Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs

Christine Timko, Helen Valenstein, Patricia Y. Lin, Rudolf H. Moos, Gregory L. Stuart, Ruth C. Cronkite

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Background: Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems.Methods: We surveyed directors of a sample of substance use disorder treatment programs (SUDPs; N=241) and batterer intervention programs (BIPs; N=235) in California (70% response rate) to examine the extent to which SUDPs address IPV, and BIPs address substance abuse.Results: Generally, SUDPs were not addressing co-occurring IPV perpetration in a formal and comprehensive way. Few had a policy requiring assessment of potential clients, or monitoring of admitted clients, for violence perpetration; almost one-quarter did not admit potential clients who had perpetrated IPV, and only 20% had a component or track to address violence. About one-third suspended or terminated clients engaging in violence. The most common barriers to SUDPs providing IPV services were that violence prevention was not part of the program's mission, staff lacked training in violence, and the lack of reimbursement mechanisms for such services. In contrast, BIPs tended to address substance abuse in a more formal and comprehensive way; e.g., one-half had a policy requiring potential clients to be assessed, two-thirds required monitoring of substance abuse among admitted clients, and almost one-half had a component or track to address substance abuse. SUDPs had clients with fewer resources (marriage, employment, income, housing), and more severe problems (both alcohol and drug use disorders, dual substance use and other mental health disorders, HIV + status). We found little evidence that services are centralized for individuals with both substance abuse and violence problems, even though most SUDP and BIP directors agreed that help for both problems should be obtained simultaneously in separate programs.Conclusions: SUDPs may have difficulty addressing violence because they have a clientele with relatively few resources and more complex psychological and medical needs. However, policy change can modify barriers to treatment integration and service linkage, such as reimbursement restrictions and lack of staff training.

Original languageEnglish (US)
Article number37
JournalSubstance Abuse: Treatment, Prevention, and Policy
StatePublished - Sep 7 2012
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by the Robert Wood Johnson Foundation and the Department of Veterans Affairs (VA) Office of Research and Development (Health Services Research & Development Service, RCS 00–001). The funding bodies did not have a role in the study’s design; data collection, analysis, and interpretation; and manuscript writing. The views expressed here are the authors’ and do not necessarily represent the views of the Department of Veterans Affairs. We thank Alexandra Cowden Hindash for help with data analysis.


  • Batterer intervention
  • Intimate partner violence
  • Service centralization
  • Substance abuse treatment policy
  • Substance use disorder
  • Treatment integration


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