Dangerous Liaisons: Substance Abuse and Sex. INSTITUTION Columbia Univ., New York, NY
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DOCUMENT RESUME ED 451 425 CG 030 737 TITLE Dangerous Liaisons: Substance Abuse and Sex. INSTITUTION Columbia Univ., New York, NY. National Center on Addiction and Substance Abuse. SPONS AGENCY Carnegie Corp. of New York, NY.; Henry J. Kaiser Family Foundation, Menlo Park, CA. PUB DATE 1999-12-00 NOTE 149p. PUB TYPE Reports Descriptive (141) EDRS PRICE MF01/PC06 Plus Postage. DESCRIPTORS *Adolescents; At Risk Persons; Comparative Analysis; *Drinking; *Illegal Drug Use; Prevention; Program Descriptions; *Rehabilitation; *Sexuality; *Substance Abuse; Violence ABSTRACT This report takes a comprehensive look at the connections between alcohol, drug use, and sex. Two national data sets on more than 34,000 teenagers and two sets on arrested and incarcerated sex offenders were analyzed. A review of the literature, interviews with experts, and an examination of programs aimed at prevention of abuse were included in the analysis. Chapter 1 presents an introduction and executive summary of the report. Chapter 2 describes the connection between substance use and sex.It includes discussion of religious beliefs, cultural and family values, and media messages and entertainment containing sexual images. Chapter 3 discusses how alcohol and drugs can affect sexual performance and pleasure. Chapter 4 discusses the relationship between alcohol, drugs, anddangerous sexual activity. Individuals using alcohol and drugs are more likely to initiate sex at earlier ages, have more sexual partners and more casual sex partners, and have sex with higher risk partners. Chapter 5 presentsspecific problems associated with substance abuse and sex among America's teens. Chapter 6 discusses how substance abuse is related to sexual violence. Chapter 7 reviews information concerning sex offenders, recidivism, and treatment. Chapter 8 details substance abuse among prostitutes. Chapter9 presents ideas for improving policy and practice by summarizingprevention programs already in place. Chapter 10 providessuggestions on how to break down the connection between substance abuse and sex. (Contains 9appendixes, 14 figures, 19 tables, and over 400 references.) (JDM) Reproductions supplied by EDRS are the best that can be made from the original document. Dangerous Liaisons: Substance Abuse and Sex December 1999 Funded by: The Henry J. Kaiser Family Foundation The Carnegie Corporation of New York BEST COPYAVAIIAB U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvement PERMISSION TO REPRODUCE AND EDUCATIONAL RESOURCES INFORMATION DISSEMINATE THIS MATERIAL HAS CENTER (ERIC) This document has been reproduced as BEEN GRANTED BY received from the person or organization originating it. Minor changes have been made to improve reproduction quality. Points of view or opinions stated in this TO THE EDUCATIONAL RESOURCES document do not necessarily represent INFORMATION CENTER (ERIC) official OERI position or policy. 1 S./ 2 Board of Directors Joseph A. Califano, Jr. Chairman and President of CASA Kenneth L Chenault President, Chief Operating Officer and Director, American Express Company James Dimon Mary Fisher Founder of Family AIDS Network, Inc. Douglas A. Fraser Professor of Labor Studies at Wayne State University (former President of United Auto Workers) Leo-Arthur Kelmenson Chairman of the Board of FCB Worldwide Donald R Keough Chairman of the Board of Allen and Company Incorporated (former President of The Coca-Cola Company) David A. Kessler, M.D. Dean of Yale University School of Medicine LaSalle D. Leffall, Jr., M.D., F.A.C.S. Charles R. Drew Professor of Surgery, Howard University Hospital (Past President of the American Cancer Society and Past President of the American College of Surgeons) Manuel T. Pacheco, Ph.D. President of The University of Missouri Joseph J. Plumeri, II Chairman, Primerica Financial Services Nancy Reagan Former First Lady E. John Rosenwald, Jr. Vice Chairman of The Bear Stearns Companies Inc. George Rupp, Ph.D. President of Columbia University Michael P. Schulhof Louis W. Sullivan, M.D. President of Morehouse School of Medicine Michael A. Wiener Founding Directors James E. Burke (1992-1997) Betty Ford (1992-1998) Barbara C. Jordan (1992-1996) Linda Johnson Rice (1992-1996) Michael I. Sovern (1992-1993) Frank G. Wells (1992-1994) Copywright © 1999 The National Center on Addiction and Substance Abuse at Columbia University 3 Table of Contents Accompanying Statement i I. Introduction and Executive Summary 1 Alcohol, Drugs and Sexual Activity 2 Recommendations 5 II. Substance Use and Sex: What's the Connection? 