Alcohol, drugs and family violence: A question of framing and boundary markers

Can alcohol and drugs be called a ‘cause’ of family violence? What do we even mean when we talk about ‘causes’ of social problems? In this post, ANZSOG Research Fellow Sophie Yates (@MsSophieRae) outlines research she presented last month at the 5th European Conference on Politics and Gender. She explains why problem framing is so important in public policy, and explores the framing of policy actors talking about alcohol and drugs in Victoria’s Royal Commission into Family Violence.

My PhD is about the treatment of gender in Victoria’s 2015-16 Royal Commission into Family Violence (RCFV). I attended the Commission’s public hearings in mid 2015 looking for how people talked about gender, but not really sure what my focus would be. Then what I started to notice (sitting day after day on those uncomfortable chairs) was expert witnesses’ contesting framings of what was supposed to be the same problem. Problem framing matters because the way a problem is framed links directly to the actions that are taken to address it. I decided to take a frame analysis approach, with the basic questions of “where does gender fit in key policy actors’ framing of family violence in the RCFV?” and “where does gender fit in the RCFV’s report and recommendations?” Today’s post looks at just one of the topics I’m analysing – the relationship between alcohol and other drugs (AOD) and family violence.

Here's my main argument (for those with more time, lots more detail below): Overall, while putting AOD on its agenda at all was a strong statement in the context of pressure from family violence advocates to downplay the issue, the RCFV’s report and recommendations reflect a fairly gendered approach to AOD and family violence. The Commission's framing was similar to that of feminist advocates working on drug and alcohol issues, who want more attention paid to alcohol-related family violence but seek to place AOD misuse in the context of unequal power relations between men and women. While gender equality framing was common, the individualised or degendered public health framing of other experts consulted was not apparent in the Commission’s discussion of AOD and family violence. Thus, gender equality advocates appear to have most strongly influenced the framing of this important Royal Commission, and through the Commission influenced the policy landscape in Victoria for some time to come.

Controversy: Alcohol, drugs and family violence

Alcohol and other drugs (AOD) is an interesting topic to analyse, because the relationship between AOD and family violence is extremely controversial. I argued in my paper that much of the controversy boils down to whether it’s acceptable to say that AOD causes violence. I interviewed several of the nine expert witnesses from the Commission’s AOD topic, and one of them explained to me that the way people treat AOD and causation is a ‘boundary marker’. This meant that if you’re not really careful to say that alcohol doesn’t cause violence, you lose your credibility with certain types of audiences, such as the family violence service sector and others who specialise in gender-based violence. Why is that, I wondered?

Growing up on opposite sides of the fence

Firstly, my participants said that the AOD sector and the family violence sector have grown up on “opposite sides of the fence”. One (an AOD practitioner) reflected that “we’re all carrying baggage from our history”:

So the drug and alcohol sector’s baggage is that we sprung up out of a group of disenfranchised people who’d had histories of their own addiction, who’d come through the other end, who had picked people up off the streets who were like them, and it was advocating for them and fighting with them against the world.

The ‘medical’ model of addiction as disease or disorder favoured by the AOD sector can also be seen as allowing men to shift responsibility for violence. To complicate things, AOD workers see more families where violence of varying degrees occurs between all family members, and in particular, said one of my participants, “they see more violence and abuse from women than you would within the [family violence] sector”.

On the other hand, the family violence sector works with women and children experiencing relatively uni-directional violence, often from the same men that the AOD sector is supporting. Their history is trying to get the public and the government to realise that family violence is a serious problem, and getting men to take accountability for their violence. These different histories present problems of both language and understanding.

Community attitudes to intoxication and responsibility

Then there’s the problem of community attitudes to alcohol and violence. None of the experts at the Commission said that intoxication could excuse violence, but community surveys show that a significant minority of people in Australia do believe that if you’re drunk, you’re not as responsible for your actions as when you’re sober. There’s this idea that people get drunk, lose control, and then ‘snap’ and become violent.

This is the exact opposite of the women’s movement’s power and control analysis of violence, where men are seen to use violence instrumentally and deliberately, in a way that is connected to the unequal distribution of power between men and women on a societal level. Researchers from this tradition argue that the problem is not due to reactive anger. Thus, attributing causality to drug and alcohol addiction can imply a lack of control on the part of abusers. It also moves the analysis from structural factors that we are all responsible for, to individual factors that are under the domain of personal responsibility.

