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Addicts of all types typically experience an increasing tolerance to the mood-altering effects of their substance/behavior of choice. In simplest terms, this occurs because the brain adjusts to excessive dopamine levels (created by the repeated use of an addictive substance or behavior) by producing less dopamine and/or reducing the number of dopamine receptors in the brain. In other words, the brain develops a tolerance to addictive substances and behaviors. (I have written about the neurochemistry of addiction in easy to understand terms here.) Because of this, addicts must, over time, use more of or a more intense version of an addictive substance or behavior to get the same high they experienced when they first started. This, in a nutshell, is escalation.

Usually this concept is easier to understand if we’re talking about a substance abuse issue, such as heroin addiction. Ask yourself: Does anyone shoot smack right out of the gate? Not really. Instead, heroin addicts start out with beer or pot or a prescription medication. As time passes, their tolerance increases and they start drinking more beer or hard liquor, or smoking larger amounts of pot, or crushing and snorting the pills they’re using for a faster, more impactful hit. Then, as their brain continues to adapt, they start using “harder” drugs like heroin. Initially they might just sprinkle a bit into the pot they smoke or the pills they’ve been crushing and snorting. Eventually, however, and with no clear intent to do so, they find themselves cooking and injecting their new drug of choice, wondering how the heck they ended up in a back alley with a needle in their arm.

Sex and love addictions escalate in similar fashion. For example, modern-day sex addicts typically start out with a relatively generic and mostly harmless activity such as viewing and masturbating to online porn. As with other addictive activities, the brain adjusts to increased dopamine levels wrought by porn use. As time passes, porn users need to look at more porn or more intense porn to get the desired rush. Eventually, the user is looking at porn for hours at a time, getting turned on by more and more extreme imagery, and engaging in other compulsive sexual activities (both online and in the real world). Suddenly, an activity that began as harmless recreation has become an all-consuming behavior, pushing the user away from family, friends, real world romances, work, school, hobbies, and anything else that he or she used to enjoy.

Common forms of escalation for sex and love addictions include (but are not even remotely limited to) the following:

  • Hours (sometimes days) lost to the pursuit of sex and/or romance (online or real world)
  • Sex with strangers and/or dangerous individuals
  • Escorts, sensual massage, prostitution (buying and/or selling)
  • Viewing extreme sexual imagery, some of which might be illegal
  • Engaging in unsafe sex
  • Having sex in dangerous locations (public parks, restrooms, elevators, etc.)
  • Serial affairs
  • Multiple ongoing affairs
  • High numbers of casual and/or anonymous sexual encounters
  • Exhibitionism and/or voyeurism (online or real world)
  • Substance abuse in conjunction with sex and romance

Did you notice the last item on this list? If not, let me state it again very clearly. One of the ways in which sex and addiction1love addictions often escalate is through substance abuse (a secondary addiction). For instance, alcohol may serve as “liquid courage,” helping sex and love addicts do the things their addiction wants them to do even if those actions violate their internal value systems. Other times, addictive substances help sex and love addicts to tolerate the emotional discomfort – the shame and remorse – that they feel after acting out.

Sex addicts in particular tend to have co-occurring substance abuse issues, especially with cocaine, methamphetamine, and other stimulant drugs. These substances cause feelings of euphoria, intensity, and power, along with the drive to obsessively do whatever activity the user wishes to engage in, including having sex, for extended periods. For instance, dual sex/meth addicts say that meth lets them be sexual for days at a time, especially if an erection enhancing drug like Viagra, Levitra, or Cialis is along for the ride. Unfortunately, stimulant drug abuse is wildly debilitating. So people addicted to both stimulants and sex are in for a very bumpy ride, experiencing a double dose of physical, emotional, and life consequences.

For more information about sex and love addiction, check out my recently published book, Sex Addiction 101. If you feel you may need clinical assistance with sex and/or love addiction, therapist and treatment referrals can be found here and here.

Robert Weiss LCSW, CSAT-S is Senior Vice President of National Clinical Development for Elements Behavioral Health. In this capacity, he has established and overseen addiction and mental health treatment programs for more than a dozen high-end treatment facilities, including Promises Treatment Centers in Malibu and Los Angeles, The Ranch in rural Tennessee, and The Right Step in Texas. He is also the author of several highly regarded books, including Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction. For more information please visit his website,



Robert Weiss PhD, LCSW is Chief Clinical Officer of Seeking Integrity LLC, a unified group of online and real-world communities helping people to heal from intimacy disorders like compulsive sexual behavior and related drug abuse. As Chief Clinical Officer, Dr. Rob led the development and implementation of Seeking Integrity’s residential treatment programming and serves as an integral part of the treatment team. He is the author of ten books on sexuality, technology, and intimate relationships, including Sex Addiction 101, Out of the Doghouse, and Prodependence. His Sex, Love, and Addiction Podcast is currently in the Top 10 of US Addiction-Health Podcasts. Dr. Rob hosts a no-cost weekly Sex and Intimacy Q&A on Seeking Integrity’s self-help website, (@SexandHealing). The Sex and Relationship Healing website provides free information for addicts, partners of addicts, and therapists dealing with sex addiction, porn addiction, and substance abuse issues. Dr. Rob can be contacted via Seeking and All his writing is available on Amazon, while he can also be found on Twitter (@RobWeissMSW), on LinkedIn (Robert Weiss LCSW), and on Facebook (Rob Weiss MSW).

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