Sex, Drugs & the Brain

1. Sex, Drugs & the Brain

2. Agenda • Effects of drugs on sexual behavior • Neuroscience of porn • Discuss the debate on porn & sex addiction & treatment • A case study- you’re the therapist!

3. Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs: Chapter 8: Drug Use & Prevention: From Cradle to Grave “Love, Sex, & Drugs”

4. Drugs & Sex • Combo of sex & drugs help lower inhibitions, improve performance, increase fantasies. Used to shield one’s self from their own sexuality & emotional involvement • Psychoactive drugs: “Any substance that directly alters the normal functioning of the central nervous system when it is injected, smoked, snorted, or absorbed through the blood” (p.G.22) • General side effects? • Lack of interest • Physical depression • Inability to achieve orgasm or erection • Trigger aggression, rape, harassment • High risk sexual behaviors • Affect hormonal release, blood flow, blood pressure, nerve sensitivity , and muscle tension • Many psychoactive drugs affect the hypothalamus, which can trigger hormonal changes

5. Neurotransmitter Disruption • Neurotransmitter: “Chemicals that are synthesized within the body that transmit messages between nerve cells. The activity of these chemicals is strongly affected by psychoactive drugs” (p. G.19) • Serotonin • Mood, aggression, self-esteem • Dopamine • Mood, emotional behavior, motor control & orgasm • Norepinephrine • Increases HR, motivation & confidence

6. Women & Alcohol • Orgasm decreases when blood alcohol level increases • 36% of chronic alcoholics said they had orgasms less than 5% of the time • Study also found that sexual dysfunction was the best predictor of continued problems with alcohol abuse • Heavy drinking produces increases in plasma testosterone, which can inhibit ovulation & decrease infertility • Also causes menstrual disturbances, spontaneous abortions, miscarriages, and FAS disorders

7. Men & Alcohol • A blood alcohol concentration (BAC) of 0.05 (about 3 beers in 1 hour for a 200lb male) has a very measurable effect on erectile ability • Alcohol diminishes spinal reflexes, thus decreasing sensitivity & erectile ability • Lowers testosterone • In one study, 60% of heavy users reported impotence • Initially more confidence b/c it acts on the reptilian brain • Aggression, fight, flight and fear

8. Adolescents & Alcohol • Already prone to risky behaviors, alcohol just increases it • Unplanned pregnancies, STIs • England study: children 13 to 14 yrs old who drank at least once a wk had a 10-fold higher chance of having sex compared to nondrinkers

9. Cocaine & Amphetamines • Release dopamine, which stimulates the pleasure center in the limbic system, the same system stimulated during excitation & orgasm…great initially • Meth in particular intensifies sexual feelings • Difference b/t the two is the duration of action: meth lasts hours longer than coke • Purity, amount, what else is taken with it matters • High is so great, that users depend on it to enjoy sex (continued use = sexual dysfunctions) • Someone who is normally shy vs. someone who is more experienced • Higher incidence of antisocial and other personality disorders, as well as preexisting social/emotional problems

10. Tobacco • Romantizied- light up after sex • Studies show that young people are 2-3x more likely to begin smoking if they have been heavily exposed to tobacco in movies • Nicotine can both stimulate & relax depending on mental state and setting • nicotine constricts blood vessels (erectile issues), slows vasocongestive response; reduces circulating testosterone • Reduces fertility in women • Giving up smoking can be a great stimulator for your sex drive

11. Opioids • Pain pills, fentanyl, demerol, methadone • Downers often used to lower inhibitions, though the depressive effects often decrease performance & desire • Long-term use- impaired performance & decrease in sex drive • Impotence • Menstrual disruption

12. Sedative-Hypnotics • Benzodiazepines, barbiturates, and street Quaaludes “alcohol in pill form” • Lower inhibitions to relax, but induce physical depression that lowers inability to perform or perform sexually • Sedative effect- weak physically • Short-acting sedative-hypnotics • Rohypnol – amnesia

13. Marijuana • “Mirror that magnifies” many effects- sensory enhancement, novelty enhancement, seemingly prolongation of time, diffusion of ego, & sexual fantasy • Shared with people in a social setting, expectations of relaxing, lower inhibitions • One study showed it was associated w/ inhibited orgasm but not inhibited desire • Very few studies on MJ and sexuality • Smoking to an excess often prevents the user from learning how to have sexual relations w/o being high (so cycle is perpetuated)