7 Physiological Connections 7 Arousal 7 Aggression 8 Vulnerability 8 Personal, Social and Cultural Connections 8 Risk-Takers and Sensation-Seekers 8 High Expectations 9 The Excuse 9 The Setting 9 Popular Culture 10 Religion 11 High-Risk Populations 11 Teenagers 11 Women 11 Gay and Bisexual Men 11 Alcohol and Drug Abusers and Addicts 12 Prostitutes 12 The Chicken and Egg Syndrome 12 III. Alcohol, Drugs and Sexual Pleasure 13 Alcohol 13 More Alcohol Equals More Sexual Problems 14 Acute Effects on Men 14 Chronic Effects on Men. 14 Acute Effects on Women 14 Chronic Effects on Women 15 Nicotine 15 Marijuana 15 Cocaine 16 Amphetamines 17 Opiates 17 Volatile Nitrates (Poppers) 18 Psychedelics/Hallucinogens 18 Lysergic Acid Diethylamide (LSD) 18 MDMA (Ecstasy) 18 -2- 4 Phencyclidine (PCP) 19 Ketamine 19 Gamma Hydroxybutyric Acid (GI-1B) 19 Prescription Drugs 20 Anabolic-Androgenic Steroids 20 Antipsychotics and Antidepressants 20 Benzodiazepines 20 Viagra 21 Poly-Substance Use 21 IV. Alcohol, Drugs and Sexual Activity 23 Prevalence 23 Increased Consumption of Alcohol Equals Increased Sexual Activity 24 Early Initiation of Sexual Activity 24 Multiple Sex Partners 24 Alcohol and Multiple Sex Partners 24 Drugs and Multiple Sex Partners 25 Casual Sex Partners 26 Alcohol, Drugs and STDs 27 Heavy Alcohol Users Have Higher STD Rates 27 Drug Users Often Have STDs 28 Alcohol, Drugs and HIV/AIDS 28 Alcohol and HIV/AIDS 28 Drugs and HIV/AIDS 29 Alcohol, Drugs and Condom Use 29 Alcohol and Condom Use 29 Drugs and Condom Use 30 Alcohol, Drugs and Unintended Pregnancy 30 V. Alcohol, Drugs and Sex Among America's Teens 33 Teens Sexual Activity 33 Teen Alcohol and Drug Use 34 Sex and Drugs May be Red Flags for Each Other 34 Early Initiation of Sexual Activity 35 The More Alcohol and Drugs, the More Sex Partners 36 Teens are Poor Condom Users With or Without Alcohol and Drugs 36 VI. Substance Abuse and Sexual Violence 39 Rape and Sexual Assault 39 Alcohol 39 Drugs 40 Alcohol, Drugs and Date Rape 42 Alcohol and Date Rape 42 Drugs and Date Rape 43 Alcohol, Drugs and Violence Among Intimate Partners 43 Alcohol, Drugs and Sexual Abuse of Children 44 -3- Victims of Sexual Violence 45 VII. Sex Offenders, Recidivism and Treatment 47 Characteristics of Substance-Abusing Sex Offenders 47 Demographic Characteristics 48 Substance Abuse and Criminality in the Families of Sex Offenders 49 Sexual and/or Physical Abuse History 49 Mental Health Problems 49 Educational and Vocational Experiences 49 Recidivism 50 Treatment 50 Why Invest in Treatment? 51 VIII. Substance Abuse and Prostitution 53 Trading Sex for Drugs 53 Condom Use Among Prostitutes 54 Alcohol and Drug Use by Those Who Frequent Prostitutes 55 Drugs and Sexual Violence Among Prostitutes 55 IX. Improving Policy and PracticeExperience from the Field 57 Prevention Programs 58 Prevention Programs for Adolescents 58 Prevention Programs for College Students 60 Prevention Programs for Gays 62 Substance Abuse Treatment Programs 62 Victims of Sexual Violence 62 Sex Offenders 63 X. Breaking the Dangerous Liaisons Between Substance Use and Sex. 65 References 69 Appendix A 113 Appendix B 117 Appendix C 131 Appendix D 135 Appendix E 145 Appendix F 149 Appendix G 151 Appendix H 155 Appendix I 169 -4- Accompanying Statement By Joseph A. Califano, Jr. Chairman and President This CASA report, Dangerous Liaisons: Substance Abuse and Sex, is an unprecedented effort to analyze the complex connections between substance abuse and sexual activity, function, pleasure and violence, with particular attention to the consequences of such connections for our nation's teenagers. The report is the culmination of two years of work, including the most penetrating analyses of relationships between substance use and sexual activity ever undertaken. In preparing the report, we conducted original analyses of various national data sets of more than 34,000 teenagers, as well as data sets of sexual offenders; reviewed more than 800 articles and books; talked with more than 100 experts in relevant fields; and examined dozens of prevention and treatment programs concerned with substance abuse, sex and sexual violence. Before graduating from high school, every teen in America will have to make a conscious choice--most on numerous occasions--whether to drink alcohol, whether to use illegal drugs and whether to have sexual intercourse. Even more troubling, many children will face these choices in middle school when they are 10- to 13-years-old. Those children and teens who choose to drink or use illegal drugs are much more likely to have sexual intercourse, to have it at younger ages andwhile still teens--to have sexual intercourse with several individuals. Among the report's key findings are these: Teens who drink are seven times likelier than those who don't to have sexual intercourse. Teens who use drugs are five times likelier than those who don't to have sexual intercourse. Adolescents are initiating sex at earlier ages. Fifteen-year-old females reporting sexual intercourse increased from less than five percent in 1970 to 21 percent in 1995 and males from 20 percent in 1972 to 27 percent in 1987.1 CASA's analysis suggests that the percent of 15-year-olds who have hadsex continues to rise - -in 1997, 38 percent of 15-year-old girls and 45 percent of 15-year-old boys reported having had sexual intercourse.Over the same period, the age of at which teens started using drugs and binge drinking dropped. The latest available numbers from this data set.