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Co-Occurring Sex Addiction and Substance Use

The term addiction is often used to describe the overuse of drugs or alcohol in a way that has significantly and negatively impacted the user's life, but it can also be used to describe the overuse of certain behaviors, also known as process addictions, with the same effect. Sex addiction is classified as out-of-control sexual behavior that provides the brain with a surge of serotonin but is still distressing to the person, similar to substance abuse. In many cases, sex addiction and substance abuse co-occur and may worsen one another.

Why Sex Addiction and Substance Misuse Co-Occur

It is important to note that sex addiction is not defined as what society would deem “excessive sex” or sexual behaviors that do not fall into the general norm. In order to be classified as sex addiction, the behaviors, thoughts, and actions must be seen as distressing to the person experiencing them. Just like drug or alcohol addiction, individuals who deal with this disorder do not typically enjoy the actual act of sex and see it as a means to diminish their thoughts or to increase serotonin in the brain. It may be used as a form of coping for underlying trauma. Other symptoms of this addiction include prostitution, voyeurism, obsessive sexual thoughts and fantasies that are disturbing, shame or guilt, committing criminal sex offenses, and participation in high-risk sexual activities.

Sex Addiction
Drugs Often Linked To

Sex Addiction

In the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), behavioral addictions are included as a diagnosable condition, with sex addictions falling under this umbrella of disorders. Men and women who suffer from this disorder utilize sex, especially in high-risk sexual situations, in order to promote the “feel good” neurotransmitter, serotonin, in the brain. This neurotransmitter is also increased when certain drugs are used, which is why both substance abuse and sex are often used simultaneously. 

Studies of the effects of certain drugs show that those substances often directly impact a person’s sexual desires or libido. Reversely, 42% of individuals struggling with sex addiction reported problems with chemical dependency as well. Similar studies have also shown that interactions between sex addiction and drug or alcohol abuse occur because they produce similar effects, specifically instant gratification and increased serotonin.


In many cases, sex addiction and the use of stimulants, such as cocaine or meth, not only co-occur but also increase the incidence of one another. These substances increase a person’s energy, feeling of euphoria, libido, and willingness to participate in risky behaviors. Because of these increased sensations, many studies have shown that the use of sex or sexual behaviors does also increase, but so does the risk of unwanted pregnancies and sexually transmitted diseases, making this combination extremely negative and potentially life-threatening. 

In some cases, stimulants are used to increase the feelings of euphoria and pleasure one may feel when engaging in sexual behaviors. This is common for individuals with sex addictions as they seek to increase the amount of serotonin produced during this experience. In other cases, sex or other risky behaviors are a side effect of drug use.

Depressants (Alcohol)

Increased alcohol abuse is also linked to sex addictions but for different reasons than stimulants. Alcohol is often used either to initiate sexual interactions or to cope with the shame or guilt that may follow once these acts are complete. It is widely known that side effects of alcohol abuse can include decreased inhibition, increased relaxation, increased euphoria, loss of coordination, and difficulty in making decisions. Because of this, individuals who are intoxicated may be more willing to participate in risky behaviors, particularly sexual ones. Alcohol use may also ease any negative thoughts or feelings that may be present before, during, or after these interactions. Because these behaviors are distressing to the individual, increased alcohol consumption may develop in order to cope with increasing negative thoughts.

Alcohol addiction, or alcoholism, typically develops as a coping mechanism for sex addiction, but it may also cause increased sexual behaviors which lead to addiction. The bottom line is that both sex and alcohol increase serotonin levels within the brain and continued use may cause the brain to crave that feel-good neurotransmitter, thus leading to an increase in both alcohol abuse and sexual behaviors.

Sex Addiction & Other Co-Occurring Disorders

Sex Addiction and Other Co-Occurring Disorders

While sex addiction and sexual behaviors are often seen as co-occurring with substance use, there has been an increase in the occurrence of sex addiction and the recent spike in technology or internet addiction. Studies have shown that increased access to sexual materials that the internet provides has increased the incidence of sex addiction and acting upon sexual desires, despite those desires being negative or distressing to the individual. 

Ready-made access to sexual content increases use of these materials which can increase the need for more. This is what connects sex addiction to substance use. The more those substances are used, the more the body needs in order to achieve the same effects. When it comes to sex addiction, the more that an individual partakes in these behaviors, the more they need in order to have the same burst of serotonin. Because of the similarity in both internet and sex addictions, studies have not found a large distinguishing line between the two. Most have shown a strong correlation between the internet and sex addiction and how they produce the same effects within the individual user’s brain.

Sex Addiction Treatment

How To Treat Co-Occurring Sex Addiction

Men and women who suffer from co-occurring substance abuse and sex addiction will need to be treated for both conditions at the same time. If sex addiction caused or worsened substance abuse, or vice versa, treating only one condition will be ineffective. The main forms of treatment for these co-occurring conditions include individual therapy with a clinician that has experience in treating both disorders, cognitive behavioral therapy, EMDR, group therapy, and, in more severe cases, inpatient treatment. 

Treatment for these disorders may also include support groups designed to connect men and women who struggle with similar conditions. It can help these people to make meaningful connections, develop trusting relationships, and hold one another accountable throughout this entire process.

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