Recently while training about the intersection of intimate partner violence and addiction, I heard a longtime addictions counselor say this: “in true recovery, intimate partner abuse stops because it is the drugs that make a mess of our relationships.”

This is simply not true. While an understandable misconception, it is inaccurate. It’s also a dangerous misconception because if you believe that, you might also assume that treating addiction is a sufficient intervention when someone who is addicted also abuses a partner. In reality, both problems — the disease of addiction and the perpetration of intimate partner violence — need responses. These must be separate and distinct from one another.

A range of studies indicate there is up to a 60 percent overlap (Bland 2013; Warshaw & Tinnon, 2018; El-Bassel, Gilbert, Wu, Chang & Fontdevila, 2006) between substance misuse and intimate partner violence. It is understandable why many people incorrectly believe substance misuse or addiction causes violence.

So how does addiction interact with abuse? To understand that interplay, it’s helpful to first understand the abusive values framework from the field of domestic violence that I developed over 31 years in the field. We can use the framework to deeply consider the root causes of abusive behaviors and then apply it to addiction in order to better understand the two disorders.

At the invitation of J. Cherry Sullivan, Hampshire HOPE coalition coordinator, I presented a two-hour training to help people working in the trenches of the opioid epidemic better understand this interplay. The session was presented at the Hadley Farms Meeting House in Hadley for about 60 people, most of whom were members of the Drug Addiction and Recovery Teams known as the DART program. Launched by Hampshire HOPE in 2016, those teams pair up specially trained police officers with recovery coaches to reach out to people who have experienced an opioid overdose, and they also work with family members. This column includes many of the concepts taught at that training last month.

In order to be abusive, a person consciously or unconsciously harbors these beliefs. The words in italics are real examples of how the abuser might express that belief:

1.) I can hurt or intimidate you or misuse my power or show contempt if I feel uncomfortable.

“You shouldn’t have made me feel that way!”

2.) I am inherently superior or the male gender is superior or traits culturally associated with “the feminine” are inferior or identities unlike my own are inferior, such as nonbinary, gender expression, age, race, (dis)ability, LBGTQ, etc.

“Don’t be such a whiny little bitch.”

3.) It is your job to accept me as I am, no matter what I do.

“You knew who I was when we got together.”

4.) I have the right to tear you down if you point out something about me that threatens my self-concept.

“Who do you think you are, telling me?”

5.) You must celebrate me, my self-perceived strengths, my growth and change, and not mention how little I have actually changed.

“All that was in the past. It’s over. I’m doing great and nothing is ever good enough for you! How long do I have to suffer because of one mistake?”

6.) I can act disgusted and insulted and insulting if you point out significant things that I forget or do not know.

“What the hell do you know about it, anyway? So you’re perfect?”

7.) I can establish reality (fact patterns) to my liking.

“No, that never happened. I never said that. You’re crazy.”

8.) I can be contemptuous or violent if you complain, because I should NEVER be answerable to you.

“I don’t answer to you.” “What did you say? Shut your mouth if you know what is good for you.”

How do these values interact with what we know about substances like opioids alcohol and drugs? Do the chemical processes themselves simply make a person more violent?

With rare exceptions, no. The chemical process of addiction is real and powerful, yet the addiction exists within the context of these values. This means substances either amplify or reveal abusive values already held by a person. In other words, people may say things they would otherwise hold back — but the beliefs are still there, within them.

When people maintain the false, abusive belief they can hurt, intimidate or show contempt for a partner if they feel uncomfortable — and they also struggle with substance use disorder — we can anticipate substance use will unleash those behaviors because we know that most stages of substance use disorder produce significantly uncomfortable and distressing neurochemical and emotional experiences.

We know that people in early stages of addiction as well as the early stages of recovery feel very uncomfortable a great deal of the time. We also know that people who hold values that allow them to be aggressive or make their needs superior to their partners are prone to controlling, intimidating or otherwise abusive behavior when experiencing the addiction process or the early stages of recovery.

But it’s important to understand that it isn’t the substance that causes the violence — it’s the abusive values.

Where do these abusive values come from? The sad truth is they are predominant in our culture. We are all in a relationship with abusive values somehow, either surviving them or to some degree, endorsing them.

Addiction occurs within the larger culture of inequalities, reinforced by violence. Addiction can be a coping mechanism that helps people survive the impact of abusive values in our culture or in their intimate partnership. It can also serve to numb perpetrators of abuse which then allows them to continue behaving in abusive ways.

With this deeper understanding of the intersection between intimate partner violence and addiction, we can redefine being in recovery from addiction to also include being responsible for interacting safely and respectfully with your intimate partners, no matter what is going on.

If an addiction specialist is working with someone who is abusive in their intimate partnerships, they should seek out help from colleagues who are trained to understand the specific needs of people who are abusive. There is a powerful set of resources that directly support the abusive person’s change process. The Department of Public Health lists on its website all the certified Intimate Partner Abuse Education groups are available throughout our state. Groups are free or charge a sliding scale fee. Visit this site to learn more: https://www.mass.gov/service-details/intimate-partner-abuse-education-program-services.

JAC Patrissi directs the Domestic Violence Services for Behavioral Health Network and provides training design and delivery for the state Department of Public Health through the nonprofit, Growing A New Heart. She is a member of the Hampshire HOPE opioid prevention coalition run out of the city of Northampton’s Health Department. Members of the coalition contribute to a monthly column in this space about local efforts underway to address the opioid epidemic.