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Most of us have been there. Some level of intoxication, clouded judgment, maybe even some regret the morning after. Most of us are no stranger to some of the psychological interplay between substance use and sexual behavior. And it’s not always cause for alarm. 
Much has been said about this interplay and I don’t expect to cover it all here. In broad terms, many people use substances to mask or cope with insecurity and/or anxiety around their sexual behaviors. Unfortunately, alcohol and many stimulants (among other substances) often exacerbate conditions like erectile dysfunction. In effect, this creates a vicious cycle of use, some level of sexual discomfort, and at times continued use. ​


Unintended Consequences, Blame, Shame, and Sex-Positivity

Substance use also increases the risk of sexual assault, unplanned pregnancy, and other adverse sexual consequences. Despite all of this, access to substances is typically fairly easy and the enjoyment from dopamine release is undeniable. If a cycle exists, it can be hard to break. 
It’s not my intent to teetotal or wag a finger, as I am distinctly pro-pleasure and sex-positive. On the contrary, my aim is to shed some light on this interplay and share some tools/resources that might facilitate sexual and personal goal attainment.


Four Ways to Start Exploring Your Relationship With Substance Use and Sexuality


1. Challenge shaming messages that you have received and replace them with affirming and normalizing ones that paint sexuality as positive.

Picture of a man holding a glass of wine and a cigarette. Learn more from an online sex therapist in Minnesota here. We can talk about erectile dysfunction treatment Minneapolis, MN as well as Gottman couple therapy and more here.

You can’t change what you don’t know. So, it follows that in order to optimize your relationship with substance use and sexuality, you will want to have a firm grasp of all potentially shaming messages around sex that you may have internalized. These may have originated from your family of origin, religious tradition, society at large, or elsewhere, and can be difficult to perceive at first. With practice and some critical awareness, they will become more apparent. Sometimes, challenging these thoughts is sufficient but more often it helps to have a solid replacement at the ready for when old thoughts creep back up. “Mind Over Mood” by Dr. Dennis Greenberger and Dr. Christine Padesky has excellent resources for practicing and utilizing cognitive reframing.


2. Seek out peers and partners that share these beliefs and values.

This one can be tricky. You may understandably feel very close to peers and partners who hold somewhat toxic or destructive sexual beliefs. As noted above, these beliefs are typically deeply ingrained and can be hard to detect. Of course, people evolve, and the people in your life may naturally take on more “sex-positive” beliefs. Unfortunately, that doesn’t always happen. At a minimum, you may wish to engage the people in your life in conversations around sexuality both to gauge where their beliefs fall and share your own, seeing if and where they align. Exploration of so-called “good, bad, and normal” sexual practices/behaviors might be a good starting point for this, with an invitation to gently encourage peers to question and when necessary revisit old beliefs (see above process).


3. Set firm boundaries with those who might reinforce old shaming scripts.

You may find that it’s not always possible or even desirable to “cut people out of your life” entirely. In that case, you might come up with some “I statements” that assert your beliefs and clarify your sexual values. Examples might include “________ is important to be because _________, “I don’t think that way anymore though I respect your right to make your own decisions,” etc. 


4. Reflect on motivation for being sexual.


Sex Therapy for Substance Abuse and Sexuality May Help

If you are experiencing some of the higher-risk consequences discussed above or notice significant functional impairment in your daily life as a result of substance use, there is help. Working with a specialized sex therapist and participating in recovery support groups (not limited to 12 Steps) has helped many people align with their recovery and sexual goals. For gay men, in particular, grappling with methamphetamine use, I highly recommend “Lust, Men, and Meth” by Dr. David Fawcett. 


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