What does it mean to say that something ‘causes’ something else?

Finally, different research traditions use the word ‘cause’ in different ways, leading to clashes and misunderstanding between public health/epidemiology researchers and domestic/family violence researchers. In his witness statement to the Commission, addiction researcher A/Prof Peter Miller argued that it is logical to refer to alcohol as a cause, based on epidemiological and public health arguments that if you take something away (i.e. alcohol) and the problem (i.e. violence) is diminished or disappears, that thing can be termed a cause of the problem (p.5). One of my interview participants made a similar argument:

Well I think that you can be very definitive [with causes] in public health. With statistical analysis you can show what the variables have been and what the result is if you change those variables.

In the domestic/family violence research tradition, people say that because not all men who use alcohol are violent and not all violence is associated with alcohol use, these substances can’t be seen as causal factors. Gender inequality and violence-supportive attitudes are seen as more ubiquitous factors than alcohol use, so alcohol is framed as ‘contributing’ to or ‘reinforcing’ the violence, or ‘co-occurring’ with the violence that is already there.

AOD and family violence in the Royal Commission

With all that in mind, it was interesting to examine the submissions, testimony and witness statements of the contributors to the Commission’s AOD module. What I observed was a difference in framing between those who seemed to take a public health or epidemiological approach to the problem on the one hand, and feminist researchers and advocates on the other.

Public health vs feminist framing in RCFV expert witnesses

Australia has several formal and well-run policy advocacy coalitions that work to address the harms of alcohol abuse (“it’s public health”, remarked one of my participants, “they’re great organisers”). A strong anti-alcohol lobby saw the RCFV as a potential vehicle for the enactment of a broader policy aim to restrict the supply of alcohol in Australia. They were quite successful in getting their issue on the Commission’s agenda. This was aided, according to one of my participants, by the voices of female victim/survivors from the Commission’s consultation stage combined with a perceived reluctance from the family violence sector to address alcohol issues:

...they said to me “we’ve just spoken to hundreds of women, and so many of them talked about the role of alcohol. And yet we talk to the violence against women sector, and they say it’s got nothing to do with alcohol.”

Five alcohol policy coalitions or research centres made submissions to the Commission. Most of these emphasised as a top priority the prescription of (degendered) population-level interventions to reduce the physical and economic availability of alcohol. They made these recommendations on the basis that problematic alcohol use is “one policy factor amenable to change, with a robust body of evidence supporting interventions that can make a decisive impact on reducing alcohol-related harms” (p. 16). While gender is often mentioned as a factor by these groups, it tends to be seen as one category variable among many, rather than an organising principle that structures society and affects the experiences and opportunities of different groups of people. It’s not a focus of their analysis.

The public health framing of these anti-alcohol groups – exemplified by Foundation for Alcohol Research and Education CEO Michael Thorn in his witness statement and evidence – has been demonstrated in other contexts to be a move away from structural gendered explanations towards framing domestic/family violence as primarily a health problem (Agustín 2013; Kantola 2010). According to Kantola (2010, ch 7), domestic/family violence then becomes a smaller part of a bigger public health problem (rather than a smaller part of a bigger gender equality problem). There is then a corresponding focus on eradicating health problems such as AOD abuse rather than addressing gender inequality or gendered intersections between problematic substance use and family violence.

While feminist researchers such as expert witnesses Prof Cathy Humphreys and Ingrid Wilson agreed with the public health-type advocates on many points, there were some clear differences of emphasis in their framing. These actors don’t shy away from discussion of the relationship between AOD and family violence, but they are clear that gender is an important part of the equation. Thus, while they advocate for the role of AOD to be recognised and responded to in this policy area, they do so in a way that demands a continuing focus on gender and men’s violence against women. In other words, they try to address the problem while staying on the right side of the ‘boundary marker’. Their recommendations for addressing the problem are also rooted in gender awareness. For example, they aim to increase the AOD sector’s understanding of the gendered dynamics of family violence, and they want service providers in both sectors to recognise that many women who are abused turn to AOD as a coping mechanism.

