Archives of Sexual Behavior

, Volume 47, Issue 3, pp 757–770 | Cite as

A Qualitative Investigation Comparing Psychosocial and Physical Sexual Experiences Related to Alcohol and Marijuana Use among Adults

  • Joseph J. PalamarEmail author
  • Patricia Acosta
  • Danielle C. Ompad
  • Samuel R. Friedman
Original Paper


Alcohol and marijuana are two of the most prevalent psychoactive substances and each may result in distinct psychosocial and physical sexual experiences and different sexual risk behaviors. With marijuana becoming more accepted in the US along with more liberal state-level policies, it is important to examine and compare users’ psychosocial and physical sexual experiences and sexual risk behavior associated with these drugs. In this study, we interviewed 24 adults who recently used marijuana before sex. Participants were 50 % female and all self-identified as heterosexual and HIV-negative. Using thematic analysis, we compared self-reported psychosocial and physical sexual experiences of alcohol and marijuana. Participants described differences between drugs with regard to psychosocial (e.g., partner interactions and contexts before sex, partner choice, perceived attractiveness of self and others, disinhibition, and feelings of regret after sex) and physical sexual experiences (e.g., sexual dysfunction, dose effects, sensations of body/sex organs, length and intensity of sex, and orgasm). Alcohol use was commonly associated with social outgoingness and use facilitated connections with potential sexual partners; however, alcohol was more likely than marijuana to lead to atypical partner choice or post-sex regret. Both alcohol and marijuana had a variety of negative sexual effects, and the illegality of marijuana reportedly facilitated intimate encounters. While sexual experiences tended to be similar across males and females, we did find some variation by gender. Results can inform prevention and harm reduction programming that will allow us to design more realistic programs and to craft interventions, which guide potential users to make safer choices.


Marijuana Alcohol Risk behavior Orgasm Sexual dysfunction 



This study was funded by the Center for Drug Use and HIV Research (CDUHR) via the National Institute on Drug Abuse (NIDA) (P30DA011041). The first author was also supported by NIDA (K01 DA038800).


