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LETTER |
The authors are with the Social Intervention Group, Columbia University School of Social Work, New York, NY.
Correspondence: Requests for reprints should be sent to Nabila El-Bassel, DSW, Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Ave, New York, NY 10027 (e-mail: ne5{at}columbia.edu).
We thank Brewer et al. for acknowledging our study’s contribution to the literature on intimate partner violence (IPV) and drug abuse among women on methadone. We did not intend to give the impression that this relationship had not been studied longitudinally in the past; our message was meant to underscore that ours was the first such study to use a random sample.
While Brewer et al.1 examined the use of specific drugs as longitudinal predictors of violence, their study included a nonrandom subsample of 82 women who were selected from an intervention study of 150 families headed by one or more parents in methadone treatment. Our use of a random sample of 416 women extends the generalizability of our study findings to a broader population of women receiving methadone. Another contribution of our study is the examination of the longitudinal associations between IPV and frequent drug use in both directions (i.e., experience of frequent drug use at time 1 increases risk of IPV at time 2, and IPV at time 1 increases risk of drug use at time 2), whereas Brewer et al. examined only one direction (drug-use factors leading to IPV).
We also used propensity score matching, which enables stronger causal inferences when the data used are from an observational study (i.e., a study without random assignment). We agree that we did not control for IPV in the analysis at baseline; it would be important to do so in future longitudinal analyses.
Brewer et al. offer excellent suggestions regarding future steps for investigating the mechanisms underlying the relationship between drug abuse and IPV and the need to gather data on perpetrators’ perceptions of factors precipitating IPV. Our qualitative findings suggest that the contextual mechanisms that link IPV and frequent drug use may stem from gender-based conflicts around procuring and splitting drugs2; from power imbalances in gender role expectations, where women are expected to provide drugs for their partners; and from the low social status of drug-using women.2–4 More research is needed to understand the nuances of these mechanisms and the temporal relationships between specific incidents of drug use and IPV.
References
1. BrewerDD, Fleming CB, Haggerty KP, Catalano RF. Drug use predictors of partner violence in opiate-dependent women. Violence Vict. 1998;13(2):107–115.[Medline]
2. GilbertL, El-Bassel N, Rajah V, Foleno A, Frye V. Linking drug-related activities with experiences of partner violence: a focus group study of women in methadone treatment. Violence Vict. 2001;16(5):517–536.[Medline]
3. El-BasselN, Gilbert L, Rajah V, Foleno A, Frye V. Fear and violence: raising the HIV stakes. AIDS Educ Prev. 2000;12(2):154–170.[ISI][Medline]
4. El-BasselN, Gilbert L, Rajah V. The relationship between drug abuse and sexual performance among women on methadone: heightening the risk of sexual intimate violence and HIV. Addict Behav. 2003;28(8): 1385–1403.[CrossRef][ISI][Medline]
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