Drugs and sexual consent

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Psychoactive drugs Psychoactive Drugs.jpg
Psychoactive drugs

Drugs and sexual consent is a topic that discusses the impacts of drugs on sexual activity that lead to changes in sexual consent. Sexual consent is the voluntary agreement to engage in sexual activity, which is essential in preventing sexual violence. [1] Consent can be communicated verbally or nonverbally and should be freely offered. [2] However, drug use, particularly psychoactive drugs (i.e. alcohol and some illicit drugs) that alter mental processes, can affect people's decision-making and consent communication ability, potentially impacting the autonomous aspect of sexual consent.

Contents

The definition of sexual consent, "agreement to engage in sexual activity", highlights that willingness is equivalent to consent and desire is equal to "wantedness", though they are not always related. [3] Therefore, individuals can provide consent for sex even if they do not necessarily desire it, making the boundary of "sexual consent" unclear. [4] The situation complicates the legitimate judgment of sexual violence, blurring the line between consensual sex and rape when the accuser is severely intoxicated and cannot clearly express disagreement. [5]

Most studies on drug and sexual consent are based on self-reports that emphasize the psychological and sociological aspects, while the direct biological mechanisms remain largely unexplored. However, the indirect physiological effects of drugs on sexual consent, such as impaired cognition and judgment, may lead to changes in sexual behavior and affect sexual consent.

Psychological and sociological aspects

A study demonstrated three ways drugs could affect sexual consent in psychological and sociological aspects.

Increased perceived sexual autonomy

Perceived sexual autonomy Noun-sexual-harassment-4670347.svg
Perceived sexual autonomy

Drugs could improve the autonomous aspect of sexual consent, thus raising the tendency of the user to engage in both desired and undesired sex. [3]

Firstly, drug use may diminish cognitive issues that keep people from engaging in sexual behaviors. [3] This includes removing impediments to sexual activity, such as social conventions, religious beliefs, and sexual guilt. For some individuals, drug-taking is necessary for them to participate in homosexual sex, which frees them from a sense of taboo. [6]

Through expanding user's sexual boundaries and limitations, drug also improves people's participation in different varieties of sex, including those that are previously undesired. [3] Some claimed that they would consent to have sex that they would not try in sobriety, [7] for example, BDSM, role play, and use of sex toys. [3]

Individuals on drugs reported feelings of intimacy, trust, love, and a strong desire to have sex with multiple sexual partners. [3] Due to the symbolic nature of closeness and trust, drug use may also boost a desire to engage in sex without using condoms. [3] Once the effects of the drugs wear off, these emotional attachments may fade away, leading to emotions of regret. [8]

Others' perception of drug users being sexually available

Consent Oberlin Consent Initiative.jpg
Consent

Individuals on drugs claimed to be viewed by others as sexually available, that is, more likely to provide consent to engage in sexual activities. [6] Two fundamental presumptions appeared to be connected to this impression. [3] (1) People believe using drugs makes it simpler to persuade others to engage in sexual activity as drugs have a reputation for promoting sexual pleasure, making men perceive women on drugs as "horny" and more sexually available. [6] (2) Drug users are also thought to be prepared to offer sex trade for drugs, implying a sense of reciprocity between these transactions. [3] Despite their initial reluctance, women often provide sex in return for drugs, [3] with 57% of opiate users reported receiving drugs or money in return for sex. [9] Unlike buying drugs with cash, the sex-bought method is often implicit with unspecific pricing standards. [3] People are less likely to relate implicit exchange with predicted bad outcomes, so they are more likely to encourage the behavior than explicit trades. [3]

Several studies have found that significant drug use can impair or change judgment, resulting in irrationality and overexcitability during drug-related sexual conduct. [10] This might be due to people focusing on achieving orgasm regardless of their sexual partner's experience. [11] Some drugs impair sexual awareness, making it harder to make sexual decisions. [3] The meaningfulness of consent made by a high individual on the verge of passing out was challenged. [12] People on drugs are more "suggestible". In other words, they are more willing to obey their sexual partner's orders. [3]

Drugs also impair the capability to communicate sexual consent. [3] Those who used marijuana reported an inability to speak out or oppose sexual behaviors though cognitively reluctant. [13] Narcotics can also impair muscular control, making it difficult to indicate no through body language. [7]

Biological activity of drugs

Although it is commonly believed that recreational drugs act as aphrodisiacs and serve as preludes to sexual activities, their specific mechanisms remain to be explored. [14] Various models have been composed to imitate the drug kinetics of these drugs on sex. However, most drug-sex study data were collected from small sample interviews and self-reports. [15] Social environment, drug dosage, duration of use, and user characteristics are other factors that should be considered. [16]

The section focuses on discussing several most used recreational drugs. Methamphetamine, which has more direct studies on its biological mechanism of sexual consent, is also explained.

