1-2016-sexWhen you are trying to change your relationship with substances, one important piece is to think through the ways your relationship with substances is entwined with your relationship to sex. Why? Because for many people, making changes in substance use patterns (either reducing or abstaining) has a direct effect on their sex life and intimate relationships.

When you think about it, you may realize that substances have become a way to either increase positive feelings about sex (i.e., performance, comfort, interest) or to numb or distance from thinking about sex at all. Additionally, while alcohol or other drugs may have initially increased your positive feelings about sex, over time you may have found that you can’t have sexual relations due to your use or maybe can’t feel comfortable having sex without using. You may even realize that sex has become another compulsive behavior in its own right. As a result, you may find that your thoughts and feelings about your sex life have a significant influence on your ability to make changes in your substance use.

It’s not uncommon for people trying to make changes in their substance use to find themselves with a tremendous sense of vulnerability in being either sexually or emotionally intimate. For some, this results in anxiety, fearfulness and withdrawal, which leads to isolation or distancing from intimate relationships. Others immediately dive into relationships. Either way, sex and intimacy can create lots of emotional upset and upheaval which is not something you really need when you are trying to make changes in your life!

It’s important to spend some time thinking about how it relates to your change process, since having a satisfying and enjoyable sexual life can be an important part of building a healthy and satisfying life for yourself. Doing this work can also help you ensure that sex does not become a trigger to relapsing to old substance use patterns you are trying to avoid.

First, consider whether or not there are any sexual circumstances that you might face that are also related to substance use. Do you believe that it improves your performance or experience of feeling turned-on, do you use substances to escape negative thoughts, to feel relaxed, brave and confident, or even to feel comfortable displaying affection and tenderness? When you make a decision to not use substances, you may find that you are making a decision to be intimate with another person without a chemical chaperone. In other words, substances create a space between you and another person. It’s a little buffer to intimacy and you may really miss its absence. Many people describe feeling overwhelmed with feeling vulnerable or exposed when they try to connect intimately or sexually with another person while sober.

What to do? Making significant life changes can require that you establish or re-establish intimacy with the important people in your life. It may feel really important to you to set a goal of a meaningful and satisfying sex life, but going at a manageable pace is important. By stopping and thinking about your sex life and the impact it had or has on your path to change, you can pinpoint your goals for making sex enjoyable and evaluate sex as a potential trigger.

Thinking it through:

Research findings indicating that treatment outcomes improve when sexual health is addressed as a part of the change process. The trick can be to begin to understand what intimacy and sexual closeness mean for you and your life. Thinking through your answers to the questions below can contribute to lasting positive change with substances, since understanding more about yourself and these issues can help you to make constructive goals and plan ahead.


  1. Since starting to make changes in your substance use, has your sex life been affected in any of the following ways? If not, has it been affected in some other way?
    • less interest in sex
    • less satisfaction from sex
    • less satisfaction for your partner (partner complaining)
    • compulsive sexuality (feeling compelled to masturbate frequently or have sex with others in a way that seems excessive to you)
    • difficulties in physical performance (no or delayed orgasm, difficulties achieving or maintaining an erection, problems with vaginal lubrication, numbness)
  2. Are you worried that sex will be difficult or not much fun without alcohol and other drugs?
  3. Is there someone in your life with whom you can talk honestly about these issues?
  4. What are some situations in which sex and substance use were/are linked for you?
  5. What are your plans for sex during the next three months?
  6. Can you imagine being in a situation in which sex might act as a trigger to use? If yes, how, specifically?
  7. How can you cope with the relationship between sex and using now and in the future? What are your goals for this relationship?