Domestic Abuse and Coercive Control

Domestic abuse is not limited to physical assault. It can include intimidation, humiliation, threats, sexual abuse, financial control, isolation, stalking, and patterns of coercive control that make someone feel trapped and unsafe. In pharmacy settings, you may notice only brief moments of concern, but those moments can matter. A person collecting medicines may seem unusually anxious, unable to speak freely, or closely monitored by the person with them.^[1][3][4]

Coercive control is often about power rather than visible injury. One person may answer every question, refuse to let the other speak, control their phone, rush them away, or insist on hearing private conversations. Medication-related concerns can also be relevant. You might notice repeated requests that do not fit the adult's usual pattern, confusion about whether someone is allowed to take medicines, or signs that treatment is being disrupted by another person's control.^[2][3][7][8]

What You Might Notice

In a pharmacy, domestic abuse may show up through small but important warning signs such as:^{[4][1][9] [6][1]}

• one person speaking for another and not allowing them privacy
• fearfulness, flinching, distress, or unexplained injuries
• missed collections, chaotic medicine use, or pressure from a partner or family member
• children appearing frightened, withdrawn, or affected by tension at home

Domestic abuse can place both adults and children at risk, even when the children are not the person speaking to you.

That matters because children living with domestic abuse may experience fear, instability, emotional harm, neglect, or direct abuse themselves. A pharmacy encounter with an adult can therefore raise safeguarding concerns about the wider household as well.^[6][1]

Responding Safely in Your Role

Your role is not to investigate or challenge a controlling person directly. Instead, stay observant, respond calmly, and think about safe escalation. If an opportunity arises to speak to someone privately, even briefly, that may help them ask for support, but privacy should never be forced if it could increase risk. Record what you have seen or heard factually and follow the pharmacy's safeguarding procedure. Timely action, especially when children may also be affected, can be an important step towards safety.^[6][9][5]

References (numbered in text) Why we include references

1. HM Government. (2021). Domestic Abuse: Statutory Guidance. GOV.UK. Find (opens in a new tab)
2. Home Office. (2015; updated 2023). Controlling or Coercive Behaviour: Statutory Guidance Framework. GOV.UK. Find (opens in a new tab)
3. Stark, E. (2007). Coercive Control: How Men Entrap Women in Personal Life. Oxford University Press. Find (opens in a new tab)
4. Barcelos, A., Latham-Green, T., Barnes, R., Gorton, H., Gussy, M., Henderson, C., Khatri, M., Knapp, P., & Solomon, J. (2024). Lifeguard Pharmacy: the co-development of a new community pharmacy response service for people in danger from domestic abuse or suicidal ideation. International Journal of Pharmacy Practice, 32(6), 452–. Find (opens in a new tab)
5. Home Office. (2021). Ask for ANI and Safe Spaces schemes: Training toolkit. Find (opens in a new tab)
6. Department for Education. (2018; updated 2023). Working Together to Safeguard Children: statutory guidance for inter-agency working. GOV.UK. Find (opens in a new tab)
7. Grace, K. T., & Anderson, J. C. (2018). Reproductive Coercion: A Systematic Review. Trauma, Violence & Abuse, 19(4), 371–390. Find (opens in a new tab)
8. Derby and Derbyshire Safeguarding Adults Board. (2024). Safeguarding Adults Practice Guidance (v4.1). Find (opens in a new tab)
9. General Pharmaceutical Council. (2017). Standards for Pharmacy Professionals. Find (opens in a new tab)