Alcohol

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Alcohol

Alcohol is a depressant and a psychoactive drug that can alter human behavior. [17] The views of alcohol on sexual consent vary significantly. Alcohol is frequently seen as a significant sexual facilitator, disinhibitor, and possibly an aphrodisiac. [14] It often precedes and facilitates sexual activity in social settings, encouraging people to be more receptive to sex. [16] Similar to other drugs, people who drink are often seen as being more sexually available and more seductive after drinking. [3] [18]

However, other studies suggest excessive alcohol may have negative effects on sex. Alcohol can interfere with the release of sexual hormones, such as testosterone, estrogen, and progesterone, possibly stifling sexual arousal. [14] It can also directly affect blood flow or other physiological processes in sexual organs. It has been hypothesized that alcohol's depressive effects on the central nervous system (CNS) may cause erectile dysfunction, decreased vaginal secretions, diminished sexual responsiveness, and other sexual dysfunctions. [19] [20] The physiological response to sex decreases with alcohol consumption in women, despite increasing self-reporting sexual desire and ability to reach sexual orgasm. [21] In addition, the neurotransmitter gamma-aminobutyric acid (GABA), which blocks impulse transmission, is most prominently increased by alcohol. [15] High blood alcohol level increases its activity in the spinal cord potentially causing drowsiness, [15] making it more difficult to communicate sexual consent.

THC Tetrahydrocannabinol.svg
THC

Marijuana

Marijuana, also known as cannabis, is of the highest consumption in the recreational drug market. [22] 70% of marijuana consumers viewed it as an aphrodisiac and 81% increased sexual delight and satisfaction. [23] However, limited physiological evidence indicates that it stimulates sexual desire or improves sexual function. [15] Most evidence suggests the link between the two is indirect. Delta-9-tetrahydrocannabinol (THC), the primary psychoactive component of marijuana, has a similar structure to the neurotransmitter anandamide. THC can target the hippocampus and orbitofrontal cortex to affect memory formation and induce hallucinations. [15] [24] It also influences feelings of pleasure, sensation, and other cognitive functions. [25] In addition, high THC dosage impairs basic motor control and reactions. [25] The ability to communicate consent after initiating sexual activities decreases while intoxicated. However, the mechanisms of the self-reports effect of marijuana to promote sexual enjoyment are still unclear. This stimulation could result from a general improvement in sensory experience. [15]

Heroin Heroin - Heroine.svg
Heroin

Opioid

Opioids, also known as heroin, are the world's second most popular drug. [23] They are CNS depressants that relieve pain and induce sedation. [26] Some users describe a rush of euphoria after using the drug similar to sexual orgasms. [15] Due to the ability to delay orgasm, muscle relaxation, and analgesic effects, opioid is also used in self-medication for sexual dysfunctions such as premature ejaculation in males or dyspareunia in female. [15] However, long-term opioid use can influence the neuroendocrine system, inhibiting gonadotropin-releasing hormones to decrease libido and lower testosterone levels in men. [15]

Previous research has been limited to self-report studies. However, opioid sedation can impair cognitive function, [27] potentially impairing judgment about sexual boundaries and consent. It can also alter pain perception and pleasure, [28] affecting drug-users' ability to assess their comfort level accurately during sexual activity.

Methamphetamine

Methamphetamine Racemic methamphetamine.svg
Methamphetamine

Methamphetamine (MA) is a potent stimulant impacting the CNS. From self-report studies, It has been found to enhance sexual desire, promote pleasure, and delay orgasm. [15] However, methamphetamine use is greatly associated with high-risk sexual behaviors and reduction in sexual inhibition. [29] [30] Methamphetamine can increase the likelihood of engaging in atypical sexually behaviors, such as pedophilia, group sex, and same-sex intercourse among heterosexual individuals. [25]

One issue related to sexual consent concerns whether agreement is made under conscious conditions. Methamphetamine abuse is linked to neurotoxicity in the brain and has deleterious effects on cognitive processes, [31] for example, deficits in episodic memory, executive functioning, information processing speed, motor skills, and language abilities. [32] The impairment of cognitive ability could thus lead to diminished capability to provide informed and enthusiastic consent.

