How Drugs & Alcohol Can Fuel Violent Behaviors
Substance use disorders (SUDs), a medical condition defined by the uncontrollable use of drugs and/or alcohol despite the negative consequences, have been associated with a range of adverse outcomes, including suicide, premature death, comorbid mental illness, and violence.1 In fact, research indicates that up to 75% of individuals who begin treatment for a SUD report having engaged in physical assault, mugging, using a weapon to attack another person, and other violent crimes.2
The connection between drug addiction, alcoholism, and violence crosses many thresholds (individual psychology, public health, and domestic violence, to name a few), and is vitally important in understanding the scope of how controlled substances can affect people.
Statistics on Substance Abuse and Violence
Drug-related violence statistics include the following:3-7
- In 2016, alcohol caused approximately 90,000 domestic violence deaths worldwide.
- Alcohol or drug use is involved in 40-60% of domestic abuse situations.
- More than half of individuals who abuse their elder parents (age 60 or older) are dependent on alcohol or drugs.
- Each year, about 300,000 victims of violent assaults report that their attackers were under the influence of alcohol.
- Alcohol plays a role in 32% of all murders in the United States.
- Chronic substance users have a greater risk of dying by suicide.
Risk Factors and Causes
Substance abuse is the largest precipitator of violence in adults and adolescents, but there are other factors that impact an individual’s behavior and contribute to a person’s aggressive tendencies. Risk factors tend to exist in a cluster rather than isolation. Thus risk factors for aggressive behaviors may stem from a combination of factors, including:8,9,10
- Age. Younger people tend to have higher rates of aggression.
- Co-occurring mental health problems. Individuals exhibiting current symptoms of depression tend to act aggressively.
- Polysubstance use.
- Gender. Males tend to exhibit more aggressive tendencies than women.
- A family history of drug or alcohol abuse.
- Adverse childhood experiences. Violent youths tend to have violent parents.
- Genetic predisposition. A study attributes the cause of aggression to genetic predisposition.
- Antisocial attitudes and beliefs. Research indicates that adolescents with antisocial or delinquent peers may be dishonest, break rules, or be hostile toward others.
- Location. Children who grow up in disadvantaged neighborhoods plagued with violence, drug use, and crime are at an increased risk of becoming violent.
Alcohol Use and Violence
Alcohol consumption is more closely associated with violent behavior than any other substance.6 In fact, severe alcohol intoxication—by the perpetrator, victim, or both—plays a part in nearly half of all violent crimes and sexual assaults.6
As indicated above, intoxication alone does not cause violence, but it may increase the likelihood for violent behavior in some individuals. Researchers have a few theories, including:2,11,12
- The disinhibition hypothesis. Alcohol encourages people to engage in behaviors they would typically suppress, like aggression. This is because alcohol disrupts normal brain function and consequently weakens the areas that control impulses and urges.
- Alcohol myopia. An intoxicated individual’s focus narrows like a camera lens, only bringing a small frame into focus. For some, this narrowed view leads to misperception. A bump in a bar, for instance, may be perceived as an act of hostility.
- Cognitive function impairment. Alcohol interrupts cognitive processing, making it difficult to problem-solve, control anger, and make good decisions—all of which influence how an individual responds to a situation.
- The consideration of future consequences. Research indicates that individuals who ignore future consequences and focus on the here-and-now are more aggressive when intoxicated.
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Drug Use and Violence
The correlation between substance abuse and violent behavior has been well documented. One study found that more than 26% of respondents who reported using alcohol, cannabis, and cocaine in a 12-month period, also reported committing a violent crime within the same time frame.13
Some individuals use aggressive techniques to steal money to buy more drugs; others may be involved in the drug-trafficking, which often leads to violent crimes.13 For others, violence is a long-term side effect of the substance they abuse. Individuals addicted to methamphetamine, for instance, may suffer from anxiety, confusion, insomnia, mood disorders, and aggressive or violent behavior.14
In addition, the psychological risks associated with cocaine use include violent, erratic, or paranoid behavior. Similarly, hallucinogens may cause unpredictable, erratic, and violent behavior that can lead to serious injury or even death.15
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Impacts and Effects
Substance abuse can lead to an increase in domestic violence, sexual assault, suicide attempts, and other aggressive behaviors.
