How Substance Abuse and Intimate Partner Violence Are Connected — and How to Get Help

Substance abuse and intimate partner violence are closely connected, but the relationship goes far beyond the idea that drugs or alcohol simply “cause” abuse. Substance use can increase the immediate risk or severity of violence in some situations, while survivors may also use substances to cope with trauma or have their substance use deliberately exploited by an abusive partner. Research among people entering substance use treatment has found particularly high rates of partner aggression. Across studies reviewed by Fals-Stewart and Kennedy (2005), approximately 40% to 60% of married or cohabiting patients entering substance use treatment reported partner aggression during the preceding year. That statistic describes a treatment population rather than all intimate partner violence cases, but it illustrates why addiction treatment and relationship safety cannot always be addressed separately.

Note: Substance use does not excuse intimate partner violence, and it is rarely the sole cause. Alcohol and other drugs may increase the short-term likelihood of aggression in some people, while abuse itself can contribute to substance use through trauma, chronic pain, coercion, and attempts to cope. Effective care considers safety, trauma, and substance use together.

How Substance Use and Intimate Partner Violence Are Connected

The link between substance use and intimate partner violence (IPV) is not simple or one-directional. Alcohol has one of the clearest associations with same-day violence. However, intoxication does not make someone abusive or remove responsibility for violent behavior.

In a longitudinal diary study, 272 men entered either domestic violence treatment or alcoholism treatment. Among these participants, severe male-to-female physical aggression was over elevenfold more likely on days when the men consumed alcohol than on alcohol-free days (Fals-Stewart, 2003). More recent research reinforces that same-day relationship. In a 2025 study, 216 women experiencing physical or repeated psychological IPV completed daily surveys for 90 days. Their partners’ IPV perpetration was 2.25 times as likely on days involving substance use, with patterns involving alcohol showing some of the clearest associations with psychological, physical, and sexual IPV (Schick et al., 2025).

Some drugs can also fuel violent behavior by affecting judgment, impulse control, perception, and emotional regulation. But substance use should be understood as one possible risk factor within a much larger pattern rather than as an explanation that shifts responsibility away from the person using violence.

In practice, three dynamics can overlap:

• A perpetrator’s substance use may increase the immediate likelihood or severity of aggression.
• A survivor’s substance use may be deliberately weaponized against them.
• A survivor may use alcohol or drugs to cope with trauma, pain, fear, or other effects of abuse.

Each situation requires a different response.

When Addiction Becomes a Weapon: What Is Substance Use Coercion?

One of the most important and less widely understood connections between addiction and domestic violence is substance use coercion. The National Center on Domestic Violence, Trauma & Mental Health uses this term to describe abusive tactics directed at a partner’s substance use, treatment, sobriety, or recovery. Rather than substance use being incidental to the abuse, the abusive partner intentionally uses it to gain or maintain control (Warshaw & Tinnon, 2018).

Substance use coercion can include:

• Pressuring or forcing substance use. An abusive partner may pressure someone to drink or use drugs, make them use more than they want, or deliberately expose them to substances.
• Controlling access. An abusive partner may control money, medication, alcohol, or drugs and use that control as leverage.
• Sabotaging treatment or recovery. They may prevent appointments, interfere with medication, reintroduce substances, or discourage a partner from seeking treatment.
• Threatening to disclose substance use. Substance use may be used to discredit a survivor with family members, employers, law enforcement, courts, child welfare agencies, or other authorities.

A national survey of callers to the National Domestic Violence Hotline documented these tactics directly. 27% reported being pressured or forced by an abusive partner to use alcohol or other drugs or to use more than they wanted. Another 37.5% said a partner had threatened to report their substance use to someone in authority in order to prevent them from obtaining something they needed, such as custody, employment, benefits, or a protective order (Warshaw et al., 2014).

The effect on recovery was particularly striking. Although 15.2% of respondents had tried to get help for their substance use, 60.1% of those individuals said a current or former partner had tried to prevent or discourage them from getting that help (Warshaw et al., 2014). This is why entering an alcohol rehab program may address only part of the problem when an abusive partner is actively interfering with treatment or threatening a survivor’s safety.

When Substance Use Is a Response to Trauma

For some survivors, substance use begins or increases as a way of coping with what they are experiencing. Intimate partner violence can contribute to anxiety, depression, PTSD symptoms, sleep problems, chronic stress, physical injuries, and chronic pain. Alcohol or drugs may temporarily numb distress even when their longer-term effects make recovery more difficult (World Health Organization [WHO], 2026).

That does not mean substance use caused the abuse or that the survivor is responsible for another person’s violence.

