Is Sex an Underrated Risk for Relapse in Substance Use Disorders?

Sexualized substance use (SSU) describes the use of psychotropic substances in the context of sexual activity. As a research topic, the interplay between substance use and sexuality has so far been limited to specific target groups like the “chemsex” of men, who have sex with men, sexual risk behavior of adolescents and young adults [2], or certain aspects of sexual behavior like compulsive sexual behavior or sexual dysfunction. For a non-clinical sample, the “Global Drug Survey” investigates adults of different ages, gender identities, and sexual orientations regarding substance use patterns. Here, 31.2% of men and 22.9% of women reported any SSU. Alcohol, cannabis, and MDMA were the most commonly used substances in a sexual context. Considerably less is known about the role of sexualized substance use among adult individuals with substance-related disorders and their effects on the course of the disorder, for example, with regard to relapses after achieving substance abstinence.

SSU was reported by individuals with a SUD who were undergoing rehabilitation treatment. Furthermore, patients consider sexual activity as a potential risk factor for relapse, with this being particularly the case for stimulant users. The topic of sexuality is highly important for patients and should, therefore, be given greater consideration in therapy in the future.

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