Prescription drug abuse among female survivors of intimate partner violence: a call for research

Abstract

Substance abuse, including the misuse of prescription drugs, has increased in the last two decades around the world (McCabe, et al., 2007; National Institute on Drug Abuse [NIDA], 2023; World Health Organisation [WHO], 2020). Global sources estimated that 5.5% of people aged 15-64 years worldwide had used an illicit drug and that 0.7% of the adult population suffered from drug use disorders. A proportion of disorders is associated with the non-medical use of prescription drugs such as synthetic opioid analgesics, anxiolytics, hypnotics or psychostimulants (NIDA, 2023; WHO, 2020). Furthermore, prescription drug abuse (PDA) might be higher in specific populations such as women with substance use disorder (SUD; Peteet, 2020), especially among those who had attempted suicide (Icick, 2017). Some of the factors that have been related with PDA are histories of abuse and the lessened stigma associated with the use of prescription drugs compared to the use of illegal drugs (Fleary et al., 2013). For example, survivors of violence have presented a greater vulnerability to substance abuse (Khantzian, 1997), than has serious medical consequences (Benyamin et al., 2008).

Intimate partner violence (IPV) is a global public health problem associated with several physical and mental health consequences in women such as depression, anxiety, or substance abuse (Campbell, 2002). Among these consequences, Bailey et al. (2019) indicated that women abused substances to manage their emotions. This relationship has been mostly supported by the self-medication hypothesis, which holds that people with an addiction problem seek to cope with emotional distress through substance use (Khantzian, 1997).

Although the relationship between IPV and substance use has been established among women (Ahmadabadi et al., 2019; Golding, 1999), few studies have examined the specific relationship between IPV and PDA. In recent years, an increase in PDA among Spanish women who had suffered IPV has been observed (Ministerio de Igualdad, 2020). The most prevalent prescribed drugs were both anxiolytic and antidepressant drugs, with higher rates of use among IPV survivors than among the general population (Crespo et al., 2017). In other countries, studies found that almost half of participants were taking pain and/or psychotropic medications to cope with IPV impact (Wuest et al., 2007). On the other hand, victimization histories were more extensive among women who used sedative-hypnotics and opiates compared to women who did not (Kubiak et al., 2006).

As IPV may be a predisposing factor for the development of PDA (Kubiak et al., 2006), the main goals of this review were to provide a summary of recent research on the relationship between IPV and PDA, identify gaps in knowledge and propose specific avenues for future research.