Alcohol abuse and the risks of violence

The WHO’s World Report on Violence and Health is an important and timely document. The global epidemic of violence of the past century, much of it invisible and undocumented, continues unabated in the 21st century. Aimed mainly at researchers and practitioners, the repor t summarises the research evidence in seven separate but related areas of violence: youth violence, child abuse, violence by intimate partners, abuse of the elderly, sexual violence, self-directed violence and collective violence. As the report notes, it is unfortunately the case that research and prevention efforts for the various types of violence have often been developed in isolation from one another. Researchers tend to work in a particular area of violence, with little interaction between researchers working in different areas. Thus, while many researchers may be familiar with the material in one or two chapters, I imagine most readers would f ind much that is new to them. One of the strengths of the report is the way in which it makes links between the different types of violence, pointing out that there are common features and that “different types of violence are linked to each other in important ways, often sharing similar risk factors” (p. 244). These common risk factors include poverty, which is linked with all forms of violence, family or personal histories marked by divorce or separation (associated with youth violence, intimate partner violence, sexual violence and suicide), alcohol and substance use and abuse (all interpersonal forms of violence, as well as suicide), and a history of family violence (youth violence, intimate partner violence, sexual violence and suicide). In addition, the cultural context, particularly in relation to attitudes to women and children, is strongly linked to each of the different types of violence. Both from this report and other research, there is overwhelming evidence that alcohol consumption is a major risk factor for violence. Long-term alcohol abuse and dependence greatly increases the risk of suicide. In relation to youth violence, drunkenness is an impor tant situational factor that can precipitate violence. Although alcohol is not necessarily the direct cause of intimate partner violence, women who live with heavy drinkers run a far greater risk of physical partner violence. These women are also at risk of suffering more severe injuries, as men who have been drinking inflict more serious violence at the time of an assault. While consumption of alcohol does have the psychopharmacological effect of reducing inhibitions, the connections between violence, drinking and drunkenness appear to be socially learnt rather than universal. The evidence quoted by the report suggests that alcohol may act as a cultural ‘break time’, providing the opportunity for anti-social behaviour and that men are Violence and Health