Family Matters: Substance Abuse and The American Family | CASAColumbia

Dangerous Liaisons: Substance Abuse and Sex

Dangerous Liaisons: Substance Abuse and Sex

Published: December 1999

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This report examines the relationship between sex and substance abuse or addiction, with particular attention to the consequences of such connections for our nation’s teenagers.


CASAColumbia’s work for this report involved:

  • Analyses of national data on teenagers and on sexual offenders
  • Review of more than 800 publications
  • Interviews with more than 100 experts in relevant fields
  • An examination of prevention and treatment programs associated with substance abuse, sex and sexual violence


This report found that teens who drank or used drugs were much more likely to have sex, initiate it at younger ages and have multiple sexual partners, and were therefore placing them at higher risk for sexually-transmitted diseases (STDs), HIV/AIDS and unintended pregnancies.

Key findings in this report include the following:

  • Teens under age 15 who had ever had a drink were twice as likely to have had sex as those who didn’t drink
  • Teens under age 15 who had ever used drugs were almost 4 times as likely to have had sex as those who had never used drugs
  • Teens age 15 and older who drank were 7 times likelier to have had sexual intercourse and twice as likely to have had it with 4 or more partners than non-drinking teens
  • Teens age 15 and older who had used other drugs were 5 times likelier to have had sexual intercourse and 3 times likelier to have had it with 4 or more partners than those who didn’t

Additionally, 63% of teens who had used alcohol and 70% of teens who were frequent drinkers had had sex, compared to 26% of those teens who never drank. Similarly, 72% of teens who had used drugs and 81% of those who used drugs heavily had had sex, compared to 36% of those teens who had never used drugs.

Despite the co-occurrence of substance abuse and sexual activity, including risky and violent sexual activity, remarkably few public or private prevention, treatment or counseling programs attended to the connection.


The report urges that alcohol and drug treatment programs confront the connection, and that drug and alcohol counselors be trained to spot and help deal with sexual problems of clients. Substance abuse prevention and sex education programs for children and teens should deal with the relationship between sexual activity and drinking or using drugs.

The report stresses the importance of parent power, recommending that, in exercising their influence, parents talk to their children about the relationship between drinking alcohol, using drugs and sex. It also urges middle and high schools to create comprehensive prevention programs that address the link between substance abuse and sex.

Health care, social service and treatment providers should create programs that address both substance abuse and sex, and programs for victims of sexual violence should be sensitive to the possibility of substance abuse. Additionally, state and federal criminal justice and prison systems should assess all sex offenders to identify treatment needs related to alcohol and drug abuse.

A Note on the Language
In 2012, CASAColumbia stopped using words like “drug abuse”/“drug abuser” because the terms have negative connotations. Instead, we now distinguish between “addiction” (clinical criteria for the disease) and “risky use” (use of addictive substances in ways that increase the risk of harm but do not meet criteria for addiction). Some reports and other publications published prior to 2012 still contain this outdated language.

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