Family Violence

Health Promotion Disease Prevention

Instructor: Gregory M. Chase, MS Emergency Medicine, MSHED, PA-C, RN

Teen Violence, Community Health Introductory Program: Principles of Instructional Design

Author: Gregory M. Chase, MS, MSHED, PA-C, RN.
Dr. David Sellen, PhD precepting

Teen Violence, are you at risk?

1 in 5 female high school students reports being physically and/or sexually abused by a dating partner. Abused girls are significantly more likely to get involved in other risky behaviors. They are 4 to 6 times more likely to get pregnant and 8 to 9 times more likely to have tried to commit suicide.
On the average, more than three women are murdered by their husbands or boyfriends, every day.

Teens and Dating Violence

Dating violence is a pattern of controlling behaviors that one partner uses to get power over the other, and it includes:

• Any kind of physical violence or threat of physical violence to get control
• Emotional or mental abuse, such as playing mind games, making you feel crazy, or constantly putting you down or criticizing you
• Sexual abuse, including making you do anything you don’t want to, refusing to have safe sex or making you feel badly about yourself sexually

Does your boyfriend:

• Have a history of bad relationships or past violence; always blames his/her problems on other people; or blames you for “making” him/her treat you badly?
• Try to use drugs or alcohol to coerce you or get you alone when you don’t want to be?
• Try to control you by being bossy, not taking your opinion seriously or making all of the decisions about who you see, what you wear, what you do, etc.?
• Talk negatively about people in sexual ways or talk about sex like it’s a game or contest?
  

Do you:

• Feel less confident about yourself when you’re with him/her?
• Feel scared or worried about doing or saying “the wrong thing?”
• Find yourself changing your behavior out of fear or to avoid a fight?

Dating violence is more than just arguing or fighting.

Teens who abuse their girlfriends or boyfriends do the same things that adults who abuse their partners do. Teen dating violence is just as serious as adult domestic violence.

Teens are seriously at risk for dating violence. Research shows that physical or sexual abuse is a part of 1 in 3 high school relationships.

In 95% of abusive relationships, men abuse women. However, young women can be violent, and young men can also be victims. Gay, lesbian, bisexual and trans-gendered teens are just as at risk for abuse in their relationships as anyone else.

Abusive relationships have good times and bad times. Part of what makes dating violence so confusing and painful is that there is love mixed with the abuse. This can make it hard to tell if you are really being abused.

Unfortunately, without help, the violence will only get worse. If you think you may be in an abusive relationship, please call the National Domestic Violence Hotline to talk with someone about it. You can also call the Hotline for more information about dating violence or other resources for teens. Their number is 1-800-799-SAFE (7233) or TTY 1-800-787-3224. To find out more about safety planning to help you keep you safe, click here.

Questions For Review

• Love doesn't have to hurt, how can you help a friend at risk? List 3 things you can do to help.
• Should you get involved? What are the risks you might face, your friend if you and if you do not?
• The following are several common patterns found amongst battered women: shame, abuse is their fault, they deserve the abuse. Explain each of the behaviors listed and the theory of their root cause.
• For each of the behaviors listed, state what one thing you can do to help move your friend past these hurdles. Think about this as you ponder a difficult question: Listen, support, believe, respect privacy, non judgemental.

In the United States, teens and young women experience the highest rates of relationship violence. In fact, 1 in 10 female high-schoolers say they have been physically abused by a dating partner in the past year.

Abused girls are significantly more likely to get involved in other risky behaviors. They are 4 to 6 times more likely to get pregnant and 8 to 9 times more likely to have tried to commit suicide.
On the average, more than three women are murdered by their husbands or boyfriends, every day.

