Sexual Uses of Alcohol and Drugs and the Associated Health Risks
Sexual Uses of Alcohol and Drugs and the Associated Health Risks
Background: Young people in European countries are experiencing high levels of alcohol and drug use and escalating levels of sexually transmitted infections. Individually these represent major public health priorities. Understanding of the association between sex and substance use, and specifically the strategic roles for which young people utilise substances to facilitate sexual activity, remains limited.
Methods: Respondent driven sampling methodology was used in nine European cities to survey 1,341 16–35 year olds representing youth and younger adults who routinely engage in nightlife. Participants self-completed questionnaires, designed to gather demographic, social, and behavioural data on historic and current substance use and sexual behaviour.
Results: Respondents reported strategic use of specific substances for different sexual purposes. Substances differed significantly in the purposes for which each was deployed (e.g. 28.6% of alcohol users use it to facilitate sexual encounters; 26.2% of cocaine users use it to prolong sex) with user demographics also relating to levels of sexual use (e.g. higher levels of: ecstasy use by males to prolong sex; cocaine use by single individuals to enhance sensation and arousal). Associations between substance use and sex started at a young age, with alcohol, cannabis, cocaine or ecstasy use before age 16 all being associated with having had sex before the age of 16 (odds ratios, 3.47, 4.19, 5.73, 9.35 respectively). However, sexes differed and substance use under 16 years was associated with a proportionately greater increase in early sex amongst girls. Respondents' current drug use was associated with having multiple sexual partners. Thus, for instance, regular cocaine users (c.f. never users) were over five times more likely to have had five or more sexual partners in the last 12 months or have paid for sex.
Conclusion: An epidemic of recreational drug use and binge drinking exposes millions of young Europeans to routine consumption of substances which alter their sexual decisions and increase their chances of unsafe and regretted sex. For many, substance use has become an integral part of their strategic approach to sex, locking them into continued use. Tackling substances with both physiological and psychological links to sex requires approaching substance use and sexual behaviour in the same way that individuals experience them; as part of the same social process.
Alcohol's role in reducing inhibition, impairing judgement, and consequently promoting sexual behaviour, has been recognised and exploited by individuals for thousands of years. Alcohol continues to play a central role in facilitating sexual relationships both through personal consumption and encouraging existing and potential sexual partners to consume in order to achieve effects ranging from relaxation to complete sexual disinhibition. However, while high alcohol consumption is associated with having more sexual partners, it is also related to higher levels of sexually transmitted infections (STIs), unwanted pregnancies and terminations. Further, early initiation into alcohol use is associated with early sexual debut along with increased sexual risk behaviours such as non-use of condoms.
Despite such negative associations, drinkers, especially youths, continue to value alcohol's sexual effects. However, in recent decades a range of other drugs have joined alcohol on young people's social and sexual menus. Cannabis, ecstasy, and cocaine, frequently used in combination with alcohol, are now often part of a modern night out socialising and looking for potential sexual partners. However, like alcohol, recreational drugs also affect decision-making and consequently can increase risk-taking. While literature on the adverse effects of recreational drug use on sexual health is patchy, studies suggest their use can leave individuals unable to negotiate safe sex (e.g. condom use) or refuse or repel unwanted sexual advances. Early drug initiation and greater frequency of drug use (e.g. cannabis, cocaine) have also been associated with having more sexual partners and non-use of condoms. Consequently, amongst teenage girls drug use is linked to increased risks of pregnancy and abortion.
Little information is available on how culturally widespread associations between sex and substance use are or on whether such associations are consistent between different young communities. Furthermore while substance use and sex are known to be associated, little research has explored to what extent such associations are incidental or result from individuals' deliberate use of alcohol and drugs to achieve sexual objectives. However, tackling increasing STIs, as well as other dangers to public health represented by alcohol and drug use, requires an understanding of both the relationships between substance use and sexual risk behaviours, and the extent to which the social and physiological effects of alcohol and drugs form a part of users' sex lives.
Here, we present findings from an international study investigating the relationships between sex, alcohol and drug use, covering initiation into such behaviours to current strategic use of substances to achieve sexual outcomes. We utilise a sample of 16–35 year olds from nine European countries, all recruited from populations frequenting pubs/bars and nightclubs.
