Which Factors Increase the Odds of Drinking Before Sex?

It’s a firmly established fact that people who drink significant amounts of alcohol before having sex substantially increase their odds of participating in risky sexual practices and developing a sexually transmitted infection. However, researchers know relatively little about the factors that make a person more likely to drink alcohol before having sex. In a study published in August 2014 in the journal Drug and Alcohol Dependence, researchers from several U.S. institutions examined the potential impact of two specific factors: the absence or presence of a current relationship and the presence of diagnosable symptoms of alcohol use disorder.

Alcohol and Sex

Alcohol produces its intoxicating effects by altering the chemical balance inside the brain. One of the primary effects of this intoxication is a substantial decline in the effective exercise of such higher-level mental skills as the ability to think clearly, the ability to make logical decisions, the ability to control impulsive behaviors and the ability to plan for the future. All of these changes can increase the likelihood that an alcohol consumer will engage in some sort of unsafe sexual practice. Among young people in particular, alcohol intoxication is associated with such practices as having sex with a stranger or new acquaintance, having sex that doesn’t involve the use of a condom and having sex with more than one person in a short span of time. Apart from risky consensual sexual activity, alcohol consumption is also firmly linked with increased risks like rape, “date rape” and other forms of sexual assault.

Alcohol Use Disorder

The alcohol use disorder diagnosis is the result of a shifting general consensus on the nature of alcoholism and non-addicted alcohol abuse. Traditionally, addiction specialists, doctors and public health officials have treated alcoholism – a condition centered on a physical dependence on ongoing alcohol consumption – as a distinct issue from alcohol abuse, a dysfunctional, alcohol-related behavioral state found in people who don’t have a physical dependence on continued drinking. However, for decades, increasing evidence has indicated that many of the symptoms of alcohol abuse and alcoholism are essentially interchangeable and can occur separately or together in any person affected by drinking problems. In May 2013, the American Psychiatric Association officially responded to this accumulation of evidence by eliminating split definitions for alcoholism and alcohol abuse and replacing them with the single, comprehensive definition for alcohol use disorder. An affected individual can have a mild, moderate or severe case of this condition that includes only symptoms of alcoholism, only symptoms of alcohol abuse or simultaneous symptoms of both problems.

Which Factors Increase the Odds?

In the study published in Drug and Alcohol Dependence, researchers from Columbia University, Stony Brook University, the New York State Psychiatric Institute and the National Institute on Alcohol Abuse and Alcoholism used information from a coast-to-coast federal project called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine the potential impact of alcohol use disorder and a person’s current state of relationship involvement on his or her chances of consuming alcohol before a sexual encounter. The authors chose these factors, in part, because no previous research efforts had focused on them in particular. A total of 17,491 alcohol consumers with a current history of sexual activity took part in the study. The researchers looked for individuals in this group who consumed alcohol before having sex in most or all circumstances. After completing their work, the researchers concluded that a diagnosis for alcohol use disorder and a person’s current state of relationship involvement have a combined effect on the odds of consuming alcohol before having sex. More specifically, they found that, among people with diagnosable alcohol use disorder symptoms, not being in a relationship substantially increases the odds that drinking will precede sex. The study’s authors note that, apart from any issues related to sexual conduct, the odds of having alcohol use disorder are affected by an individual’s involvement or lack of involvement in a relationship. They believe that the findings of their current project underscore this connection by detailing its impact on the odds that a person will have sex after drinking.  In addition, they urge public health officials to conduct alcohol- and HIV-related campaigns that emphasize the risks associated with having sex while under the influence of alcohol. They believe that such campaigns should especially focus on adults with alcohol use disorder not involved in relationships.

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