Abstract
Women in abusive relationships are five times more likely than other women to become dependent on substances. Despite evidence of the co-occurrence of substance use and domestic violence (DV), shelters have been hesitant to implement policies and practices to support women residents using substances while seeking shelter services. This research aimed to determine the current landscape of practices and policies to manage residents’ substance use within Ontario Violence Against Women (VAW) shelters. An anonymous web-based survey was distributed to Ontario VAW shelters (N = 96) governed by the Ministry of Community and Social Services (MCSS). Results suggest that few shelters operate from an abstinence-based approach, and most have already implemented minimal and moderate-risk practices to manage substance use. Those shelters implementing more moderate and higher-risk substance use management practices tend to have more frontline and relief staff employed than shelters with lower staff levels. However, bed capacity at the shelter did not make a difference. Many shelters operate using lower-risk practices and policies, but self-reported that they operate using a harm reduction model. Nevertheless, it does not seem that all shelters use the same definition of harm reduction. The substance use management approaches and the early stage continuum of practices developed from this survey will provide a foundation for developing a better common understanding of harm reduction practices and a flexible framework to accommodate the unique needs of VAW shelters.
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References
Baker, C., Billhardt, K., Warren, J., Rollins, C., & Glass, N. (2010). Domestic violence, housing instability, and homelessness: A review of housing policies and program practices for meeting the needs of survivors. Aggression and Violent Behaviour, 15, 430–439. https://doi.org/10.1016/j.avb.2010.07.005.
BC Society of Transition Houses (2011). Reducing barriers to support for women fleeing violence: A toolkit for supporting women with varying levels of mental wellness and substance use. Retrieved from http://bcsth.ca/sites/default/files/publications/BCSTH%20Publication/Women's%20Services/ReducingBarrierToolkit.pdf. Accessed 21 July 2015.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. https://doi.org/10.1191/1478088706qp063oa.
Brown, B., Harris, M., & Fallot, R. (2013). Moving toward trauma-informed practice in addiction treatment: A collaborative model of agency assessment. Journal of Psychoactive Drugs, 45(5), 385–393. https://doi.org/10.1080/02791072.2013.844381.
Burke, P., Chapman, C., Hohman, M., Manthey, T., Slack, K., & Stout, D. (2010). Guiding as practice: Motivational interviewing and trauma-informed work with survivors of intimate partner violence. Partner Abuse, 1, 92–104.
Chung, S., Domino, M. E., & Morrissey, J. P. (2009). Changes in treatment content of services during trauma-informed integrated services for women with co-occurring disorders. Community Mental Health Journal, 45(5), 375–384. https://doi.org/10.1007/s10597-009-9192-9.
Cohen, L., Field, C., Campbell, A., & Hien, D. (2013). Intimate partner violence outcomes in women with PTSD and substance use: A secondary analysis of NIDA clinical trials network “women and trauma” multi-site study. Addictive Behaviours, 38, 2325–2332. https://doi.org/10.1016/j.addbeh.2013.03.006.
Covington, S. S. (2008). Women and addiction: A trauma-informed approach. Journal of Psychoactive Drugs, 40(5), 377–385. https://doi.org/10.1080/02791072.2008.10400665.
Fillmore, S., & Hohman, M. (2016). Traditional, alternative, and harm reduction approaches: What do social work students think? Journal of Social Work Practice in Addictions, 15, 252–266. https://doi.org/10.1080/1533256X.2015.1056527.
Fowler, D. (2007). The extent of substance use problems among women partner abuse survivors residing in a domestic violence shelter. Family & Community Health, 30(1), S106–S108.
Glenn, C., & Goodman, L. (2015). Living with and within the rules of domestic violence shelters: A qualitative exploration of residents’ experiences. Violence Against Women, 21(12), 1481–1506. https://doi.org/10.1177/1077801215596242.
Government of Ontario. (1990). French Language Services Act, R. S. O., c. F.32. Retrieved from: https://www.ontario.ca/laws/statute/90f32. Accessed 1 August 2017.
