Violence among individuals in substance abuse treatment: the role of alcohol and cocaine consumption

This study examined factors associated with expressed violence in the 90 days prior to substance abuse (SA) treatment among 125 men and 125 women recently enrolled in treatment. Approximately 85%, of the sample reported a significant conflict situation. and over 32%, reported an incident of physical violence. Both general alcohol and cocaine use patterns (on days not involving significant interpersonal conflict). as well as alcohol and cocaine use on the day of the violent incident, were associated with violence severity. Regression analyses revealed that race, education, age, and both general drinking and cocaine use patterns were associated with violence severity for the most severe violent incident reported. Similarly regression analyses focusing on alcohol and cocaine use on the day of the most severe incident revealed that higher drinking levels, younger age, minority status. and the interaction of alcohol and cocaine use were associated with violence severity. The results provide important information regarding factors associated with expression of violence among men and women in SA treatment. and have implications regarding the assessment of violence risk factors. Further. the findings suggest that screening and intervention approaches for violence-related problems should be routine in SA treatment. and appear to be especially indicated for patients reporting alcohol consumption. and co-occurring alcohol and cocaine consumption. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.