A new study suggests a connection between misuse of prescription drugs and incidents of dating violence. Researchers at the University of Michigan Injury Center found misusing prescription sedatives and opioids was more common prior to dating violence, while alcohol use or a combination of alcohol and marijuana use were more common prior to non-dating violence, HealthCanal reports.

“Without the alcohol or prescription drugs involved, they simply might walk away from a potentially violent situation,” lead researcher Quyen Epstein-Ngo said in a news release. “The alcohol and other substance use may be the tipping points.”

The researchers looked at use of prescription sedatives and opioids immediately preceding violent dating conflicts, on the day of the conflict, among high-risk urban youth. The study included 575 participants, ages 14 to 24, over a one-year period. Women were more likely to be involved in dating violence.

Of the 1,262 incidents reported in the study, substance use occurred immediately before 44 percent of conflicts. About half of dating violence incidents involved drug use.

“Our findings indicate that interventions that address violence among youth should address substance use and psychological factors, as well as be tailored by type of violence—dating versus non-dating—and by gender,” Epstein-Ngo said.

The results are published in the journal Addictive Behaviors.