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Substance Use and Domestic Violence: What to Know, and Why Couples Treatment Isn’t Always Safe

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National Domestic Violence Hotline: call 1-800-799-7233, text START to 88788, or chat at thehotline.org. Free, confidential, and available 24/7. If you are in immediate danger, call 911. If you’re worried someone checks your phone or computer, consider reading this on a device they can’t access. The Hotline has guidance on clearing your browsing history.

October is Domestic Violence Awareness Month. This year’s national theme, from the Domestic Violence Awareness Project, is “With Survivors, Always”. For a site about couples and addiction, it’s a good moment to be direct about something that doesn’t get said often enough in recovery spaces: alcohol and drugs show up in a lot of abusive relationships, but they don’t cause abuse, and treating the substance use doesn’t make a relationship safe.

This article is for anyone trying to make sense of a relationship where drinking or drug use and fear exist side by side. It explains how the two connect, why couples-based treatment isn’t appropriate when there’s abuse, and where to go for help instead.

How common this is

Intimate partner violence is common, and it happens in every kind of relationship. According to the CDC’s National Intimate Partner and Sexual Violence Survey, released in February 2026, more than 1 in 3 women and more than 1 in 6 men in the U.S. have experienced contact sexual violence, physical violence, or stalking by an intimate partner during their lifetime.

The CDC defines intimate partner violence as including four types of behavior:

  • Physical violence: hurting or trying to hurt a partner using physical force.
  • Sexual violence: forcing or attempting to force a partner into a sex act, sexual touching, or a non-physical sexual event.
  • Stalking: a pattern of repeated, unwanted attention and contact that causes fear.
  • Psychological aggression: verbal and non-verbal communication intended to harm a partner mentally or emotionally or to exert control.

That last category matters. Abuse doesn’t always leave marks. Controlling money, isolating someone from friends and family, monitoring their phone, making threats, and constant humiliation are all forms of abuse.

Alcohol and drugs don’t cause abuse

It’s common to hear some version of “he’s only like that when he drinks” or “she’s a different person when she’s using.” Substances can make a violent situation more dangerous, and they often accompany it. A 2006 review in Substance Abuse Treatment, Prevention, and Policy noted that roughly 60% of men entering substance use treatment who had partners reported at least one incident of partner violence in the year before treatment, and that intoxication often accompanies violence. The same review describes considerable disagreement among researchers about whether alcohol causes violence or simply occurs alongside it.

What domestic violence experts emphasize is that abuse is a pattern of power and control, not a loss of control. A few things point to this:

  • Most people who drink heavily are not violent toward their partners.
  • Many people who are abusive are abusive while sober, too.
  • People who become violent while drinking often direct it at a partner, not at a boss, a police officer, or a stranger. That selectivity reflects choice.
  • Getting sober can reduce some violent incidents, but it doesn’t address the beliefs and behaviors behind abuse on its own.

This distinction is not academic. If a family believes the drinking is the problem, they may wait for sobriety to fix things, or blame themselves for not getting their partner into treatment sooner. Neither is fair to the person being harmed.

When substances become part of the abuse

Researchers use the term substance use coercion for abuse that targets a partner’s use of alcohol or drugs as a means of control. In a 2014 survey of 3,025 callers to the National Domestic Violence Hotline, reported by the National Center on Domestic Violence, Trauma & Mental Health:

  • 27% said an abusive partner had pressured or forced them to use substances, or to use more than they wanted.
  • Among callers who had tried to get help for their substance use, 60% said their partner had tried to prevent or discourage them.
  • 37.5% said their partner had threatened to report their substance use to authorities to keep them from getting custody, jobs, benefits, or protective orders.

Other forms of substance use coercion include introducing a partner to drugs, controlling their supply, using withdrawal as leverage, and sabotaging recovery by bringing alcohol home, mocking meetings, or blocking transportation to treatment.

If any of this sounds familiar, it is not a personal failing. Using substances to cope with abuse is a common and understandable response, and it can also make it harder to leave or get help. Advocates at the Hotline understand this and will not judge you for it.

Why couples treatment isn’t safe when there’s abuse

Couples-based treatment can be an effective approach for addiction, and much of this site is about it. But it rests on assumptions that don’t hold in an abusive relationship: that both partners can speak freely, that both are equally safe at home after a session, and that the problem is shared.

The National Domestic Violence Hotline is direct about this: “We at The Hotline do not encourage anyone in an abusive relationship to seek counseling with their partner,” because “abuse is not a relationship problem.” Among the reasons it gives:

  • An abusive partner may use what was said in a session against the other person later.
  • A session may feel safe, but that safety doesn’t follow anyone home.
  • The power imbalance at the center of abuse can’t be addressed by working on communication.
  • If the therapist doesn’t recognize the abuse, the abusive partner may successfully shift blame onto the other person.

The clinical literature reaches similar conclusions. The 2006 review cited above notes that conjoint treatment for partner violence is “typically viewed as inappropriate, ineffective, ethically questionable, and potentially dangerous”, with concerns that it can reduce accountability and escalate conflict. Some researchers have studied carefully screened couples-based approaches for lower-level conflict, but those studies screen out relationships with fear or serious violence.

That’s why responsible couples programs screen each partner separately and privately before any joint work begins. Our guide to whether couples should get sober together lists the indicators that rule out joint treatment, including fear of a partner, violence that caused injury, use or threat of a weapon, threats to kill, stalking, and violation of a protective order. If any of those apply, separate care is the right path.

