Simultaneous Treatment for Drug and Sex/Porn Addiction

David Fawcett PhD, LCSW

Because the nature of sexualized drug use has long been misunderstood, professionals have been ill-equipped to treat it. It was frequently assumed that if someone stopped using drugs, their sexual compulsivity would take care of itself. For countless addicts, this approach has prolonged their addictive behaviors and suffering.

Combining drugs and sex in an addictive manner creates a web of behaviors that quickly consumes the user with thoughts of drugs and sex, obsessively planning both drug use and sexual encounters, acting out sex, and even obsessing about the next “party and play” encounter before the current liaison is complete. This compulsive behavior has another name—sex addiction. Not every sex addict is a drug addict, but most of the people who fuse drug use with sexual activity either already are or will soon become sex addicts.

Sex addiction mirrors substance addiction in several important ways. There is a loss of control indicated by a persistent desire or unsuccessful efforts to control or stop the sexual behaviors. There is a continuation of the behavior despite adverse consequences. Finally, there is an obsession or preoccupation with obtaining, using, or recovering from the behavior.

As the science of brain function evolves, it has become clear that certain behaviors, in addition to drugs, cause chemical changes that are indeed addictive because they are progressive and because tolerance develops This means that more of or a more intense version of the substance or behavior is needed to achieve the same high. Another way to overcome tolerance is to combine substances with behaviors. In time, of course, this leads to cross and co-occurring addictions.

Cross and co-occurring addictions are actually relatively common with sex addicts. One survey of self-identified sex addicts found that 69% of heterosexual men, 79% of heterosexual women, and 80% of homosexual men admitted to a cross or co-occurring addiction or some other similarly problematic behavior. Another survey of self-identified sex addicts found that 58% reported either current or past issues with drug addiction, and 31% reported either current or past issues with alcoholism. Compulsive gambling (29%), compulsive video gaming (37%), eating disorders (47%), and compulsive spending (49%) were also common.

One factor common to sexual addicts and those who pair substance use with sex is that sexual behavior, with or without drug use, is primarily used as a mood changer to mask emotional pain. Sex ultimately becomes less about erotic desire and more about avoiding emotional discomfort. As such, the major challenge of recovery from sex addiction, with or without paired drug use, is learning how to experience, in a healthy way, the various emotions that bubble up once the numbing effects of the addiction have worn off.

Sex addicts often share characteristics related to their family of origin, such as multiple addictive and/or compulsive disorders. Among adults who experienced dysfunction at an early age, there is sometimes an inability to sustain intimacy in relationships due to a failure to trust others enough to form a bond with them, as well as a rigid and authoritarian personality, resulting in resistance to accountability. A variety of other factors may lead to compulsive sexual behavior. These include childhood abuse, significant losses of primary caregivers, an enmeshed relationship with a parent, exposure to inappropriate sexual information or behaviors, and other forms of trauma.

In this way, drug addiction, sex addiction, and paired drug/sex addiction can be conceptualized as intimacy disorders. These behaviors compensate for the inability of an individual to adequately bond in intimate relationships, and indeed may cause or worsen any intimacy concerns that are present. The ultimate treatment goal of these addictions is “mastering the experience of forming enduring and trusting intimate connections with others,” and, I would add, an intimate connection with oneself. The most common barriers preventing addicts from achieving these intimate connections include shame, the inability to self-regulate emotions, and maintaining sexual boundaries.

Because these addictions are so similar, and often are tied together, treatment for these addictions should also be similar. And if the addictions are paired, they must be treated simultaneously. If an addict is treated for only half of his addiction (usually the drug half), he or she will inevitably relapse related to the other half (usually the sexual half). For lasting sobriety, both halves of the addiction must be treated concurrently.

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If you or someone you care about is struggling with sex addiction, porn addiction, or paired substance/sex addiction, professional help is available at our Seeking Integrity treatment center. You can find free resources on our affiliated website, SexandRelationshipHealing.com.