Furthermore, Methamphetamine users have been found to differ from non-users in high-risk behavior related neurocognitive decision-making processes. [33] This research reveals the weaker activation of the risk and reward-modulating regions in brains of casual drug users. As the system is responsible for handling risks and rewards, neurological differences suggest that during decision-making, methamphetamine users may be less concerned about the potential risks associated with a choice. Instead, they may focus more on the potential gains and immediate outcomes. This could explain why methamphetamine users may engage in high-risk sexual behaviors or have sex with partners who they would not in sobriety. They only consider the immediate pleasure rather than long-term risks.

Animal studies confirm that methamphetamine and sexual behavior activate the same neurons in the CNS responsible for motivation and reward. [34] Methamphetamine and sexual behavior are considered as "rewards" that trigger the release of dopamine, causing feelings of pleasure and satisfaction. These pleasurable feelings in turn acts as a motivation again, encouraging people to compulsively seek natural rewards. In sum, this co-activation of neuronal populations suggests that methamphetamine use leads to compulsive seeking of natural rewards, in this case, sexual behavior, proving the drug heightens sexual consent autonomy.

Drug-facilitated sexual assault (DFSA)

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DFSA

Drugs do not only affect one's decision on sexual consent but also cause a loss of ability to express it. Date rape drugs including ethanol, benzodiazepines, gamma-hydroxybutyrate, and ketamine are frequently used in facilitating sexual assault. [35]

Ethanol

Ethanol is sometimes used as a date rape drug, as it can cause amnesia, impaired motor coordination, and mental confusion, all of which can aid the actions of sexual predators. [35]

Benzodiazepines

Benzodiazepines are medications used to treat anxiety, stress, and insomnia. When the drug binds to the GABA receptor, sedation and muscle relaxation occurs. [35] Flunitrazepam is a common benzodiazepine used in rape facilitation since it causes memory blackouts. [36]

Ketamine

Ketamine is a dissociative anesthetic often abused for its euphoric and hallucinogenic tendencies. [35] The drug could induce dissociation in the brain, which is the separation or disconnection in activities between the thalamus and limbic systems, [37] causing amnesia that facilitate sexual abuse. [38]

Gamma-hydroxybutyrate (GHB)

GHB have a chemical structure similar to neurotransmitter GABA. It is commonly used as a date rape drug due to its euphoric and CNS depressant effects [39] which can slow down brain activity. Additionally, individuals may experience poor concentration and confusion after taking GHB. [40]

Application

Drug-taking was found to impact the capacity to make sexual decisions, raise engagement in anal intercourse, willingness to have multiple sex partners, and decreased condom usage. This increases susceptibility to sex-related health issues and associated harms, including HIV and venereal disease. [41]

A key aspect of harm reduction is educating those who might use sex-related drugs about the consequences of doing so, and encouraging them to evaluate their possible sexual partners. [5] Public education about drugs and sexual consent could also lessen victim-blaming beliefs and increase social support. [3] Due to a lack of knowledge and education regarding sexual consent-related issues, bar industry employees have found it challenging to stop sexual harassment. [42] Implementing policies and prevention strategies could be aided by future education initiatives, like bystander prevention. However, many nightclubs claimed to have "zero-tolerance" drug usage policies, making it difficult to provide instruction without seeming to support drug use. [3]

Related Research Articles

<span class="mw-page-title-main">Recreational drug use</span> Use of drugs with the primary intention to alter the state of consciousness

Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Recreational drugs are commonly divided into three categories: depressants, stimulants, and hallucinogens.

<span class="mw-page-title-main">Psychopharmacology</span> Study of the effects of psychoactive drugs

Psychopharmacology is the scientific study of the effects drugs have on mood, sensation, thinking, behavior, judgment and evaluation, and memory. It is distinguished from neuropsychopharmacology, which emphasizes the correlation between drug-induced changes in the functioning of cells in the nervous system and changes in consciousness and behavior.

