Substance Abuse

Theories of the Relationship between Substance Abuse and Interpersonal Violence

Several theoretical models have been advanced to account for the relationship between substance use and interpersonal violence. For example, the tripartite conceptual framework posited three possible links between substance use and violence. The first stems from psychopharmacological effects of drugs, which may contribute to impairment in cognitive abilities and increased arousal and irrational behavior (e.g., violence). This framework is conceptually similar to the proximal effects model and the psychopharmacological model, both of which suggest that violence results from the acute and chronic effects of intoxication. Physiologic effects of drugs are thought to increase the likelihood of violence by inhibiting anxieties regarding perceived punishment. It has also been hypothesized that drugs may increase sensitivity to pain, resulting in an increased risk of reactive aggression. Additionally, drugs may interact with several neurotransmitter systems, including dopamine, serotonin, and gamma-aminobutyric acid, but the precise interactions are unknown.

The second component of the tripartite framework involves the hypothesis that violence occurs in the context of criminal behavior, such as in the procurement of drugs for economic gain or to support a drug habit (also described as an economic motivation model). The third component suggests that violence occurs within the broader system of substance use (e.g., fights over failing to pay debts) and that violence may be used to uphold rules associated with the drug market. These latter components may also be helpful [Page 696]in explaining intimate partner violence. For example, trying to obtain drugs (e.g., forcing a partner to obtain drugs) and supporting a drug habit (e.g., stealing money from a partner to pay for drugs, leading to financial difficulties) could place intimate partners at risk for aggression.

Another theoretical model used to explain the relationship between substance use and violence is general deviance theory. This theory hypothesizes that substance use may not cause violence and that violence may not lead to substance use, but rather individuals more apt to be involved in one type of deviant behavior are also at risk for other types of deviant behavior. This theory is consistent with the spurious model, which proposes that violent behavior and substance use are not causally linked but, rather, both are by-products of a common third variable, such as antisocial personality disorder or child abuse victimization. Thus, violence and substance use may be viewed as deviant behaviors within the spectrum of a general deviance syndrome. An advantage of this theory is the emphasis placed on the role of environmental influences in the onset of both behaviors. For example, it is possible that cultural norms may support both violence and substance use as evidence or proof of masculinity, which may inadvertently increase the strength of the relationship between aggression and substance use.

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