Domestic Violence and Substance Abuse
Domestic violence includes verbal, emotional, and physical intimidation; and can be delivered in the form of threats, destroying another’s possessions; hurting pets; forced sexual acts; and physical acts (including hitting, hair pulling, punching, slapping, and more) to hurt spouses, parents, stepparents, children, siblings, other relatives, and intimate partners. Research indicates that: 16
- Between 25% and 50% of men who commit acts of domestic violence also suffer from SUDs.
- 80% of child abuse cases involve the use of drugs and alcohol.
- Women who abuse alcohol and other drugs are more likely to be victims of domestic violence.
Suicide and Substance Abuse
There are several factors that impact suicidal behavior in individuals, but substance use—and especially alcohol use—has been linked to a significant number of suicides and suicide attempts.
The World Health Organization defines suicide as a form of “self-directed violence.” In a 2019 survey, 63,000 people aged 18 or older who reported alcohol use in the past month, attempted suicide. Approximately 24,000 of those respondents admitted to heavy alcohol use in the past month. Furthermore, the same survey found that 80,000 respondents, who had attempted suicide in 2019, used alcohol or illicit drugs in the past year and 54,000, who attempted suicide, used both alcohol and illicit drugs in the past year.17
Furthermore, severe intoxication is present in about 30% to 40% of suicide attempts. Research indicates that alcohol dependence is associated with a suicide risk that is 10 times greater than the suicide risk in the general population, and individuals who abuse illicit drugs by injection are at a suicide risk 14 times higher than the general population.18
Other data found alcohol above the legal limit in 22% of suicides, heroin, and other prescription painkillers in 20% of suicides, cannabis in 10.2% of suicides, and cocaine or amphetamines present in approximately 8% of suicide deaths in 2016.18
Crime and Substance Abuse
Crime is closely associated with SUDs. Research suggests that among prison populations, alcohol abuse and dependence were found in 18% to 30% of men and 10% to 24% of women. Similarly, drug abuse and dependence were found in 10% to 48% of men and 30% to 60% of women.19 Studies indicate that violent offenders are more likely to abuse sedatives and alcohol.19
Sexual Assault and Substance Abuse
Estimates show that about half of all sexual assaults that take place on college campuses involve alcohol by the perpetrator, victim, or both.20Alcohol, however, doesn’t cause sexual assault, it’s a contributing factor for sexual aggression. Men who have reported binge and heavy alcohol consumption are more likely than other men to report committing sexual assault, one study found.21
As mentioned above, alcohol alters perceptions and lowers inhibitions. One study asked sober men to read a story about a man forcing a date to have sex. Participants revealed that they would be more likely to act like the man in the story when they were intoxicated.21
Besides alcohol, other drug use is associated with an increased risk of sexual violence. A study of young opioid users found that 41% of female participants and 11% of male participants reported being forced to have sex without their consent while they were using drugs.22
Treatment for SUD and Violent Behavior
Effective treatment for individuals with a SUD and violent behaviors include programs and services to address their addiction—which may include detoxification, inpatient rehab, or outpatient treatment—and support services to help them confront their aggressive tendencies.
Though intake protocols at most SUD treatment facilities include mental disorder screenings to assess an individual’s risk of suicide, violence to others, inability to care for themselves, risky behaviors, and the danger of physical or sexual victimization, among other things, it’s impossible for every facility to address every need of every individual needing treatment.16
It might require a variety of agencies or resources to help support an individual’s varied needs, including substance abuse treatment, mental health counseling, aggression support groups, anger management, parenting training, legal help, and more. In domestic violence situations, for instance, support groups become part of the treatment or aftercare plan for both victims (survivor support groups) and perpetrators (batterers’ intervention programs).16 This may be done through referrals to other community programs or specialized facilities. In fact, one study found that the most effective treatment for individuals with a SUD and a history of domestic violence provided addiction services and batterers’ intervention simultaneously, but in separate programs.23
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How to Help Someone with a SUD and Violent Behaviors
Your personal safety needs to be your number one priority. If you have a loved who struggles with drug and alcohol use and tends to be violent, don’t approach them alone. Seek help from a health care provider, mental health professional, or law enforcement.