Teens and Dating Violence

Dating violence is a pattern of controlling behaviors that one partner uses to get power over the other, and it includes:

• Any kind of physical violence or threat of physical violence to get control
• Emotional or mental abuse, such as playing mind games, making you feel crazy, or constantly putting you down or criticizing you
• Sexual abuse, including making you do anything you don’t want to, refusing to have safe sex or making you feel badly about yourself sexually

If you haven't dated much, it can be hard to know when a relationship is unhealthy. Some signs of teen dating abuse include:

• Partner with a history of bad relationships or past violence; always blames his/her problems on other people; or blames you for “making” him/her treat you badly?
• Try to use drugs or alcohol to coerce you or get you alone when you don’t want to be?
• Try to control you by being bossy, not taking your opinion seriously or making all of the decisions about who you see, what you wear, what you do, etc.?
• Talk negatively about people in sexual ways or talk about sex like it’s a game or contest?
  

Do you:

• Feel less confident about yourself when you’re with him/her?
• Feel scared or worried about doing or saying “the wrong thing?”
• Find yourself changing your behavior out of fear or to avoid a fight?

Teen Girls & Pregnancy Rates in Intimate Partner Violence

Teenage girls in physically abusive relationships are much more likely than other girls to become pregnant. Abuse can get worse during pregnancy, and it can harm the baby growing inside you. Never get pregnant hoping that it will stop the abuse. You can ask your doctor about types of birth control that your partner doesn't have to know you are using. If you are under 18, your partner could get arrested for having sex with you, even if you agreed to have sex. Laws covering this are different in each state.

Dating violence is more than just arguing or fighting.

Teens who abuse their girlfriends or boyfriends do the same things that adults who abuse their partners do. Teen dating violence is just as serious as adult domestic violence.

Teens are seriously at risk for dating violence. Research shows that physical or sexual abuse is a part of 1 in 3 high school relationships.

In 95% of abusive relationships, men abuse women. However, young women can be violent, and young men can also be victims. Gay, lesbian, bisexual and trans-gendered teens are just as at risk for abuse in their relationships as anyone else.

Abusive relationships have good times and bad times. Part of what makes dating violence so confusing and painful is that there is love mixed with the abuse. This can make it hard to tell if you are really being abused.

Leaving an abusive dating relationship

If you think you are in an abusive relationship, learn more about getting help. See a doctor or nurse to take care of any physical problems. And reach out for support for your emotional pain. Friends, family, and mental health professionals all can help. If you're in immediate danger, dial 911.

If you are thinking about ending an abusive dating relationship, keep some tips in mind:

• Create a safety plan, like where you can go if you are in danger.
• Make sure you have a working cellphone handy in case you need to call for help.
• Create a secret code with people you trust. That way, if you are with your partner, you can get help without having to say you need help.
• if you're breaking up with someone you see at your high school or college, you can get help from a guidance counselor, advisor, teacher, school nurse, dean's office, or principal. You also might be able to change your class schedules or even transfer to another school.
• if you have a job, talk to someone you trust at work. Your human resources department or employee assistance program (EAP) may be able to help.
• Avoid walking or riding alone.
• Be smart about technology. Don't share your passwords. Don't post your schedule on Facebook, and keep your settings private.

Unfortunately, without help, the violence will only get worse. If you think you may be in an abusive relationship, please call the National Domestic Violence Hotline to talk with someone about it. You can also call the Hotline for more information about dating violence or other resources for teens. Their number is 1-800-799-SAFE (7233) or TTY 1-800-787-3224. To find out more about safety planning to help you keep you safe, click here.

Avoiding date rape drugs

Date rape drugs are drugs that are sometimes put into a drink to prevent a person from being able to fight back during a rape. These drugs have no color, taste, or smell, so you would not know if someone put them in your drink. They also make it hard to remember what happened while you were under their influence.

If you go to a club, bar, or party, here are some steps to take to avoid date rape drugs:

• Don't accept drinks from other people.
• Keep your drink with you at all times, even when you go to the bathroom.
• Do not drink from punch bowls or other open containers.
• If you lose track of your drink, dump it out.

What are date rape drugs?

These are drugs that are sometimes used to assist a sexual assault. Sexual assault is any type of sexual activity that a person does not agree to. It can include touching that is not okay; putting something into the vagina; sexual intercourse; rape; and attempted rape. These drugs are powerful and dangerous. They can be slipped into your drink when you are not looking. The drugs often have no color, smell, or taste, so you can't tell if you are being drugged. The drugs can make you become weak and confused or even pass out so that you are unable to refuse sex or defend yourself. If you are drugged, you might not remember what happened while you were drugged. Date rape drugs are used on both females and males.

