A sudden spike in the number of drug-related domestic violence cases in Tonga is worrying, says the kingdom's Women and Children Crisis Center.
Such cases, where the perpetrator is a drug user or trafficker, have risen annually for the last three years.
In 2017 there were 11 cases, in 2018 it increased slightly to 13, and last year saw 34 cases recorded.
The centre's director, 'Ofa Guttenbeil-Likikiliki, said the severity of the violence in the cases was horrific.
"There is the use of objects, violently used on the survivors. Being locked up in their room for hours on end without food and water, and then threatening her, the life of the children and her close family members," Ms Guttenbeil-Likiliki said.
"This can happen in normal domestic violence situations but it is exacerbated in these incidences where drugs [are] linked to the case because of the mental state of the drug user," she said.
When drug users and traffickers were involved, survivors and their families were often intimidated into silence - not just by the perpetrators but also their affiliates.
'Living in fear'
Because there are no social services in Tonga, survivors of domestic violence relied on services provided by NGOs like the Women and Children Crisis Center as well as church organisations.
But Ms Guttenbeil-Likiliki said there was only so much they could do.
"We still need to talk about the programmes that we can provide to support women who are living in fear and how they can be protected once they come out and speak.
"And how we can share information with the police and not at the detriment of putting her more at risk or the lives of her children at risk," she said.
However, Ms Guttenbeil-Likiliki said each year she saw more and more women, who have been subjected to violence and abuse, finding the courage to reach out for support.
"We know that there are so many more out there," she said.