14. MDMA & MDA (Ecstasy) • History • Reports of calmness, heightened sensual awareness, warmness toward others, enhances touch, empathy • Ability to have erection and orgasm is compromised w/ high doses • Manipulates serotonin. Reverses the reuptake, results in an excess in the synapse, thus it has a more calming effect than meth (even though it is a psychostimulant) • Depletion of serotonin “down regulation” • Over heating, high BP and HR • Environment • Now cut with ALL kinds of bad shit http://www.ecstasydata.org/stats.php

15. Volatile Nitrates (amyl, butyl) • Vasodilators and muscle relaxants sold in head shops & adult stores • AKA “Poppers” • Intensify orgasm by dilating blood vessels in the penis. • Relax anal sphincter muscles • Dizziness, fainting, severe headaches

16. Selective Serotonin Reuptake Inhibitors “SSRIs alleviate depression by upping the levels of serotonin in the brain and curbing the production of the neurotransmitter dopamine. Unfortunately, dopamine is also responsible for the feelings of elation and ecstasy that accompany falling in love. By suppressing dopamine, Fisher argues, drugs like Prozac block your ability to have these feelings, thus making it harder to fall in love and stay in love” (Van Mourik, 2007).

17. Take some time to get to know about sexually transmitted infections….and please watch “And the Band Played On”

18. Behavioral Process Addiction • Addictions that don’t necessarily involve substance use • Compulsion to continue or repeat activity • Continues behavior in spite of negative consequences • Belief in loss of control, lack of will power and strength to stop • Defense mechanisms to hide or mask behavior • Psychological euphoria/reward • Tolerance: Increases behavior to maintain desired effect • Withdrawal symptoms that interfere with normal functioning: anxiety, depression, anger • Craving • Dr. Angela Broadus

19. Behavioral Addictions • Gambling • Internet/Online • Internet addiction • Cybersex • Cyber-relationships • Gambling • Information addiction • Online gaming / computer game addiction • Video gaming addiction • Television addiction • Cell phone addiction • Food • Dr. Angela Broadus

20. What are your PERSONAL attitudes & values about porn?

21. Pornography • Literature or art calculated solely to supply sexual excitement • Erotica: respectful, affectionate • Hard core & soft core • Degrading & violent • Fetish • “One person’s pornography is another person’s erotica, and one person’s erotica can cause someone else to lose her lunch.” -Kipnis, 1996

22. The Porn Explosion! • As of 2010 there were more than 100,000 websites offering explicit pornography. • These sites are visited on at least a monthly basis by 72 million people. • About 70% of the visits are during work hours. • 10% of cybersexual surfers are addicted and spend up to 8 hours a day watching pornography online. • Dr. Angela Broadus • According to FBI, Salt Lake City, Utah ranks number 1 for internet searches for adult-related content. -Knox, 2006

23. Porn Explosion cont’ • $10-14 billion-a-year industry - this is more than the money spent on football, baseball, hockey and basketball tickets combined • Rentals of X-rated videos in the U.S. increased from 79 million in 1985 to 759 million in 2001 – over an 850% increase! • $465 million spent in 2001 on adult pay-per-view movies – most of the $$ goes to media companies like Time Warner and AT&T • General public is a bit hypocritical – say there is too much violence, sex & profanity on TV and that the Federal Communications Commission (FCC) should be stricter. Yet…NCIS (Naval Criminal Investigative Service) & Desperate Housewives most popular

24. Impact on Intimate Relationships • Helpful • Possible use for sex education • Possible use for erotic arousal for couples • Increased communication • Sexual stimulation w/o the potential of rejection, criticism, pregnancy, STDs • Harmful • Poor sex education • Much porn stresses male penile performance • Much perpetuates gender role stereotypes • Possible dissatisfaction with partner’s appearance and performance, just like Cosmo and People mags • Cindy Gallop’s “Make Love, Not Porn” • http://blog.ted.com/2009/12/02/cindy_gallop_ma/

25. Your Brain on Porn • Your Brain on Porn Series • http://yourbrainonporn.com/your-brain-on-porn-series • Dr. Patrick Carnes: Internet's Role in the Spread of Sex Addiction • http://www.youtube.com/watch?v=ZkVplYJdSsU

26. David Ley & Marty Klein

27. So…are you a sex addict? Sexual Addiction Screening Test (SAST)

28. Discussion Joe Kort: Depathologizing Porn David Ley: Sex Addiction: Rejected Yet Again by APA & The Profit in Sex Addiction Marty Klein: You’re Addicted to What? Challenging the Myth of Sex Addiction

29. A Case Study: Meet Zoolander