Saying ‘No’ to Drugs But Dying in Violence

(Note the date on this study – 1997.)

 Substance Abuse in Home Is a Risk Factor

People who do not use illegal drugs but live in households where such drugs are used are 11 times as likely to be killed as those living in drug free homes according to a study reported today in the Journal of the American Medical Association.

Killings were also 70 percent more likely among non-drinkers in households where alcoholism exists, according to the study, which examined. the effect of substance abuse on homicides and suicides in the three counties that include Seattle, Memphis and Cleveland.

“Our concept Of the individual at risk for violent death should be broadened to include not only the substance abuser, but also those who may be at risk because of the presence of others within the household who are substance abusers,” the researchers said.

The study, by researchers at the University of Washington, the University of Tennessee, Case Western Reserve University and Emory University, found that people who mix alcohol with drugs were 16.6 times more at risk for suicide and 12 times more at risk for homicide then those who abuse neither. Not only were alcoholism and drug abuse associated with more frequent suicide, the researchers reported, but homicides also increased among people who did not consume drugs or alcohol but lived with others who did.

Dr. Frederick P. Rivara the lead researcher said the study underscored the need to confront the abuse of alcohol and drugs on many levels, including basic medical care.

“Physicians don’t usually screen for substance abuse, and substance abuse has many implications, including violence.” Dr Rivara said in a telephone interview from Seattle.  He said the study documented that alcohol and drug abusers posed a risk not just to themselves but also to others in their household.  Alcohol is generally recognized as a factor in killings and suicides.  The researchers alluded to previous studies showing that 40 percent to 70 percent of homicide victims were found during autopsies to have had alcohol in their blood.

But the potentially fatal impact of chronic substance abuse on other household members was often overlooked the researchers said.  They studied reports by medical examiners on 438 suicides and 388 homicides occurring at home in Shelby County, Tenn., King County, Washington, and Cuyahoga County, Ohio, during a three- to five-year period beginning in August 1987.  The victims’ proximity to alcohol or drugs was compared with that of a control group of residents of the same or similar neighborhoods.

Alcohol abuse increased the risk of suicide three-fold, whether or not the subject lived alone, the study said, but “non-drinking individuals who lived with others who drank were not at increased risk of suicide.”

The study said,  “Alcohol impairs judgment, possibly causing individuals to place themselves in situations at high risk of violence.”  But the use of illegal drugs by those younger than 50, it found, was associated with a higher incidence of suicide both among drug users and those who lived with them. Drug use was too infrequent to be measured in those over 50.

The link between violence and drug use, the researchers suggested, may result from “drug-seeking activities, such as interaction with drug dealers and theft to obtain resources for drug purchase.”  The study reported that drug abuse in a home increased a woman’s risk of being killed by a spouse, lover, or close relative by 28 times.  “That the true risk factor may be the drug culture environment is supported by our finding that even non-drug users who lived in households where illicit-drug use occurred were at greatly increased risk of homicide,” it said.

Commenting on the study, Susan Ohanesian of Project Return, an organization in New York that helps people overcome problems resulting from substance abuse. said there was a broader pattern of violence in homes where drugs and alcohol were used to excess. “You see high levels of depression and very low levels of self esteem as the abused person comes to believe they deserve the abuse,” Ms. Ohanesian said.

Ms. Ohanesian, the senior director of substance abuse services at the organization, said the risk of violence was there whether a domestic partner abstained from drugs and alcohol or not,  In addition to Dr. Rivara the authors of the study included Dr. Beth Mueller and Carmen T. Mendoza in Seattle; Dr. Grant Somes in Memphis, Dr Norman B.  Rushforth  in Cleveland, and Dr. Arthur L. Keller. They cautioned that the study ” is limited to homicides and suicides in homes and said that the dynamic of violent deaths outside might be quite different.   They also acknowledged that alcoholism and drug abuse, rather than causing killings and suicides,  “may play a role solely as markers for other risk factors” like anti-social behavior, or a history of mental illness or depression,

Source: New York Times, NATIONAL, August 20, 1997                                        

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