Humans have used drugs with sex for millennia—the reasons are much broader than you think
On their own, sex and drugs are cultural taboos. Combining them only adds to our reluctance to talk about them. But understanding how sex and drugs are connected isn't something we should shy away from or perceive as deviant.
Humans have intentionally used drugs to facilitate and enhance their sexual experiences for millennia. Ancient Egyptians used extracts from the blue lotus flower to increase sexual desire. More recently, in the 1960s, psychedelic advocate Timothy Leary stated: "LSD is the most powerful aphrodisiac ever discovered by man".
Despite this long history, our understanding of the relationship between sex and drugs remains limited. Researchers have traditionally had a tendency to focus on associations between drug use and "risky" sexual behavior, such as lack of condom use or having multiple sexual partners.
Studies have also highlighted links between drug use and "impaired" sexual function, such as difficulties in maintaining an erection or achieving an orgasm. This leaves us with a picture of sex on drugs that is disproportionately focused on the negatives.
More recently research exploring the relationship between sex and drugs has focused on "chemsex". Chemsex usually refers to men who have sex with other men using drugs like methamphetamine or mephedrone to enhance and prolong their sexual experience.
While this is important, it doesn't capture the experiences of people who have different gender and sexual identities. Harm reduction campaigns about combining sex and drugs is targeted at gay and bisexual men, meaning that other groups who engage in this activity are unlikely to take such information on board.
Because of the emphasis on chemsex, we know little about women's experiences of sex on drugs and what enhancement might look and feel like in these contexts. Since the FDA approval of Viagra for treating erectile dysfunction in the 1990s, there have been calls for the development of a female counterpart. But what medical condition such a drug might 'treat' for people with vaginas is unclear.
Sex and sexuality
Our restricted view of the relationship between sex and drugs is beginning to be corrected as new research emerges attending to pleasure and benefit.
One recent study reveals a diverse group of people across a range of sexual and gender identities who use drugs to enhance sex, with equally diverse motivations and experiences. For some it was about improving emotional connection, while for others desire was heightened or bodily sensations were increased. Some also found that sex enhanced the experience of drugs as well as drugs enhancing the sexual experience. The study demonstrates the limitations of thinking about sexual enhancement in purely physical terms by highlighting the ways that drugs can enhance emotional aspects of sex.
Another study explores how LGBTQ people use drugs to transform and enhance their experiences of gender, often in relation to sex. Drugs allowed them to express their gender and sexual identities in different ways and challenge traditional binaries. For many of the participants drugs provided the opportunity to play and experiment with gender, with some gay men describing the liberation and social bonding of putting on drag while using drugs.
The drugs we use with sex
The drugs that people combine with sex tend to reflect wider substance consumption patterns. Using data from the Global Drug Survey, a 2019 study found that the three most commonly used drugs with sex were alcohol, cannabis and MDMA respectively. This was true for participants across gender and sexual identity categories. The study also found that while the use of "chemsex drugs" (methamphetamine, mephedrone and GHB/GBL) with sex was highest among gay and bisexual men, other groups also report having sex on these drugs.
Alcohol is the drug that most people will be familiar with and some may have intentionally used it to relax prior to sex. For the most part, alcohol is used to facilitate sex whereas drugs are used to enhance the experience. However some will use combinations of drugs rather than sole use of a substance.
Alcohol and cocaine are used in combination – as cocaine is a stimulant, it offsets the depressive effect of alcohol. Cocaine, like other stimulants such as methamphetamine, is used to prolong the sexual experience.
Illicit or recreational drugs aren't the only ones used for sex, some medications are too. The pain killer Tramadol is known to be effective in overcoming premature ejaculation in men, although some use this drug without a prescription or medical supervision.
Understanding the benefits of using drugs to enhance sexual experiences is an important topic of research in its own right, albeit a neglected one up to now.
But further knowledge of pleasure and how it works could help us to understand the sex-related problems people experience too. It would be a shame if our cultural shyness about sex and drugs prevented us from improving an aspect of life we all have the right to experience.