Genesis The Podcast

At the Intersection of Addiction and Violence: The complex connection between substance use and abuse

• Genesis Women's Shelter

Share episode

Courtney Messina, Director of Clinical Services for Greenhouse Inpatient & Outpatient Treatment Centers in Grand Prairie and Arlington, Texas, and a Licensed Professional Counselor Supervisor and Licensed Chemical Dependency Counselor, joins us to explore the invisible threads that bind the scourge of addiction to the turmoil of domestic violence. In this episode, we peel back the layers of these intertwined crises through the powerful narrative of "Amy," whose experience with substance dependency and an abusive relationship illuminates the harsh realities faced by victims of domestic violence. We navigate the often misunderstood concept of addiction as a complex brain disorder, dismantling the myth that it is a choice, and delve into how this malady exacerbates the already volatile nature of abusive relationships.

Ms. Messina, who has worked in the field of behavioral health since 2014, articulates the nuanced approach required to address the consequences of these co-occurring disorders. Our dialogue traverses from the statistical to the personal, examining the multifaceted forms of abuse and the vicious cycle it creates, often leading victims to seek solace in substances. This episode offers an insightful journey into the heart of these social issues and the transformative power of empathy and targeted support.

Speaker 1:

Today we explore the intersection of addiction and domestic violence with licensed professional counselor Courtney Messina. I'm Maria McMullen and this is Genesis, the podcast. Courtney Messina is the Director of Clinical Services for Greenhouse Inpatient and Outpatient Treatment Centers in Grand Prairie in Arlington, Texas, and a licensed professional counselor supervisor and licensed chemical dependency counselor, working in the behavioral health field since 2014. Ms Messina also works part-time for Texas Christian University in Fort Worth, providing counseling services to student athletes. Her passion for working with individuals who have co-occurring disorders fuels her sense of purpose to serve those who are fighting the battle against the disease of addiction and likewise challenged with managing their mental health. Her recent opinion piece in the Dallas Morning News urged readers to remember that addiction is a disease and domestic violence can be an unfortunate side effect. Courtney, welcome to the show.

Speaker 2:

Hi, good morning.

Speaker 1:

Well, good afternoon. So I first became acquainted with your work through an opinion piece that you authored for the Dallas Morning News in December 2023, discussing the intersection of addiction and domestic violence. Listeners can find this article on the Dallas Morning News website, dallasnewscom. The article included a personal story about a client you call Amy. What happened to Amy?

Speaker 2:

So Amy had actually been to treatment here with us a handful of times and I had actually gotten the chance to work with her myself for a short stint since one of her therapists was out sick. So I got to know her story fairly well and Amy was a client that definitely had some extensive trauma and the trauma had started all the way back into her childhood and then continued on, unfortunately, into her marriage which did involve domestic violence.

Speaker 2:

She was here for treatment a handful of times and this most recent time when she'd made it back. As I mentioned in my article, we did encounter one another in the elevator one day and it's very sad to say, but at that time I did not even recognize her. Amy is a gorgeous woman and I remember at the time thinking oh my goodness, you know she looks. She looks so thin, she looks so frail. She was utilizing a walker. At that time she had a very large bruise on her face when her husband had hit her. Now, on the brighter side of things, when she was here for treatment the recent time, she did complete the program and she finally was able to begin to work through some of her past trauma which unfortunately had led to her history of drug and alcohol use. And in addition to her completing the program, we were very proud of her. She finally made that brave choice to ultimately remove herself from the unhealthy marriage and start her, or begin to start her life all over on her own.

Speaker 1:

So just to clarify for listeners when you say treatment, you're talking about treatment for chemical dependency.

Speaker 2:

Yes, Treatment for chemical dependency and severe mental illness correct.

Speaker 1:

And all of this happened for Amy and for others at Greenhouse Inpatient and Outpatient Treatment Centers right.

Speaker 2:

Yes, ma'am that is correct.

