Alcohol or drug abuse plays a role in at least 40% of incidents of partner abuse, according to a Department of Justice study (1). And one survey of abuse shelter staff found drugs and alcohol were involved in at least 50-60% of domestic violence cases (2). Such persons may not have been diagnosed with a substance abuse problem, but alcohol or drug use is still implicated in the violence.
At an appropriate point in the interview ask, “And what about alcohol use?” Some clients think only hard liquor is “real” alcohol, so pose this follow-up question: “What about beer, wine or other alcohol?” Some counselors postpone detailed questions about the quantity and frequency of alcohol use until the end of the assessment, to elicit a more candid answer.
The four “CAGE” questions can help determine whether the alcohol use is excessive:
- “Have you ever felt you ought to Cut down on your drinking?”
- “Have people Annoyed you by criticizing your drinking?”
- “Have you ever felt bad or Guilty about your drinking?”
- “Have you ever had an Eye-opener to steady your nerves or get rid of a hangover?”
The CAGE questions can be adapted to assess drug abuse (“Have you ever felt you ought to Cut down on your use of marijuana?,” etc.) Answering “yes” to one or more of the CAGE questions is indicative of substance abuse.
Because substance abuse can interfere with the client’s social relationships and thought processes, as well as trigger future incidents of violence, the client should be encouraged to begin treatment right away. Treatment may include referral for:
- Individual counseling by a qualified alcohol and drug abuse counselor
- Alcoholics Anonymous meetings, or a similar 12-step group for drug addiction
- Medical evaluation
- Residential detoxification and treatment
The domestic violence service provider should provide follow-up counseling and support as appropriate.
(1) Greenfeld LA. Alcohol and crime: An analysis of national data on the prevalence of alcohol involvement in crime. NCJ 168632. 1998. Figure 6.
(2) Bugarin A. The prevalence of domestic violence in California. Sacramento: California Research Bureau, 2002, p. 12.
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