The three most common date rape drugs are:

• Rohypnol (roh-HIP-nol). Rohypnol is the trade name for flunitrazepam (FLOO-neye-TRAZ-uh-pam). Abuse of two similar drugs appears to have replaced Rohypnol abuse in some parts of the United States. These are: clonazepam (marketed as Klonopin in the U.S.and Rivotril in Mexico) and alprazolam (marketed as Xanax). Rohypnol is also known as:
  Circles
  Forget Pill
  LA Rochas
  Lunch Money
  Mexican Valium
  Mind Erasers
  Poor Man's Quaalude
  R-2
  Rib
  Roach
  Roach-2
  Roches
  Roofies
  Roopies
  Rope
  Rophies
  Ruffies
  Trip-and-Fall
  Whiteys
  
• GHB, which is short for gamma hydroxybutyric (GAM-muh heye-DROX-ee-BYOO-tur-ihk) acid. GHB is also known as:
  Bedtime Scoop
  Cherry Meth
  Easy Lay
  Energy Drink
  G
  Gamma 10
  Georgia Home Boy
  G-Juice
  Gook
  Goop
  Great Hormones
  Grievous Bodily Harm (GBH)
  Liquid E
  Liquid Ecstasy
  Liquid X
  PM
  Salt Water
  Soap
  Somatomax
  Vita-G
  
• Ketamine (KEET-uh-meen), also known as:
  Black Hole
  Bump
  Cat Valium
  Green
  Jet
  K
  K-Hole
  Kit Kat
  Psychedelic Heroin
  Purple
  Special K
  Super Acid
  

 

These drugs also are known as "club drugs" because they tend to be used at dance clubs, concerts, and "raves." The term "date rape" is widely used. But most experts prefer the term "drug-facilitated sexual assault." These drugs also are used to help people commit other crimes, like robbery and physical assault. They are used on both men and women. The term "date rape" also can be misleading because the person who commits the crime might not be dating the victim. Rather, it could be an acquaintance or stranger.

What do the drugs look like?

Rohypnol comes as a pill that dissolves in liquids. Some are small, round, and white. Newer pills are oval and green-gray in color. When slipped into a drink, a dye in these new pills makes clear liquids turn bright blue and dark drinks turn cloudy. But this color change might be hard to see in a dark drink, like cola or dark beer, or in a dark room. Also, the pills with no dye are still available. The pills may be ground up into a powder.

GHB has a few forms: a liquid with no odor or color, white powder, and pill. It might give your drink a slightly salty taste. Mixing it with a sweet drink, such as fruit juice, can mask the salty taste.

Ketamine comes as a liquid and a white powder.

What effects do these drugs have on the body?

These drugs are very powerful. They can affect you very quickly and without your knowing. The length of time that the effects last varies. It depends on how much of the drug is taken and if the drug is mixed with other drugs or alcohol. Alcohol makes the drugs even stronger and can cause serious health problems even death.

Rohypnol

The effects of Rohypnol can be felt within 30 minutes of being drugged and can last for several hours. If you are drugged, you might look and act like someone who is drunk. You might have trouble standing. Your speech might be slurred. Or you might pass out. Rohypnol can cause these problems:

• Muscle relaxation or loss of muscle control
• Difficulty with motor movements
• Drunk feeling
• Problems talking
• Nausea
• Can't remember what happened while drugged
• Loss of consciousness (black out)
• Confusion
• Problems seeing
• Dizziness
• Sleepiness
• Lower blood pressure
• Stomach problems
• Death

GHB

GHB takes effect in about 15 minutes and can last 3 or 4 hours. It is very potent: A very small amount can have a big effect. So it's easy to overdose on GHB. Most GHB is made by people in home or street "labs." So, you don't know what's in it or how it will affect you. GHB can cause these problems:

