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Screening Chemically Dependent Battered Women

Reprinted from The A Files Washington State Coalition Against Domestic Violence Newsletter, Vol. 3., No. 3, Pages 127-138, October 2001
Note: This article is written primarily for Domestic Violence Program Advocates. A companion article written by Patti Bland specifically for Substance Abuse Treatment Providers can be found at the Washington State Coalition on Women’s Substance Abuse Issues web page

About the Issue

This issue of the A-Files makes visible the experience of substance abusing battered women and our challenge as advocates to develop responsive services in our programs. Safety is an essential element frequently lacking in the lives of women and children who have been impacted by domestic violence. While most women who have experienced intimate partner violence do not suffer from chemical dependency, it is important to acknowledge the many women who live, work or receive services at our programs who are dealing with addiction and recovery issues. Although we cannot always ensure safety, we are obliged to provide as safe an environment as possible for all women who use our services or work at our programs. Barriers to women’s safety and sobriety are magnified when routine screening for substance abuse fails to occur.

In her article, “Building A bridge from Substance Abuse to Safety – for Battered Women”, author Patti Bland lays out a strong rationale for including substance abuse screening and making room in our programs for women who misuse substances. When our advocacy is not informed by the experience of substance abusing battered women, we are limiting our ability to respond and learn from women who are living with violence. We must ask ourselves touch questions and reevaluate our work practices. Do our practices increase safety and validate the experiences of chemically dependent battered women? What message do we send to the victim, to the batterer, to our community if we do not serve substance abusing women in our programs? Additionally, this issue of the A-Files includes: support group tools, practical strategies, resources, and information about Patti Bland’s supplemental resource packet in the And Now What section.

At the Coalition, we recognize the work of advocates is both incredibly hard and vitally necessary. Showing up everyday with compassion, an open mind and resilience is the least that is asked of advocates. By stretching our thinking about what it takes and with whom we work to end all forms of violence, we remain rooted in the experience of recovering battered women. We encourage you to read this A-Files. Let the voices of survivors direct us to apply their experience, strength and hope to our daily advocacy work.

Screening Chemically Dependent Battered Women: IN......NOT OUT!

By Patricia J. Bland, M.A. CCDC ©2001

(Includes excerpts from Women Talk about Substance Abuse and Violence, ten women interviewed by Debi Edmund and Patti Bland; edited by © Debi Edmund, 6/2000)

Safety is an essential element frequently lacking in the lives of women and children who have been impacted by domestic violence. While most women who have experienced intimate partner violence do not suffer from chemical dependency, it is important to acknowledge the many women who live, work or receive services at our programs who are dealing with addiction and recovery issues. Although one cannot always ensure safety, we are obliged to provide as safe an environment as possible for all women who must use our services or work at our programs. Barriers to women’s safety and sobriety are magnified when routine screening for substance abuse fails to occur.
Screening for substance misuse is often routinely neglected by advocates for battered women. Failure to ask key questions or to recognize cues indicating the presence of both domestic violence and addiction stems from a variety of causes. These causes include: lack of time, sense of helplessness to assess outside one’s own area of expertise, fear of “opening up a can of worms,” concerns about angering or hurting a woman’s feelings, lack of knowledge of community resources as well as lack of trust in other system providers. These barriers are compounded if they exist within a culture that routinely denies access to services for women with substance abuse or addiction issues.

Why Screen?

Domestic violence and addiction frequently occur in tandem although research indicates neither causes the other. Individually, each can be chronic, progressive and often lethal. Together, severity of injuries and lethality rates climb (Dutton, 1992). Battered women’s advocates have an ethical responsibility to routinely screen for addiction issues as well as offer options and services to women who may be at increased risk for more lethal domestic violence due to their own or a partner’s substance abuse. Advocates for battered women need to ask women about both their own substance use as well as their partners’ use. “Nearly 75% of all wives of alcoholics have been threatened, and 45% have been assaulted by their partners” (AMA, 1994). A recent study in Memphis, TN found in 94% of domestic violence calls, the assailant had used alcohol alone or in combination with cocaine, marijuana, or other drugs within six hours of the assault. Brookoff et al found 92% of assailants and 42% of victims in the Memphis study used alcohol or other drugs on the day of the assault.