There can also be a medical pathway that deserves careful attention. A survivor experiencing injuries, chronic pain, insomnia, anxiety, or other effects of trauma may receive legitimate treatment for those conditions. When medications with misuse or dependence potential are involved, clinicians should consider trauma history, medication safety, current substance use, and coercion by a partner without assuming that appropriate medical treatment itself caused a substance use disorder.

Who Can Face Additional Barriers to Safety and Treatment?

Intimate partner violence can affect people of any gender, sexual orientation, race, age, socioeconomic background, or relationship type. However, someone’s broader circumstances can shape both their exposure to abuse and their ability to get help.

• Gender and gender expectations may influence how abuse is experienced, recognized, and reported. Rigid ideas about masculinity, femininity, control, or relationship roles can also make some survivors less likely to identify what they are experiencing as abuse.
• LGBTQ+ survivors may encounter additional forms of coercion, including threats of being outed, discrimination, or concern that a service provider will not understand the dynamics of a same-sex or non-heterosexual relationship.
• Race, immigration status, and economic insecurity can create additional obstacles. Someone may fear discrimination from institutions, immigration consequences, financial instability, or losing housing or employment if they seek help. An abusive partner may deliberately exploit those fears. Economic control can be particularly powerful. A person who does not independently control household money may find it difficult to obtain transportation, treatment, legal assistance, medication, or safe housing, including access to a drug rehab program.

The important point is not that any identity automatically leads to greater violence, but that social, financial, legal, and cultural circumstances can affect what options are realistically available to a survivor.

Why Survivors Can Face Real Barriers to Seeking Help

Seeking help for intimate partner violence is already difficult. When substance use is involved, the options can become even more complicated.

• Fear of legal or child-custody consequences may prevent a survivor from contacting law enforcement, seeking medical care, or disclosing substance use honestly. The National Domestic Violence Hotline survey found that 24.4% of respondents were afraid to call police because they believed their substance use could lead to arrest or cause authorities not to believe them (Warshaw et al., 2014).
• Access to safe housing can also be complicated. Policies vary among shelters and residential services, and historically some programs have used substance-related eligibility restrictions. Domestic violence organizations increasingly advocate lower-barrier, trauma-informed approaches that can support survivors who are actively using substances as well as those in recovery.
• Financial control creates another obstacle when an abusive partner controls bank accounts, transportation, insurance information, identification documents, or communication.
• Stigma affects credibility. A survivor experiencing addiction, mental health symptoms, and abuse at the same time may worry that disclosure of one issue will cause professionals to discount another.

These are practical safety barriers, not simply a lack of motivation to seek help.

Why Trauma-Informed Care Matters When Intimate Partner Violence is Present

Trauma-informed behavioral healthcare recognizes these overlapping factors rather than isolating addiction from the circumstances surrounding it. SAMHSA recommends trauma-informed approaches that recognize the effects of trauma, attempt to avoid retraumatization, and integrate that understanding into behavioral health services (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014).

Studies of people receiving addiction treatment have repeatedly found substantial histories of violence and trauma. However, the figures vary by population and should not be generalized to everyone receiving treatment. A study of 91 adults seeking treatment for cocaine dependence found that 85.7% had experienced physical assault during their lifetime. Among those who had been assaulted, 46.2% reported assault by an intimate partner (Dansky et al., 1999). An earlier study of 60 women in residential chemical dependency treatment found that 73% reported having been raped, and 45% reported being raped more than once (Teets, 1997).

These were relatively small clinical samples and should not be treated as current population-wide prevalence estimates. Their importance is that they demonstrate how easily addiction treatment can miss major trauma and safety issues when clinicians look only at substance use.

What Trauma-Informed Addiction Treatment Can Include

Genuinely trauma-informed care asks what a person has experienced, how those experiences may affect substance use and recovery, and what could make treatment safer. Trauma therapy may be one part of that process when clinically appropriate.

For someone experiencing both addiction and IPV, comprehensive care may also involve:

• assessment for trauma, mental health concerns, and substance use;
• confidential discussion of relationship safety and coercive control;
• individualized safety planning;
• attention to medication access and possible medication-related coercion;
• coordination with domestic violence advocates when appropriate; and
• treatment planning that does not blame the survivor for strategies they used to cope.

A person’s substance use and physical safety should not be treated as competing priorities.

Breaking the Cycle Requires More Than Treating Substance Use

Meaningful change requires communication between services that have historically approached intimate partner violence, mental health, and addiction as separate issues. Therefore, substance use treatment providers need to recognize signs of coercive control and understand how an abusive partner can interfere with recovery. Domestic violence programs need ways to support survivors whose substance use would otherwise become another barrier to safety. Healthcare providers also need to understand that disclosure of addiction may occur in the context of trauma or ongoing abuse.

Families and friends have a role as well. Learning how to talk to a loved one about substance use can help, but if intimate partner violence may also be present, safety should shape how and when that conversation happens.