• Relaxation
• Drowsiness
• Dizziness
• Nausea
• Problems seeing
• Loss of consciousness (black out)
• Seizures
• Can't remember what happened while drugged
• Problems breathing
• Tremors
• Sweating
• Vomiting
• Slow heart rate
• Dream-like feeling
• Coma
• Death

Ketamine

Ketamine is very fast-acting. You might be aware of what is happening to you, but unable to move. It also causes memory problems. Later, you might not be able to remember what happened while you were drugged. Ketamine can cause these problems:

• Distorted perceptions of sight and sound
• Lost sense of time and identity
• Out of body experiences
• Dream-like feeling
• Feeling out of control
• Impaired motor function
• Problems breathing
• Convulsions
• Vomiting
• Memory problems
• Numbness
• Loss of coordination
• Aggressive or violent behavior
• Depression
• High blood pressure
• Slurred speech

Is alcohol a date rape drug? What about other drugs?

Any drug that can affect judgment and behavior can put a person at risk for unwanted or risky sexual activity. Alcohol is one such drug. In fact, alcohol is the drug most commonly used to help commit sexual assault. When a person drinks too much alcohol:

• It's harder to think clearly.
• It's harder to set limits and make good choices.
• It's harder to tell when a situation could be dangerous.
• It's harder to say "no" to sexual advances.
• It's harder to fight back if a sexual assault occurs.
• It's possible to blackout and to have memory loss.

The club drug "ecstasy" (MDMA) has been used to commit sexual assault. It can be slipped into someone's drink without the person's knowledge. Also, a person who willingly takes ecstasy is at greater risk of sexual assault. Ecstasy can make a person feel "lovey-dovey" towards others. It also can lower a person's ability to give reasoned consent. Once under the drug's influence, a person is less able to sense danger or to resist a sexual assault. Even if a victim of sexual assault drank alcohol or willingly took drugs, the victim is not at fault for being assaulted. You cannot "ask for it" or cause it to happen.

The information on our website is provided by the U.S. federal government and is in the public domain. This public information is not copyrighted and may be reproduced without permission, though citation of each source is appreciated.

Date rape drugs fact sheet was reviewed by:
Susan Weiss
Chief, Science Policy Branch
National Institute on Drug Abuse
found online at womenshealth.gov
A federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services.
200 Independence Avenue, S.W. Washington, DC 20201
202-690-7650 Monday through Friday, 9 a.m. to 5 p.m. EST (closed on federal holidays).

Questions For Review

• Love doesn't have to hurt, how can you help a friend at risk? List 3 things you can do to help.
• Should you get involved? What are the risks you might face, your friend if you and if you do not?
• The following are several common patterns found amongst battered women: shame, abuse is their fault, they deserve the abuse. Explain each of the behaviors listed and the theory of their root cause.
• For each of the behaviors listed, state what one thing you can do to help move your friend past these hurdles. Think about this as you ponder a difficult question: Listen, support, believe, respect privacy, non judgemental.

Internet-Based Exercises

• Teen Violence, "Love doesn't Have to Hurt," check this website for additional study: http://www.apa.org/pi/cyf/teen.pdf
  
• Teens have the right to: equality, honesty, compromise, individuality, responsibilities, openness, clear boundaries; Discuss how each of these basic human rights play an important role in prevention of domestic violence.
  Research here: http://www.cdc.gov/ncipc/dvp/bestpractices.htm
  

References

The information on our website is provided by the U.S. federal government and is in the public domain. This public information is not copyrighted and may be reproduced without permission, though citation of each source is appreciated.

Date rape drugs fact sheet was reviewed by:
Susan Weiss
Chief, Science Policy Branch
National Institute on Drug Abuse
found online at womenshealth.gov
A federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services.
200 Independence Avenue, S.W. Washington, DC 20201
202-690-7650 Monday through Friday, 9 a.m. to 5 p.m. EST (closed on federal holidays).

Burnley, Jane et al. (eds.). 1996. National Victim Assistance Academy Textbook. Washington, DC. Office for Victims of Crime.
National Center for Health Statistics. 2002. "How to cite Electronic Media." www.cdc.gov/ncbswww/howto/sitelec/citelec.htm