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Substance Abuse, Sexual Activity, and Culture


'I wouldn't recommend sex, drugs or insanity for everyone, but they've ... Going to a beer 'kegger' to find a date. Having a glass (or two) of wine before sex ... – PowerPoint PPT presentation

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Title: Substance Abuse, Sexual Activity, and Culture

(No Transcript)
I wouldn't recommend sex, drugs or insanity for
everyone, but theyve always worked for
me.Hunter S. ThompsonAmerican Journalist and
  • Physiological
  • Multicultural
  • Social Aspects for Women
  • Personal
  • Cultural

Specific Drugs and Physiological Change in Sexual
Rewards Pathway
  • Activation of Dopamine neurons
  • Learning value stimuli and actions associated
    with rewards including sex, food, liquid and
  • Learning process helps animals and people learn
    how to get sex.
  • As use increases and individual becomes more
    addicted, getting drugs becomes more valuable and
    everything else less valuable.
  • Addicted humans
  • will pass up sex to
  • get the drug.

Candy is dandy but liquor is quicker.
  • Sexual behavior promoted by drugs indirectly
  • Lowered inhibitions and relaxation facilitate
    social interaction.
  • Emotionality warm feelings towards others.
  • Confidence and energy to seek partners

Alcohol Use and Sexual Dysfunction
  • Central nervous system depressant
  • Impotence
  • Shrunken testicles and reduced sperm count
  • Long term sexual dysfunction despite abstinence.
  • Reduce vaginal secretions and ability to have
  • Alters ovulation and delayed menstruation.

Marijuana Use and Sexual Activity
  • studies show that marijuana smoking enhances
    sexual behavior and increases sexual
    desire.---The Journal of Sex Research
  • THC Delta-9-tetrahydrocannabinol enhances
  • Aphrodisiac-like effect
  • Loosens inhibitions
  • Enhance sensate focus
  • Slows perception of time
  • Chronic use leads to reproductive damages.
  • Lower sperm count and sperm motion.

Stimulants - Cocaine and Amphetamines
  • Increased dopamine, serotonin and norepinephrine.
  • Greater desire. Whole body orgasm.
  • Increased energy.
  • Repeated stimulation triggers dopamine deficiency
  • Diminished desire due to sleep and food
  • Difficulties with erection and ejaculation.
  • Difficulties for women to achieve orgasm.
  • Amphetamines cause impotence and delayed

Research Difficulties
  • In researching the effects of
  • drugs on human development,
  • it is difficult to control for other
  • factors, such a prenatal care
  • or nutrition.
  • As a sample group, drug users are unreliable
    self-reporters, therefore it is difficult to
    record the effects of specific drugs.

Drug Use Pregnancy
  • In a nationally representative survey of drug use
    among pregnant women
  • 20.4 percent (820,000 women) reported smoking
  • 18.8 (757,000 women) reported drinking alcohol
  • 5.5 or (221,000 women) used an illicit drug at
    least once

Fetal Alcohol Syndrome
  • Fetal Alcohol Syndrome
  • 2 out of every 1000 births
  • Growth Retardation
  • Facial Changes
  • Behavioral Changes
  • 1-2 drinks/week increase risk of any FAE
  • Miscarriage
  • Still birth
  • Nervous system and intellectual development
  • Alcohol produces by far the most serious
    neurobehavioral effects in the fetus when
    compared to other drugs including heroin, cocaine
    and marijuana. Over three times as many women
    used alcohol during pregnancy than used illegal

Meth and Pregnancy
  • low birth weight, cleft palates, and other
  • Babies born to the "meth mice" had muscle
    coordination problems that lasted at least 12
    weeks after birth
  • With the exception of any major organ system
    damage, birth outcomes are thought to improve if
    the mother stops using in the last one to three
    months of the pregnancy.
  • Upon birth, babies exposed to meth in utero are
    frequently very sleepy for the first few weeks,
    often not waking to feed. After this time, they
    are often jittery, irritable and have a shrill

Poly Drug Exposure
  • Evaluations of the polydrug-exposed children
    revealed that
  • 13 had severe speech and language disorders,
  • 10 had significant cognitive deficits, and
  • 81 had behavior problems after the age of 3
    years. These deficits could not be attributed to
    social/environmental factors alone and probably
    reflect the effect of toxins on the developing
  • Polydrug-exposed children had learning problems
    related to impaired neurodevelopment and
    attention deficits, their IQs were normal.
  • Among children with FAS, however, 67 had some
    degree of mental retardation.