“He drank and he used marijuana heavily. He also used other drugs. The abuse kept going. Not even just when he drank. I mean stressful times. He really hurt me, and I remember just lying, pregnant, in a ball, sobbing as he just drank himself into oblivion.”

Research supports universal screening. Actually finding out whether substance abuse or addiction is impacting safety and being able to effectively advocate requires more than checking off boxes or asking questions from a list. The first requirement for respectful screening is an honest evaluation of one’s own attitudes and beliefs about addiction. Before a woman can open up to an advocate she must feel safe. Components of safety include ensuring confidentiality, being culturally competent, and avoiding judgmental or overly directive interactions. Effective screening and intervention requires system-wide respect for women’s choices and autonomy. Screening for safety and sobriety cannot guarantee survival but may increase a woman’s options and improve her odds. Women benefit from non-judgmental advocacy that acknowledges the impact of substance use, abuse and addiction on safety for women and their children. Advocates for battered women must understand getting safe is a process possible for addicted battered women only when tools to support sobriety are provided as part of the process.

“Somebody wanted to show me support, listen to me, not yell at me, not scream at me, just look at some options, instead of that. Through them showing love to me, I began to love myself. I didn’t deserve the punishment, the continuous bad relationships, continuous abusing the drugs, and the shame and the guilt I felt from all that. I deserved better. It was also okay to heal from all of that.”

Screening In...Not Out

Chemically dependent battered women typically experience barriers to services and are often denied shelter, housing, employment, child custody, health insurance and other services. Impacted by both domestic violence and addiction, they are attempting to survive in a world that condemns them for both their substance abuse and their choice of partner. Failure to provide safe services for chemically dependent battered women is a form of able-bodyism. Shelter policies that deny access to services for an entire class of people are both discriminatory and oppressive and cannot be tolerated. The point of screening battered women for substance abuse is not to deny access to victim services but to improve advocacy and safety planning for any women in need of assistance or support. Model programs in Washington state welcome women seeking safety and sobriety and are committed to reducing service barriers and ending isolation for chemically dependent battered women and their children.

“It (using) kept me isolated so I stayed at home in my room with the curtains drawn. On top of him keeping me isolated and not allowing me to go anywhere. I think the biggest thing it did was keep me from getting out and getting the help I needed.”

Think-Rethink

A commitment to serve women dealing with both domestic violence and substance abuse requires critical thinking about policies on the part of battered women’s advocacy programs. Policies supporting a clean and sober environment must be balanced with guidelines making it safe for women who are unable to refrain from use without support to safely tell us they need help. We must keep in mind that in many cases the immediate risk from domestic violence may be more acute than risk from chronic drug or alcohol abuse. We must also be aware risks from overdose or withdrawal can be as lethal as any batterer.
Ideally substance use and abuse should be discouraged as a safety issue for those living and working in our shelters and programs. Guidelines supporting both abstinence and harm reduction are important. This can be challenging for both battered women and advocates who may not be experiencing problems with alcohol or other drugs as well as for those who are. For those whose lives are not threatened by a chronic progressive illness marked by relapse (non-alcoholic/addicts), alcohol or other drug use is merely an option. For women who are not chemically dependent, being unable to have access to substances during a shelter stay or before group may merely be an inconvenience rather than a major barrier to safe services. Chemically dependent battered women have a right to ask us to support their sobriety. To do so is empowering. To do so makes it possible for them to get free from both batterers and substances that put them at risk.

Understanding Domestic Violence and Substance Abuse

“All I know is when I was being abused, all I wanted was more and more. The marijuana wasn’t enough. Then I started getting into the crack. It was easier just to stay stoned and numb and not have to deal with it. The drugs were what made me forget about all the abuse and set aside the fear and terror I had from the abuse and that was my only escape. It was a way to get away from my husband and not feel trapped.”

