Substance Abuse, Sexual Activity, and Culture

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I wouldn't recommend sex, drugs or insanity for
everyone, but theyve always worked for
me.Hunter S. ThompsonAmerican Journalist and
Writer

• Physiological
• Multicultural
• Social Aspects for Women
• Personal
• Cultural

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Specific Drugs and Physiological Change in Sexual
Activity
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Rewards Pathway

• Activation of Dopamine neurons
• Learning value stimuli and actions associated
  with rewards including sex, food, liquid and
  drugs.
• 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.

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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

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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
  orgasms.
• Alters ovulation and delayed menstruation.

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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
  pleasure.
• Aphrodisiac-like effect
• Loosens inhibitions
• Enhance sensate focus
• Slows perception of time
• Chronic use leads to reproductive damages.
• Lower sperm count and sperm motion.

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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
  deprivation.
• Difficulties with erection and ejaculation.
• Difficulties for women to achieve orgasm.
• Amphetamines cause impotence and delayed
  ejaculations.

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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.

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Drug Use Pregnancy

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

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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
  drugs.

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Meth and Pregnancy

• low birth weight, cleft palates, and other
  malformations
• 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
  cry.

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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
  brain.
• 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.
•  

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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
  intercourse.

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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.
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• In comparison to abstainers, Episodic drinkers
  are
• -3 times more likely to engage in sexual
  activity
• -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
  drinkers.

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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
  behavior.

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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
  payment).
• 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.

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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.

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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.

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• 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
  activity.
• 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.

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Womens Substance Abuse and Sexual Behavior
Sexual Abuse/Violence
Dual Diagnosis
Spiritual Emptiness
Other Addictions
Criminal Behavior/Sex Industry
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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

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Disempowerment / Creating Distance From Trauma

• Intrusive memories
• Coping mechanisms- attempts to regain control
  over their world/empowerment

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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.

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CAPTAIN MORGAN

• 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
  myself.

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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

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Treatment and Recovery

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

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• 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

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Substance Abuse, Sexual Activity, and Culture

• The connection between sex and drug use in
  American Culture

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• 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 . . .

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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.

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Drug-sex links in the U.S. Culture Alcohol

• The link between sex and alcohol is culturally
  established
• Going to a beer kegger to find a date
• Having a glass (or two) of wine before sex
• Celebrating an anniversary with champagne

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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
  smoking
• 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

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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

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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

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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

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College Culture

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

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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
  culture.
• 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

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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
  popular.
• Another reported drug combination involves the
  use of poppers, Viagra methamphetamine.
• PCP has also become popular among some segments
  of the male gay community.

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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
  addiction

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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.

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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.

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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.