Home > In plain sight?: a rapid review of the international literature and a national estimate of the prevalence of women who use substances and experience domestic violence in Ireland.

Prakashini Banka, Sonam and Lavelle Cafferkey, Sadie and McDonagh, David and Walsh, Ruby and Comiskey, Catherine (2022) In plain sight?: a rapid review of the international literature and a national estimate of the prevalence of women who use substances and experience domestic violence in Ireland. Dublin: SAOL Project.

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According to the World Health Organization, violence against women is a major public health problem as well as a violation of women's human rights. This research aimed to understand the unique needs, internationally, of women who experience both substance use and domestic violence and to provide the first estimate of the hidden prevalence nationally in Ireland, based on figures from 2020.

A well-defined rapid literature review was conducted. A defined rapid review utilises the standard systematic methodology and also adheres to the Preferred Reporting Items for SysteMAmatic reviews checklist (PRISMA). For the national prevalence estimation, indirect estimation techniques using benchmarks and multipliers, as recommended by the European Monitoring Centre for Drugs and Drug Addiction, were used.

Within the review a total of 4,136 articles were originally retrieved from the databases. Following further detailed screening using strict inclusion and exclusion criteria, 14 articles of sufficient quality and relevant content were deemed eligible. The review found that women who use substances and experience domestic violence suffer additional depression and Post-Traumatic Stress Disorder. They have additional challenges with sexual wellbeing, infectious diseases, and reproductive health. Fears were also expressed about the perpetuation of domestic violence intergenerationally. Motherhood, pregnancy, and loss of care of children was also a constant fear and a barrier to accessing services.

A national minimum multiplier of 3% (95% CI of 2.15% to 3.85%) derived from a European general population survey was applied. The benchmark of women who use substances was derived from the EMCDDA informed general population survey on substance use in Ireland. The first estimates of the minimum scale of the hidden prevalence revealed that in Ireland, in 2020, at least 11,000 women suffered the duality of hidden domestic violence and personal substance use within that year alone. Furthermore, at least 48,000 of women who used substances in 2020 had experienced these challenges in their lifetime.

Women who endure violence in their homes and who use substances are unseen and their needs unknown. They are forced to experience a duality of secrecy for the protection of themselves and their children. This research provides the first minimum estimate of national prevalence, and the review provides evidence on the need for accessible, targeted, and specific interventions. Based on these findings, a range of recommendations at the individual, community, service, and policy levels have been provided.

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