Understanding the impact of dual problems may very well enhance a woman’s chances for achieving both safety and sobriety. A correlation between substance abuse and domestic violence occurs in 44% to 80% of reported domestic violence incidents depending on what research one chooses to cite (Mackey, 1992). Most women are neither chemically dependent nor battered. However, should women experience domestic violence, develop substance abuse, addiction or both, risks to their health and that of their children increase significantly. Substance abuse may occur as a coping method some battered women use as they attempt to survive the ongoing threat of violence directed at them by intimate partners seeking to gain or maintain power and control (Bland, 1994).

“For me the substance abuse when I first started using was over abuse, was over a rape, and so that’s how I learned to cope with any type of abuse was to get high, and it made everything okay.”

Some battered women may consider using substances less emotionally and physically damaging than facing daily bouts of physical, emotional and sexual abuse with little to blunt the pain.

“The drug didn’t hurt as much as reality hurt.”

The Minnesota Coalition for Battered Women (1992) notes abused women may also use alcohol or drugs for a variety of other reasons including: coercion by an abusive partner, chemical dependency, cultural oppression, over-prescription of psychotropic medication or, for women recently leaving a battering relationship, a new sense of freedom.

“The drugs are an element of control. If they can keep you on the drugs, using or addicted to the drugs, they’re in control. And it’s like strings on a puppet. They just keep you under control because you want that other hit. You want that other drink.”

Defining Substance Abuse and Addiction

It is critical for advocates to learn to recognize the differing safety and advocacy needs of women who are alcoholic/addicts versus those who use or misuse substances.

Alcohol and drugs effect the brain and the body whether addiction is present or not. Substance abuse is a destructive pattern of use of drugs including alcohol, which leads to significant (social, occupational, medical) impairment or distress. Often the substance use continues in spite of significant life problems related to that use.

“We used marijuana every day. I did a lot of cocaine. When I used cocaine all I wanted to do was that next line. I didn’t care about putting the kids on the bus or getting the kids to school. I lost my children.”

Substance use and misuse are behaviors not character defects. According to the American Society for Addiction Medicine, addiction is not a behavior, it is a disease. When a person begins to exhibit symptoms of tolerance (the need for significantly larger amounts of substance to achieve intoxication) and withdrawal (adverse reactions after a reduction of substance) it is likely that the person has progressed from abuse to dependence and addiction.

“One day I didn’t want to drink and I had to. It was the scariest feeling.”

Addiction, according to the medical model, is considered a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. Addiction is characterized by continuous or periodic impaired control over drinking alcohol or using other drugs, preoccupation with drugs or alcohol, use of drugs or alcohol despite adverse consequences, and distortions in thinking, most notably denial.

“I didn’t think marijuana was addictive.”
“How do you get up in the morning and not smoke a joint?

Although a person may choose to use alcohol or drugs a person does not choose how one’s body will respond to that choice.

“When I was a little kid, we all got like, shots of whiskey. And I loved it. You got that warm feeling and everything was going to be okay.”

Alcoholics and addicts do not cause addiction and they do not ‘like’ it. They have a major illness. The number one symptom of this illness is to believe one is well.

“I thought alcoholics were the people in the gutters, the winos pushing their shopping carts with all their belongings in it. And I figured since I had a job, a car, the whole nine yards, that I was doing pretty good.”

This belief plus social acceptance of drinking or taking medication to kill pain makes it hard for alcoholic addicts to seek help they need. Many times they don’t seek help. As advocates we must remember addiction is treatable and long-term recovery is possible.

“I am for the first time in my 41 years dealing with life on life’s terms without somebody telling me how to do it. I can actually talk to people now without being drunk. I can actually laugh without being high. And I can actually walk out a door without being paranoid. That feels good. That feels so good. Because I want to live.”

The Family Disease – Risks when Domestic Violence is Present

While chemical dependency is often considered the ‘family disease,’ looking for a ‘family cure’ when domestic violence is present can be dangerous. Battered chemically dependent women should not be required to participate in family counseling or conjoints that include their abuser. While a chemically dependent battered woman may choose to participate in counseling that includes her abusive partner, advocates should advise her of both the risks and limitations of such a plan. Refer women to chemical dependency treatment programs where family counseling includes safety planning for children and strong linkages exist between the treatment program and its sister domestic violence victims service program.
Women with substance abusing partners may consider participating in 12 step or other support groups such as Al -Anon or Nar-Anon but risks should be explored. Sometimes practicing detachment and avoiding enabling can lead to increased risk for harm if their partner is a batterer. Should a woman be partnered with an abuser who is enrolled in a chemical dependency treatment program, under no circumstances should she be asked to lift a protection, no contact or other type of restraining order in order to support that partner’s recovery from substance abuse.

