Does “one more” often turn into “more than you intended?”

Do you find having sex to be difficult or “impossible” without being under the influence?
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Do your loved ones protest against your drinking or use?

Do you find that your behavior is drastically different “under the influence” than “sober?”
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Is using alcohol or drugs to have sex “normal?”

Addictions and substance use disorders can be difficult to detect, especially in times and contexts when drinking and use are encouraged. The following are some criteria used in the DSM-V to differentiate between casual and problematic use:

• Taking the substance in larger amounts or for longer than you're meant to.
• Wanting to cut down or stop using the substance but not managing to.
• Spending a lot of time getting, using, or recovering from use of the substance.
• Cravings and urges to use the substance.
• Not managing to do what you should at work, home, or school because of substance use.
• Continuing to use, even when it causes problems in relationships.
• Giving up important social, occupational, or recreational activities because of substance use.
• Using substances again and again, even when it puts you in danger.
• Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
• Needing more of the substance to get the effect you want (tolerance).
• Development of withdrawal symptoms, which can be relieved by taking more of the substance.​

Interplay Between Sex and Substances

Being sexual and using substances both have significant payoffs and it’s understandable that many people are drawn to both behaviors, often simultaneously. The following is a partial list of some possible consequences related to substance abuse and sex:

• Violation of personal sexual boundaries (that might be less likely to occur sober)
• Having sex without being fully present to the experience/sensations, including failure to recall past sexual experiences
• Unwanted transmission of sexually transmitted infections (STIs)
• Unplanned pregnancy
• Possible financial consequences associated with decisions around substances and/or sexual practices
• Difficulty with sexual functioning (e.g. erections, ejaculation, lubrication, orgasm, etc.)

What to Do If You Think You Might Have a Problem

1. Take stock of the situation. Cultivate an awareness of your use. How much are you using? Is your use consistent or more context-dependent? You can’t change what you don’t know.
2. Set SMART (specific, measurable, attainable, realistic, time-bound) goals. Set yourself up for success by envisioning the change you wish to see. When you have a target, it can be easier to start taking the steps necessary to modify your behavior. You may also gain insight into the behavioral change process and reasons underlying your use.
3. Increase accountability. Change is hard enough, there’s little sense in doing it alone. Find a trusted mental healthcare provider and recovery support groups (peers and mentors) to facilitate your recovery journey. 

​Even small changes to your drinking or substance use can create meaningful shifts in your life. Many clients notice improvements in work/life balance, relationships, and sexual wellbeing. In therapy, we look at the underlying reasons for use, including escapism, loneliness, trauma, anxiety, or depression. When substance use is reduced or eliminated, people often find it easier to connect with others and experience greater intimacy and sexual satisfaction. Therapy can help you make changes that support healthier relationships and a more fulfilling sexual life.

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Individualized Therapy, Including Harm Reduction Approaches

​Your goals in therapy are unique, and so is the path we take to get there. For some, that may mean exploring harm reduction strategies to lessen the impact of alcohol or other substances on daily life, relationships, or sexuality. For others, it might mean working toward moderation, safer use, or complete abstinence. Whatever your goals, therapy offers a supportive space to understand the reasons behind your patterns, make changes that feel sustainable, and create healthier, more fulfilling connections with yourself and others.

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Related Blog Posts

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• Penis, Out of Order
• Exploring Sexual Values
• Taboo Topics for Couples: Let's Talk About Sex

Begin Therapy for Substance Abuse and Sexuality in Minnesota

Beginning therapy in Minnesota with one of our skilled sex therapists can be simple and worry-free. We can help you either in-person at our Plymouth, MN counseling clinic, or anywhere in the state with online therapy in Minnesota! Explore your personal relationship with substances and sex here. All you have to do to get started is:

1. Schedule a free consultation
2. Meet with one of our sex therapists online or at our clinic
3. Feel more in control of your sexuality, finally.

Other Sexual Wellness Institute Services

​Sexual concerns often have many layers. We know these issues are complex so, at Sexual Wellness Institute, we also offer sexual desire therapy, sex and porn addiction, couples counseling, low libido or mismatched sexual desire, infidelity therapy and specialized services for teens. Let us enhance your sexual health in a meaningful and comprehensive way. Ask your online therapist about additional resources in your area of Minnesota. ​Check out our award-winning sex therapy blog as well!