Get Help Now - Call 24/7 888-401-1241 100% Confidential
Who Answers?

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.


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.


David Fawcett PhD, LCSW is a social worker and sex therapist specializing in addictive disorders. He is the author of Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery (Healing Path Press, 2015) which explores the intersection of gay men, drug use, and high-risk sexual behavior. The book was named “2016 Best Nonfiction Literature” by POZ magazine. David has been in the AAA fellowship for over 40 years with a sobriety date of May 25, 1979. He is also Vice President for Clinical Programming at Seeking Integrity ( which develops and operates treatment programs for fused drug and sex behaviors (chemsex), sex addiction and porn addiction. His work with crystal meth has led to invited presentations and consultations in France, the Netherlands and the UK. He is the host of a weekly webinar called “Addiction Q&A” and a podcast series called “Sex, Love and Addiction: Healing Conversations for Gay, Bisexual and Transgender Men.” Both are available at no cost at He frequently presents workshops on LGBT health, addiction, HIV, and co-occurring disorders both in the US and internationally and is well-known for his work with persons living with HIV. He is the recipient of numerous awards, including the 2018 NALGAP President’s Award. Most recently he co-produced Crystal City, a 90-minute documentary that follows the struggles and successes of eight gay men in recovery from crystal meth in New York and which is currently screening at film festivals in the US and Europe. It is also available for general distribution on Amazon Prime.


  1. Im interested to hear more about this topic. I been struggling with substances and their relationship with my sex life for a long time. I thought it would go away when I addressed my childhood sexual abuse issues but that hasnt been the case at all – the exact opposite actually.. Im about to return to a treatment facilty (familiar with me) next week. I will be bombarding the councellors with lots of questions. If theres anything you could suggest, a direction I might wanna take…feel free to offer what you can. I look forward to joining in on Tuesday nights after I return from treatment.
    Thank you

  2. sophia fimbres Reply

    my husband is addicted to porn and smoking meth. i feel left out like why he doesnt fuck me better instead of porn😒😒😒

Write A Comment


Who Answers?

Calls to the general helpline will be answered by a paid advertiser of one of our treatment partners.