Intimate partner violence and prescription of potentially addictive drugs: prospective cohort study of women in the Oslo Health Study

Abstract

Objectives

To investigate the prescription of potentially addictive drugs, including analgesics and central nervous system depressants, to women who had experienced intimate partner violence (IPV).

Design

Prospective population-based cohort study.

Setting

Information about IPV from the Oslo Health Study 2000/2001 was linked with prescription data from the Norwegian Prescription Database from 1 January 2004 through 31 December 2009.

Participants

The study included 6081 women aged 30–60 years.

Main outcome measures

Prescription rate ratios (RRs) for potentially addictive drugs derived from negative binomial models, adjusted for age, education, paid employment, marital status, chronic musculoskeletal pain, mental distress and sleep problems.

Results

Altogether 819 (13.5%) of 6081 women reported ever experiencing IPV: 454 (7.5%) comprised physical and/or sexual IPV and 365 (6.0%) psychological IPV alone. Prescription rates for potentially addictive drugs were clearly higher among women who had experienced IPV: crude RRs were 3.57 (95% CI 2.89 to 4.40) for physical/sexual IPV and 2.13 (95% CI 1.69 to 2.69) for psychological IPV alone. After full adjustment RRs were 1.83 (1.50 to 2.22) for physical/sexual IPV, and 1.97 (1.59 to 2.45) for psychological IPV alone. Prescription rates were increased both for potentially addictive analgesics and central nervous system depressants. Furthermore, women who reported IPV were more likely to receive potentially addictive drugs from multiple physicians.

Conclusions

Women who had experienced IPV, including psychological violence alone, more often received prescriptions for potentially addictive drugs. Researchers and clinicians should address the possible adverse health and psychosocial impact of such prescription and focus on developing evidence-based healthcare for women who have experienced IPV.

Article summary

Article focus

• Cross-sectional studies have suggested that IPV is associated with increased medication use in women.

• Although substance abuse is common among women who have experienced IPV, former studies have not addressed the prescription of drugs with addiction potential.

• We assessed the relationship of IPV to prescription rates for potentially addictive drugs, including analgesics and central nervous system depressants, for women in Oslo, Norway.

Key messages

• This longitudinal study showed that women who had experienced IPV, including psychological violence alone, more often received prescriptions for potentially addictive drugs compared with other women.

• Prescription rates were increased both for potentially addictive analgesics and central nervous system depressants.

Related collections

Jaypee UN SDG 03

Most cited references27

• Record: found
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• Article: not found

Health consequences of intimate partner violence.

Jacquelyn Campbell (2002)

Intimate partner violence, which describes physical or sexual assault, or both, of a spouse or sexual intimate, is a common health-care issue. In this article, I have reviewed research on the mental and physical health sequelae of such violence. Increased health problems such as injury, chronic pain, gastrointestinal, and gynaecological signs including sexually-transmitted diseases, depression, and post-traumatic stress disorder are well documented by controlled research in abused women in various settings. Intimate partner violence has been noted in 3-13% of pregnancies in many studies from around the world, and is associated with detrimental outcomes to mothers and infants. I recommend increased assessment and interventions for intimate partner violence in health-care settings.

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The Oslo Health Study: The impact of self-selection in a large, population-based survey

Anne Johanne Søgaard, Randi Selmer, Espen Bjertness … (2004)

Background Research on health equity which mainly utilises population-based surveys, may be hampered by serious selection bias due to a considerable number of invitees declining to participate. Sufficient information from all the non-responders is rarely available to quantify this bias. Predictors of attendance, magnitude and direction of non-response bias in prevalence estimates and association measures, are investigated based on information from all 40 888 invitees to the Oslo Health Study. Methods The analyses were based on linkage between public registers in Statistics Norway and the Oslo Health Study, a population-based survey conducted in 2000/2001 inviting all citizens aged 30, 40, 45, 59–60 and 75–76 years. Attendance was 46%. Weighted analyses, logistic regression and sensitivity analyses are performed to evaluate possible selection bias. Results The response rate was positively associated with age, educational attendance, total income, female gender, married, born in a Western county, living in the outer city residential regions and not receiving disability benefit. However, self-rated health, smoking, BMI and mental health (HCSL) in the attendees differed only slightly from estimated prevalence values in the target population when weighted by the inverse of the probability of attendance. Observed values differed only moderately provided that the non-attending individuals differed from those attending by no more than 50%. Even though persons receiving disability benefit had lower attendance, the associations between disability and education, residential region and marital status were found to be unbiased. The association between country of birth and disability benefit was somewhat more evident among attendees. Conclusions Self-selection according to sociodemographic variables had little impact on prevalence estimates. As indicated by disability benefit, unhealthy persons attended to a lesser degree than healthy individuals, but social inequality in health by different sociodemographic variables seemed unbiased. If anything we would expect an overestimation of the odds ratio of chronic disease among persons born in non-western countries.

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Physical and mental health effects of intimate partner violence for men and women.

Sharon K. Davis, James Coker, Sima Desai … (2002)

Few population-based studies have assessed the physical and mental health consequences of both psychological and physical intimate partner violence (IPV) among women or men victims. This study estimated IPV prevalence by type (physical, sexual, and psychological) and associated physical and mental health consequences among women and men. The study analyzed data from the National Violence Against Women Survey (NVAWS) of women and men aged 18 to 65. This random-digit-dial telephone survey included questions about violent victimization and health status indicators. A total of 28.9% of 6790 women and 22.9% of 7122 men had experienced physical, sexual, or psychological IPV during their lifetime. Women were significantly more likely than men to experience physical or sexual IPV (relative risk [RR]=2.2, 95% confidence interval [CI]=2.1, 2.4) and abuse of power and control (RR=1.1, 95% CI=1.0, 1.2), but less likely than men to report verbal abuse alone (RR=0.8, 95% CI=0.7, 0.9). For both men and women, physical IPV victimization was associated with increased risk of current poor health; depressive symptoms; substance use; and developing a chronic disease, chronic mental illness, and injury. In general, abuse of power and control was more strongly associated with these health outcomes than was verbal abuse. When physical and psychological IPV scores were both included in logistic regression models, higher psychological IPV scores were more strongly associated with these health outcomes than were physical IPV scores. Both physical and psychological IPV are associated with significant physical and mental health consequences for both male and female victims.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (publisher-id): bmjopen

Journal ID (hwp): bmjopen

Title: BMJ Open

Publisher: BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2012

Publication date (Electronic): 5 April 2012

Publication date PMC-release: 5 April 2012

Volume: 2

Issue: 2

Electronic Location Identifier: e000614

Affiliations

[1 ]Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway

[2 ]Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway

[3 ]Institute of Clinical Medicine, University of Oslo, Oslo, Norway

[4 ]Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway

[5 ]Department of Obstetrics and Gynaecology, St Olavs University Hospital, Trondheim, Norway

Author notes

Correspondence to Dr Lise Eilin Stene; lise.e.stene@ 123456ntnu.no

Article

Publisher ID: bmjopen-2011-000614

DOI: 10.1136/bmjopen-2011-000614

PMC ID: 3323816

PubMed ID: 22492384

SO-VID: 223c158b-d1df-4ee8-80ca-f70224e06d8f

Copyright © © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

History

Date received : 15 November 2011

Date accepted : 9 February 2012

Categories

Subject: Epidemiology

Subject: Research

Subject: 1506

Subject: 1681

Subject: 1692

Subject: 1704

Subject: 1723

Subject: 1724

ScienceOpen disciplines: Medicine

Data availability:

ScienceOpen disciplines: Medicine

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