The Relationship Between Alcohol Use Disorder & Sex Addiction

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Contributor: Staff at Sierra Tucson

Most people are able to drink alcohol in moderation without experiencing significant negative effects. But for those who develop alcohol use disorder, which is the clinical term for alcoholism, any use of this substance can quickly lead to a wide range of devastating outcomes.

Common characteristics of alcohol use disorder include powerful cravings and an inability to control the amount or frequency of their alcohol use.

What many people don’t realize, though, is that cravings, compulsions, and lack of control aren’t limited to alcoholism and other substance use disorders. For example, some people feel compelled to engage in frequent and often dangerous sexual behaviors — and once they begin to act on these impulses, they feel powerless to stop.

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Those who struggle with this behavioral concern, which is commonly referred to as sex addiction or compulsive sexual behavior, often experience pervasive guilt, shame, frustration, and other distressing emotions.

What Is Sex Addiction?

In a PowerPoint presentation on the website of NAADAC, the Association for Addiction Professionals, Stefanie Carnes, Ph.D., CSAT-S, defined sex addiction as “a pathological relationship to a mood-altering experience (sex) that the individual continues to engage in despite adverse consequences.” [1]

Sex addiction is not listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which is the standard reference book for healthcare professionals in the United States and many other nations.

However, the most recent version of the International Classification of Diseases (ICD-11), which was published by the World Health Organization in 2019, includes an entry for compulsive sexual behavior disorder.

People at a concert and some deal with Compulsive Sexual BehaviorAccording to the ICD-11, compulsive sexual behavior disorder is characterized by “a persistent pattern of failure to control intense, repetitive sexual impulses or urges.” [2]

The ICD-11 also notes that this disorder causes “marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.” [3]

Similarities Between Alcohol Use Disorder & Compulsive Sexual Behavior

The DSM-V lists the following as among the diagnostic criteria for alcohol use disorder:

  • Spending considerable amounts of time acquiring and using alcohol or recovering from the effects of alcohol use
  • Failing to fulfill personal, occupational, or academic responsibilities due to alcohol use
  • Trying but failing to reduce or exert greater control of one’s alcohol use
    Using alcohol in situations where it is clearly hazardous to do so

Mayo Clinic’s list of possible signs that a person is struggling with compulsive sexual behavior includes several entries that are similar to the DSM-V’s criteria for alcohol use disorder.

For example, the Mayo Clinic website notes that symptoms of compulsive sexual behavior [4] include:

  • Experiencing intense, recurrent sexual fantasies and urges that take up a considerable amount of time
  • Feeling helpless to control the onset or duration of sexual fantasies and also feeling compelled to act on them
  • Having problems forming and maintaining healthy interpersonal relationships
  • Trying unsuccessfully to reduce or control sexual fantasies, urges, or behaviors
  • Engaging in sexual behaviors that can have significant negative consequences, including sexually transmitted infections, relationship damage, difficulties at work, and legal problems.

In a 2006 article in the journal Psychiatry, author Timothy W. Fong, M.D., discussed how many people engage in compulsive sexual behaviors or consume alcohol as a means of escaping or numbing themselves to anxiety, sadness, and other forms of pain.

“One of the fundamental hallmarks of compulsive sexual behavior is continued engagement in sexual activities despite the negative consequences created by these activities,” Fong wrote. “This is the same phenomenon seen in substance use and impulse control disorders. Psychologically, sexual behaviors serve to escape emotional or physical pain or are a way of dealing with life stressors.” [5]

However, Fong continued, people who continue to engage in compulsive sexual behaviors or use alcohol in this manner often find themselves trapped in “a cycle of more problems and increasing desperation, shame, and preoccupation.” [6]

The Prevalence of Compulsive Sexual Behavior & Alcohol Use

Until recently, relatively minimal research had been conducted on the nature and prevalence of sex addiction or compulsive sexual behavior. In the past decade, experts have begun to make strides toward developing a better understanding of this concern.

Man sitting on the floor struggling with Compulsive Sexual BehaviorIn November 2016, researchers in Minnesota attempted to identify the rate of distress and loss of control regarding sexual urges and behaviors among adults in the United States. Their study involved 2,325 adults ages 18-50 who had been randomly selected from all 50 states. The subjects were assessed using the National Survey of Sexual Health and Behavior (NSSHB).

The results of this study, which were published in the Nov. 8, 2018, edition of the journal Psychiatry, revealed that 8.6% of adults reported “clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behaviors.” [7]

Though prior estimates suggested that men were considerably more likely than women to struggle with compulsive sexual behaviors, the Minnesota study found that 10.3% of men and 7.0% of women met the criteria established by the researchers.

The effort to document the prevalence of alcohol use and addiction has been much more robust in the United States. For example, the National Survey on Drug Use and Health (NSDUH) has been conducted since 1971.

The 2019 version of the NSDUH [8] revealed the following:
Among people age 12 and older, 6.8% of males and 3.9% of females met the clinical criteria for a diagnosis of alcohol use disorder.
Among adults age 18 and older, 29.7% of men and 22.2% of women told researchers that they had engaged in binge drinking at least once in the previous 30 days.

Also, a review of six years of NSDUH data indicated that 10.5% of children and adolescents in the United States live with at least one parent who struggled with alcohol use disorder in the past year. [9]

Decades of research have documented the prevalence and impact of alcohol use disorder. As experts work to gain similar insights about sex addiction, the similarities between the two may help provide a path to greater understanding and the development of more effective treatment methods.


References

1. Carnes, S. (Undated). Sex Addiction, Neuroscience Trauma and More! [PowerPoint slides]. https://www.naadac.org/assets/2416/stefanie_carnes_neuroscience-trauma_ac16.pdf.

2. World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). Compulsive sexual behavior disorder. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1630268048.

3. World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). Compulsive sexual behavior disorder. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1630268048.

4. Mayo Clinic. (2020, February 7). Compulsive sexual behavior. https://www.mayoclinic.org/diseases-conditions/compulsive-sexual-behavior/symptoms-causes/syc-20360434.

5. Fong, T. W. (2006, November). Understanding and managing compulsive sexual behaviors. Psychiatry (Edgmont). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945841/.

6. Fong, T. W. (2006, November). Understanding and managing compulsive sexual behaviors. Psychiatry (Edgmont). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945841/.

7. Dickenson, J. A. (2018, November 9). Distress Associated With Difficulty Controlling Sexual Urges and Behaviors. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2713037.

8. National Institute on Alcohol Abuse and Alcoholism. (2021, May). Alcohol Facts and Statistics. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics.

9. Lipari, R. N. and Van Horn, S. L. (2017, August 24). Children Living with Parents Who Have a Substance Use Disorder. The Center for Behavioral Health Statistics and Quality. https://www.samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html.


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The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on June 14, 2021
Reviewed by Jacquelyn Ekern, MS, LPC on June 14, 2021
Published on AddictionHope.com

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.