safety alert

If you are in danger, please use a safer computer, call 911 or your local hotline or call the National Domestic Violence Hotline: 1-800-799-SAFE (7233 voice), 1-800-787-3224 (tty). There is always a computer trail, but you can click ESCAPE to leave the site quickly.

Screening and Identification

We recommend that programs examine their criteria for services and avoid blanket service restrictions for women seeking shelter or other services based solely on their alcohol or drug use history. In many cases, the batterer is more of an immediate threat than the risks associated with substance use. It is important to stress that overdose and withdrawal can pose serious health risks that can become life threatening. These problems can occur even when routine screening reveals no obviously existing substance abuse issues. For this reason, it is important for programs to develop linkages with emergency department personnel, detoxification center staff and other chemical dependency professionals.

A substance screen is an opportunity to help a victim of domestic violence identify whether or not her safety is impacted by her own or another person’s use, misuse or addiction to a substance. This discussion is a preliminary step to determine the likelihood that an alcohol or other drug problem exists that could impact her safety. Screening for substance use involves honest talk with individuals about their partner’s alcohol and drug use as well as their own, observing their behavior and recognizing signs of use.

Advocates are asked to routinely screen for substance use because some of our intervention and follow-up, including information and referrals we provide, will be based on whether or not substances pose a safety risk for the domestic violence victim and/or others. Routine screening is simple and does not require advocates to provide a full assessment.

Screening differs considerably from an assessment. An assessment uses diagnostic instruments and processes to determine if the person is abusing, or is dependent on alcohol or other drugs. We may describe assessment as an option for women who are concerned about their use and provide information and referral should any woman we are screening express interest in an assessment for themselves or others.

Respectful screening involves conveying the message that addiction and violence can happen to anyone. Advise women “Any woman is vulnerable; you are not alone.” A successful intervention requires internally moving beyond the notion, “Why doesn’t she just quit?” or “Why doesn’t she just leave?” Questions such as these convey lack of knowledge and failure to understand the complexity of safely ending a relationship with either a substance or an abusive partner.

Honestly discussing substance abuse as a safety risk is extremely important. A woman’s decision to keep using or to decline treatment, advocacy or shelter should not be viewed as failure. Recovery is both an option and a process that can take time. Screening and referral can help build a bridge from substance abuse or addiction to health and safety for chemically dependent battered women and their children.

Women facing the dual stigma of both addiction and domestic violence may be reluctant to openly seek help. Generally speaking, women do not self-identify as either addicted or battered unless their safety is assured. Safety includes knowing you are not being labeled or judged.

When screening for substance use be sure to:

Ensure privacy. Children should not be present.
Communicate respect and trust. When screening over the phone, let callers know you are asking these questions to better determine their safety needs rather than weed them out. Assure those you screen, both on the phone and in person, except for safety concerns (e.g., CPS or APS-mandated requirements), anything discussed will be held in strictest confidence and will not jeopardize their ability to receive appropriate services.
Listen carefully and observe behavior. Notice signs of possible alcohol and other drug use. Signs of use include slurred or rapid speech, smell of alcohol, track marks, scabbing, unusual or extreme behavior such as nodding off or being overly alert, staggering, tremors, glassy eyes, dilated or constricted pupils, difficulty sitting still, and tactile hallucinations that lead to scratching or skin picking. Notice if the person you are talking to is disoriented or confused for no apparent reason, argumentative, defensive or angry about questions relating to substance use. Please note that any one thing here does not mean a person is to be automatically labeled as an addict. For example, slurred speech could mean a hearing deficit. Scratching could mean scabies. Confusion could be stemming from a head injury. The purpose of screening is to notice areas of possible concern, to recognize patterns and to help women determine what might be their best options.

Keep in mind that chemically dependent battered women have little reason to trust. Both their bodies and their partners have let them down. Consequently, substance-abusing battered women are often reluctant to disclose use. Disclosure may not be perceived as a viable option. Understand denial. Denial is the most frequent response to questions about substance use whether alcohol or other drug use is an issue or not. For this reason, it is important to provide every woman with brief information about safety and sobriety regardless of the outcome of a screen.

Respectful screening creates an environment where it may seem safer for a woman to dislose use. Ask questions in a non-judgmental manner.

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