Co-Occurring Drug Use and Sexual Behavior: Terms and Definitions

Dr. David Fawcett

At Seeking Integrity: Los Angeles we treat two primary disorders: 1) Compulsive Sexual Behavior Disorder, and 2) Co-Occurring Drug Use and Sexual Behavior.

Compulsive Sexual Behavior Disorder (CSBD) encompasses what is commonly referred to as sex addiction, along with porn addiction and love/relationship addiction. There are a variety of other terms used to describe CSBD, but generally we’re talking about the same thing.

Co-Occurring Drug Use and Sexual Behavior is less easily defined and understood. To help with this, I have created a list of the most common variants, with brief explanations of what each of those variants looks like.

  • Chemsex: This is a term primarily used by gay men (and sometimes others) to describe the use of drugs (nearly always some form of stimulant, such as amphetamines, cocaine, meth, or prescription stimulants) as a way to enhance sexual experience.
  • Paired Stimulant Use and Sex: This is a long-standing pattern of concurrent amphetamine, cocaine, meth, or prescription stimulant use paired with sexual behavior so that one behavior automatically triggers the other. A sexual thought or actual sexual behavior can trigger thoughts of drug use, and vice versa.
  • Fused Drug and Sex Behavior: This is the result of an ongoing pattern of co-occurring drug use and sex to the point where the two behaviors are fused, resulting in one behavior being dependent on the other. This is often characterized by an escalation in both drug use and sexual behavior as tolerance to the intensity builds over time.
  • Cycling Drug and Sex Behavior: This is a pattern where substance use and sexual behavior alternate over a period of time—usually a few days to several months. Sometimes a person engages in one behavior in an attempt to control the other. For example, “I don’t want to look at porn anymore, so I’ll drink or get high instead.”
  • Alcohol/Drugs for Sexual Disinhibition: Some individuals use the disinhibiting and confidence-building properties of alcohol and other drugs to overcome fears about sexual desires and behaviors or to overcome feelings of low self-worth in sexual settings.
  • Alcohol/Drugs to Numb Sexual Shame: Some individuals use the dissociative (emotionally numbing) properties of alcohol and other drugs to reduce the shame, anxiety, stress, guilt, and depression they feel about their sexual orientation, gender identity, or sexual behaviors in general.
  • Ritualized Drug Use and Sex: This is a ritualized cycle of addiction where the user devotes a great deal of time and energy to planning for drug and sex behaviors—clearing their schedule, lining up a supply of drugs and sex partners, creating time for “recovery” after a binge, etc.

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If you or someone you love is struggling with sex, porn, or paired substance/sex addiction, we offer both inpatient treatment and low-cost online workgroups. For extensive free information, including webinars, podcasts, blogs, resources, and daily inspiration for healing, we urge you to explore our sister website,