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What is Chemsex Addiction?

Chemsex addicts seek sex when they get high, or they get high to enjoy sex. Chemsex addicts nearly always have sex when using drugs and rarely enjoy sex without drugs. Over time, drugs and sex are so frequently paired that they become ‘wired together’ in the brain as a dual addiction. In this way, repeatedly pairing drug/alcohol abuse and sex creates a single co-occurring addictive problem. Thus, both issues must be treated.

Sometimes chemsex is thought of as primarily a gay thing, with gay men mixing stimulant drugs like meth and cocaine with erection enhancers (Viagra, Cialis, Levitra, etc.) and sexual activity. However, chemsex is common among more than just gay men. Straight men and plenty of women also pair substance use with sexual behavior, sometimes to overcome sexual shame or low self-esteem, other times to enhance the sexual experience.

It’s not unusual for people who pair drugs and sex to explain it as a ‘lifestyle choice.’ And that continues until the reality of their addiction takes them down. At that point, these individuals typically enter a substance abuse treatment program, which unfortunately will address only half of their problem – the drug part.

Long-term sobriety for chemsex addicts requires confronting and healing not only substance abuse but compulsive sexual behaviors. And in both cases, we must address the underlying (often unconscious) conflicts, confusion, and stressors related to adult intimacy and sex. Consider the fact that many of the clients at our specialized Seeking Integrity chemsex treatment program can’t recall the last time they had sex sober. Some admit they’ve never had sober sex.

So, understandably, treatment for chemsex addiction must address all of the following: substance abuse, compulsive sexuality, sober intimacy, and relationship building. These foundational issues, if left unaddressed in treatment, will drive and sustain relapse.

Chemsex Addicts

Typically, Chemsex addicts experience one or more (usually more) of the following:

  • They have unresolved early-life complex (layered) trauma – neglect, physical abuse, emotional abuse, sexual abuse, bullying, etc.
  • They feel sexually and romantically undesirable and unlovable due to age, looks, lack of life success, sexual dysfunction, past rejection, or some other deeply rooted manifestation of low self-esteem.
  • They are unable to fully enjoy sex unless they get high first.
  • They get high before and/or after sex to tamp down feelings of shame and self-hatred.
  • They hate themselves for what turns them on.
  • They hate themselves for who turns them on.
  • They consider themselves damaged goods related to a chronic sexual health concern (HIV, for example).
  • They desperately want intimate romantic connection but settle for non-intimate sex paired with drugs.
  • They use their ability to purchase and supply drugs as a way to obtain sex, often with younger, more vulnerable individuals.
  • They choose to meet their primary emotional needs via external gratification and external validation rather than pursuing truly intimate emotional connection with partners, friends, family, and community.

There are two primary categories of Chemsex addiction.

  • Stimulant Chemsex Addiction: Typically, this involves methamphetamine, cocaine, and other stimulant drugs. These drugs lead to sexual disinhibition and an emotional state of feeling sexually masterful, potent, and desirable. With stimulants on board, sexual inhibitions are gone. Suddenly users feel alive, sexy, and powerful. Combining stimulants like meth with sex temporarily removes sexual shame and inhibitions, though only while high. Over time, pairing drugs and sex becomes a life focus, often involving drug-delivery sex workers, strangers coming and going at all hours, and using drugs while porn plays endlessly on a digital device. The progression of stimulant chemsex addiction sees addicts ‘losing’ days, weekends, or longer to drug and sex marathons. Often, there are multiples sex partners in a binge and nobody uses protection.
  • Dissociative Chemsex Addiction: Typically this involves opioids, alcohol, marijuana, K, ecstasy, and similar ‘lose yourself’ drugs. Combining dissociative drugs with sex leads to both sexual disinhibition and an ongoing emotional state of emotional ‘numbness.’ With dissociative substances on board, sex becomes easier to tolerate and manage. Anxiety about past sexual trauma or abuse and other issues that have kept the addict from fully engaging in sexual passion are diminished. For these individuals, sex might only tolerable when high or drunk. The progression of dissociative chemsex sees addicts waking up with strangers lying next to them, to STDs, to robberies, assaults, rape, and many other consequences.

Long-term sobriety from chemsex addiction requires expert therapeutic assistance, with special attention given to the impact of unresolved early-life trauma, and on developing healthy adult intimacy and connection without the use of substances. Simultaneously treating both substance abuse and sex/intimacy issues leads to fewer relapses and more robust long-term sobriety.

Whatever form or pattern it takes, paired drug and sex addiction is a serious issue requiring specialized treatment. If you think that you or a loved might be struggling with chemsex, I suggest you take this anonymous 25-question substance use and sexual disorders screening test. You can also contact Seeking Integrity with questions via email or phone at 747.234.4325.

What is Chemsex Addiction?

Robert Weiss PhD, LCSW

Robert Weiss PhD, LCSW is Chief Clinical Officer of Seeking Integrity Treatment Centers. He is an expert in the treatment of adult intimacy disorders and related addictions, most notably sex/porn/relationship addictions along with co-occurring drug/sex addiction. A clinical sexologist and practicing psychotherapist, Dr. Rob frequently serves as a subject matter expert for major media outlets including CNN, HLN, MSNBC, OWN, The New York Times, The Los Angeles Times, and NPR, among others.Dr. Rob is the author of Prodependence: Moving Beyond Codependency, Out of the Doghouse, Sex Addiction 101, and Cruise Control, among other books. He blogs regularly for Psychology Today and Psych Central. His podcast, Sex, Love, & Addiction, is rated as a Top 10 Addiction Podcast for 2019. He also hosts a weekly live no-cost Webinar with Q&A on A skilled clinical educator, Dr. Rob routinely provides training to therapists, hospitals, psychiatric organizations, and even the US military. Over the years, he has created and overseen nearly a dozen high-end addiction and mental health treatment facilities across the globe. For more information or to reach Dr. Rob, visit You can also follow him on Twitter (@RobWeissMSW), LinkedIn (Robert Weiss LCSW), and Facebook (Rob Weiss MSW).

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APA Reference
Weiss PhD, R. (2019). What is Chemsex Addiction?. Psych Central. Retrieved on October 23, 2020, from


Last updated: 14 Oct 2019
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