5Anger and substance use disorders often co-occur, increasing the risk for negative consequences such as physical aggression, self-harm, distressed relationships, loss of a job, or criminal justice involvement. According to a 2014 meta-analysis of 23 studies, nearly half of people who committed homicides were under the influence of alcohol and 37 percent were intoxicated (Kuhns, Exum, Clodfelter, & Bottia, 2014). Anger, violence, and associated traumatic stress can often correlate with the initiation of drug and alcohol use and can be a consequence of substance use. Individuals who experience traumatic events, for example, may experience anger and act violently, as well as misuse drugs or alcohol.