Sexual addiction in drug addicts: The impact of drug of choice and poly-addiction

Abstract

Objective:To compare the risk of comorbid sexual addiction in a sample of individuals with a diagnosis of substance dependence, stratifying the sample by drug of choice as well as by mono versus polysubstance addiction. Method: All data were collected at Santa Casa de São Paulo, Brazil. The study sample comprised all alcohol or drug dependents admitted to the Addiction Treatment Unit between November 2013 and August 2014. A generalized linear model with a binomial distribution was performed to compare the odds of having a Sexual Addiction Screening Test (SAST) score greater than 6 points in the subgroups analyzed. Results: A total of 133 participants were included in our analysis, all reporting cocaine/crack and/or alcohol as drug of choice. Polysubstance addicts had a significant higher risk of a positive screening for sexual addiction compared to monosubstance addicts, age-sex adjusted odds ratios of sexual addiction being respectively 2.72 (95CI 1.1-6.71) and 0.37 (95CI 0.15-0.91). The odds of a SAST score greater than 6 was not statistically different between the cocaine/crack and alcohol groups, respectively 0.38 (95CI 0.14-1.02) and 2.67 (95CI 0.98-7.25). We found a significant relation between stronger drug addiction and greater levels of sexual addiction in the cocaine/crack group (p=0.0012), but not in the alcohol group. Conclusion: Our study reinforces the importance of assessing sexual behavior of drug addicts in clinical practice, especially considering users of multiple substances or with severe dependence.

Is Compulsive Sexual Behavior Different in Women Compared to Men?

“…Two studies investigated CSBD in participants with substance dependence [ 43 , 44 ] who also reported very high CSBD frequency. Diehl et al [ 43 ], reported 28.4% of participants with substance dependence displayed clinically relevant levels of CSBD (measured with SAST).…”

“…Diehl et al [ 43 ], reported 28.4% of participants with substance dependence displayed clinically relevant levels of CSBD (measured with SAST). Likewise, Antonio et al [ 44 ] reported that 18.9% of participants with alcohol dependence and even 40.3% with crack/cocaine dependence showed clinically relevant levels of CSBD (SAST).…”

“…In an attempt to further conceptualize CSB, many studies regarding psychiatric comorbidities and psychological traits have been conducted. In the studies reviewed CSB has been reported to have correlations with perfectionism [ 45 ], paraphilias and sexual dysfunction [ 30 , 46 ], mood disorders (e.g., anxiety and depression) [ 26 , 35 , 38 , 41 , 47 , 48 ], experience of childhood sexual abuse [ 47 , 49 , 50 ], OCD [ 35 , 41 ], Autism Spectrum Disorder [ 42 ], general emotional dysregulation [ 31 ], substance abuse [ 43 , 44 ], maladaptive schemata [ 51 ], excitement seeking in general [ 45 , 52 ], compulsivity and impulsivity [ 47 , 49 , 53 ], high sexual arousal/excitation [ 25 ], higher neuroticism [ 47 ], avoidant coping mechanisms [ 54 ], high rates of psychiatric comorbidity in general [ 38 ], high distress rates and negative emotions [ 14 ], boredom [ 48 ], general childhood adversities and trauma [ 30 , 33 , 43 , 49 , 55 , 56 , 57 , 58 , 59 ], pathological buying [ 37 ], insecure attachment style [ 60 , 61 , 62 ] and risky sexual behavior [ 32 ] in both genders.…”

“…Clinical samples mostly target other clinical populations and survey CSBD as a correlate. Rates of CSBD have been investigated in samples of patients with OCD [ 41 ], ASD [ 42 ] and those with alcohol and drug associated disorders [ 43 , 44 ]. While prevalence in the OCD sample was comparable to prevalence found in large non-clinical samples (5.4% in men and 1.4% in women [ 41 ]), prevalence seemed to be much higher in individuals using drugs [ 43 , 44 ].…”

“…Rates of CSBD have been investigated in samples of patients with OCD [ 41 ], ASD [ 42 ] and those with alcohol and drug associated disorders [ 43 , 44 ]. While prevalence in the OCD sample was comparable to prevalence found in large non-clinical samples (5.4% in men and 1.4% in women [ 41 ]), prevalence seemed to be much higher in individuals using drugs [ 43 , 44 ]. It is important to note that the SAST was used in the drug-using sample using a cut-off of six, which is validated for the Brazilian population.…”