The song says, "It's that time of year when the world falls in love." But it's also when Facebook fills with bitter posts against the holidays and photos of kittens eating latkes or breaking Christmas ornaments; consumerism runs rampant; Kathy can't try to out Anderson anymore; some of us don't get epiphanies until after the Epiphany doldrums; and many of us would like to hide in bed with the covers over our heads.
It is also the time of year when those of us who do clinical work with sexually active people often see a spike in their distress level about their connection between drugs and sex.
There has been plenty of good scientific study about the frequent link between the use of lots of alcohol (more than five drinks over a few hours more than twice per week) �" or between use of powder cocaine, crack, meth, and ecstasy �" and sexual behavior that can feel out of bounds (Rhodes, 1996). Unfortunately, there has not been much good research published about helping these users detangle their sex lives from their drug use, once they make the decision to seek recovery. In more casual observation, those of us working in the field have seen broad evidence of relapses that were brought on by the lack of tools for untangling the sex-drug connection.
Arnold M. Washton released a workbook in 2008 through Hazelden Publishing titled, "Quitting Cocaine: Your Personal Recovery Plan." In this workbook, he developed a list of 10 tips to break the sex-drug connection, and any of us who are David Letterman fans can vouch for the impact of a Top Ten list. Some (myself included) have suggested that Washton's version is not only judgmental, but also both sex-negative and heterosexist. It reflects similar ineffective notions trapped in the boxes of distorted cultural thinking that still dominate many of our schools when they're addressing this health issue (Ley, 2012).
As a professional, with more than a passing interest in seeing LGBTIs move toward a healthier understanding of sex and sobriety, it remains clear to me that moralizing doesn't serve as an effective treatment strategy (MacCoun and Reuter, 2001). The following is my own version of a Top Ten List reflecting a more ground-tested and results-oriented approach.
The top 10 tips to help break the connection between drugs and sex
10. No matter what, do not give up.
Whether it is small incremental ways to reduce harm by limiting your use or being in one of many forms of treatment and mutual support, keep at it and keep moving forward. Once you surrender to the process, don't go back to the pull of giving up on a good life.
9. Take stock of your sex life �" including taking your own sexual inventory.
Where were you selfish, dishonest, or inconsiderate? Did you unjustifiably arouse jealousy, suspicion, or bitterness? Where were you at fault? What could you have done differently? Examine any possible fear you may have of intimacy or rejection, and any attitudes you may have toward others or yourself that take value away from sex. Ask yourself what you want out of many kinds of relationships �" from possible casual sex partners to friends to friends with benefits to partners to whatever else might be in between, with ou without sex. Have you set realistic standards to aim for? For example: What is your ideal for the kind of sex you want? What is your ideal for the kind of relationships you want? Where (if ever) do those overlap?
8. Not enough "lead in your pencil" or "oil in your engine?" Don't let it get you down.
It is pretty normal for people to have little or no sex drive after they stop using drugs: This too shall pass. For most people, it can take several weeks to months for their sex drive to kick back in as something they might feel is normal for them. Your brain chemistry may not even return to baseline for one to two years, so expect you will be working on this for a time. Hint: this then becomes a great time to explore sensuality and different kinds of intimacy.
7. It will not happen overnight.
You are probably going to feel frustrated and afraid that sex without drugs will be boring and unsatisfying. Learning how to enjoy sex without using drugs is a process that may take some time and practice.
You may want to consider developing a safe-feeling friendship (or a few) with whom you can practice. Getting through the vulnerability of finding such friends without emotional baggage is part of getting better. Three rules of thumb for very early recovery that many people use: (1) "Fuck but don't send flowers" �" you have awhile before you get a better handle on yourself, and taking a hostage in the process isn't fair to you or the other person; (2) "Don't play with anybody crazier than you" �" you know if someone still has a lot of work to do before they don't feel like a commodity or they're still too fragile or dysfunctional; (3) You are entitled to bring on yourself as much misery as you would like in your early recovery, but you are not entitled to drink or use over it, so be careful.
