Sexualized Drug Use: The Pairing of Addictive Behaviors

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Dr. David Fawcett

It is natural to wonder if one’s pairing of addictive substances and behaviors has become problematic. For example, my clients often ask whether having a glass of wine as a prelude to an intimate encounter is a problem. For most people, the answer is obviously no, though for others the situation may be less clear.

Today, it is rare for someone to experience a solitary addictive behavior—for example, being an alcoholic with no other drug use. Once someone realizes they have an addiction problem, they may discover concerns about multiple drugs or behaviors. The pairings are endless: alcohol, cannabis, and sexual acting out; poppers or porn followed by bingeing on food; amphetamines and sexual acting out followed by benzodiazepines to treat the resulting remorse and physical comedown; and more.

The pairing of drugs and behaviors becomes significant when two or more addictive actions have become incorporated into the same addictive ritual. For example, a porn addict might discover that smoking cannabis loosens them up and gets them in the headspace to look at porn. If this pairing is made with enough frequency, cannabis and pornography will become intertwined into the same addictive ritual. Once this occurs, cannabis will trigger an urge for porn, and porn will trigger an urge for cannabis.

Pairings can occur with any addictive substances or behaviors. The classic combination familiar to many is amphetamines and sex. In the gay community, this is known as chemsex, but many other variations can occur. Different classes of drugs and various types of behaviors can be blended into all sorts of ritualized behaviors that take on a life of their own. When packaged together, these drugs and behaviors become mutually reinforcing and triggering, vastly complicating a person’s ability to become truly clean and sober.

The inability of many professionals to grasp how different addictions can be incorporated into the same ritual has adversely impacted many people trying to recover. Counselor training programs focus on substances, or mental health, or behavioral (process) addictions, resulting in silos of knowledge. For example, drug treatment programs are notoriously bad at identifying and treating co-occurring compulsive sexual behavior.

A mentor of mine once wisely stated, “People find what they are trained to look for.” If a therapist hasn’t been taught to understand behavioral addictions, lacks competency in completing a thorough sexual history to detect sexual issues, or isn’t trained to look for broader addictive pairings, it is a disservice to a client. I have had countless men and women recovering from drug addiction who came to me with a history of chronic relapse related to sexual behavior, having been told to just get clean and sober and that their sex problems would take care of themselves.” Experience has shown me that won’t happen.

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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.