Partner Substance Research Articles

Alcohol misuse and criminal offending: Findings from a 30-year longitudinal study

BackgroundThis study examined the associations between measures of alcohol abuse/dependence (AAD) and several classifications of offending behaviour to age 30 in a New Zealand birth cohort. MethodsOutcomes included: assault; use of a weapon; theft/burglary/vehicle conversion; property damage/vandalism/arson; and fraud/embezzlement/misappropriation of funds. The study also used measures of AAD symptoms; and time-dynamic covariate factors including life stress, other substance use, mental health status, peer and partner substance use and offending, and unemployment. Data were analysed using conditional fixed effects regression modelling augmented by time-dynamic covariate factors to control for confounding. ResultsThose with five or more AAD symptoms had unadjusted odds of offending that ranged from 6.23 to 21.25 times higher than those with no symptoms, with little evidence to suggest these associations varied with age. Adjustment for both unobserved fixed effects and time-dynamic covariate factors reduced the magnitude of the associations between AAD and offending, with those with five or more AAD symptoms having odds of offending that were 0.88–4.10 times higher than those with no symptoms. After adjustment, only the associations between AAD and: a) assault (OR=4.10; 95% CI=1.91–8.62; p<0.0001); and b) property damage/vandalism/arson (OR=3.87; 95% CI=1.30–11.39; p<0.0001); remained statistically significant. ConclusionsThe results suggest a causal association between alcohol misuse and “impulsive” crimes such as assault and property damage/vandalism/arson, with estimates suggesting that AAD accounted for approximately 9.6–9.9% of these types of reported offending in the cohort.

Alcohol misuse and violent behavior: Findings from a 30-year longitudinal study

BackgroundThis study examined the associations between measures of alcohol abuse/dependence (AAD) and violent offending and intimate partner violence (IPV) to age 30 in a New Zealand birth cohort. MethodsOutcomes included: measures of violent offending, violence victimization, and physical IPV perpetration and victimization. The study also used measures of AAD symptoms; and time-dynamic covariate factors including life stress, other substance use, mental health status, peer and partner substance use and offending, and unemployment. Data were analysed using conditional fixed effects regression modelling augmented by time-dynamic covariate factors to control for confounding. ResultsThose with five or more AAD symptoms had unadjusted rates of violence outcomes that ranged from 4.10 to 11.85 times higher than those with no symptoms, but these associations did not differ by gender. Adjustment of the associations for both unobserved fixed effects and time-dynamic covariate factors reduced the magnitude of the associations for violent offending, violence victimization and IPV perpetration, with those with five or more AAD symptoms having rates of violence outcomes that were 1.91–3.58 times higher than those with no symptoms. However, control for both fixed effects and time-dynamic covariate factors reduced the associations between AAD symptoms and physical IPV victimization to statistical non-significance (IRR=0.73, 95% CI: 0.51–1.06). ConclusionsThe results suggest a causal association between alcohol misuse and violent offending/victimization and IPV perpetration, with estimates suggesting that alcohol use disorder accounted for approximately 4.6–9.3% of the reported violent offending/victimization and IPV perpetration in the cohort.

The Intersection of Mutual Partner Violence and Substance Use Among Urban Gays, Lesbians, and Bisexuals

Intimate partner violence among gays and lesbians has gained increased attention in recent years. The present study assessed mutual partner violence within a gay, lesbian, bisexual (GLB) community sample to explore how mutual partner violence relates to the use of psychoactive substances. The results suggest that individuals engaging in mutual partner violence are more likely to report the use of numerous drugs than other subjects. However, this finding holds more consistently among men. The results also indicate that the exchange of violence is more significant for substance use than the particular type of violence involved. The authors suggest that minority stress may be an underlying mechanism of both substance use and partner violence and may contribute to the intersection of these deviant phenomena in the GLB community.

HIV Sexual and Drug-Use Risk in Drug-Dependent Pregnant Patients in Comprehensive Drug Treatment

This secondary analysis study investigated HIV sexual and drug-use risk in drug-dependent pregnant patients over the first month postrandomization to reinforcement-based treatment (RBT) (n = 47) or usual care (UC) (n = 42). Analysis of primary outcomes had indicated that RBT participants spent significantly longer time in treatment and recovery housing than UC participants. The present study examined the ability of 9 risk markers—age, race, estimated gestational age at treatment entry, lifetime substance abuse treatment episodes, history of prostitution charges, history of serious depression, current heroin injection status, current housing status, and current partner substance use—to predict changes in HIV risks. Sexual risk declined for participant subgroups with prostitution-charge histories and unstable housing. Drug-use risk declined for heroin injectors and nondepressed participants. A relationship was found between number of lifetime drug treatment episodes and sexual and drug-use risk. The role of risk markers in the response of drug-dependent pregnant women to drug treatment require attention.

