Heavy alcohol use contributes to a range of significant harms to people other than the drinker themselves. In intimate relationships, harms associated with a partner’s alcohol use may range from minor incidents to those with more severe impacts, including violence. Violence occurring in the context of intimate relationships is commonly referred to as intimate partner violence, although other terms in use include domestic abuse and domestic violence.
In this blog, we describe the findings of our rapid review that examined alcohol’s contribution to intimate partner violence.
Globally, intimate partner violence is the most common form of violence perpetrated against women. Although women may also perpetrate violence against their male partners, women are more likely to experience sexual violence, severe physical violence and to be murdered by their male partner. Intimate partner violence can also occur in the context of lesbian, gay, bisexual and/or transgender relationships, but it is currently difficult to be certain about prevalence.
Globally, intimate partner violence is the most common form of violence perpetrated against women.
Studies consistently show an association between alcohol use and intimate partner violence and that women are at a higher risk of having physical violence perpetrated against them by a partner who has been drinking than men are. Although the vast majority of drinkers will not experience violence in their relationships, high rates of heavy drinking are found among perpetrators of intimate partner violence, and compared to men in the general population, higher rates of men in substance use treatment have perpetrated violence against an intimate partner.
Although the vast majority of drinkers will not experience violence in their relationships, high rates of heavy drinking are found among perpetrators of intimate partner violence, and compared to men in the general population, higher rates of men in substance use treatment have perpetrated violence against an intimate partner.
We found that there are different ideas and explanations about how and why alcohol use is linked to intimate partner violence. Alcohol does not work alone as a cause of violence in intimate relationships, and is linked via its interaction with a range of factors. Some are related to the individual, such as their personality traits or experiences of adversity in childhood; others are to do with how alcohol affects the dynamics of the intimate relationship; and others are environmental, such as how society views drunken behaviour and how our drinking culture may reinforce (and even ‘excuse’) the links between men’s drinking and violent behaviour in general. The physical and cognitive effects of alcohol also play a role.
Alcohol does not work alone as a cause of violence in intimate relationships, and is linked via its interaction with a range of factors.
Our rapid review also looked at the evidence for what might effectively address the links between alcohol and intimate partner violence. A public health (or whole population) approach views alcohol-related intimate partner violence as a preventable consequence of alcohol and its interaction across the individual, relationship and environmental factors identified. Within a public health approach, policy and interventions that target the whole population, such as measures that reduce the availability or increase the price of alcohol, are thought to be the most effective and efficient way of tackling the problem. Minimum unit pricing, for example, has been predicted to impact on intimate partner violence as an extension of its effect of reducing alcohol use among would-be perpetrators.
However, the high prevalence of intimate partner violence perpetration amongst men receiving substance use treatment also highlights the need to address the problem among groups of individuals at risk of intimate partner violence and amongst those who are already involved. Integrated interventions, which alongside treating heavy alcohol use concurrently address perpetration of intimate partner violence, have been proposed as the best solution. We found, however, that few studies have been undertaken and that we need more research to develop the evidence base.
The high prevalence of intimate partner violence perpetration amongst men receiving substance use treatment also highlights the need to address the problem among groups of individuals at risk of intimate partner violence and amongst those who are already involved.
Bringing the evidence together through this rapid review has revealed the complexity of the relationship between alcohol and intimate partner violence. Overall, we concluded that we urgently need more research to help develop our understanding of the various factors that link alcohol use to intimate partner violence. We also need more in-depth research with men and women who have experienced violence in their relationships to better understand the impact across different types of drinking behaviours and the different forms of intimate partner violence.
Bringing the evidence together through this rapid review has revealed the complexity of the relationship between alcohol and intimate partner violence.
Our rapid review also identified that we are some way off being able to develop clear recommendations for policy and practice on tackling this issue. However, we suggest that future policy actions on this topic acknowledge the complexity of the relationship.
We also called for the further development and evaluation of integrated interventions to address the high rates of intimate partner violence perpetration among men accessing treatment for problems with their alcohol use. This is currently the focus of a National Institute for Health Research funded research programme, ADVANCE, led by one of our rapid review co-authors.