Signs that what’s happening may be abuse

Every relationship has conflict. Abuse is different: one partner uses fear, control, or harm to dominate the other. Some signs:

  • You feel afraid of your partner, or you plan your words and actions around their reactions.
  • Your partner controls your money, phone, car, or who you see.
  • They threaten to hurt you, your children, your pets, or themselves if you leave.
  • They pressure you to drink or use, or interfere when you try to cut back or get treatment.
  • They threaten to report your substance use to take away your children, job, or housing.
  • They push, hit, choke, or physically restrain you, even once.
  • Apologies and promises after an incident are followed by the same pattern again.

Choking or strangulation deserves special mention. Domestic violence advocates treat it as one of the most serious warning signs, and it should always be taken seriously even if there are no visible injuries.

What to do instead

If you recognize your relationship in this article, there are people whose entire job is helping with exactly this, confidentially and without pressure to do anything you’re not ready for.

  • Talk to an advocate. The National Domestic Violence Hotline is available 24/7 by phone at 1-800-799-7233, by text (START to 88788), and by chat. Advocates can help you think through options, connect you with local programs, and build a safety plan.
  • Make a safety plan. The Hotline’s safety planning resources cover personal safety, children, pets, and digital safety. A plan is useful whether you stay, are thinking about leaving, or have already left.
  • Get substance use help on your own terms. If you want treatment for your own use, individual treatment is the safer route. SAMHSA’s National Helpline (1-800-662-4357) is free, confidential, and available 24/7. When you talk to a program, it’s reasonable to ask whether staff are trained to recognize domestic violence and whether your information will be shared with anyone.
  • Specialized lines are available. The Hotline lists StrongHearts Native Helpline (1-844-762-8483) for Native American and Alaska Native people, love is respect’s National Teen Dating Abuse Helpline (1-866-331-9474) for young people, and The Deaf Hotline by videophone (1-855-812-1001). Spanish-language support is at espanol.thehotline.org.
  • In an emergency, call 911. If you or someone else is in immediate danger, call 911.

If you’re worried about a friend or family member

If someone you love is in a relationship where drinking or drug use and fear seem to go together, the most helpful things are usually simple. Listen without judgment. Believe them. Don’t pressure them to leave on your timeline, since leaving can be the most dangerous time, and they know their situation best. Let them know the Hotline is available to them, and to you as someone trying to help.

If you’re worried about your own behavior

If you’ve read this and recognized your own behavior, that recognition matters. Substance use treatment can be an important part of change, but on its own it won’t address the patterns behind abuse. Be honest with any treatment provider about what’s been happening at home, and ask about programs specifically designed for people who have harmed a partner. Couples counseling is not the place to start.

Frequently asked questions

Does alcohol cause domestic violence?

No. Alcohol and drugs often accompany domestic violence and can make situations more dangerous, but they do not cause abuse. Most people who drink heavily are not violent, many abusive people are abusive while sober, and abuse is a pattern of power and control rather than a loss of control.

If my partner gets sober, will the abuse stop?

Not necessarily. Sobriety may reduce some incidents, but it does not address the beliefs and behaviors behind abuse on its own. Your safety should not depend on whether your partner stays sober. An advocate at the National Domestic Violence Hotline can help you plan for your safety either way.

What is substance use coercion?

Substance use coercion is abuse that targets a partner’s use of alcohol or drugs as a means of control. It includes pressuring or forcing someone to use, controlling their supply, sabotaging their recovery, preventing them from getting treatment, and threatening to report their use to take away custody, jobs, or housing.

Should we go to couples counseling or couples rehab if there is abuse?

No. The National Domestic Violence Hotline does not encourage anyone in an abusive relationship to seek counseling with their partner, because abuse is not a relationship problem and what is said in sessions can be used against the person being harmed. Separate, individual care is the safer path.

Can I get help for my own substance use if my partner is abusive?

Yes. Individual treatment is the safer route, and you can ask programs whether staff are trained to recognize domestic violence and how your information is protected. SAMHSA’s National Helpline at 1-800-662-4357 is free, confidential, and available 24/7, and Hotline advocates can help you plan around treatment safely.

How do I contact the National Domestic Violence Hotline?

Call 1-800-799-7233, text START to 88788, or chat at thehotline.org. The Hotline is free, confidential, and available 24 hours a day, 7 days a week. If you are in immediate danger, call 911.

Where to turn

National Domestic Violence Hotline: call 1-800-799-7233, text START to 88788, or chat at thehotline.org. Free, confidential, and available 24/7. If you are in immediate danger, call 911.

For substance use treatment referrals, SAMHSA’s National Helpline is free, confidential, and available 24/7 at 1-800-662-4357. If you are thinking about suicide or are in emotional crisis, call or text the 988 Suicide & Crisis Lifeline. More resources are on our crisis support page.

For couples where there is no fear or violence, and both partners want help with substance use, the Couples Assessment screens each partner’s needs and connects couples with independent licensed providers. Care Navigators can also be reached at 888-500-2110, Monday through Friday, 9am to 6pm Pacific, including to help find individual care. Care Navigators are not clinicians and do not provide medical advice, diagnosis, or treatment.

References

Couples Rehab is an independent educational and referral resource. We do not provide medical or clinical care directly and are not a treatment provider or a domestic violence service. This article is for informational purposes and is not a substitute for advice from a qualified professional or a domestic violence advocate. Our sourcing and review process is described in our editorial standards.

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