BackgroundIntimate partner violence (IPV) is a significant global public health issue. The consistent evidence that alcohol use by one or both partners contributes to the risk and severity of IPV suggests that interventions that reduce alcohol consumption may also reduce IPV. This study sought to review the evidence for effects on IPV of alcohol interventions at the population, community, relationship and individual levels using the World Health Organization ecological framework for violence.MethodsEleven databases including Medline, PsycINFO, CINAHL and EMBASE were searched for English-language studies and grey literature published 1 January 1992 – 1 March 2013 investigating whether alcohol interventions/policies were associated with IPV reduction within adult (≥18) intimate relationships. Eleven studies meeting design criteria for attributing effects to the intervention and ten studies showing mediation of alcohol consumption were included in the review. The heterogeneity of study designs precluded quantitative meta analysis; therefore, a critical narrative approach was used.ResultsPopulation-level pricing and taxation studies found weak or no evidence for alcohol price changes influencing IPV. Studies of community-level policies or interventions (e.g., hours of sale, alcohol outlet density) showed weak evidence of an association with IPV. Couples-based and individual alcohol treatment studies found a relationship between reductions in alcohol consumption and reductions in IPV but their designs precluded attributing changes to treatment. Randomized controlled trials of combined alcohol and violence treatment programs found some positive effects of brief alcohol intervention as an adjunct to batterer treatment for hazardous drinking IPV perpetrators, and of brief interventions with non-dependent younger populations, but effects were often not sustained.ConclusionsDespite evidence associating problematic alcohol use with IPV, the potential for alcohol interventions to reduce IPV has not been adequately tested, possibly because studies have not focused on those most at risk of alcohol-related IPV. Research using rigorous designs should target young adult populations among whom IPV and drinking is highly prevalent. Combining alcohol and IPV intervention/policy approaches at the population, community, relationship and individual-level may provide the best opportunity for effective intervention.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-881) contains supplementary material, which is available to authorized users.

Introduction and Aims. Heavy and binge drinking contributes to increased risk and severity of violence in intimate relationships, but its role in the initiation and escalation of intimate partner violence (IPV) is not well-understood. This study explores the dynamics of drinking and IPV from the perspectives of women with lived experience of alcohol-related IPV. Design and Methods. A qualitative constructivist grounded theory study using interviews with 18 women aged 18-50 years who experienced fear or harm from an alcohol-affected male partner. Participants were recruited from the community in Victoria, Australia. Results. Participants experienced alcohol-related IPV as a cycle of escalating violence accompanying the male partner's progression to intoxication as follows: starting to drink (having fun); getting drunk (looking for a fight); intoxicated ('switching' to escalated violence); drunk (becoming incapacitated); hungover/coming down (becoming mean-tempered); sober (returning to 'normal' life); and craving (building up to drinking again -for dependent drinkers). Participants identified safe and unsafe stages in the cycle but feared the unpredictability of drunken violence. Participants actively managed safety through four main strategies: preventing (e.g. limiting his drinking); predicting (e.g. recognising signs); responding (e.g. avoiding arguments); and protecting (e.g. removing self and children). Anticipating abuse when a partner drinks was the central process for participants living this cycle.

The experience of harm attributable to the drinking of others differs by gender. For preventing harm to women, the primary focus should be on heavy or harmful drinkers in close proximity relationships; for preventing harm to men, a broader approach is needed. This and further work investigating the dynamics among gender, victim-perpetrator relationships, alcohol, and harm to others will help to develop interventions to reduce alcohol-related harm to others which are specific to the contexts within which harms occur.

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