“I got clean and sober and started working, and putting money away to get out of the relationship. And I think he saw that. He became more demanding. Attempts to be controlling escalated. His abuse of the kids escalated as I was sober. His attempts seemed more desperate.”

Effective Safety Planning for Substance Abusing Battered Women

Chemically dependent battered women may have a hard time recognizing options or gauging their safety. Some women may experience blackouts. Blackouts may mean the absence of memories for some events. Experiencing a blackout does not mean a person has passed out or lost consciousness. Nor does it mean psychological blocking out of events or repression. A blackout is an amnesia-like period often associated with heavy drinking. People in a blackout state may appear to be functioning normally but later have no memory of what occurred (Kinney and Leaton, 1991).

“I was a blackout drinker from the age of 15. My alcoholism was sitting home sipping wine all day. I could sip a whole gallon. I thought I was crazy. Not really thinking, it’s the alcohol.”

Safety planning problems can include being unable to recall a safety strategy, not knowing how an injury was sustained or failing to remember making a police report, let alone remembering a court date.

“Getting off the chemicals has made it much easier for me to deal with the other situations I need to in order to get back on my feet.”

The only memory substance users have of what happens during use is the one that is formed when they are under the influence of alcohol or in a drugged state. Thus if a person under the influence inaccurately perceives herself as safe or “able to handle it,” sobering up the next day may be insufficient to correct the distortion. This toxic thinking or distortion of perception is termed euphoric recall (Johnson, 1980) and theoretically has the potential to increase risk for substance abusing battered women.

“For me once I pick up the alcohol or the other substances, it’s like that safety plan goes out the window.”

While blackouts impact memory, there is no evidence to support the contention that a blackout alters judgement or behavior at the time of its occurrence (Kinney and Leaton, 1991). Thus, batterers cannot be excused for their behavior when they are under the influence merely because they cannot remember it. Euphoric recall, like blackout, may be misused by batterers to minimize, rationalize or deny their abusive behavior:

“He was more abusive when he was drinking and he was abusive when he was not drinking.”
“The abuse escalated, especially when he was coming down from coke, or if he had a hangover from coke.”

Advocates must consistently give the message that using substances as an excuse for violence is not acceptable. Collusion with this erroneous belief helps a batterer avoid accountability for abusive actions and can mistakenly encourage a victim to believe once substance abuse ceases the violence will definitely stop.

“If you sober up a perpetrator and he doesn’t have treatment for his issues, then what do you have? You have a sober perpetrator. And now he’s more aware.”

Domestic Violence as a Barrier to Recovery

Recovery for women, especially battered women, is all about empowerment. Recovery is built on an individual woman’s experience, strength and hope as well as her belief that change can successfully occur for herself and for her children. Women may not be able to choose how their bodies respond to substances but they have power to take action. This power may be reflected in their decision to go to whatever lengths are necessary to survive for themselves and for their children when they are ready and when it is safe to do so. Recovery is hampered when domestic violence is present.

“This man tried to strangle me. After that happened, then I relapsed. And I was in relapse mode off and on for a whole year after that.”

Abusers want to exert power and will go to whatever lengths are necessary to gain and maintain control.

“Going to a meeting wouldn’t be anything he would tolerate because there would be other men there. Something could happen. So his controlling made it real difficult for me to do what I needed to do for myself.”

Both battered women and addicted women may blame themselves if they are unable to stay safe or sober. If the battered woman and addicted woman are one and the same, the level of guilt and shame may be compounded.

“He was always saying the reason he would abuse me was because of my drug use, even though he had his drug use, or he would bring the drugs to me.”

