequent waves. Crack or cocaine use in the past 6 months at Wave 1 was associated with an increased likelihood of injurious IPV and severe verbal abuse at subsequent waves. Findings also suggested that sexual IPV was significantly associated with subsequent use of crack or cocaine. The multiple bidirectional associations found linking these problems underscore the need for conducting routine screening for IPV and substance misuse among women in low income, urban EDs, and for improving linkages to services that will ultimately reduce the risk of morbidity, disability, and mortality related to these co-occurring problems.

Intimate Partner Violence During Pregnancy: Maternal and Neonatal Outcomes

“…[25][26][27] Research has demonstrated the significant impact of IPV on women's health behaviors during pregnancy, including higher rates of smoking, 11,28 alcohol use, and substance use. [29][30][31] Inadequate weight gain, smoking, alcohol use, and substance use are well-established risk factors for adverse neonatal outcomes and will be discussed in greater detail below.…”

Identifying and Intervening with Substance-Using Women Exposed to Intimate Partner Violence: Phenomenology, Comorbidities, and Integrated Approaches Within Primary Care and Other Agency Settings

“…Unique factors identified with IPV and drug use, specifically, included potential dependence on partners for drug supply, coerced sexual behavior to obtain drugs as well as low status of drug-using women, which could further impede negotiation of condom use by partners. Despite substantial research indicating significantly higher prevalence of all types and severity of IPV victimization among drug or alcohol dependent women and bidirectional associations between using different types of drugs and alcohol and IPV victimization, 7,26 the availability and use of effective screening, brief interventions and coordinated systems of care to address these co-occurring problems in health care settings remain very limited. Although several IPV screening tools for women in health care settings have been evaluated and validated over the past decade, to our knowledge, only one IPV screening tool (the Jellinek Inventory for assessing Partner Violence [J-IPV] scale) has been validated with drug dependent women in a drug treatment setting.…”

“…27 Because the majority of women with SUDs never receive substance abuse treatment, it is important to extend the reach of IPV screening and brief interventions that target women with SUDS to health care settings where women with SUDs are more likely to receive services. Given the disproportionately large number of women with SUDs who receive emergency care services for injuries or medical or psychiatric problems related to IPV, 26 it is particularly important to introduce routine screening for IPV among women with SUDs in emergency care settings. Scaling routine screening for IPV in emergency care settings may significantly increase the identification of women with SUDs at risk of IPV and link them to appropriate IPV services and substance abuse treatment.…”

Estudio del consumo de sustancias psicoactivas y conflictividad familiar en sujetos condenados por delitos de violencia de género

“…Analizando los tipos de drogas comúnmente involucrados en el contexto de la violencia doméstica, algunos estudios han destacado la proliferación del consumo de cocaína, tanto esnifada como en base 11 , al contrario de lo que sucede en otros, en los cuales el consumo de cannabis es el que mantiene una mayor asociación con la victimización familiar 12 . Sin embargo, revisando este problema podemos observar que el consumo de alcohol es la sustancia más tradicionalmente ligada con los agresores por delitos de violencia de género, tanto en nuestro país como en otros 13,14 .…”