Speaker 1:

So addiction is a disease and according to the NIH, the National Institute on Drug Abuse, and this is a quote it is considered a brain disorder because it involves functional changes to brain circuits involved in reward, stress and self-control. Those changes may last a long time after a person has stopped taking drugs, and they go on to say it is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects and both are in many cases preventable and treatable. But if left untreated they can last a lifetime and may lead to death. So the NIH also identifies another critical factor the initial decision to take drugs is typically voluntary, but with continued use a person's ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction. Listeners can find this information on the website nidanihgov. Courtney, what can you add to these defining factors to help us better understand the disease of addiction and its complexities?

Speaker 2:

Absolutely so.

Speaker 2:

First and foremost, a large percentage of us addiction professionals within the industry do practice from the perspective that addiction is not a choice. It is a disease that impacts someone's ability to choose, and a lot of the content that I'm about to share with listeners actually comes directly from part of our weekend family support curriculum that we utilize to educate our families about the disease of addiction and many of the surrounding factors. And so addiction occurs in a part of the brain known as the mid brain. It can also be classified as what we know as the primal brain, and so the primal brain cannot produce thoughts that's the easiest way to think of this and it really has one job, and that one job is to keep us alive. So, for example, it's the part of the brain that tells us to whether it's breathe or drink or eat, or our heart to beat, etc. And pain and pleasure also occur in the same part of the brain, the primal brain, and so this part of the brain will send us messages, say, for instance, telling us to stop doing something or hey, you're sick, etc. And we actually once thought that addiction occurred in another part of our brain known as the frontal cortex, but we actually know now that it occurs rather in the primal brain. And so a little bit of information about the frontal cortex. So the frontal cortex in our brain. The easiest way to think about this is that it's the part of the brain that can think and it knows right from wrong. It has a moral compass, if you will, and it's the part of the brain that can weigh the consequences of decisions, whereas the primal part of our brain cannot. And so we used to think that addiction was a choice that somebody can actually choose to stop. But now that we know it occurs in the part of the brain that cannot think, we know it's not a choice. And the other piece to this is that we can think of addiction as a malfunction of our pleasure sensories. So, due to the high levels that addiction does produce, ie using drugs and alcohol, other behaviors, for example eating, can result in us feeling pleasure Maybe it's shopping, physical intimacy, et cetera and so what happens is our brain lumps our addiction into the same category with other essential life functions like breathing.

Speaker 2:

I mentioned a few a few seconds ago, and so one of the ways I like to teach about this is think about if you were to hold your breath, your brain is eventually going to scream at you, telling you to to breathe until you do.

Speaker 2:

And so you can think about this from an addiction perspective.

Speaker 2:

If somebody who is addicted to alcohol or drugs say alcohol, if that person stops drinking, that part of our brain, that primal part of our brain, is going to scream at that person to drink until they do. And so it's really from the perspective that your brain thinks that you're essentially going to die and it's telling you to drink in order to save you. And so when clients or when individuals are struggling with the disease of addiction, by an individual going to treatment, this allows that person's brain to actually heal Because, when you think about it, they're stopping that exposure of the brain to drugs, to alcohol. And while that client is in treatment not having that exposure of the brain to drugs, to alcohol, and while that client is in treatment not having that exposure, it's reducing essentially the likelihood for that individual to respond to what we call craving or that drive for their drug of choice, and then allows us, as the therapeutic team or the treatment team, to work with that person to strengthen their ability to use not their primal brain, remember, it's the frontal cortex.

Speaker 1:

Right. So do you find that clients who come for treatment for addiction have a history of trauma as well? What are the stats there?

Speaker 2:

Yes, absolutely. For our center here I would say probably about 70 to 75% of our clientele come to treatment and have some sort of trauma within their backgrounds. Now, that doesn't necessarily mean that all of them have a formal diagnosis of PTSD, which is stands for post traumatic stress disorder, but because of the trauma that they've experienced somewhere along the line in their past, a lot of the times, unfortunately, their way of coping with the traumatic experiences is turning to drugs or alcohol.

Speaker 1:

Okay. You also noted some compelling facts in the piece relating addiction to domestic violence, and among them, alcohol or drug use is involved in 60% of domestic violence situations, and how alcohol myopia can fuel rage that leads to violence. Let's talk about the factors that lead to abuse due to addiction to drugs or alcohol. What's happening here?

