Dr. David Fawcett

Countless individuals pair substance use and sexual behavior. Often, this pairing involves a stimulant drug like cocaine or methamphetamine, although alcohol and a wide variety of other drugs are also used in conjunction with sex, including erectile dysfunction drugs like Viagra, Levitra, and Cialis.

There are numerous motivations for substance and sexual pairings, any of which can create a mutually reinforcing pattern. Based on my extensive clinical experience working with substance abusers, sex addicts, and paired substance/sex addicts, I have identified the following themes. Note that these are not discrete categories. Any individual may identify with several themes that describe their behavior.

• Using Substances for Sexual Disinhibition: Some people use the disinhibiting and confidence-building properties of alcohol and other drugs to overcome fears about their sexual desires and behaviors or to overcome feelings of low self-worth in sexual settings.
  • Example: Jason’s low self-esteem leaves him feeling unwanted and unattractive. So, when he goes out at night trying to meet someone he drinks heavily, knowing he is only able to approach a woman about hooking up when he is drunk. Sadly, he often gets so drunk that women who might otherwise be interested choose to ignore him. And those who are willing to go home with him typically leave disappointed because he is too drunk to perform sexually.
  • Example: Elise grew up in a family with rigid religious views about sex. Even though she had moved away to a larger city, she had difficulty moving past her upbringing, which emphasized the singular role of sex as procreation. That kept her from feeling comfortable during intimate encounters with her boyfriend. She discovered that having some alcohol helped her ignore the critical voices in her mind and tuck them away into some other compartment in her head. Basically, the drinks allowed her to relax and at least try to enjoy experimentation with her boyfriend.
• Using Substances to Numb Sexual Shame: Some people use the dissociative or numbing properties of alcohol and other drugs to reduce the shame, anxiety, stress, guilt, and depression they feel about their sexual orientation, gender identity, sexual arousal template, sexual behaviors, or other personal aspects such as their body.
  • Example: Eric reluctantly admits that he is attracted to both men and women, but mostly to men. Because of his family’s conservative religion and his personal beliefs about what it means to be gay (i.e., weak and effeminate), he struggles painfully with his bisexual/gay orientation. He finds that the only way he can overcome this shame and act on his sexual desires is to drink or get high first. Afterward, he continues to use alcohol, usually in conjunction with porn, to numb the shame he feels about what he just did.
  • Example: When Jackie is feeling sexual, she smokes marijuana and chats online with dozens of men and sometimes a few women, typically engaging in dirty talk and mutual masturbation. Usually, after several weeks of this behavior, she feels ashamed, as if there is something inherently wrong with her that causes her to behave in this way. So, she turns off the computer and numbs herself with marijuana and food. These cycles seem to alternate every couple of weeks.
• Seeking Intensity to Achieve Intimacy and Connection: Intimacy encompasses behaviors that require trust, vulnerability, empathy, respect, tenderness, and an emotional connection. Unfortunately, for many people who combine sex and drugs, achieving a sense of intensity is the closest they can get to intimacy. Intensity is arousing. It brings feelings of escape, excitement, stimulation, altered consciousness, validation, possibility, and a (false) sense of connection. That said, intensity is a numbing force that creates emotional disconnection rather than connection.
  • Example: Alexander describes his longing for a stable relationship, comparing himself to friends who are partnered. However, he has never really worked through the impact of the abuse he experienced as a child, leaving him unable to trust others enough to be vulnerable. He finds that amphetamines help him overcome his inhibitions, and they help him to express his deepest sexual desires to others—typically people with whom he has no emotional connection. Despite the intensity of these encounters, he is ultimately left feeling empty because any sense of connection fades with the dimming of the drug intoxication. There is simply no lasting emotional fulfillment.
  • Example: Monica grew up in an abusive household where she found herself defending her younger siblings from alcoholic parents. Unsurprisingly, she learned to disconnect from her own needs and to focus on the needs of her siblings. Looking back, she describes her early years as “just existing in survival mode.” Her adult relationships have been stormy, alternating between being emotionally shut down and using substances, notably alcohol and cocaine, to break through her defensive walls and function sexually. She finds that risky men and situations heighten the intensity in ways that allow her to at least feel something, despite the emotional and physical consequences of her behaviors.

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If you or a loved one are struggling with sex, porn, or substance/sex addiction, Seeking Integrity can help. In addition to residential rehab, we offer low-cost online workgroups for male sex addicts and male porn addicts new to recovery. Click HERE for information on our Sex Addiction Workgroup. Click HERE for information on our Porn Addiction workgroup.