Recovery impacts nearly every aspect of daily life, for the person in recovery, but also has a tremendous effect on loved ones. Substance abuse was cited as the reason for 34.6% of all divorces and approximately 53 million people (19.4%) 12 years of age and older have used illegal drugs or misused prescription drugs within the last year.

Addiction can create and/or enhance barriers in relationships including financial burden, emotional distress and abuse, loss of trust, and lack of communication.

Culture and the media often glamorize substance and alcohol use in sexuality, and many individuals rely on drugs and alcohol to feel comfortable sexually this can result in difficulties managing healthy sexuality in recovery. Many people associate drug and alcohol use with enhanced sexuality and functioning. Alcohol and drugs can have short-term properties that enhance sexual desire and arousal, however, various risk factors make engaging in sexual behaviors, while under the influence, dangerous. Increased potential for sexual dysfunction, high-risk sexual behaviors, sexually transmitted infections/diseases, including HIV/AIDS, sexual violence, and unwanted pregnancy are common risk factors.

Understanding the intersectionality between substance and alcohol addiction and the effect it has on physiological responses, psychological responses, and sexual response and functioning is essential in navigating sexuality and intimacy in life after addiction.

How the Human Brain Functions

Let’s face it, no one wants to address the elephant in the room when conversations about alcohol and substance use and sexuality come up. Most people would not use drugs and/or alcohol if they didn’t experience some perceived enhancements. Many people report enhancements in sexual areas including desire, arousal, and pleasure while under the influence of drugs and/or alcohol.

What many people don’t know or don’t consider are the number of significant risks and challenges. associated with illicit substance use and/or chronic alcohol use to sexual health and functioning.

Drugs and alcohol have a direct effect on neurological chemistry and functioning because they interfere with the way neurons send, receive, and process signals. Substances vary in the process by which they interfere with neurological functioning based on several factors including, but not limited to the specific substance being used, amount of the drug and/or substance being used, route of administration, frequency of use, etc.


Stimulants are a class of drugs that stimulate the central nervous system. Illicit stimulants (i.e. cocaine, methamphetamines, ecstasy) can over-activate chemical signals in specific neurotransmitters such as dopamine and norepinephrine. Dopamine is responsible for experiencing pleasure, and signals reward and motivation. Norepinephrine is responsible for providing energy to the body and increased heart rate. For centuries stimulants have been known for their aphrodisiac properties. The characteristics of stimulants can naturally leave people with temporary increased feelings of euphoria, energy, and alertness, delayed orgasm, short-term increases in sex drive, and lower inhibitions.

Although short-term enhancements have been demonstrated in stimulant use, long-term abuse of stimulants has been associated with sexual dysfunction. These sexual dysfunctions include: an inability to achieve or maintain an erection, vaginal dryness, reduced sperm count in men, higher infertility rates in women, lower levels of sexual desire, decreased testosterone, inability to orgasm, and a host of other sexual health issues.


The characteristics of alcohol act on both excitatory and inhibitory neurotransmitters, in the brain. Alcohol can have early stimulating effects but is primarily a depressant. Alcohol has depressant effects, that suppress excitatory neurotransmitters while increasing inhibitory neurotransmitters. This contributes to the slowed speech, thoughts, and movements one may experience when under the influence of alcohol. Alcohol also has stimulating effects, because it increases the release of dopamine, activating the brain’s “reward system.”

The increased dopamine in the brain tricks your mind into believing the alcohol is increasing the feelings of pleasure, due to increased adrenaline. The increased level of adrenaline is often associated with partying and lowered inhibitions. During the period of increased pleasure, alcohol is simultaneously altering other neurological chemicals in the brain that are enhancing depressive feelings. Alcohol may increase testosterone levels in both men and women resulting in increased sexual desire and arousal. Alcohol consumption can also result in lower inhibitions during sex which contributes to the belief that sex under the influence of alcohol results in the feeling of being loosened up.

Studies have found that excessive alcohol consumption can cause negative physiological outcomes contributing to decreased genital response. Prolonged alcohol consumption can lead to decreased blood flow to the penis, depressed central nervous system, erectile dysfunction, vaginal dryness, orgasmic dysfunction, and delayed ejaculation.


Opioids, sometimes called narcotics are primarily used to treat severe pain. Opioids are substances that attach to proteins called opioid receptor cells in the brain, spinal cord, and other parts of the body behaving like an inhibitory neurotransmitter. Opioids decrease the number of pain signals from the brain thus resulting in pain relief. Opioids can result in feelings of euphoria, making them prone for abuse. Opioids (i.e., fentanyl, oxycodone, codeine) are highly addictive, especially when taken for long periods.

Like many other drugs of abuse, individuals abusing opioids may initially express enhanced sexual experiences, however, long-term effects of opioid abuse have been associated with diminished sexual desire, impaired sexual performance, decreased testosterone, and decreased levels of sexual satisfaction.

5 Easy Ways to Facilitate Sexual Wellness in Addiction Recovery

In recovery, your body is healing and reestablishing homeostasis. Physical, Psychological, Relational, and Sexual changes are par for the course in your healing journey.

Achieving sexual health in addiction recovery begins here:

1. Give yourself permission and space to heal mentally, physically, and emotionally

2. Seek healthy support in recovery including counseling with a Licensed Mental Health and/or Addiction Professional

3. Speak with a medical provider for assistance in navigating sexual challenges and dysfunctions you may be experiencing

4. Develop healthy habits such as exercise, a balanced diet, and improvement of healthy mental lifestyles.

5. Practice open and honest communication with your partner about sex and intimacy challenges