Interventions to reduce intimate partner violence perpetration by men who use substances: A systematic review and meta-analysis of efficacy

Introduction: While the prevalence of intimate partner violence (IPV) perpetration by men who use substances is high, limited evidence exists about how best to reduce IPV among this group.

Method: A systematic narrative review with meta-analysis was conducted to determine the effectiveness of interventions to reduce IPV by men who use substances. Inclusion criteria were: randomised and non-randomised controlled trials; adult heterosexual male IPV perpetrators where at least 60% of participants were alcohol and/or drug users; the intervention targeted IPV with or without targeting substance use (SU); outcomes included perpetrator and/or victim reports of IPV, SU or both. The Cochrane Effective Practice of Organisation of Care Tool was used to assess methodological quality.

Results: Nine trials (n= 1014 men) were identified. Interventions were grouped into: 1) integrated IPV and SU interventions (n=5); 2) IPV interventions with adjunct SU interventions (n=2) and 3) standalone IPV interventions (n=2). Cognitive behavioural and motivational interviewing therapies were the most common approaches. Data from individual trials showed a reduction in SU outcomes in the short-term (≤3mths) (n=2 trials) and IPV perpetration at different time points (n=3 trials) for interventions compared with treatment as usual (TAU). Meta-analysis with integrated IPV and SU interventions showed no difference in SU (n=3 trials) or IPV outcomes (n=4 trials) versus SU TAU.

Conclusions: Little evidence exists for effective interventions for male IPV perpetrators who use substances. Meta-analysis shows that outcomes in integrated intervention groups are not superior to TAU. Greater attention needs to be paid to the nature of the relationship between IPV and SU in intervention design, the optimum approach to and duration of intervention, and type and timing of outcome measures.