Heavy Cocaine Use and Sexual Behavior

• Date: 01 July 1988
• Published date: 01 July 1988
• DOI: 10.1177/002204268801800309
• Subject Matter: Article

The

Journal

of Drug Issues, 18(3),437-455, 1988

HEAVY

COCAINE

USE

AND SEXUAL BEHAVIOR

Patrick

T.

Macdonald

Dan

Waldorf

Craig

Reinarman

Sheigla

Murphy

The research discussed here explores the sexual

behavior

of

two hundred

and

twenty-eight heavy

users

of

cocaine.Intensive, face-to-face, tape-recorded

interviews with each user uncovered some interesting

differences in sexuality among various user groups.

Jibr example, male users were found to have greater

levels

of

sexual enhancement from cocaine,than were

female users. Another finding was that freebasers

and

snorters

of

the drug

had

similar levels

of

sexual

impairment, while injectors experienced far worse

levels

of

sexual dysfunction. The widespread myth-

ology that cocaine is always a sexual aphrodisiac

was certainly not confirmed by this research effort. It

was found that there were a myriad

of

responses to

the same dosage level ofcocaine, depending, in part,

upon the setting

of

the usage, as well as the back-

ground experiences

of

the

user.

Throughout history various substances have been used to enhance sexual

desire or performance. These so-called aphrodisiacs have taken many forms,

both legal and illegal. For example, the

bark

ofan African tree,johimbe, has quite

areputatioIi as a sexual stimulant. Likewise, damiana, alcohol, and kava-kava

are all substances

that

have historically been used to reduce sexual inhibitions

(Selden,

1979).

With

the

expansion of

the

illegal drug culture in the 1960s, a

number ofillicit drugs came to be associated with sexual stimulation as well. For

example, marijuana (Cohen, 1982; Goode, 1969;

Koff,

1974; Halikas et al., 1982;

Gawin, 1978), MDA (Gay et al., 1982) and amphetamines (Smith, 1982) gained

modest reputations as aphrodisiacs. Cocaine, however, has probably achieved

the

most prestige among drug connoisseurs as

the

paramount sexual stimulant.

Patrick

T.

Macdonald,

Alcohol Research Group, School of Public Health, U. C., Berkeley. Berkeley, CA 94720.

Dan

Waldo~

Institute for Scientific Analysis, San Francisco, CA 94123.

Crall

Helnarman,

Department of

SocioiollY

1

Ant~POlollY,

Northeastern University, Boston, MA 02115.

Sheilla

Murphy,

Institute for Scientific Analysis, San

tan

Cl

sco, CA 94123. Support for this article was provided by a National Institute of Drug Abuse (NIDAl

grant

(1.R01.

03791-01)

to Dan Waldorf, Principal Investigator, Cocaine Cessation Project, URSAInstitute.

<0

Journal of Drug Issues, Inc. 0022-0426/881031437-455 $1.00

437

MACDONALD

For centuries, cocaine

has

been associated with sexual vigor.

It

has been added

to various elixers

and

drinks to produce an uplifting

result

(Phillips, 1975).

Its

ability to induce euphoria, along with increased energy has made it the luxury

drug among those who use it. Among

the

claims made about cocaine in

the

literature are reports of heightened sexual desire (Wesson, 1982; Smith, 1982;

Grinspoon

and

Bakalar, 1976)

and

prolongation of

the

period ofsexual intercourse

(Phillips

and

Wynne, 1978; Gay et al., 1982). Still other claims have been made

about cocaine's ability to increase

the

intensity of orgasm (Phillips

and

Wynne,

1978),

and

the

tendency for it to increase sexual assertiveness and innovation (Gay

et aI., 1982).

More recently, however,

the

dark

side of cocaine

and

sexuality

has

received

quite a

bit

ofpress. Anumberofdrug researchers have begun to level a wide range

of assertions concerning cocaine's penchant for producing sexual dysfunction,

especially among heavy users of

the

drug (Waldorf et al., 1977; Buffum, 1982;

Siegel, 1982; Smith et al., 1984; Washton et al., 1983; Estroff

and

Gold, 1985-86).

Dysfunctions which have been noted as common to heavy users of both sexes

include lack of desire, problems achieving orgasm,

and

physical insensitivity.

Among males,

there

are

reports ofusers having problems achieving

and

maintain-

ing erections, as well as isolated cases of painful, long-lastingerections (priapism)

(Gay and Sheppard, 1973). With female users, lubrication problems have been

noted, as well as inflammations of

the

vagina due to marathon sexual sessions.

There

are

also accounts of "excessive, compulsive masturbation"

patterns,

especially among those using cocaine alone (Smith, 1982).

This myriad of sexual problems associated with cocaine use is said to be

the

result ofcertain styles

and

techniques of use. For example, little

has

been written

on

the

negative sexual effects produced by small amounts of cocaine used

intranasally. In contrast, most reports of sexual dysfunctions center around users

who

are

either

heavy, long-term users or who utilize some rapid delivery

technique of ingestion, such as injection or freebasing. Most of these negative

reports come from

the

clinical files of those eitherseeking

treatment

(Siegel, 1982;

Smith, 1982) or calling a cocaine hotline (Washton

and

Gold, 1984; Washton et al.,

1983; Estroff and Gold, 1985-86). Because of this,

the

data

may in fact be

nonrepresentative even of those who use cocaine heavily. Another problem with

the

current

state

of knowledge in

the

area

of cocaine

and

sexual behavior is

that

much of

the

"data" is largely from clinical reports

that

are

merely anecdotal, again

rendering it susceptible to a variety of methodological problems.

The study reported here attempts to deal with some of these methodological

problems by gathering empirical data from a purposive sample of regular cocaine

users

and

ex-users who were not associated with

treatment

programs or hotlines.

It

is

part

of a larger study of

the

social-psychological processes of cocaine

cessation, which interviewed both users

and

ex-users.

It

was not designed to be a

definitive study of

the

effects of cocaine on sexuality, as our focus was primarily on

the

negative effects associated with cocaine use.

Methods

The subjects for

the

study primarily used cocaine. Heavy users of other drugs

such as-alcohol, heroin, barbiturates

and

amphetamines were excluded. We made

438 JOURNAL OF DRUG ISSUES