Intersections of Substance Use, Overdose Risk, and Intimate Partner Violence: A Dyadic Approach to Violence Prevention in Criminal Legal Settings

Background: When examining the relationship between intimate partner violence (IPV) and substance use, most studies have focused exclusively on individual-level correlates without considering cross-partner associations. Given the bidirectional nature of IPV within intimate relationships, a dyadic (couple) approach may assist in gaining a more precise understanding of the complex interrelationships between IPV, substance use, and overdose risks among couples. Methods: We employed the Actor-Partner Interdependence Model (APIM) using baseline data from a randomized controlled trial to examine how perpetration and experience of IPV in the past three months may be associated with substance use and non-fatal overdose risks among men in community supervision programs in New York City and their intimate partners (N=412 participants; 212 male and 196 female). The actor and partner effects were estimated using a multilevel logistic regression model with membership of a couple as a random effect for partner dependency, adjusting for key demographic factors. Findings: Over one-third of the participants (n=157, 38.1%) reported experiencing IPV and perpetrating IPV (n=149, 36.2%). Female participants who had been in the ER due to drugs or alcohol were more likely to report experiencing IPV (OR=2.62, 95% CI=1.02-6.88, p=0.046) and perpetrating IPV (OR=2.41, 95% CI=1.02-5.73, p=0.046) than those who had not been in the ER. Male participants who had been in the ER due to drugs or alcohol were also more likely to report perpetrating IPV (OR=3.07, 95% CI=1.31-7.16, p=0.010). Male participants who had experienced overdose were more likely to report perpetrating IPV than those who had not (OR=2.90, 95% CI=1.20, 7.01, p=0.018). No partner effects of overdose risks were significantly associated with participants’ reports of IPV. Implications for D&I Research: Our findings suggest a complex relationship between IPV and substance use behaviors, with primarily actor effects, but no significant partner effects. Understanding these relationships is important for developing integrated interventions that address both IPV and substance use risks among tice-involved populations. Such approaches may help address racial health inequities in drug overdose rates among non-Hispanic Black and Latinx populations, who are disproportionately impacted by the criminal legal system due to racialized drug laws and policing.