An aphrodisiac is a substance alleged to increase libido, sexual desire, sexual attraction, sexual pleasure, or sexual behavior. These substances range from a variety of plants, spices, and foods to synthetic chemicals. Natural aphrodisiacs, such as cannabis or cocaine, are classified into plant-based and non-plant-based substances. Synthetic aphrodisiacs include MDMA and methamphetamine. Aphrodisiacs can be classified by their type of effects. Aphrodisiacs that contain hallucinogenic properties, such as bufotenin, have psychological effects that can increase sexual desire and sexual pleasure. Aphrodisiacs that have smooth muscle relaxing properties, such as yohimbine, have physiological effects that can affect hormone concentrations and increase blood flow.

<span class="mw-page-title-main">Club drug</span> Category of recreational drugs

Club drugs, also called rave drugs or party drugs, are a loosely defined category of recreational drugs which are associated with discothèques in the 1970s and nightclubs, dance clubs, electronic dance music (EDM) parties, and raves in the 1980s to today. Unlike many other categories, such as opiates and benzodiazepines, which are established according to pharmaceutical or chemical properties, club drugs are a "category of convenience", in which drugs are included due to the locations they are consumed and/or where the user goes while under the influence of the drugs. Club drugs are generally used by adolescents and young adults.

A date rape drug is any drug that incapacitates another person and renders that person vulnerable to sexual assault, including rape. The substances are associated with date rape because of reported incidents of their use in the context of two people dating, during which the victim is sexually assaulted or raped or suffers other harm. However, substances have also been exploited during retreats, for example ayahuasca retreats. The substances are not exclusively used to perpetrate sexual assault or rape, but are the properties or side-effects of substances normally used for legitimate medical purposes. One of the most common incapacitating agents for date rape is alcohol, administered either surreptitiously or consumed voluntarily, rendering the victim unable to make informed decisions or give consent.

Stimulant psychosis is a mental disorder characterized by psychotic symptoms. It involves and typically occurs following an overdose or several day binge on psychostimulants, though one study reported occurrences at regularly prescribed doses in approximately 0.1% of individuals within the first several weeks after starting amphetamine or methylphenidate therapy. Methamphetamine psychosis, or long-term effects of stimulant use in the brain, depend upon genetics and may persist for some time.

Drugs and prostitution have been documented to have a direct correlation.

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

Sex and drugs refers to the influence of substances on sexual function and experience. Sex and drugs date back to ancient humans and have been interlocked throughout human history. Sexual performance is known as the execution of the act of sex and the quality of sexual activity. This includes elements such as libido, sexual function, sensation. Drugs are termed as any chemical substance that produces a physiological and or psychological change in an organism. Drugs categorized as psychoactive drugs, antihypertensive drugs, antihistamines, cancer treatment, and hormone medication have a significant impact on sexual performance. Various drugs result in different effects, both positive and negative. Negative effects may include low libido, erection issues, vaginal dryness and anorgasmia. Positive effects usually address these issues, overall enhancing sexual performance and contributing to a more enjoyable sexual experience. It is crucial to know that the impact of drugs on sexual performance varies among individuals, especially among different genders.

A drug with psychotomimetic actions mimics the symptoms of psychosis, including delusions and/or delirium, as opposed to only hallucinations. Psychotomimesis is the onset of psychotic symptoms following the administration of such a drug.

<span class="mw-page-title-main">Party and play</span> Drug use to facilitate sexual activity

Party and play (PnP), also known as chemsex or wired play, refers to the practice of consuming drugs to enhance sexual activity. This sexual subculture involves recreational drug users engaging in high-risk sexual behaviors under the influence of drugs, often within specific sub-groups. Activities may include unprotected sex with multiple partners during sessions over extended periods, sometimes lasting days. The drug of choice is typically methamphetamine, commonly referred to as crystal meth, tina, or T. Other substances like mephedrone, GHB, GBL, ketamine, and alkyl nitrites are also used. The term slamsex is used for injection drug users.