Youthand Sexual Behavior
  • Association between substance use and risky
    sexual behavior has been well documented among
    youth/adolescents (12-18yrs), in that adolescents
    who use alcohol/drugs have the highest risk of
    engagement in risky sex.
  • Among ethnic groups, substance use was one of
    the strongest predictors of high numbers of
    sexual partners among
  • - African-American females
  • - Caucasian females and males 
  • Black males have similar predictors, but include
    episodic drinking as an additional predictor.
  • Overall, males across ethnic divisions have a
    higher likelihood of substance use during sexual

Episodic Drinking
  • Drinking and drug use are consistent predictors
    of sexual behavior, risky or not.
  • Alcohol, however, has been shown to be the
    consistent predictor of unsafe sex.
  • In comparison to abstainers, Episodic drinkers
  • -3 times more likely to engage in sexual
  • -3.5 times more likely to have multiple sexual
    partners in their lifetime
  • -5.6 times more likely to use alcohol/drugs
    before sex
  • -5.6 times more likely to have multiple
    partners within the year.
  • While Non-Episodic drinkers also run the risk of
    unsafe sex with multiple partners, the data seems
    to indicate that the odds run higher for Episodic

Adolescent Use
  • Drinking initiated at the age of 10 years or
    younger indicates drug/alcohol use during sex
    twice as likely to occur compared to those
    individuals that initiate substance later (age 15
    or older.)
  • Adolescents who use drugs had similar odds, but
    with a higher risk of engaging in unsafe sexual

Bisexually Active Men
  • Studies seem to indicate that within this group,
    sexual exchanges with women indicate a higher
    involvement with substance use than exchanges
    with men (both in terms of paying and receiving
  • Ethnicity was significantly related to the
    likelihood of 'sex-for-drugs' exchanges.
  • African-American respondents had a higher
    likelihood to have given or received "sex for
    drugs" transactions than Whites, but do so less
    frequently than Whites.

Men who have Sex with Men(MSM) Among
Asian/Pacific Islander (API)
  • Research indicates that high levels of substance
    use is an important factor associates w/having
    unprotected anal intercourse (UAI) among API men
    in the MSM population.
  • Surveys of API MSM indicate that sexual activity
    while intoxicated is the most significant
    predictor of high risk sexual activity.
  • Individuals using substances during sex are 5
    times more likely to engage in UAI than those who
    do not.

MSM Among API, Continued
  • In a study done in 2000-2001, an average of 33
    of respondents reported being intoxicated on
    alcohol or at least one type of drug during sex
    within the last six months of the study.
  • Most common drugs used during intercourse
    ecstasy, marijuana, inhalant nitrites, and
    crystal meth.
  • Said to enhance the experience, may increase the
    odds of risky behavior due to social
    disinhibition, increased feelings of euphoria,
    and prolonged intercourse.

  • UAI is most associated with use of ecstasy and
    inhalants, (but NOT with marijuana or meth.)
  • Birthplace was only demographic factor associated
    with intoxicated/high risk sex, with US born
    individuals most likely to engage is said
  • Type of Substance varied by partner category
  • Steady sexual partner associated w/alcohol,
    ecstasy, marijuana
  • Exchange/casual partner associated with
    alcohol, ecstasy, marijuana, poppers or GHB.

Womens Substance Abuse and Sexual Behavior
Sexual Abuse/Violence
Dual Diagnosis
Spiritual Emptiness
Other Addictions
Criminal Behavior/Sex Industry
Physical/Sexual Abuse
  • 80 of female substance abusers have been victims
    of childhood physical/sexual abuse.
  • High risk sexual behavior including
  • Sex trade industries
  • Multiple sex partners
  • Sex with IV users and unprotected sex
  • Often Leads to
  • HIV
  • Unwanted pregnancies

Disempowerment / Creating Distance From Trauma
  • Intrusive memories
  • Coping mechanisms- attempts to regain control
    over their world/empowerment

Physical/sexual abuse and psychiatric disorder
  • 39.3 in comparison to general population, 21.3
    for lifetime depression.
  • 78 mood, anxiety or substance abuse.
  • Participants view alcohol and drugs as
    self-abusive or an impediment to normal life.
  • Sex addiction and codependency often underlie
    chemical addiction.

  • I always talk about how abusive Captain Morgan
    is to mewhen I do sit down to take that drink I
    know hes going to abuse me.Its like Im
    in the cycle of abuse. Whether its a man
    doing it to me or whether I am doing it to

Women Criminality Recovery
  • A Womens Way Through the Twelve Steps By
    Stephanie S. Covington PhD
  • Women incarcerated for drug offenses rose 888
    from 1986 to 1996
  • Few women offenders receive treatment for their
    drug abuse
  • PTSD is a common experience

Treatment and Recovery
  • Treatment is more successful with relational
    focus as opposed to structure.
  • Key issues for women in recovery
  • - Sexuality
  • - Relationships
  • - Self
  • - Spirituality

  • I believe that addiction is a misguided search
    for self-love and spiritual fulfillment. Its as
    if people knock on many different doors in the
    hope of finding happiness and fulfillment. You
    may try money, drugs, status, work, or sex and
    relationships, all in the mistaken belief that
    these will make you happy and give you personal
    power. You may reach for a bottle instead of
    quietly listening within
  • - Charlotte Kasl, PhD

Substance Abuse, Sexual Activity, and Culture
  • The connection between sex and drug use in
    American Culture

  • Within the larger culture, there are sub-cultural
    groups, each identified with their own specific
    sex-drug links. Some of these are
  • Prostitutes
  • Sex addicts
  • club culture
  • Gay and bisexual men
  • College youth
  • High school age youth
  • Many psychoactive substances used in our culture
    are linked to sexual activity, including . . .