Speaker 2:

to addiction to drugs or alcohol. What's happening here? So, when we think about drug and alcohol use, the use of drugs and alcohol is going to impair someone's judgment and it's going to therefore lower their inhibitions. And in addition to those things, drugs and alcohol also affect someone's mood and their cognition, and so what I mean by that is someone may engage in behaviors that they would not typically engage in when they are sober or not under the influence of alcohol and drugs. So, for example, I'm sure many listeners are familiar with the saying well, maybe if you get some liquid courage before you do something, you'll be more likely to do it right and so that sort of somewhat cliche saying.

Speaker 2:

What that's really referring to is that piece behind drugs and alcohol affecting our cognition and lowering our inhibitions.

Speaker 2:

And so, because alcohol, for instance, disrupts our normal brain functioning, it could lead somebody to be more likely to engage in some sort of violent or aggressive behaviors.

Speaker 2:

And it just so happens that I recently read an article of the treatment center I work for is actually featured as part of this website, but the website is known as alcoholorg, and there was an article that I read on there recently by a Dr Jeffrey on, and Dr Jeffrey on notes a statistical analysis that showed that up to 86% of homicide offenders, 60% of sexual offenders and 57% of men involved in marital violence were drinking at the time of the offense.

Speaker 2:

So this is evidence for the concept that when somebody is under the influence of alcohol or drugs, it can lead to them engaging in violent or aggressive behaviors. Another thought behind this concept, too, is that, for individuals who might already be more prone to aggression or violence, that drinking alcohol or being under the influence of drugs may increase the risk of that individual engaging in some sort of violent or aggressive behavior. And so, again, whether somebody already is more prone to be aggressive or violent. What we have to remember is that the drugs or the alcohol A it poisons the brain, but B it does lower our inhibitions, and that's where a lot of individuals get into trouble.

Speaker 1:

Yeah, that does make a lot of sense, and never can we excuse domestic violence, abuse or violent behavior or sexual violence because of addiction or drug or alcohol use, and the National Domestic Violence Hotline explains that and this is a quote from their website drugs and alcohol are not the root issues of abuse. Abuse is about power and control. Achieving sobriety doesn't necessarily end the abuse. Do you see these characteristics of power and control in your work and how do you address them?

Speaker 2:

So we absolutely do. I want to first start off by saying many of our clients struggle with having and maintaining healthy relationships. They are involved in unhealthy relationships that unfortunately consist of abuse, sometimes currently, things that are going on right now or at some point in their past, and what I would encourage listeners to be mindful of when it comes to abuse A there's a cycle of abuse, unfortunately. That's why so many individuals you'll hear somebody say get caught in this cycle, and part of the cycle of abuse is the abusive partner being in control of the other person. I think a lot of the times when we think of abuse, we sometimes immediately go to maybe physical violence, but we have to remember that abuse, where it of course can constitute some sort of physical violence, sometimes it can also include, you know, maybe something like continuous intimidation or threats of violence, or insults or the abusive. They will try to isolate the other individual that is experiencing the violence or the intimidation, etc. And so the way that we, as addiction and mental health professionals, address this nature of the abusive partner wanting this power and control.

Speaker 2:

So first, first off, we do a lot of group treatment here, or group therapy, and so in those group therapy sessions, our clinicians are providing lots and lots of psychoeducation on certain topics related to this. So, for instance, we have group therapy topics on healthy relationships. We teach our clients about the importance of self-esteem and knowing their self-worth. We know that because a lot of our clientele do come from a history that involves trauma. We do a lot of education here at the facility about the residual effects of trauma and how to overcome what somebody has experienced as a result of that trauma moving forward in their lives. We actually have groups here that teach on particularly domestic violence. We actually teach this class once a month here at the facility.

Speaker 2:

In addition to the group therapy piece, in the one-on-one individual sessions that our clinicians have with clients who this area applies to, our clinicians will help our clients essentially on how to get help right or how to potentially get out of their abusive relationship, and this could even be something along the lines of okay, how are you, how are you going to get out, how are you going to escape your abusive partner?