When giving evidence to the Commission, Humphreys was very keen for gender to be seen as a key causal factor, with AOD as a contributor:

the Our Watch analysis ...does look at two causal factors being gender inequity and violence supportive attitudes. So they have got that very clearly, and then they have a range of contributing factors as well, and alcohol and drugs being one of the contributing factors. So I think that there's potential ...that we can be on the same page and that there is a common language and some common understandings there that we can sign up to or that we could champion (RCFV transcript, p. 611).

Fellow panellist A/Prof Peter Miller (an addiction researcher) disagreed, responding that “it is more than just attitudes and gender inequity”:

I think we have really strong evidence from a big body of longitudinal evidence to show that child abuse, experience of child abuse, growing up in adverse surroundings, in bad family settings, having peers - these are major predictors that go beyond just attitudes. We also have to talk about genetics (RCFV transcript, p. 611-12).

This exchange is a good example of the tension between framing family violence as having primarily societal causes (such as gender inequality), or having primarily individual causes (such as AOD or family of origin factors).

The Royal Commission’s treatment of AOD and family violence

The Commissioners were determined to incorporate factors other than gender into their investigation of the Victorian family violence service system. According to Commissioner Neave (interviewed and identified with permission), their terms of reference required them to look beyond men’s violence towards women, and they very much treated those ToR as ‘ground rules’. They wanted to operate innovatively and “explore things that added to our knowledge, rather than repeating what had been said in so many other reports”.

For these reasons, coupled with submissions and community consultations that repeatedly referenced the role of AOD, the Commission decided to focus some of its attention on this issue – despite push-back from the family violence sector, who were concerned that this would dilute the message about gender. The Commission argued that a focus on alcohol consumption did not excuse violent behaviour: rather, “more extensive engagement with all of the risk factors that contribute to family violence is required to appropriately respond to violence, to support victims, and to hold perpetrators to account” (RCFV Report, vol. III, p. 300).

This led anti-alcohol advocates to hope that the Commission would make ‘courageous recommendations’ (as one participant put it) such as reducing the density of liquor licenses, reducing trading hours, or regulating alcohol advertising. However - possibly due to the tight 14-month timeframe - the RCFV decided to leave the technical and politically controversial aspects of alcohol supply and regulation to the Government’s intended (now underway) review of the Liquor Control Reform Act 1998. This recommendation caused consternation among some of my interview participants, as the Government is seen as being “in bed with the alcohol industry” or “in the pocket of the liquor industry”, and thus isn’t trusted to independently review the evidence on alcohol’s harms.

Rather than recommend some of the ‘harder’ policy options such as alcohol regulation, the Commission decided on ‘softer’ options around workforce training and service availability and integration. While these measures were certainly called for by researchers and advocates, they were not the top priority of the loudest public health/epidemiology voices. On the other hand, the Commission does appear to have attended to the concerns of feminist actors who wanted to make sure that increasing attention to drugs and alcohol did not diminish perpetrator accountability or water down the focus on gender as a key driver of family violence. Many of the recommendations relating to alcohol and drugs, when inspected closely, contain hints or safeguard relating to gender and accountability (for example recommending input from ANROWS research on new AOD/family violence sector coordinated perpetrator interventions, or recommending that family violence advisors be located in AOD services – thus bringing family violence expertise into the AOD sector – but not the reverse).

The Commission’s discussion of causal factors positions AOD as an individual risk factor that “reinforce[s] the gendered drivers of family violence” (RCFV report, vol. III, p. 248) - along with other factors like mental health, exposure to violence, and socioeconomic inequality. It emphasises that much family violence is not linked to AOD misuse. This framing mirrors very closely the input of feminist actors. It positions intoxicated perpetrators, particularly men, as responsible for their own actions, and suggests that cultural norms rather than any effect of the alcohol itself are to blame for any disinhibition and subsequent violence.

Finally, contrary to the public health usage of the word ‘cause’ as described above, Commissioner Neave outlined (in interview) an approach to causality that was much less definitive. She argued that “it’s not possible with complex social phenomena to give a scientific answer” about which factors cause what percentage of the problem.