The Tobacco-Sex Connection in American Culture
  • The use of cigarettes in romantic and sexual
    situations has been portrayed by the movie
    industry and encouraged (often with financial
    incentives) by the tobacco industry.
  • The image of a cigarette after sexual activity
    was so common that now it is used satirically to
    denote sex.

Drug-sex links in the U.S. Culture Alcohol
  • The link between sex and alcohol is culturally
  • Going to a beer kegger to find a date
  • Having a glass (or two) of wine before sex
  • Celebrating an anniversary with champagne

Sexual imagery and innuendo permeate the culture
  • Alcohol most often linked to sexuality in media
  • Sex and seduction portrayed in movies and in
    popular music frequently involve drinking and
  • The assumption that alcohol enhances sex is
    deeply ingrained in our culture
  • Despite popular belief, alcohol and sex can be a
    less-than-perfect match

Alcohol and Sexual Pleasure
  • Alcohol lowers inhibitions, increases self
    confidence and promotes sociability.
  • Both men and women often use alcohol to increase
    the chances of having sexual intercourse and
    they often get the results they seek
  • Heavy use-or sometimes any use-may reduce
    performance and pleasure
  • Disinhibition can also lead to high-risk sexual
    activity and the potential for sexual violence

Teenagers and Use of Psychoactive Substances
  • Most commonly used drugs are alcohol, tobacco,
    and marijuana
  • Teenage substance abuse is linked with risky
    sexual behavior
  • Media portrays alcohol/
  • drug use in a positive social context
  • Negative consequences are ignored

The link between alcohol and sexual aggression
  • In a University of Michigan study of high school
    students, 18 of females and 39 of males said it
    is acceptable for a boy to force sex if the girl
    is stoned or drunk.
  • Both male and female students believe that male
    drinkers are more aggressive, that female
    drinkers are more sexually available, and that a
    drinking woman bears some responsibility for
    subjecting herself to sexual violence.
  • Such beliefs reinforce the connection between
    substance use and sex
  • Alcohol use may be a cue for sexual aggression

College Culture
  • Alcohol remains the drug of choice among college
  • Students believe alcohol facilitates sexual
  • Binge drinking on the rise among college students

Club Culture, Drugs and Sex
  • After hours clubs and raves consist of
    multiethnic urban, suburban and college youth and
    young adults. A subculture of the polydrug abuse
  • Popular club drugs include ecstasy (MDMA),
    ketamine, other amphetamines, GHB and cocaine.
  • Use of designer drugs such as ecstasy is
    associated with heightened sensations and
    enhancement of the sexual experience
  • Drug combinations are often used to enhance
    euphoric feelings and sexuality

Drugs, Sex and Gay and Bisexual Men
  • This group is at higher risk from mixing
    substance abuse and sex.
  • Some segments are part of the polydrug subculture
  • Amphetamines and cocaine are particularly
  • Another reported drug combination involves the
    use of poppers, Viagra methamphetamine.
  • PCP has also become popular among some segments
    of the male gay community.

Drugs and Sex Addicts
  • Incidence of sex addiction is in the population
    is estimated at 3-6.
  • Co-occurrence with substance abuse is common
  • In a study of cocaine addicts entering an
    outpatient treatment program, 70 were also
    engaging in compulsive sex. Cocaine is the most
    frequently abused drug.
  • Fewer than 17 report that sex is their only

Why is there such an enormous market for alcohol
drugs in our culture?
  • It is psychological, biological and cultural
  • We are in a state of cultural psychopathology
  • The need for intoxication is a basic human drive
    that is as important as food, water and sex
  • Secondary to the elimination of emotional pain
    and anguish is the basic need for humans to
    experience pleasure.

Why ? .
  • It is the afflictions of modern culture that
    create the need
  • It is the failure of love at the biological,
    psychological, social and spiritual levels.
  • Somatosensory Affection Deprivation (SAD) in
    infants and children results in abnormal
    development and function of the brain
  • The pleasure circuits of the brain are damaged,
    along with the circuits that mediate depression
    and violence.

Why? . . .
  • The emotional pain of depression/alienation
    resulting from failed intimate love relationships
    beginning with mother and father-results in
    impaired ability to experience integrated
    pleasure which results in contentment and joy.
  • Drugs and alcohol are used to drown emotional
    pain and to stimulate pharmacologically the
    pleasure that every human needs to survive
    emotionally, psychologically, and spiritually.