  1. Bedoya, C. A., Mimiaga, M. J., Beauchamp, G., Donnell, D., Mayer, K. H., & Safren, S. A. (2012). Predictors of HIV transmission risk behavior and seroconversion among Latino men who have sex with men in project EXPLORE. AIDS and Behavior, 16, 608–617.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Brodbeck, J., Matter, M., & Moggi, F. (2006). Association between cannabis use and sexual risk behavior among young heterosexual adults. AIDS and Behavior, 10, 599–605.CrossRefPubMedGoogle Scholar
  3. Castilla, J., Barrio, G., Belza, M. J., & de la Fuente, L. (1999). Drug and alcohol consumption and sexual risk behaviour among young adults: results from a national survey. Drug and Alcohol Dependence, 56, 47–53.CrossRefPubMedGoogle Scholar
  4. Coleman, L. M., & Cater, S. M. (2005). A qualitative study of the relationship between alcohol consumption and risky sex in adolescents. Archives of Sexual Behavior, 34, 649–661.CrossRefPubMedGoogle Scholar
  5. Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol, 63, 101–117.CrossRefGoogle Scholar
  6. Covington, S. S., & Kohen, J. (1984). Women, alcohol, and sexuality. Advances in Alcohol and Substance Abuse, 4, 41–56.CrossRefPubMedGoogle Scholar
  7. Dermen, K. H., & Cooper, M. L. (2000). Inhibition conflict and alcohol expectancy as moderators of alcohol’s relationship to condom use. Experimental and clinical psychopharmacology, 8, 198–206.CrossRefPubMedGoogle Scholar
  8. Dunn, M. S., Bartee, R. T., & Perko, M. A. (2003). Self-reported alcohol use and sexual behaviors of adolescents. Psychological Reports, 92, 339–348.CrossRefPubMedGoogle Scholar
  9. Hall, J. A., & Moore, C. B. (2008). Drug facilitated sexual assault—a review. Journal of Forensic and Legal Medicine, 15, 291–297.CrossRefPubMedGoogle Scholar
  10. Hingson, R. W., Zha, W., & Weitzman, E. R. (2009). Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. Journal of Studies on Alcohol and Drugs, s16, 12–20.CrossRefGoogle Scholar
  11. Johnson, S. D., Phelps, D. L., & Cottler, L. B. (2004). The association of sexual dysfunction and substance use among a community epidemiological sample. Archives of Sexual Behavior, 33, 55–63.CrossRefPubMedGoogle Scholar
  12. Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Miech, R. A. (2014) Monitoring the Future national survey results on drug use, 1975–2013: Volume I, secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan.
  13. Kerr, D. C., Washburn, I. J., Morris, M. K., Lewis, K. A., & Tiberio, S. S. (2015). Event-level associations of marijuana and heavy alcohol use with intercourse and condom use. Journal of Studies on Alcohol and Drugs, 76, 733–737.CrossRefPubMedGoogle Scholar
  14. Kerrigan, S. (2010). The use of alcohol to facilitate sexual assault. Forensic Science Review, 22, 15–32.PubMedGoogle Scholar
  15. Kingree, J. B., & Betz, H. (2003). Risky sexual behavior in relation to marijuana and alcohol use among African-American, male adolescent detainees and their female partners. Drug and Alcohol Dependence, 72, 197–203.CrossRefPubMedGoogle Scholar
  16. Kingree, J. B., Braithwaite, R., & Woodring, T. (2000). Unprotected sex as a function of alcohol and marijuana use among adolescent detainees. Journal of Adolescent Health, 27, 179–185.CrossRefPubMedGoogle Scholar
  17. Lannutti, P. J., Jennifer, & Monahan, L. (2002). When the frame paints the picture: Alcohol consumption, relational framing and sexual communication. Communication Research, 29, 390–421.CrossRefGoogle Scholar
  18. Lewis, M. A., Hove, M. C., Whiteside, U., Lee, C. M., Kirkeby, B. S., Oster-Aaland, L., … Larimer, M. E. (2008). Fitting in and feeling fine: conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking. Psychology of Addictive Behaviors, 22, 58–67.CrossRefPubMedGoogle Scholar
  19. Livingston, J. A., Bay-Cheng, L. Y., Hequembourg, A. L., Testa, M., & Downs, J. S. (2013). Mixed drinks and mixed messages: Adolescent girls’ perspectives on alcohol and sexuality. Psychology of Women Quarterly, 37, 38–50.CrossRefPubMedGoogle Scholar
  20. Miech, R.A., Johnston, L.D., O’Malley, P.M., Bachman, J.G., Schulenberg, J.E. (2015). Monitoring the Future national survey results on drug use, 19752014: Volume I, secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan.
  21. Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis. An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
  22. Motel, S. (2014, November 5). 6 facts about marijuana. Pew Research Center. Retrieved from
  23. Mutchler, M. G., McDavitt, B., & Gordon, K. K. (2013). “Becoming bold”: Alcohol use and sexual exploration among Black and Latino young men who have sex with men (YMSM). Journal of Sex Research, 51, 696–710.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Palamar, J. J. (2014). An examination of opinions toward marijuana policies among high school seniors in the United States. Journal of Psychoactive Drugs, 46, 351–361.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Palamar, J. J., Fenstermaker, M., Kamboukos, D., Ompad, D. C., Cleland, C. M., & Weitzman, M. (2014a). Adverse psychosocial outcomes associated with drug use among US high school seniors: A comparison of alcohol and marijuana. American Journal of Drug and Alcohol Abuse, 40, 438–446.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Palamar, J. J., Ompad, D. C., & Petkova, E. (2014b). Correlates of intentions to use cannabis among US high school seniors in the case of cannabis legalization. International Journal of Drug Policy, 25, 424–435.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Parsons, J. T., Vicioso, K. J., Punzalan, J. C., Halkitis, P. N., Kutnick, A., & Velasquez, M. M. (2004). The impact of alcohol use on the sexual scripts of HIV-positive men who have sex with men. Journal of Sex Research, 41, 160–172.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Pedrelli, P., Bitran, S., Shyu, I., Baer, L., Guidi, J., Tucker, D. D., … Farabaugh, A. H. (2011). Compulsive alcohol use and other high-risk behaviors among college students. American Journal on Addictions, 20, 14–20.CrossRefPubMedGoogle Scholar
  29. Poulin, C., & Graham, L. (2001). The association between substance use, unplanned sexual intercourse and other sexual behaviors among adolescent students. Addiction, 96, 607–621.CrossRefPubMedGoogle Scholar
  30. Rehm, J., Shield, K. D., Joharchi, N., & Shuper, P. A. (2012). Alcohol consumption and the intention to engage in unprotected sex: Systematic review and meta-analysis of experimental studies. Addiction, 107, 51–59.CrossRefPubMedGoogle Scholar
  31. Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23, 334–340.CrossRefGoogle Scholar
  32. Smith, A. M., Ferris, J. A., Simpson, J. M., Shelley, J., Pitts, M. K., & Richters, J. (2010). Cannabis use and sexual health. Journal of Sexual Medicine, 7, 787–793.CrossRefPubMedGoogle Scholar
  33. Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procdures and techniques. Newbury Park, CA: Sage Publications.Google Scholar
  34. Townshend, J. M., Kambouropoulos, N., Griffin, A., Hunt, F. J., & Milani, R. M. (2014). Binge drinking, reflection impulsivity, and unplanned sexual behavior: impaired decision-making in young social drinkers. Alcoholism, Clinical and Experimental Research, 38, 1143–1150.CrossRefPubMedGoogle Scholar
  35. Tran, A., Nehl, E. J., Sales, J., & Berg, C. J. (2014). Problem drinking behaviors: Differential effects of stress and school type on college students. Open Journal of Preventive Medicine, 4, 216–221.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Tyurina, A., Krupitsky, E., Cheng, D. M., Coleman, S. M., Walley, A. Y., Bridden, C., … Samet, J. H. (2013). Is cannabis use associated with HIV drug and sex risk behaviors among Russian HIV-infected risky drinkers? Drug and Alcohol Dependence, 132, 74–80.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Walsh, J. L., Fielder, R. L., Carey, K. B., & Carey, M. P. (2014). Do alcohol and marijuana use decrease the probability of condom use for college women? Journal of Sex Research, 51, 145–158.CrossRefPubMedGoogle Scholar
  38. Wechsler, H., Dowdall, G. W., Davenport, A., & Castillo, S. (1995). Correlates of college student binge drinking. American Journal of Public Health, 85, 921–926.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Joseph J. Palamar
    • 1
    • 2
    • 3
    Email author
  • Patricia Acosta
    • 1
  • Danielle C. Ompad
    • 2
    • 3
    • 4
  • Samuel R. Friedman
    • 2
    • 5
  1. 1.Department of Population HealthNew York University Langone Medical CenterNew YorkUSA
  2. 2.Center for Drug Use and HIV ResearchNew York University College of NursingNew YorkUSA
  3. 3.Center for Health, Identity, Behavior & Prevention StudiesNew York University Steinhardt School of Culture, Education and Human DevelopmentNew YorkUSA
  4. 4.College of Global Public HealthNew York UniversityNew YorkUSA
  5. 5.National Development and Research InstitutesNew YorkUSA

Personalised recommendations