Substance abuse and violence: A review of the literature
Introduction
The term “substance” can refer to a drug of abuse, a medication, or a toxin (American Psychiatric Association [APA], 1994). Various classes of substances include: alcohol, amphetamines, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine (PCP) and sedatives, hypnotics, or anxiolytics (APA, 1994). This paper reviews the findings from diverse disciplines on the complex relationship between substance abuse and violence.
Section snippets
Relationship of substance use to violence
Most alcohol and drug use occurs among persons who are not violent (Fagan, 1990). However, alcohol and, to a lesser extent, illicit drugs are present in both offenders and victims in many violent events. Although substance abuse, particularly alcohol, has been associated with violent behavior for many decades, research has rarely documented causal linkages due to the multiple variables that are involved in assessing etiology Allen et al., 1997, Johnson & Belfer, 1995, Paglia & Room, 1998.
The
Psychosocial factors that play a role in violence
Several psychosocial factors have been found to play a role in violence (Chermack & Giancola, 1997). These factors include influences on the individual's behavior patterns, which begin developing in early childhood and continue to evolve through adulthood. Patterns of aggressive behavior and substance abuse often become intertwined early in development. These developmental factors have been identified as contributors to violence. These factors include: an aversive environment, harsh discipline,
Neurobiology of violence
Biological factors play a role in the etiology of violence; however, similar to substance use, biological factors have not been shown to cause violence. Biological factors associated with aggression include alterations in the levels of monoamine neurotransmitters (i.e., serotonin, dopamine, and norepinephrine). The most frequently cited and often oversimplified biological correlate of violence is a low level of serotonin. In general, the serotonin system plays a role in feeding psychological
Withdrawal and violence
Withdrawal produces a set of characteristic physical and psychiatric effects, and it is the pursuit to alleviate these effects with drugs or alcohol that can develop into aggressive behavior. Violence associated with daily heroin use typically occurs in desperate drug-seeking individuals who fear the symptoms of opioid withdrawal. Alcohol- and drug-induced psychotic disorders are conditions characterized by prominent delusions or hallucinations that develop during or following drug use.
Types of violence
There are three basic ways in which substance abuse is related to violence. First, violence can be perpetrated under the influence of substances. Goldstein (1985) labels this type of violence “psychopharmacological violence.” Psychopharmacological violence occurs as a result of the short- or long-term use of certain drugs that produce excitability, irritability, paranoia, or violent behavior. Psychopharmacological violence can also occur when the use of substances results in changes or
Substance use in the occurrence of violent events
Violence can occur in various phases of drug use including acute intoxication, drug-seeking behavior associated with withdrawal, and episodes of drug-induced psychosis and paranoia associated most often with stimulant use. Acute intoxication, most notably with alcohol, causes disinhibited behavior and leads to aggression in persons prone to violent behavior. In addition, substance-induced aggression during intoxication can occur in dependent or nondependent users.
A number of studies show that
Licit drugs and violence
Almost all of the common drugs of abuse may lead to violent behavior, though often by very different mechanisms (Lavine, 1997). In addition, biological links between psychoactive substance use and violence differ by type of drug, amount, and pattern of use. The following sections discuss the various licit and illicit drugs and their relationships to violence. These relationships are summarized in Table 1.
Illicit drug use and violence
Abuse of illicit drugs is also connected to crimes of violence, although there are relatively few sources of data on patterns of illicit drug use and violence Pihl & Peterson, 1993b, Reiss & Roth, 1993. Criminals who use illegal drugs commit robberies and assaults more frequently than do nonuser criminals, and they commit them especially frequently during periods of heavy drug use (Roth, 1994). In addition, there is evidence that chronic use of illicit drugs (opioids, amphetamines, marijuana,
Conclusion
This review has focused on evolving research on substance abuse and violence. Although existent research has its limitations, such as small, nonrandom samples, retrospective data, the yield in review is impressive. Evidences from empirical studies support a strong association between alcohol and violent behavior. The use of alcohol and drugs are consistently mentioned as occurring prior or during the commission of many violent events, leading to a temporal association between the two. In the
Acknowledgements
Development of this paper was supported in part by a grant from the United States Postal Service Commission on a Safe and Secure Workplace. The authors thank Naomi Goldstein, Patrick Johnson, and Herbert Kleber for their helpful input and comments on this paper.
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