Pairing Substance Use with Sexual Behavior (Chemsex)

Many addicts struggle with alcohol or drugs plus an addictive behavior – gambling, spending, porn, sex, etc. This is not exactly a surprise when we understand that the most common triggers for addiction are stress, anxiety, depression, loneliness, boredom, and other forms of emotional discomfort. Whatever the addiction, the underlying motivation is the same – emotional escape. We don’t engage in our addiction(s) to feel good; we engage in our addiction(s) to feel less.

Addictive substances and addictive behaviors both help with this by distracting us from, and numbing our ability to feel, whatever it is that we don’t want to feel. Of course, some of us are purists and we stick with our ‘drug of choice’ no matter what, whatever that drug might be. But others tend to bounce from one addiction to another or to engage in multiple addictions simultaneously.

Probably the most common manifestation of this step is the pairing of substances with sex. Typically, stimulant drugs like cocaine and meth are the substance of choice, though other drugs (including alcohol) are often in play. Sexual behaviors might range for hours of drug-fueled porn and masturbation to drug and sex parties with multiple anonymous partners and/or prostitutes. There are many variations of the substance/sex pattern.

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 (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 his/her schedule, lining up a supply of drugs and sex partners, creating time for “recovery” after a binge, etc.

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.”)

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.

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.

Next Recovery Steps

In my role as Vice President of Clinical Programming at Seeking Integrity, I work with individuals who struggle with the substance/sex pairing on a regular basis. And this is a continuation of my entire career, where I’ve focused heavily on treatment for individuals struggling to overcome chemsex addiction. That work resulted in publication of the book Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery (winner of the POZ Best Nonfiction Award) and production of the documentary film Crystal City, which follows several men in recovery from chemsex (from meth in particular) in New York (now available on Amazon Prime).

If you or someone you know is struggling with the substance/sex dynamic, whatever form that pattern takes, I invite you to join me on In the Rooms each Tuesday at 8:00pm EST (starting January 7, 2020) for an open-ended discussion about chemsex with Q&A.