Aim
To examine how substance misuse policy and practice in England includes and addresses domestic abuse or Intimate Partner Violence (IPV) perpetration in substance misusers.
Design
An analysis was conducted of drugs and alcohol policy documents 1998-2015 using key word searches and discourse analysis to examine how and whether these documents address IPV -perpetration. The role of substance misuse intoxication in domestic abuse was also examined in domestic abuse policy. Telephone interviews were conducted with 20 stake holders to ascertain whether procedures are in place in substance misuse settings to identify IPV-perpetration, whether there are care pathways for substance misusing IPV perpetators and what barriers exist to address IPV perpetration amongst substance misusing men.
Participants
Drug and alcohol and domestic abuse policy documents. Substance misuse service practitioners and managers (13) IPV agency practitioners (4). Public health policy makers (3)
Results
IPV perpetration has not been included as drug-related crime. An understanding of IPV perpetration in substance misusers with complex needs has increasingly been framed in terms of its implications for child safeguarding, and has been ‘folded in’ to policies targeting Troubled Families. New Labour alcohol policy described the prevalence and the cost of alcohol related domestic abuse but momentum to specify services for alcohol misusing victims and perpetrators was lost with the introduction of ‘localism’ policies in English drug and alcohol policy by the coalition government. Policy and literature produced by IPV perpetrator and victim organisations has consistently framed IPV-perpetration as an individual choice with intoxication as a post-hoc excuse for violence with limited implications for effective service development. Interviews with stake holders indicate a range of understandings/explanations for IPV amongst substance misusing men. Stake holders suggest that not all staff have the confidence or skills to ask men about their relationships and that there are few referral routes for substance misusing men who seek help for their IPV perpetration.
Conclusion
There are gaps and contradictions in the extent to which English drug and alcohol policy has sought to address IPV-perpetration amongst substance misusers. Recent National Institute for Health and Care Excellence guidance provide an opportunity to include domestic abuse training for all front line social care staff including in the substance misuse sector. There is a need for further research into effective services for substance misusing perpetrators and the development of training for front-line staff.