Speaker 2:

Essentially, and because so much of the abuse is centered around this control of the abusive partner having the power over the other person, we really try to empower, obviously, the victim and we try to help them figure out how are they going to regain control of their life, and we will process with them and say and try to help them remember per se hey, you know, what were you like prior to being in an abusive relationship? What were your life's goals? Because it's sad to say, but a lot of the times when somebody does get stuck in this cycle of abuse, it becomes their new norm. It's like that's what they know. They don't know anything outside of what they are experiencing.

Speaker 1:

So you raise a lot of really good points and, to sum it up somewhat, domestic violence is a very complex situation. There's a lot going on and there are many, many forms of abuse. They do not have to be physical violence. There's sexual violence, coercive control, psychological abuse, spiritual abuse, financial abuse, and the one I'm really glad you brought up is isolation, you know, and loss of identity. Survivors of domestic violence talk about these things very often at Genesis, and so you've talked a lot about the whole spectrum of abuse that anyone could experience. Now, on the other end of the spectrum of addiction and domestic violence, I'm wondering how common it is for domestic violence to lead to an addiction.

Speaker 2:

Absolutely, and when we think about rather just domestic violence in itself. So domestic violence in itself is obviously going to be incredibly traumatic to that person who is experiencing it. And, as you mentioned, Maria, unfortunately this trauma from the domestic violence that the person experiences it leads to whether it's loss of self-esteem, loss of self-worth, loss of their identity it leads to other very uncomfortable and unwanted feelings, For instance, feeling guilt over what happened, feeling some sort of shame over what happened. And what we find is that many of our clients do not know how to cope with these uncomfortable and unwanted feelings and what ultimately happens is is that they turn to, whether it's drugs or alcohol, to self-medicate or essentially numb themselves from feeling these unwanted feelings.

Speaker 2:

So the International Society for Traumatic Stress so they actually did a study recently and found that one quarter to three quarters of people who have survived abusive or some sort of violent traumatic experience do end up reporting problematic alcohol use. They also report that women who were exposed to a traumatic life event show an increased risk for an alcohol use disorder. Along with the International Society of Traumatic Stress, the American Psychological Association, they will tell us that people who are seeking treatment for post-traumatic stress disorder are actually 14 times more likely to also be diagnosed with some type of substance use disorder. So we can easily see that domestic violence, which, like we already know, is extremely traumatic for somebody. This can lead to, like I mentioned, self-medicating with drugs or alcohol, but just that person being more likely to actually be diagnosed with an actual substance use disorder.

Speaker 1:

So is there a difference between addiction and substance use disorder, or are they the same thing?

Speaker 2:

Same thing. I would say addiction is kind of more of a overarching term, if you will. And then there can be many different types of substance use disorders, whether it's alcohol or methamphetamine, or opiates or cocaine, et cetera.

Speaker 1:

So when there are children in the home where addiction and domestic violence is present, how does that impact their odds of also being abused?

Speaker 2:

So, sadly, there is going to be a great likelihood of there being some sort of abuse in some sort of fashion with the children living in the household and again, it might not be physical abuse, it could be emotional abuse, it could be verbal abuse, maybe it's a matter of neglect, and that's typically what we will see with our clients that admit to us for treatment. And, unfortunately, with domestic violence being a factor, we do see that CPS is involved, or we do have a number of clients in our facility even at this time where CPS is involved in these cases due to the domestic violence that has been going on in the house.

Speaker 1:

So, in other words, just you know, just a hypothetical example dad's abusive mom's in treatment for addiction and the kids are in foster house. So, in other words, just you know, just a hypothetical example dad's abusive mom's in treatment for addiction and the kids are in foster care.

Speaker 2:

Yes, or, for instance, maybe it could be the other way around too. Maybe the individual who is the abusive partner is in treatment for substance use, and CPS is involved because either the children are or have already been taken away from that individual or because of whatever has transpired. If that person does not successfully complete a treatment program, they are at risk of losing their children.

Speaker 1:

Yeah, it's devastating. I mean, the intersection here of addiction and domestic violence has unbelievable repercussions and consequences for everybody involved. Now this is a little off topic, but I know you work with student athletes as well and I'm curious how addiction is impacting them and if there's any connection in them coming from families where addiction and domestic violence have occurred, or possibly connection that leads, you know, between addiction, domestic violence and that might lead to dating violence or intimate partner violence by these young athletes.