Programs exist to help you find safety and healing if you’ve been the victim of physical, mental, emotional, or sexual abuse, including resources for shelter or other housing.
- Zhong, Shaoling, Yu, Rongqin, and Fazel, Seena. (2020). Drug Use Disorders and Violence: Associations with Individual Drug Categories. Epidemiologic Reviews, 42(1), 103-116.
- Ilgen, Mark, Ph.D., Kleinberg, Felicia, M.S.W. (January 20, 2011). The Link Between Substance Abuse, Violence, and Suicide. Psychiatric Times, 28(1).
- World Health Organization. (2018). Global Status Report on Alcohol and Health 2018.
- Easton, Caroline J., Ph.D. (January 1, 2006). The Role of Substance Abuse in Intimate Partner Violence. Psychiatric Times, 25(1).
- World Health Organization. (2006). Interpersonal Violence and Alcohol.
- Ärzteblatt, D. Ä. G., Redaktion Deutsches. Alcohol-Related Aggression (18.10.2013). Deutsches Ärzteblatt.
- Esang, M., & Ahmed, S. (2018). A Closer Look at Substance Use and Suicide. American Journal of Psychiatry Residents’ Journal, 13(6), 6–8.
- Murray, R. L., Chermack, S. T., Walton, M. A., Winters, J., Booth, B. M., & Blow, F. C. (2008). Psychological Aggression, Physical Aggression, and Injury in Nonpartner Relationships Among Men and Women in Treatment for Substance-Use Disorders. Journal of Studies on Alcohol and Drugs, 69(6), 896–905.
- Tuvblad, C., & Baker, L. A. (2011). Human Aggression Across the Lifespan: Genetic Propensities and Environmental Moderators. Advances in Genetics, 75, 171–214.
- Office of the Surgeon General. (2001). Youth Violence: A Report of the Surgeon General.
- Topper, Stephen M., Aguilar, Viktoria Y., Elbel, Erin, and Pierce-Shimomura, Jonathan T. (2014). Alcohol Disinhibition of Behaviors in elegans. Plos One.
- Bushman, Brad J., Ph.D., Giancola, Peter R., Ph.D., Parrott, Dominic J., Ph.D., and Roth, Robert M., Ph.D. (2012). Failure to Consider Future Consequences Increases the Effects of Alcohol on Aggression. Journal of Experimental Social Psychology, 48(2), 591-595.
- S. Department of Justice. (1994). Drugs and Crime Data. Fact Sheet: Drug-Related Crime.
- National Institute on Drug Abuse. What are the long-term effects of methamphetamine misuse?
- Substance Abuse and Mental Health Services Administration. (2004). Physical and Psychological Effects of Substance Use.
- Substance Abuse and Mental Health Services Administration. Treatment Improvement Protocol (TIP 25). Substance Abuse Treatment and Domestic Violence.
- Substance Abuse and Mental Health Services Administration. (2020). National Survey on Drug Use and Health.
- Substance Abuse and Mental Health Services Administration. (2016). Substance Use and Suicide: A Nexus Requiring a Public Health Approach.
- Håkansson, Anders and Jesionowska, Virginia. (2018). Associations between substance use and type of crime in prisoners with substance use problems—a focus on violence and fatal violence. Substance Abuse and Rehabilitation, 9, 1-9.
- National Institute on Drug Abuse. (2016). Sexual Assault and Alcohol: What the Research Evidence Tells Us.
- National Institute on Alcohol Abuse and Alcoholism. Alcohol and Sexual Assault.
- Jessell, Lauren, LMSE, Mateu-Gelabert, Pedro, Ph.D., Guarino, Honoria, Ph.D., Vakharia, Sheila P., LMSW, Ph.D., Syckes, Cassandra, MA, Goodbody, Elizabeth, BA, Ruggles, Kelly V., Ph.D., and Friedman, Sam, Ph.D. (2017). Sexual Violence in the Context of Drug Use Among Young Adult Opioid Users in New York City. Journal of Interpersonal Violence, 32(19), 2,929-2,954.
- Timko, C., Valenstein, H., Lin, P. Y., Moos, R. H., Stuart, G. L., & Cronkite, R. C. (2012). Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs. Substance Abuse Treatment, Prevention, and Policy, 7(1), 37.