Romantic Relationships and Substance Use in Early Adulthood

This study used longitudinal data from 909 young adults to examine associations between substance use and the status and quality of romantic relationships. Heavy alcohol use, marijuana use, and cigarette smoking, as well as relationship status, relationship quality, partner substance use, and other salient life circumstances were assessed at four time points in the two years after high school. Marriage, cohabiting relationships, and noncohabiting dating relationships were associated with reductions in heavy drinking and marijuana use relative to non-dating, after adjusting for adolescent substance use; marriage compared to not dating was associated with reductions in cigarette smoking. For those in romantic relationships, partner substance use moderated the associations between relationship quality and substance use for heavy drinking and for marijuana use, supporting the hypothesis derived from the Social Development Model that the protective effect of stronger social bonds depends on the use patterns of the partner to whom an individual is bonded.

Latent growth trajectories of substance use among pregnant and parenting adolescents.

We examine changes among adolescent girls in substance use during pregnancy and the postpartum period. Three separate latent growth curve analyses assessed the impact of psychosocial, behavioral, and sociodemographic factors on resumption of or change in use of cigarettes, alcohol, and marijuana. The Vulnerable Populations Model for Research and Clinical Practice (Flaskerud & Winslow, 1998) provided the theoretical foundation for this study. This is a secondary analysis of data from a sample of 305 ethnic minority females (245 Latina, 60 African American), aged 13-18 years, who were pregnant at baseline and were participating in an HIV prevention study conducted in inner-city alternative schools in Los Angeles County. Data collected at 4 time points captured changes in substance use from pregnancy through the postpartum period. Baseline predictors included ethnicity/race, partner substance use, childhood abuse history, religiosity, acculturation, depressive symptoms, length of gestation at baseline, and previous substance use. Common predictors of greater resumption and/or greater level of use included greater history of use before pregnancy, partner substance use, childhood abuse, and a longer time since childbirth. African Americans were more likely to be smoking at baseline when they were still pregnant and to use marijuana postpartum; Latinas were more likely to use alcohol over the course of pregnancy and postpartum. Other variables exerted an influence on specific substances. For instance, religiosity impacted cigarette and alcohol use. Findings may assist prenatal care providers to identify and counsel pregnant adolescents at risk for perinatal substance use and to prevent resumption or initiation of substance use after childbirth.

The Effects of Violence Acuity and Door to Service

Despite recent gains in understanding the links between intimate partner violence and substance abuse by women, the service issues related to these cooccurring problems are relatively unexplored. This study addresses 3 practice-related questions critical to the provision of services in coordinated or integrated substance abuse and intimate partner violence programs: (a) Are different “doors” to service associated with different outcomes? (b) Does the level of substance use prior to the onset of services predict changes in self-efficacy or vulnerability to battering? and (c) How does proximity of violence impact program outcomes? We followed 128 women for 6 months after admission to a state-funded demonstration project on cooccurring substance abuse and intimate partner violence on outcomes of self-efficacy, fear of violence, and substance use. The relationship between outcomes and door to service, substance use, and acuity of violence were examined using contingency analysis, analysis of covariance, and logistic regression. We discuss the findings and applications of the research to practice.

Commission versus receipt of violence during pregnancy: associations with substance abuse variables.

The tendency for women to report both commission and receipt of violence is an understudied phenomenon. In particular, little is known about individual differences as a function of commission vs. receipt of partner violence among pregnant women. Using a sample of 78 cohabiting low-SES pregnant women, the current study examines three violence subtypes based on self-report (primarily commission of violence, primarily receipt of violence, and no report of violence) and investigated differences in a range of other risk factors among these subtypes. In this sample, 47% reported higher levels of intimate partner violence (IPV) perpetration than victimization; 14% reported more IPV victimization than perpetration; and 39% reported no IPV. Results demonstrate clear differences between women reporting IPV and those not reporting IPV and clear differences between IPV subtypes in terms of partner substance use, with women reporting primarily receipt of violence also reporting more drug and alcohol abuse by their partners. Although preliminary, these findings suggest that the commission of violence may be more common during pregnancy than the receipt of violence, but that risks for these two subgroups are similar.

Helping Students to Understand the Link Between Substance Use and Intimate Partner Violence

Students studying addictive diseases must come to understand, among other issues, the interplay between intimate partner violence (IPV) and substance abuse. Statistics are important, but case examples elucidate for the students what to “listen” for in their meetings with clients. The purpose of this article is to provide several case examples of addiction and IPV and the connection between the two, and to promote classroom discussion as to how to intervene when both issues are present in a client's life.