Background: Young people in European countries are experiencing high levels of alcohol and drug use and escalating levels of sexually transmitted infections. Individually these represent major public health priorities. Understanding of the association between sex and substance use, and specifically the strategic roles for which young people utilise substances to facilitate sexual activity, remains limited.
Methods: Respondent driven sampling methodology was used in nine European cities to survey 1,341 16–35 year olds representing youth and younger adults who routinely engage in nightlife. Participants self-completed questionnaires, designed to gather demographic, social, and behavioural data on historic and current substance use and sexual behaviour.
Results: Respondents reported strategic use of specific substances for different sexual purposes. Substances differed significantly in the purposes for which each was deployed (e.g. 28.6% of alcohol users use it to facilitate sexual encounters; 26.2% of cocaine users use it to prolong sex) with user demographics also relating to levels of sexual use (e.g. higher levels of: ecstasy use by males to prolong sex; cocaine use by single individuals to enhance sensation and arousal). Associations between substance use and sex started at a young age, with alcohol, cannabis, cocaine or ecstasy use before age 16 all being associated with having had sex before the age of 16 (odds ratios, 3.47, 4.19, 5.73, 9.35 respectively). However, sexes differed and substance use under 16 years was associated with a proportionately greater increase in early sex amongst girls. Respondents' current drug use was associated with having multiple sexual partners. Thus, for instance, regular cocaine users (c.f. never users) were over five times more likely to have had five or more sexual partners in the last 12 months or have paid for sex.
Conclusion: An epidemic of recreational drug use and binge drinking exposes millions of young Europeans to routine consumption of substances which alter their sexual decisions and increase their chances of unsafe and regretted sex. For many, substance use has become an integral part of their strategic approach to sex, locking them into continued use. Tackling substances with both physiological and psychological links to sex requires approaching substance use and sexual behaviour in the same way that individuals experience them; as part of the same social process.
Alcohol's role in reducing inhibition, impairing judgement, and consequently promoting sexual behaviour, has been recognised and exploited by individuals for thousands of years. Alcohol continues to play a central role in facilitating sexual relationships both through personal consumption and encouraging existing and potential sexual partners to consume in order to achieve effects ranging from relaxation to complete sexual disinhibition. However, while high alcohol consumption is associated with having more sexual partners, it is also related to higher levels of sexually transmitted infections (STIs), unwanted pregnancies and terminations. Further, early initiation into alcohol use is associated with early sexual debut along with increased sexual risk behaviours such as non-use of condoms.
Despite such negative associations, drinkers, especially youths, continue to value alcohol's sexual effects. However, in recent decades a range of other drugs have joined alcohol on young people's social and sexual menus. Cannabis, ecstasy, and cocaine, frequently used in combination with alcohol, are now often part of a modern night out socialising and looking for potential sexual partners. However, like alcohol, recreational drugs also affect decision-making and consequently can increase risk-taking. While literature on the adverse effects of recreational drug use on sexual health is patchy, studies suggest their use can leave individuals unable to negotiate safe sex (e.g. condom use) or refuse or repel unwanted sexual advances. Early drug initiation and greater frequency of drug use (e.g. cannabis, cocaine) have also been associated with having more sexual partners and non-use of condoms. Consequently, amongst teenage girls drug use is linked to increased risks of pregnancy and abortion.
Little information is available on how culturally widespread associations between sex and substance use are or on whether such associations are consistent between different young communities. Furthermore while substance use and sex are known to be associated, little research has explored to what extent such associations are incidental or result from individuals' deliberate use of alcohol and drugs to achieve sexual objectives. However, tackling increasing STIs, as well as other dangers to public health represented by alcohol and drug use, requires an understanding of both the relationships between substance use and sexual risk behaviours, and the extent to which the social and physiological effects of alcohol and drugs form a part of users' sex lives.
Here, we present findings from an international study investigating the relationships between sex, alcohol and drug use, covering initiation into such behaviours to current strategic use of substances to achieve sexual outcomes. We utilise a sample of 16–35 year olds from nine European countries, all recruited from populations frequenting pubs/bars and nightclubs.