6. Get creative, get active �" just get out.
A moving target is harder to hit. Develop a list of alternative activities to do immediately when confronted with urges to act out in ways that would potentially combine sex and drugs.
The Bay Area Reporter's arts section lists many events that do not revolve around using alcohol or other drugs. The Castro Country Club (www.castrocountryclub.org) provides a list of clean and sober community events and meetings. Gayalcoholics (http://gayalcoholics.com/aa-roundups-events.html) is a site that provides a list of LGBT AA conventions, which is just the tip of the iceberg for 12-step-related social events. Leathermen's Discussion Group (http://www.sfldg.org) offers many informative and social events that are open to men, women, transgender people, and intersex persons.
5. Be prepared.
Understanding the stuff that gets you to associate sex with drug use is one big part of knowing how to address it. What are your triggers? Develop an action plan to anticipate and respond safely to them. Learn how to put brackets around your sex and around your romance life with recovery tools.
4. Chill out and take a time out.
Consider taking a cooling off period from sex for a short while after your last use or after a major triggering episode (some say 30 days is a good goal to work toward) to let your thoughts, feelings, and fantasies wind down. Be careful of falling into the "virgin versus whore" trap of restricting so much in your sexuality that you might binge in an unhealthy way.
3. Find good support for you.
Do you have a therapist? Do you have a group? Do you have a sponsor? Do you have some friends you confide in? Take the initiative to be open and honest with these supporters about any secret desires you have to act out in a way that would potentially combine sex and drugs, and any time you want to use sex only for seeking validation.
Recognize that everyone has sex problems and that, sometimes, people act out their own problems on you. Sometimes, that is with bad medical advice such as: prescribing "no sex for a year;" labeling you a "sex addict;" telling you that you should "just get over it;" declaring that your desires for either "vanilla" or "kinky" sex are "wrong" or "not sober;" insisting that only monogamy (or only celibacy, or only polyamory) is right for you. Nobody who is working a healthy recovery program will try to be the arbiter of your sex conduct. Learn to discern with your circle of wisdom providers.
2. Remember those supporters from Tip 3.
Talk with those people about your thoughts and concerns about not being able to engage in the kind of erotic sex you want without getting high again. Don't be afraid to dispute yourself about those thoughts. Remember, having support also means they don't always have to agree with you; being able to dialogue is part of the learning process, as is navigating different opinions.
Ask yourself what you really want out of sex, and what it means to be satisfied (and those may be different things at different times). My colleague Frank Strona likes to say, �It's allowable for a person to ask, 'Are you looking for warm fuzzies and breakfast, or are you just looking to get your rocks off?'" Decide which sexual behaviors you may wish to keep away from, which sexual behaviors are those that could place you at risk if you are not applying your recovery tools, and which sexual behaviors enhance your life and recovery.
1. Go back to Tip 3 and grow it.
Work on finding, caring for, and nurturing a social and mutual support system to which you can turn.
Here is a helpful reading list about these issues: Sex and the Sober Alcoholic, by Toby Rice Drews; The Ethical Slut, by Dossie Easton and Janet Hardy; Sexual Outsiders , by David M. Ortman and Richard A. Sprott; The Myth of Sex Addiction, by David J. Ley; and Codependents Anonymous, by CoDA Inc. If you have made the choice to get better, and you have not examined these issues, now is the time to safeguard your progress by taking a look at these helpful tips.
[Updated May 30: Since Luke Adams's Guest Opinion piece ran earlier this year, some students enrolled in a health communication and technology class taught by local advocate Frank Strona at San Jose State University put together a public service announcement featuring Mr. Adams talking about some of the points in his essay. It is available for viewing at http://youtu.be/fRJ0Pff61SQ.]
Luke Adams is an addiction specialist, mental health counselor, minister and longtime community organizer. He currently serves on the team at San Francisco City Clinic on the Mind-Body Program staff. The Mind-Body Program is part of a comprehensive set of services operating out of City Clinic that offer STD/HIV testing, linkage to care, and mental health/substance use counseling. For more information on the program, contact mailto:[email protected]. For more information on STD/HIV testing at City Clinic visit http://www.SFCityClinic.org.