<span class="mw-page-title-main">Methamphetamine</span> Central nervous system stimulant

Methamphetamine is a potent central nervous system (CNS) stimulant that is mainly used as a recreational or performance-enhancing drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder (ADHD) and obesity. It has also been researched as a potential treatment for traumatic brain injury. Methamphetamine was discovered in 1893 and exists as two enantiomers: levo-methamphetamine and dextro-methamphetamine. Methamphetamine properly refers to a specific chemical substance, the racemic free base, which is an equal mixture of levomethamphetamine and dextromethamphetamine in their pure amine forms, but the hydrochloride salt, commonly called crystal meth, is widely used. Methamphetamine is rarely prescribed over concerns involving its potential for recreational use as an aphrodisiac and euphoriant, among other concerns, as well as the availability of safer substitute drugs with comparable treatment efficacy such as Adderall and Vyvanse. Dextromethamphetamine is a stronger CNS stimulant than levomethamphetamine.

<span class="mw-page-title-main">Euphoria</span> Intense feelings of well-being

Euphoria is the experience of pleasure or excitement and intense feelings of well-being and happiness. Certain natural rewards and social activities, such as aerobic exercise, laughter, listening to or making music and dancing, can induce a state of euphoria. Euphoria is also a symptom of certain neurological or neuropsychiatric disorders, such as mania. Romantic love and components of the human sexual response cycle are also associated with the induction of euphoria. Certain drugs, many of which are addictive, can cause euphoria, which at least partially motivates their recreational use.

<span class="mw-page-title-main">Alcohol and sex</span>

Alcohol and sex deals with the effects of the consumption of alcohol on sexual behavior. The effects of alcohol are balanced between its suppressive effects on sexual physiology, which will decrease sexual activity, and its suppression of sexual inhibitions. A large portion of sexual assaults involve alcohol consumption by the perpetrator, victim, or both.

<span class="mw-page-title-main">Amphetamine dependence</span> Medical condition

Amphetamine dependence refers to a state of psychological dependence on a drug in the amphetamine class. Stimulants such as amphetamines and cocaine do not cause somatic symptoms upon cessation of use but rather neurological-based mental symptoms.

<span class="mw-page-title-main">Addiction</span> Disorder resulting in compulsive behaviours

Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use often alters brain function in ways that perpetuate craving, and weakens self-control. This phenomenon – drugs reshaping brain function – has led to an understanding of addiction as a brain disorder with a complex variety of psychosocial as well as neurobiological factors that are implicated in addiction's development.

<span class="mw-page-title-main">Psychoactive drug</span> Chemical substance that alters nervous system function

A psychoactive drug, mind-altering drug, or consciousness-altering drug is a chemical substance that changes brain function and results in alterations in perception, mood, consciousness, cognition, or behavior. The term psychotropic drug is often used interchangeably, while some sources present narrower definitions. These substances may be used medically; recreationally; to purposefully improve performance or alter consciousness; as entheogens for ritual, spiritual, or shamanic purposes; or for research, including psychedelic therapy. Physicians and other healthcare practitioners prescribe psychoactive drugs from several categories for therapeutic purposes. These include anesthetics, analgesics, anticonvulsant and antiparkinsonian drugs as well as medications used to treat neuropsychiatric disorders, such as antidepressants, anxiolytics, antipsychotics, and stimulants. Some psychoactive substances may be used in detoxification and rehabilitation programs for persons dependent on or addicted to other psychoactive drugs.

Risky sexual behavior is the description of the activity that will increase the probability that a person engaging in sexual activity with another person infected with a sexually transmitted infection will be infected, become unintentionally pregnant, or make a partner pregnant. It can mean two similar things: the behavior itself, and the description of the partner's behavior.

Discrimination against people with substance use disorders is a form of discrimination against people with this disease. In the United States, people with substance use disorders are often blamed for their disease, which is often seen as a moral failing, due to a lack of public understanding about substance use disorders being diseases of the brain with 40-60% heritability. People with substance use disorders are likely to be stigmatized, whether in society or healthcare.

Marijuana use is commonly thought to enhance sexual pleasure. However, there is limited scientific research on the relationship between marijuana and sex. The lack of research on the topic is, in part, due to U.S. drug policies centred on prohibition. In addition, the effects are difficult to study because sexual arousal and functioning are, in themselves, extremely complex and differ among individuals. Moreover, marijuana affects people differently. As a result, it is challenging to study. Men and women report greater sexual pleasure after having consumed marijuana, but there is no direct scientific evidence of the effects on the physiological components of the sexual response cycle when using the drug.

References

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