Untangling the Web of Cocaine and Sex Addiction Through Concurrent Residential Treatment

With the surging high that cocaine provides in combination with its effects on dopamine responsivity, it’s not uncommon for people to struggle with cocaine addiction and sex addiction. Outside of cocaine use, sex and addiction are also intertwined, highlighting the importance of receiving treatment for your challenges with addiction and severing the ties between cocaine and sex addiction.

“I am addicted to sex and cocaine,” said Danny James, a 31-year-old recovering sex addict. “Sex on cocaine is the thing I crave most. In fact, one without the other isn’t enough. But the two together … To put it in simplistic terms: I had to have sex and cocaine every night.”

Seeking out pleasure is a natural part of the human experience—we might indulge in a glass of wine or two after a long day, go on a yearly vacation to take a break from the stresses of our everyday routine, or enjoy a weekly outing at our favorite restaurant. And given the near-universal nature of pleasure and the human desire for it, Danny’s co-occurring cocaine and sex addiction share similar neurochemistry to the above activities.

When we experience pleasure and reward, the main reason is the flood of dopamine that is released in various regions of our brain. Of course, there are many other chemicals and processes in our brain that are involved in creating sensations of pleasure and reward, but dopamine is one of the most well-researched, and the main reason that cocaine addiction is so intertwined with sex addiction.

If you’re struggling with co-occurring cocaine and sex addiction, you may feel trapped just like Danny, unable to remove yourself from the cycle of pleasure and reward that makes it so hard to break free from. But with the right treatment program, you can overcome your concurrent cocaine and sex addiction. At the end of the process, you will have more control over each and be able to prevent them from exacerbating each other.

Cocaine and Dopamine Responsivity


The neural mechanisms that underlie cocaine addiction and tolerance are complex, to say the least, but if there’s one process that defines them, it’s a desensitization of dopamine receptors. The more you do cocaine, the more your dopamine receptors become activated, which eventually causes them to desensitize to this activation and provide you with less pleasure. This is why people addicted to cocaine need more and more to feel the same effects after prolonged use.

It’s no surprise, then, that cocaine and sex are so intertwined, as sex is linked to dopamine as well. In fact, scientists claim that “the dopamine released during orgasm is equal ‘in effect’ to one shot of heroin.” But with cocaine addiction desensitizing your dopamine receptors and making it more difficult to experience feelings of pleasure and reward, this feeling of pleasure during orgasm is likely decreased.

With these two addictions so intertwined, it’s clear why people with co-occurring cocaine and sex addiction need to seek out both activities—they’re trying to reach the dopamine high that they so strongly desire. But it’s ultimately unattainable, because the brain chemistry that underlies cocaine addiction makes it impossible to reach the level of sexual pleasure that you’re chasing.

The feeling of never being satisfied still haunts me—it’s something that never truly leaves you,” says Danny. “People you have sex with become incidental. You give yourself over to a hunger and the payoff is that you lose the capacity to have feelings for people. It’s an empty existence.”

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Sex and Addiction


Outside of the role of dopamine and cocaine addiction, other underlying neurobiological factors are also at play. One study found that both people addicted to drugs and sex showed increased activity in regions of the brain associated with motivation and reward. Interestingly, the study suggests that both of these groups showed more craving for the addictive behavior (sex and drugs) than enjoyment for them, suggesting that desire is the central component of these addictions. Given Danny’s account of craving sex on cocaine and needing both at the same time, this makes sense: with the same regions of reward in the brain underlying both addictions, craving cocaine likely leads to craving sex, and vice versa.

Although compulsive sexual behavior is still not included in the Fifth Edition of the Diagnostic Statistical Manual for Psychiatric Disorders (DSM-V), the unique connection between cocaine addiction and sex addiction make it a distinct problem. The importance of professional treatment in a residential setting is important for drug addiction of any kind, regardless of (but especially when) it takes place alongside a co-occurring disorder such as sex addiction. And, since neural activity related to each overlaps, treating one addiction while leaving the other unaddressed can be counterproductive, to say the least. The best way to accomplish dual treatment is through a program that understands the relationship between the addictions and the ways that they can feed into one another.

Severing the Ties Between Cocaine and Sex Addiction


The endless search for pleasure that comes with concurrent cocaine and sex addiction is one that can make you feel helpless, consumed by a hunger that never seems to be satisfied. “Nothing works for long enough,” Danny explains. “Each hit of coke and each orgasm just led to the need for another that would have to outdo the last. One hit, then another.” And the reality is, with this particular struggle, true satisfaction will never come without treatment.

Using the tools and professional networks of support offered by a residential treatment program, you can take control of your cocaine addiction while learning to manage your compulsive sexual behaviors and prevent the vicious cycle that underlies them from controlling your life.

Alta Mira offers comprehensive addiction rehabilitation for people struggling with concurrent cocaine and sex addiction, as well as various other substance abuse disorders. Contact us today to learn how you can learn to manage the urges that drive your struggles forward and learning coping strategies that can keep them under control.