Alcohol Consumption, Drug Use, and Condom Use Among STD Clinic Patients

Research on the association between substance use and sexual risk behavior has yielded a complex pattern of findings. Such inconsistent findings may reflect method variance, including factors such as gender of the participant, nature of the sexual event, partner characteristics, and type of substance used. The purpose of this study was to investigate the association between substance use and unprotected sex independently for alcohol, drugs, or combined substance use and to examine partner characteristics as a moderator of this association. Participants (N = 1,419; 48% women) were recruited from a publicly funded sexually transmitted disease clinic and were asked to complete an audio computer-assisted self-interview regarding their most recent sexual experience, including nature of the event, substance use, and partner characteristics. Analyses showed that alcohol use was related to condom use when gender and partner type were considered; thus, for women, but not for men, partner type interacted with alcohol consumption such that condom use was less likely when alcohol consumption preceded sex with nonprimary partners (drinking was unrelated to condom use with primary partners). Subsequent analyses examining partner substance use showed that women, but not men, who reported both they and their nonprimary partners were drinking during sex were less likely to use a condom. At the event level, alcohol consumption among sexually transmitted disease clinic patients is associated with condom use, but this association differs by gender and partner characteristics. Findings suggest the need to strengthen substance-use components in sexual risk reduction interventions for women and their partners.

Screening for Co-Occurring Intimate Partner Abuse and Substance Abuse: Challenges Across Service Delivery Systems

Substance use problems among women survivors of intimate partner abuse (IPA) present unique challenges in screening for the co-occurrence of these 2 issues. The lack of coordinated efforts and integrated services is startling given the prevalence and subsequent risks among those who suffer at the crossroads of these 2 complex and interrelated problems. This article critically examines the issues in screening to identify IPA victimization and substance abuse in selected service delivery systems. The philosophical, programmatic, and policy implications for the implementation of integrated screening and intervention across these service delivery systems are discussed as a more comprehensive approach to helping women IPA survivors who abuse substances.

Tests of Causal Links Between Alcohol Abuse or Dependence and Major Depression

There has been a great deal of research on the comorbidity between alcohol abuse or dependence (AAD) and major depression (MD). However, it is unclear whether AAD increases the risk of MD or vice versa. To examine the associations between AAD and MD using fixed-effects modeling to control for confounding and using structural equation models to ascertain the direction of causality. Data were gathered during the course of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of children from New Zealand (635 boys, 630 girls). General community sample. The analysis was based on a sample of 1055 participants with available data on AAD and MD at ages 17 to 18, 20 to 21, and 24 to 25 years. Symptom criteria for AAD and MD from the DSM-IV at ages 17 to 18, 20 to 21, and 24 to 25 years as well as measures of life stress, cannabis use, other illicit drug use, affiliation with deviant peers, unemployment, partner substance use, and partner criminality at ages 17 to 18, 20 to 21, and 24 to 25 years. There were significant (P < .001) pooled associations between AAD and MD. Controlling for confounding factors using conditional fixed-effects models and time-dynamic covariate factors reduced the magnitude of these associations, but they remained statistically significant. Structural equation modeling suggested that the best-fitting causal model was one in which AAD led to increased risk of MD. The findings suggest that the associations between AAD and MD were best explained by a causal model in which problems with alcohol led to increased risk of MD as opposed to a self-medication model in which MD led to increased risk of AAD.

HIV Risks, Substance Abuse, and Intimate Partner Violence Among Hispanic Women and Their Intimate Partners

Hispanic women in the United States are disproportionately affected by HIV infection. Substance abuse and intimate partner violence (IPV) are conditions that have been associated with risk for HIV in the general population. However, few studies have explored the intersection of these three conditions within one integrated framework. The purpose of this exploratory study was to describe the relationships between HIV risks, substance abuse, and IPV among Hispanic community-dwelling women. A total of 82 structured interviews were conducted with Hispanic women between the ages of 18 and 60. Data regarding the participant's and her partner's histories of sexually transmitted infections, substance abuse, risky sexual behaviors, and IPV were collected. Relationships between the participant's history of sexually transmitted infections, her partner's substance abuse, risky sexual behaviors, and IPV were explored. Results from this study support the importance of targeting HIV, substance abuse, and IPV prevention among Hispanics within one integrated framework.