Government of Ontario, Ministry of Community and Social Services. (2015). Violence against women emergency shelter standards. Retrieved from: http://www.mcss.gov.on.ca/mcss/open/vaw/vaw_Manual.aspx. Accessed 3 October 2016.
Greenfield, S., & Grella, C. (2009). What is “women-focused” treatment for substance use disorders? Psychiatric Services, 60(7), 880–882. https://doi.org/10.1176/appi.ps.60.7.880.
Guo, Y., Kopec, J. A., Cibere, J., Li, L. C., & Goldsmith, C. H. (2016). Population survey features and response rates: A randomized experiment. American Journal of Public Health, 106, 1422–1426. https://doi.org/10.2105/AJPH.2016.303198.
Hobden, K., & Cunningham, J. (2006). Barriers to the dissemination of four harm reduction strategies: A survey of addiction treatment providers in Ontario. Harm Reduction Journal, 3, 35–55. https://doi.org/10.1186/1477-7517-3-35.
Kellogg, S. H. (2003). On “gradualism” and the building of the harm reduction abstinence continuum. Journal of Substance Abuse Treatment, 25, 241–247.
Lee, H., & Zerai, A. (2010). “Everyone deserves services no matter what”: Defining success in harm-reduction-based substance user treatment. Substance Use & Misuse, 45, 2411–2417. https://doi.org/10.3109/10826081003712060.
Logan, D., & Marlatt, G. (2010). Harm reduction therapy: A practice-friendly review of research. Journal of Clinical Psychology, 66(2), 201–214. https://doi.org/10.1002/jclp.20669.
Lyon, E., Lane, S., & Menard, A. (2008). Meeting survivors’ needs: A multi-state study of domestic violence shelter experiences. Final report prepared for the U.S. National Institute of Justice. Retrieved from U.S. Department of Justice https://www.ncjrs.gov/pdffiles1/nij/grants/225025.pdf. Accessed 26 August 2015.
Macy, R. J., & Goodbourn, M. (2012). Promoting successful collaborations between domestic violence and substance abuse treatment service sectors: A review of the literature. Trauma, Violence & Abuse, 13(4), 234–251. https://doi.org/10.1177/1524838012455874.
Marlatt, G. (1996). Harm reduction: Come as you are. Addictive Behaviours, 21(6), 779–788.
Marlatt, G., Blume, A., & Parks, G. (2001). Integrating harm reduction therapy and traditional substance abuse treatment. Journal of Psychoactive Drugs, 33(1), 13–21. https://doi.org/10.1080/02791072.2001.10400463.
Marsh, J., D’Aunno, T., & Smith, B. (2000). Increasing access and providing social services to improve drug abuse treatment for women with children. Addiction, 95(8), 1237–1247. https://doi.org/10.1080/09652140050111168.
Martin, F., & Aston, S. (2014). A “special population” with “unique treatment needs”: Dominant representations of “women’s substance abuse” and their effects. Contemporary Drug Problems, 41, 335–360.
Martin, S., Moracco, K., Chang, J., Council, C., & Dulli, L. (2008). Substance abuse issues among women in domestic violence programs: Findings from North Carolina. Violence Against Women, 14(9), 985–997.
McKeganey, N., Morris, Z., Neale, J., & Robertson, M. (2004). What are drug users looking for when they contact drug services: Abstinence or harm reduction? Drugs: Education, Prevention and Policy, 11(5), 423–435. https://doi.org/10.1080/09687630410001723229.
Miller, G., & Gatscher, E. (2001). Shelter staff’s perceived knowledge and skill level regarding the addictive process. Journal of Addictions & Offender Counseling, 22, 21–30.
Morton, S., Hohman, M., & Middleton, A. (2015). Implementing a harm reduction approach to substance use in an intimate partner violence agency: Practice issues in an Irish setting. Partner Abuse, 6, 337–350. https://doi.org/10.1891/1946-6560.6.3.337.
OAITH Training Portal (2015). Harm reduction in VAW. Retrieved from http://training.oaith.ca/course/view.php?id=7
Office of the French Language Services Commissioner of Ontario. (2014). Francophones in Ontario. Retrieved from https://csfontario.ca/wp-content/uploads/2014/10/2014.09.18-Francophones-in-Ontario_infographic_J.pdf. Accessed 17 December 2018.