Talking to Women about Substance Abuse Issues

Many women find it easier to discuss their partner’s substance use as opposed to their own. This is particularly true of women in abusive relationships whose abusers drink or use drugs. A conversation about an abusive partner’s substance abuse gives one the opportunity to explore any history of substance use, abuse and possible addiction.

If a woman discloses her partner abuses substances, an advocate might state:

• “Many women tell me their partners don’t want to drink or drug alone. How often have you found yourself stuck using when you didn’t want to?”

This is a non-judgmental way to elicit information and provides an opportunity to explore drug related domestic violence. I/V drug users may be particularly vulnerable when targeted by batterers.

“I made it for 30 days. The minute I got out of safe environment I was right back with the man and by midnight using.”

Women disclose their partners put them on the street to trade sex for drugs against their will. Many women I/V drug users begin their drug use in the context of a relationship. They may never shoot up alone. Their partner shoots-up for them. Introducing a partner to illicit drug use is a form of domestic violence. Another form of abuse occurs when a batterer deliberately uses dirty needles or cottons or misses a vein on purpose. This also poses a risk for transmission of disease including hepatitis and HIV. Maintaining power and control by serving as a connection or determining a partner’s drug supply can also be a form of domestic violence.

“When I talked to him on the phone, he’d always tell me, all you’ve got to do is tell me babe, and I’ll go get you some more. He kept telling me that’s all I needed, a couple of bong hits or a couple of rocks and I’d be just fine.”

“I left the shelter because he bought a bag of cocaine. And so, here I was back in the same abusive relationship all over again. I wanted to be strong and even though I wanted to be out of an abusive relationship, my addictions took me back.”

Chemically dependent battered women may believe their safety will be assured if they just get sober. For a chemically dependent battered woman, getting sober can pose new risk. An abusive partner may increase violence as the recovering battered woman becomes harder to control. Before screening for substance abuse validate a woman’s survival and praise her sincerely for finding her own way to cope. This should lead to a discussion where you can include the following:

• “You deserve credit for finding a way to cope. Tell me what made you able to survive?”
• “Many women I see tell me when they experience pain they find a way to deal with it. Some women tell me they become compulsive cleaners, others get into shopping, eating or not eating, sleeping a lot or working too much. Have you tried any of these ways of coping? A lot of women tell me the best way to cope is to numb out by drinking or drugging. How often has this worked for you? Can you think of any reasons why drinking or drugging could be unsafe for someone with an abusive partner?” What kinds of luck have you had with other coping skills?”

Screening Builds a Bridge to Safety and Sobriety

“And drinking kept me in the relationship longer. When you’re drinking and you’re in that vicious circle, the other vicious circle doesn’t matter. All I cared about was getting another drink.”

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 don’t routinely self-identify as either addicted or battered unless their safety is assured. Safety includes knowing you are not being labeled or judged. Chemically dependent battered women tell us they benefit most from advocates who:

“Try to make you feel like you aren’t the only one. And that somebody else did make it. And someone else has made a life for themselves. They try to make you feel that you’re not worthless or useless.”

Chemically dependent battered women have little reason to trust. Both their bodies and their partners have let them down. Respectful screening involves conveying the message addiction and violence can happen to anyone. Advise women: “Any woman is vulnerable; you are not alone should these problems be facing you.” 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 sobriety as a safety risk is extremely important. A woman’s decision not to stop using immediately 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.

The Intervention is in the Asking

“I could not recover from substance abuse if I was still being physically abused, mentally abused, because I would be right back to using. So they walk hand in hand. I would not recover from one unless I address the other, and vice versa.”

It is not necessary for advocates to become chemical dependency counselors but it is important for them to ask about substance use. Countless intervention opportunities are missed when advocates are afraid to ask lest they offend or view intervention as futile. The intervention is in the asking. When women are respectfully asked about both their use and their safety, they hear, even if they are not yet ready to listen or enact change immediately. Often women will later share comments such as, “You know, when you said...it really made sense to me.” Supporting women through their process of change requires an understanding that motivation comes from within. It also takes knowledge of local resources. Safety and sobriety are indeed possible. Acknowledging the woman before you has managed to survive, sincerely appreciating her individual strengths and recognizing her innate dignity can support her own process and help build a healthy and powerful alliance that benefits both her and her children.

