Study: The Top 4 Drugs That "Enhance Sex" Indicate Why People Use Them

Sex and drugs have long gone hand in hand, but their relationship is more complex than it may seem. According to a survey released in the Journal of Sexual Information on Monday, the four different types of drugs people around the world most prefer to use while they’re having sex have very different impacts on the emotional and performative aspects of the sexual experience. These data provide a real-world illustration of the emotional and physical effects that drugs induce, which could help explain why people like combining them with sex in the first place.

"However, people can use drugs in combination with sex without these harms — they aren’t inevitable."

This study highlights, in intimate detail, the drugs people take to enhance their sexual experiences, as well as what happens when they do so. A team led by Will Lawn, Ph.D., a research associate at the University of College London’s clinical psychopharmacology unit, gleaned results from answers in the 2013 Global Drug Survey, an independently run survey that collected data on sex and drug use from 22,289 people in the UK, United States, Canada, Australia, and Europe. Alcohol was the most common drug used during sex, followed closely by marijuana, MDMA, and cocaine.

“In combination, they increase risk of unsafe sex, unwanted pregnancies, and STD transmission. Many drugs are associated with sex where the process of consent is affected,” Lawn tells Inverse. “However, people can use drugs in combination with sex without these harms — they aren’t inevitable.”

The team’s analysis of the Global Drug Survey data showed that 58.5 percent of men and 60.4 percent of women had sex after drinking. Thirty-seven percent of men and 26.3 percent of women had sex after smoking marijuana, and 15.5 percent of both men and women had sex on MDMA. Cocaine was up there, too: 10.2 percent of men and 9.7 percent of women had sex while on cocaine.

Besides just tracking the popularity of drugs, the Global Drug Survey broke new ground by quantifying how each one of these drugs actually affects the sexual experience. To do this, each respondent rated how each drug impacted the emotional components of sex, quality of orgasm, and the ability to perform sexually on a scale from one to 10. Out of the top four most popular drugs, only MDMA had consistent, intense effects on the sexual experience. Other less common drugs, like GHB, still had powerful effects.

When it came to sexual performance, Viagra led the pack for men — but for women, both GHB/GBL and methamphetamine were ranked highly. For both men and women, MDMA had the highest scores in “sensual aspects,” and “emotionality and intimacy.” This result fits well with the effects of MDMA that scientists have previously observed in the lab. MDMA has been shown to improve empathy in humans, and in octopuses, solitary creatures who were more likely to reach out and hug their companions after spending some time in an MDMA-infused tank.

This population-level study shows that in practice these prosocial elements translate well to sex — which is maybe part of the reason that MDMA got such high praise amongst the survey respondents.

Though they don’t report the exact ratings in the paper, the authors note that marijuana and cocaine were also rated positively, though their ratings imply they have “somewhat milder effects on the sexual experience.”

Intensity of sexual experience aside, Lawn says it makes perfect sense that people use drugs to enhance sex. But he was surprised at the small amount of people who combine sex and drugs most of the time. For instance, 4.5 percent of men reported combining sex and drugs more than 50 percent of the time, and 2.7 reported pairing drugs with sex all the time. For women, 1.6 percent reported using drugs with sex all the time.

“That is concerning,” he says. “But from this data set, we don’t know anything more about the problems that this may cause.”

Needing drugs to do any activity, including sex, is likely a cause for concern. Though this data set can’t point to specific risks that come from having sex on any of these drugs, sex doesn’t counteract the health risks that cocaine or methamphetamine pose on their own.

"People take pleasure from doing this."

Lawn hopes that as public health researchers consider his data, they approach it with an open mind. Sex is just one of the many different settings in which people do drugs, and so, when public health researchers try to communicate risks, he hopes they approach it in a delicate way.

“Researchers and public health people can think about these things in non-judgmental ways,” he says. “People take pleasure from doing this. We should try to help limit harm given that there are risks involved.”

Partial Abstract:

Introduction: Substance use in sexual contexts has received recent attention, but it has mostly been restricted to men who have sex with men and the so-called “chemsex” phenomenon.

Aim: To explore the use of licit and illicit substances in combination with sex in heterosexual, homosexual, and bisexual men and women; to explore substance-linked sex (SLS) differences across sexual orientation and sexes.

Methods: An international online self-selecting cross-sectional drugs survey, the Global Drug Survey 2013 (n = 22,289), was conducted. Respondents were asked about which drugs (including alcohol) they had had sex while on; how frequently they used drugs to enhance sex; and how different drugs changed different aspects of the sexual experience. We report descriptive statistics and test differences between men and women and between different sexual orientations.

Main Outcome Measures: The following outcome measures were recorded: (i) Percentage of each group reporting last-year use of each drug with sex, (ii) Mean subjective rating (−10 to +10) from each group for each drug on each aspect of the sexual experience.

Results: SLS occurred across sexual orientations and in both men and women. All groups reported that alcohol, cannabis, and 3,4-methylenedioxymethamphetamine (MDMA) were the most while commonly used drugs with sex. Larger proportions of homosexual and bisexual men had sex while on most drugs than heterosexual men (P < .001); and larger proportions of bisexual women had sex while on most drugs than heterosexual women (P < .004). ≥20% of each group reported having used drugs with the intention of enhancing a sexual experience; larger proportions of homosexual and bisexual men reported this behavior than heterosexual men (P < .001). There were clear dissociations between the effects of different drugs on different aspects of the sexual experience; although γ-hydroxybutyric acid/γ-butyrolactone and MDMA were rated consistently highly.