Understanding Substance Use Coercion


What is Substance Use Coercion?


Coercive tactics targeting a partner’s use of substances as part of a broader pattern of abuse and control

Substance use coercion is a critical issue for survivors of intimate partner violence (IPV) that has widespread implications for state and federal policymakers and for the domestic violence and substance use disorder treatment and recovery fields. Survivors and advocates have long described the ways that abusive partners harm IPV survivors through coercive tactics focused on substance use, as part of a broader pattern of abuse, violence, and control. These tactics are known as substance use coercion.

 


Impacts of Substance Use Coercion


Substance use coercion creates major barriers to safety and recovery for survivors of IPV, limiting their ability to engage in services and achieve health, wellbeing, and economic self-sufficiency. In order for services to be effective, safe, and accessible to survivors, practitioners and policymakers need to understand the ways that substance use coercion impacts survivors and their children. In response to these issues, a federal Technical Expert Meeting was convened in October 2019 to improve understanding about the prevalence and impact of substance use coercion and to generate recommendations for policy, research, and practice.

This Technical Expert Meeting was part of a larger initiative under the leadership of the U.S. Department of Health and Human Services (HHS), Administration for Children and Families, Family and Youth Services Bureau’s (FYSB) Family Violence Prevention and Services (FVPSA) Program; the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE); and the National Center on Domestic Violence, Trauma, and Mental Health (NCDVTMH).



Reports and Implications for Policy and Practice


Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit


Substance Use Coercion as a Barrier to Safety, Recovery, and Economic Stability: Implications for Policy, Research, and Practice

Technical Expert Meeting Summary and Report

This report summarizes the proceedings and recommendations from the October 2019 Technical Expert Meeting, including an overview of current research; insights and recommendations from people with lived experience/directly impacted by substance use coercion; and innovative responses to the intersecting issues of substance use, substance use coercion, and IPV. The report also offers recommendations for addressing substance use coercion by federal agencies and by the domestic violence, substance use, health, mental health, research, child welfare, housing, and criminal legal fields.

 

Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit


Understanding Substance Use Coercion in the Context of Intimate Partner Violence: Implications for Policy and Practice

Summary of Findings

This report summarizes findings from conversations with key informants from a range of fields including domestic violence advocates, substance use disorder treatment providers and harm reduction specialists, researchers, policymakers, and people with lived experience. Informants shared insights on the prevalence, impact, and implications of substance use coercion; discussed how substance use coercion affects service engagement and outcomes, including economic stability; and offered strategies for improving responses to substance use coercion and IPV.

 

Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit


Literature Review: Intimate Partner Violence, Substance Use Coercion, and the Need for Integrated Service Models

This literature review provides 1) an overview of the current research on substance use coercion, including the range of substance use coercion tactics and the impact of substance use coercion on survivors and their children; and 2) information on published research on the prevalence and effectiveness of integrated services addressing substance use and IPV. Findings suggest that integrated services uniquely benefit survivors and are associated with decreased substance use and experiences of violence.

 

 

Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit


Substance Use Coercion as a Barrier to Safety, Recovery, and Economic Stability: Report Highlights and Federal Policy Recommendations

Substance use coercion is a critical issue for survivors and their children, with policy implications that cut across federal programs and initiatives. This policy brief condenses highlights from the meeting report, key informant interviews, and literature review into a two-page handout to assist policymakers in understanding the needs of survivors, cross-system barriers to accessing services, and promising practices to improve service delivery and efficacy.

 

 

Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit


Substance Use Coercion as a Barrier to Safety, Recovery, and Economic Stability: A Webinar

NCDVTMH hosts a discussion with Commissioner Elizabeth Darling from the Administration on Children, Youth and Families and leaders from IPV and substance use programs around the country on substance use coercion research, innovative responses, and recommendations from people with lived experience.

View recording and download handouts.

 

Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit

Understanding Substance Use Coercion as a Barrier to Economic Stability for Survivors of Intimate Partner Violence: Policy Implications

This policy brief from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) highlights research on substance use coercion, including potential policy and practice responses for the domestic violence and substance use treatment fields and for federal agencies.

 

 


Related Resources


Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit

Mental Health and Substance Use Coercion Surveys Report

Research has demonstrated that survivors of domestic violence are at greater risk for experiencing a range of mental health and substance use conditions. Yet, most are not asked about their partners’ efforts to undermine their sanity or sobriety, to control their medication and treatment, or to sabotage their recovery and access to resources and support—tactics we refer to as mental health and substance use coercion. In the spring of 2012, the National Domestic Violence Hotline (NDVH) administered two pilot surveys designed to document these tactics.

Learn more and read the full report.

 

 

Tools for Transformation: Becoming Accessible, Culturally Responsive, and Trauma-Informed Organizations — An Organizational Reflection Toolkit

Coercion Related to Mental Health and Substance Use in the Context of Intimate Partner Violence: A Toolkit

This toolkit provides trauma-informed guidance for primary care and behavioral health providers on 1) understanding mental health and substance use coercion and their impact on safety, treatment access, and recovery; 2) incorporating questions about mental health and substance use coercion into routine clinical assessments; 3) responding to individuals who disclose experiences of coercion; 4) factoring mental health and substance use coercion into treatment planning, overdose and relapse prevention, and recovery support; 5) strategizing with survivors to address treatment sabotage by an abusive partner; 6) addressing privacy, confidentiality, and documentation; and 7) linking survivors to IPV-specific resources.

Learn more and download the full toolkit.

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