Ontario Association of Interval & Transition Houses (OAITH, 2013). Harm reduction in VAW shelters: Realities of service. Retrieved from: http://www.oaith.ca/news/training-news/2014/03/29/oaith-harm-reduction-report/.
Pauly, B. (2008). Harm reduction through a social justice lens. International Journal of Drug Policy, 19, 4–10.
Pinkham, S., & Malinowska-Sempruch, K. (2008). Women, harm reduction, and HIV. Reproductive Health Matters, 16(31), 168–181. https://doi.org/10.1016/S0968-8080(08)31345-7.
Podymow, T., Turnbull, J., Coyle, D., Yetisir, E., & Wells, G. (2006). Shelter-based managed alcohol administration to chronically homeless people addicted to alcohol. Canadian Medical Association Journal, 174(1), 45–49.
Poole, N., Greaves, L., Jategaonkar, N., McCullough, L., & Chabot, C. (2008). Substance use by women using domestic violence shelters. Substance Use & Misuse, 43, 1129–1150. https://doi.org/10.1080/10826080801914360.
Ruefli, T., & Rogers, D. (2004). How do drug users define their progress in harm reduction programs? Qualitative research to develop user-generated outcomes. Harm Reduction Journal, 1(8), 1–13. https://doi.org/10.1186/1477-7517-1-8.
Sappletona, N., & Lourençob, F. (2016). Email subject lines and response rates to invitations to participate in a web survey and a face-to-face interview: The sound of silence. International Journal of Social Research Methodology, 19(5), 611–622. https://doi.org/10.1080/13645579.2015.1078596.
Schumacher, J., & Holt, D. (2012). Domestic violence shelter residents’ substance abuse treatment needs and options. Aggression and Violent Behaviour, 17, 188–197. https://doi.org/10.1016/j.avb.2012.01.002.
Skewes, M., & Gonzalez, V. (2013). Attitudes toward harm reduction and abstinence only approaches to alcohol misuse among Alaskan college students. International Journal of Circumpolar Health, 72, 1–5. https://doi.org/10.3402/ijch.v72i0.21143.
Statistics Canada. (2016). Census profile, 2016 census. Retrieved from https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/prof/details/page.cfm?Lang=E&Geo1=PR&Code1=35&Geo2=PR&Code2=01&Data=Count&SearchText=Ontario&SearchType=Begins&SearchPR=01&B1=All&TABID=1. Accessed 9 December 2018.
Szott, K. (2015). Contingencies of the will: Uses of harm reduction and the disease model of addiction among health care practitioners. Health, 19(5), 507–522. https://doi.org/10.1177/1363459314556904.
The Jean Tweed Centre. (2013). Trauma matters: Guidelines for trauma-informed practices in women’s substance use services. Toronto: The Jean Tweed Centre.
Vakharia, S. P., & Little, J. (2017). Starting where the client is: Harm reduction guidelines for clinical social work practice. Clinical Social Work Journal, 45, 65–76. https://doi.org/10.1007/s10615-016-0584-3.
Wathen, C., Harris, R., Ford-Gilboe, M., & Hansen, M. (2015). What counts? A mixed methods study to inform evaluation of shelters for abused women. Violence Against Women, 21(1), 125–146. https://doi.org/10.1177/1077801214564077.
Wiens, T., & Walker, L. (2015). The chronic disease concept of addiction: Helpful or harmful? Addiction Theory & Research, 23(4), 309–321. https://doi.org/10.3109/16066359.2014.987760.
Zubretsky, T. (2002). Promising directions for helping chemically involved battered women get safe and sober. In A. R. Roberts (Ed.), Handbook of domestic violence intervention strategies (pp. 321–340). New York: Oxford University Press.
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Hovey, A., Roberts, C., Scott, S. et al. Understanding the Landscape of Substance Use Management Practices in Domestic Violence Shelters across Ontario. J Fam Viol 35, 191–201 (2020). https://doi.org/10.1007/s10896-019-00056-0
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DOI: https://doi.org/10.1007/s10896-019-00056-0