We Share a Similar Story

Safety and sobriety can be addressed respectfully if we acknowledge both substance use (e.g. a glass of wine with dinner), and being in an intimate relationship (e.g. dating or having a partner) is a common experience both for the women we serve and for us. This means misuse of substances or abuse within a romantic relationship could happen to anyone. Any woman may use substances or find herself with a partner. This being the case, any woman could find herself having a problem with either or both through no fault of her own.

Women suffering from addiction don’t know when they have the first drink or take the first drug what the future will hold. They expect to ‘feel better’ or ‘kill pain’ and find themselves believing they can ‘control’ it. Unfortunately, addiction is about loss of control and powerlessness. This loss of control and powerlessness does not mean one is weak or helpless. Instead, those who experience addiction cannot reasonably predict what will happen when they use. One is powerless only in terms of how one’s body, one’s liver, one’s brain responds once alcohol or other drugs are introduced inside it. Many addicted women don’t want to stop using alcohol or drugs. They want the craving, the problems and the pain of withdrawal to stop. They want to be like everybody else who can have a social drink or take medication without serious physical ramifications. Unfortunately, like anyone else discovering an allergy (e.g. an allergy to bee stings), the addict, once “stung,” must forever avoid substances or experience life-threatening consequences. Fortunately we can support women’s empowerment through our knowledge of options and available resources. The Alcohol Drug Help Line Domestic Violence Outreach Project can provide information about Washington State programs addressing both domestic violence and chemical dependency. They can be reached at 206-722-3700 or 1-800-562-1240 (WA State only). Other supportive options include: Support Groups Addressing Safety and Sobriety.

“The more you tell your story, the more you talk about what you did to get clean and sober, the stronger it makes you the more you hear it. And the longer we’re away from the abuser, and the more education we get, and the more we talk to other people about it, the stronger we become, and the more aware.”

When possible, encourage chemically dependent battered women to consider attending a support group addressing issues pertaining to both domestic violence and chemical dependency. Integrated support groups offer women a format to heal utilizing techniques that are applicable for reaching both goals of safety and sobriety. The major goal of successful groups addressing these issues is to be a safe place where women can tell their story, be believed and begin the healing and connection process.

Gender Specific Treatment Recommended

“For domestic violence survivors, women’s meetings are probably safer.”

Chemically dependent battered women should be encouraged to consider
gender specific treatment as an option that may best enhance their chances for both safety and sobriety.

Advocacy Based Counseling

“Once I walked away from that abuse (domestic violence), I knew that the next thing I had to do was something about the substance abuse. And then when I made up my mind that I wanted to quit drugs also, the advocates at the shelter were right there for me, and got me into a treatment program.”

Advocacy based counseling looks different for chemically dependent battered women who may have withdrawal issues, memory distortions and cognitive deficits. Advocacy-based counseling may include: Repeating information, providing structure, simplifying goals, advocating for their inclusion in shelters and other victim service programs and understanding the impact of chemicals on safety planning and role identity.

“And it feels in the beginning that it’s the end of the world, but it’s actually the beginning of a new life.”

Conclusion

Women from all walks of life are at risk for domestic violence and chemical dependency but screening, identification and intervention can provide empowering options. Women from all walks of life get safe and sober and raise safe, healthy children. Be a bridge to safety and sobriety, screen for substance abuse as part of a safety plan.

“I have my youngest daughter back. She lives with me. My oldest daughter is getting married and my middle daughter is a college student.”

“I’ve gained more confidence in myself. I don’t have to run and hide in a closet anymore.”

“Knowledge is power, knowledge is power.

And Now What ?

Developing Strategies for Safety and Sobriety

Women attempting to get sober may develop a plan that may include but is not limited to:

1. Identifying who to call for help (e.g. sponsor, counselor, Alcohol Drug Help Line); forming support systems, knowing about safe meetings
2. Knowing information and education about addiction
3. Removing substances and paraphernalia from the home
4. Recognizing unsafe persons, places, things
5. Understanding how to deal with legal and other problems stemming from addiction (e.g. health, CPS involvement, poor nutrition)
6. Assembling paperwork to determine eligibility for assistance or to begin seeking employment, school, housing or other options
7. Knowing how domestic violence can be a relapse issue
8. Understanding physical, emotional, cognitive, environmental and other cues indicative of risk and having a plan to deal with it; recognizing role of stress and craving, having a plan to deal with it
9. Learning how to parent, engaging in relationships, developing sober friendships
10. Knowing when and where to run in a life-threatening situation that puts your sobriety and your safety, at risk.