Moving Forward: Recovery and Safety Can Be Addressed Together

Substance abuse and intimate partner violence can intersect through intoxication, trauma, chronic pain, coercion, financial control, treatment sabotage, and barriers within the systems survivors rely on for help. No single explanation fits every relationship.

What the evidence does show is that substance use does not excuse abuse, and addiction treatment should not ignore relationship safety. When both issues are present, care that recognizes trauma, assesses coercion, supports recovery, and takes immediate safety seriously offers a more complete path forward.

If you or someone you know is experiencing intimate partner violence, confidential support is available:

• National Domestic Violence Hotline: Call 1-800-799-7233, text START to 88788, or use live chat at TheHotline.org.
• RAINN National Sexual Assault Hotline: Call 1-800-656-4673, text HOPE to 64673, or use RAINN’s online chat.
• StrongHearts Native Helpline: Call or text 1-844-762-8483 for confidential support for Native Americans and Alaska Natives.
• 911: Call in an immediate or life-threatening emergency.

If you believe an abusive partner may monitor your phone, browser, or internet activity, consider using a safer device when searching for help.

Furthermore, if substance use is also part of your situation, treatment does not have to happen in isolation from questions about trauma and safety. Contact Bright Futures Treatment Center to talk confidentially about what support could look like for you.

References

Dansky, B. S., Byrne, C. A., & Brady, K. T. (1999). Intimate violence and post-traumatic stress disorder among individuals with cocaine dependence. The American Journal of Drug and Alcohol Abuse, 25(2), 257–268. https://doi.org/10.1081/ADA-100101859

Fals-Stewart, W. (2003). The occurrence of partner physical aggression on days of alcohol consumption: A longitudinal diary study. Journal of Consulting and Clinical Psychology, 71(1), 41–52. https://doi.org/10.1037/0022-006X.71.1.41

Fals-Stewart, W., & Kennedy, C. (2005). Addressing intimate partner violence in substance-abuse treatment. Journal of Substance Abuse Treatment, 29(1), 5–17. https://doi.org/10.1016/j.jsat.2005.03.001

Schick, M. R., Clayton, A., Maxwell, C. D., & Sullivan, T. P. (2025). Patterns of substance-involved intimate partner violence perpetration: Findings from a daily diary study. Addictive Behaviors, 166, 108305. https://doi.org/10.1016/j.addbeh.2025.108305

Substance Abuse and Mental Health Services Administration. (2014). Trauma-informed care in behavioral health services (Treatment Improvement Protocol Series 57, HHS Publication No. SMA 14-4816). U.S. Department of Health and Human Services.

Teets, J. M. (1997). The incidence and experience of rape among chemically dependent women. Journal of Psychoactive Drugs, 29 (4), 331–336. https://doi.org/10.1080/02791072.1997.10400559

Warshaw, C., Lyon, E., Bland, P. J., Phillips, H., & Hooper, M. (2014). Mental health and substance use coercion surveys: Report from the National Center on Domestic Violence, Trauma & Mental Health and the National Domestic Violence Hotline. National Center on Domestic Violence, Trauma & Mental Health and National Domestic Violence Hotline.

Warshaw, C., & Tinnon, E. (2018). Coercion related to mental health and substance use in the context of intimate partner violence: A toolkit for screening, assessment, and brief counseling in primary care and behavioral health settings. National Center on Domestic Violence, Trauma & Mental Health.

World Health Organization. (2026, June 18). Violence against women. https://www.who.int/news-room/fact-sheets/detail/violence-against-women

FAQs

Is there a real link between substance abuse and intimate partner violence?

Yes. Research shows substance use is involved in an estimated 40 to 60% of intimate partner violence incidents, though the relationship is complex — substance use can lower inhibitions, but it's also frequently used by abusers as a deliberate tool of control.

Can an abuser use substances to control their partner?

Yes, this is a documented pattern called substance use coercion, where an abuser encourages, controls access to, or sabotages a partner's relationship with substances specifically to maintain control over them.

If I use drugs or alcohol, will I get in trouble for reporting abuse?

This is a real and valid fear, and it's one of the most significant reasons survivors don't seek help. While policies vary, resources like the National Domestic Violence Hotline are confidential and can help you understand your specific options without automatic legal consequences.

Why might a domestic violence shelter turn someone away for substance use?

Historically, many shelters have had strict sobriety requirements, which can leave survivors who use substances, often due to coercion or trauma, without safe housing. This is a recognized problem that advocates are actively working to change.

Where can survivors of intimate partner violence find help?

The National Domestic Violence Hotline (1-800-799-7233) is available 24/7 and confidential. RAINN and StrongHearts Native Helpline offer specialized support, and 911 should be called for immediate danger.