Women Arrested for Partner Violence and Substance Use

Discrepancies exist in research examining substance problems within groups of women arrested for intimate partner violence (IPV). In some studies women IPV arrestees have been found to be at high risk for substance-related problems, whereas in others they are found to be at low risk for substance-related problems. The current study explores these discrepancies then compares a sample of women court ordered to a domestic violence diversion program (n = 78) to a matched sample of men (n = 78) in the same program using police report information, self-report measures, the Substance Abuse Subtle Screening Inventory-3, and the Millon Clinical Multiaxial Inventory-III alcohol and drug subscales. Women IPV arrestees had a low occurrence of substance use during the arresting incident, a low incidence of substance-related diagnoses, and fewer substance-related problems than did men IPV arrestees. However, women demonstrated personality structures susceptible to nondiagnosable, hazardous drinking patterns.

An Integrated Relapse Prevention and Relationship Safety Intervention for Women on Methadone: Testing Short-Term Effects on Intimate Partner Violence and Substance Use

An Integrated Relapse Prevention and Relationship Safety Intervention for Women on Methadone: Testing Short-Term Effects on Intimate Partner Violence and Substance Use

Predictors of Unprotected Sex with Non-cohabitating Primary Partners among Sheltered and Low-income Housed Women in Los Angeles County

This study investigated associations of substance use, relationship abuse and HIV self-protective behavior with unprotected sex among 290 impoverished women with a non-cohabitating primary partner. Unprotected sex was associated with having a physically or psychologically abusive partner among low-income housed women, and having an abusive partner who also drank to intoxication among women living in shelters. Indicators of HIV self-protective behavior were associated with less frequent unprotected sex among sheltered women, even after accounting for abuse and substance use within the relationship. Results suggest the need for HIV-prevention interventions to address the problems of partner substance use and relationship abuse.

A Comparative Study Examining Associations Between Women’s Drug-Related Lifestyle Factors and Victimization Within the Family

This study explores and compares the interrelationships between lifespan childhood and adult partner victimization and the drug lifestyles for 609 women, aged 18-65, from a drug-treatment sample, a women's domestic violence shelter sample, and community samples matched with the drug-treatment and shelter samples. Significant findings indicate that lifespan childhood and adult partner victimization were the strongest predictors of women's drug-related lifestyle activities. Three proposed hypotheses were supported to suggest that an association exists between the respondents' lifespan childhood and partner victimization scores and drug-related lifestyle activities scores, with these relationships modified by intervening variables, such as age, marital status, partner substance use, and parental substance use. Findings also indicate significant differences among the four sample groups in terms of victimization and drug-related lifestyle factors. Implications, limitations, and areas for future research are discussed.

Relative prevalence of opium abuse and symptoms of opium withdrawal in women with addicted husbands who came for treatment

Relative prevalence of opium abuse and symptoms of opium withdrawal in women with addicted husbands who came for treatment

A prospective study of risk and protective factors for substance use among impoverished women living in temporary shelter settings in Los Angeles County

Alcohol and drug use are significant public health problems facing homeless women, but few prospective studies have examined risk and protective factors for substance use in this population. This 6-month prospective study identified psychosocial, behavioral, and economic predictors of drinking to intoxication, crack use, and marijuana use in a probability sample of 402 women living in temporary shelter settings in Los Angeles County with a simple majority of homeless residents (92% of these women had a history of homelessness). Engaging in sexual risk behavior and having depressive symptoms were risk factors for more frequent intoxication, marijuana use, and crack use. Drinking to intoxication was additionally predicted by perceived HIV susceptibility, lower social support, more avoidant and less active coping, and lower self-esteem. Additional predictors of marijuana use included partner alcohol misuse and less social support, whereas more frequent crack use was additionally predicted by partner alcohol misuse, lack of economic resources, and more avoidant and less active coping. These findings suggest that effective substance use programs may need an integrative approach that addresses other types of risk behaviors, assists women in strengthening their support networks and learning effective coping skills, and provides access to basic services (e.g., housing, health care). For women in relationships, there may be a further need to address issues of partner substance use.

The Relationship Between Partner Abuse and Substance Use Among Women Mandated to Drug Treatment

This study investigates the relationship between substance use and partner abuse among women (N = 1,025) who entered drug-treatment programs through the criminal justice systems in New York City and Portland, Oregon. Self-report data on substance use and partner abuse indicate that although the rate of partner abuse in both cities is well above the national average, the less substance-involved women in Portland reported more abuse than their New York counterparts. Our analyses suggest that the relationship between partner abuse and substance use during conflicts varies within the population of women offenders who are heavily drug-involved, with women in Portland reporting a greater direct link between partner abuse and substance use. The findings indicate that there is a need for drug-treatment providers to understand their clients' victimization histories and the relationship between partner abuse and substance use in order to engage clients in the treatment process and help them learn how to avoid being victimized in the future.