Speaker 2:

Yes, absolutely so.

Speaker 2:

I think you know, especially nowadays with the NIL deals in the world of college sports, I think a lot of folks kind of tend to think and it is true to some extent that student athletes are kind of given might be the case, but I can guarantee you from my experience in working with them that student athletes absolutely 100% experience challenges with addiction.

Speaker 2:

They experience challenges with severe mental illness and from my experience working with student athletes from all over the country or different parts of the country, a lot of them when they come to therapy I end up learning about their past and them coming from an abusive household. Maybe they themselves did not experience the abuse, but maybe the abuse or the domestic violence was going on between their parents or their step-parents. I have worked with athletes where the situation with their parents was unhealthy to the point where they have had to move out of the house with mom and dad and, say, move in with an aunt or an uncle or move in with their grandparents. And so I think for me working with student athletes and them experiencing many of the same struggles as the folks that we treat here at the facility, is that it's a true reminder that addiction, and whether it's addiction or mental health challenges that they certainly do do not discriminate, whether it's gender, race, age, etc.

Speaker 1:

Yeah, absolutely. We say the same thing at Genesis about domestic violence. It does not discriminate. It can happen to anyone, regardless of your status, upward mobility, where you live, gender. It's all possible that any of us could experience some form of domestic violence. I'd love to direct people to some resources where they can get more information or a phone number where they can get help. Can you give us some information? Absolutely.

Speaker 2:

So if there is an individual who is in need of help due to substance use and addiction, we do at the Greenhouse, which is a facility under the American Addiction Center's umbrella, we do have a call center and support center number that anybody can call at any hour of the day, and so that number for listeners would be 615-375-3400. And another entity I would like to give we use the acronym, it's called SAMHSA and it stands for the Substance Abuse and Mental Health Services Administration. So they do have a free, national and confidential 24-7 hotline which listeners can reach by dialing 1-800-662-4357. And that is both in English and in Spanish. And another option to reach out to SAMHSA would also be a text message option as well, which anybody who's listening can text to 435-748.

Speaker 1:

Yeah, those are really helpful, and I'd like to also remind people of the Suicide and Crisis Lifeline, which is 988. And also the number to reach out for if you're experiencing domestic violence. The number for Genesis is 214-946-HELP 214-946-4357. And the National Hotline for Domestic Violence, 800-799-7233. And you can call, chat or check out their website at thehotlineorg. Genesis website is genesisshelterorg. Courtney Messina. Thank you so much for bringing this important topic to our attention today.

Speaker 2:

Thank you so so much for having me.

Speaker 3:

Attention Spanish-speaking listeners. Thank you so, so much for having me con el personal de Génesis, en Español.

Speaker 1:

If you or someone you know is in an abusive relationship, you can get help or give help at genesisshelterorg or by calling or texting our 24-7 crisis hotline team at 214-946-HELP 214-946-4357. Bilingual services at Genesis include text, phone call, clinical counseling, legal services, advocacy and more. Call or text us for more information. Donations to support women and children escaping domestic violence are always needed. Learn more at genesisshelterorg slash donate. Thanks for joining us. I'm reminding you always that ending domestic violence begins when we believe her.

Speaker 3:

Genesis. El podcast anuncia servicios bilingües disponibles en Genesis Women's Shelter, esupport. Si usted o una conocida está en una relación abusiva, puede recibir ayuda o dar ayuda a or by calling or sending a text message to our 24-hour crisis line at 214-946-4357. Genesis Bilingual Services include text messages, calls, counseling, legal services, counseling and more. Call us or send us a text for more information, asesoría y más. Llámenos o mándenos un text para más información. Siempre se necesitan donaciones para apoyar a las mujeres o a los niños escapando de la violencia doméstica. Aprende más a nuestra página de internet en genesisshelterorg. Barra inclinada donate. Gracias por unirse con nosotros. Recuerden que el terminar la violencia doméstica empieza cuando creemos a la víctima. Thank you for joining us. Remember that ending domestic violence starts when we believe in the victim.