Know Your Local Resources

“I needed more than a 12 step program.”

1. The Alcohol Drug Help Line Domestic Violence Outreach Project can be reached at 206-722-3700 or 1-800-562-1240 (WA State only). They can provide information about accessing Detox services and ADATSA as well as Washington State programs such as the Washington State Coalition on Women’s Substance Abuse Issues. They can also provide information about gender specific treatment options in Washington such as Residence XII, Kirkland; Perinatal Treatment Services, Seattle; Mom’s Program, Tacoma; Isabella House, Spokane and Riel House, Yakima as well as other treatment and support group options for those impacted by both substance abuse and domestic violence in Washington state.
2. The Washington State Alcohol Drug Clearinghouse provides literature, videos, and information about substance abuse and addiction, much of it for free. To order call 1-800-662-9111 toll free from Washington State. From Seattle or out of state call 206-725-9696 or FAX 206-722-1032. E-mail: clearinghouse@adhl.org Web site: http://www.adhl.org/clearinghouse
3. New Beginnings for Battered Women and their Children provides a weekly drop-in support group for chemically dependent battered women seeking safety and sobriety in Seattle/King County. Contact 206-783-2848 for information.
4. Eastside Domestic Violence Program provides a transitional housing program for chemically dependent battered women and their children that includes on-site out patient treatment services through Therapeutic Health Services. Call 425-746-1940 for information.
5. The Mom’s and Women’s Recovery Center in Pierce County, Washington provides screening, assessment, intervention, treatment and support for women addressing both substance abuse and domestic violence issues. Call Sue Winskill at 253-798-6655.
6. Recommended reading: Safety and Sobriety: Best Practices in Domestic Violence and Substance Abuse, Domestic Violence/Substance Abuse Task Force of the IL DHS 7/2000. For information about this publication contact: www.state.il.us/agency/dhs ).
7. The Washington State Coalition Against Domestic Violence has the following materials developed or written by Patti Bland, M.A. CCDC available upon request. Please contact Leigh Hofheimer for copies: leigh@wscadv.org

• Support Agreement
• Non-Use Agreement
• Sample Screening Questions for Shelter Intake Form
• Sample Safety Plan
• Manifestations of Violence (group tool)
• Non-shaming meeting documentation form and progress note form
• Article: Chemical Dependency and Domestic Violence: Screening Pregnant and Postpartum Women for Safety and Sobriety, accompanying bibliography and PowerPoint presentation for perinatal health care providers
• Article: Collaborative Strategies for Addressing Women’s Safety and Sobriety
• Sample Guideline for working with chemically dependent women
• Sample Policy for working with chemically dependent battered women
• Women Talk about Substance Abuse and Violence, ten women interviewed by Debi Edmund and Patti Bland; edited by ©Debi Edmund, 6/2000)
• Screening Tools for Substance Abuse

End Notes

1. Addiction definition is adapted from definitions developed by the American Psychiatric Association and the American Society for Addiction Medicine and included in the Domestic Violence/Substance Abuse Task Force of the IL DHS 7/2000, Safety and Sobriety: Best Practices in Domestic Violence and Substance Abuse, p.vi. For information about this publication contact: www.state.il.us/agency/dhs ).
2. Special thanks to the women from New Beginnings Wednesday night support group addressing chemical dependency and domestic violence in Seattle, WA and their sisters in Springfield, IL. Grateful acknowledgements to Debi Edmund of Springfield, IL who served as their editor, Lee Berg, R.N. of St. Joseph’s Hospital, Syracuse, NY who provided technical assistance and, as always, thanks to the Alcohol Drug Help Line Domestic Violence Outreach Project Staff in Seattle, WA for everything they do.

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