Intersection of Intimate Partner Violence and Substance Use Disorders in the Veteran Population: Screening Gaps, Risk Profiles, and Lethality

Veterans with co-occurring alcohol use disorder (AUD) and opioid use disorder (OUD) face significantly higher risks of positive IPV screening and high-lethality violence exposure.
Female veterans with dual SUD diagnoses are particularly vulnerable to lethal IPV subtypes, including strangulation and escalation of violence.
Despite high prevalence, screening rates for IPV in VHA clinics remain around 22%, with extremely low referral rates to specialized family or relationship services.
Neurobiological evidence suggests structural alterations in the limbic system, specifically the amygdala-hippocampus complex, are associated with IPV perpetration in veterans with PTSD and TBI.

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