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

Archives of Sexual Behavior volume 47, pages 757–770 (2018)Cite this article

Abstract

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.

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References

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Covington, S. S., & Kohen, J. (1984). Women, alcohol, and sexuality. Advances in Alcohol and Substance Abuse, 4, 41–56.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Dunn, M. S., Bartee, R. T., & Perko, M. A. (2003). Self-reported alcohol use and sexual behaviors of adolescents. Psychological Reports, 92, 339–348.

    Article  PubMed  Google Scholar 

  • Hall, J. A., & Moore, C. B. (2008). Drug facilitated sexual assault—a review. Journal of Forensic and Legal Medicine, 15, 291–297.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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. http://monitoringthefuture.org/pubs/monographs/mtf-vol2_2013.pdf.

  • 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.

    Article  PubMed  Google Scholar 

  • Kerrigan, S. (2010). The use of alcohol to facilitate sexual assault. Forensic Science Review, 22, 15–32.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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, 1975–2014: Volume I, secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan. http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2014.pdf.

  • Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis. An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Motel, S. (2014, November 5). 6 facts about marijuana. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2014/11/05/6-facts-about-marijuana/.

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Poulin, C., & Graham, L. (2001). The association between substance use, unplanned sexual intercourse and other sexual behaviors among adolescent students. Addiction, 96, 607–621.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23, 334–340.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procdures and techniques. Newbury Park, CA: Sage Publications.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Wechsler, H., Dowdall, G. W., Davenport, A., & Castillo, S. (1995). Correlates of college student binge drinking. American Journal of Public Health, 85, 921–926.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

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).

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Authors and Affiliations

  1. Department of Population Health, New York University Langone Medical Center, 227 East 30th Street, 7th Floor, New York, NY, 10016, USA

    Joseph J. Palamar & Patricia Acosta

  2. Center for Drug Use and HIV Research, New York University College of Nursing, New York, NY, USA

    Joseph J. Palamar, Danielle C. Ompad & Samuel R. Friedman

  3. Center for Health, Identity, Behavior & Prevention Studies, New York University Steinhardt School of Culture, Education and Human Development, New York, NY, USA

    Joseph J. Palamar & Danielle C. Ompad

  4. College of Global Public Health, New York University, New York, NY, USA

    Danielle C. Ompad

  5. National Development and Research Institutes, New York, NY, USA

    Samuel R. Friedman

Authors
  1. Joseph J. Palamar
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  2. Patricia Acosta
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  3. Danielle C. Ompad
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  4. Samuel R. Friedman
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Correspondence to Joseph J. Palamar.

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Palamar, J.J., Acosta, P., Ompad, D.C. et al. A Qualitative Investigation Comparing Psychosocial and Physical Sexual Experiences Related to Alcohol and Marijuana Use among Adults. Arch Sex Behav 47, 757–770 (2018). https://doi.org/10.1007/s10508-016-0782-7

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  • DOI: https://doi.org/10.1007/s10508-016-0782-7

Keywords

  • Marijuana
  • Alcohol
  • Risk behavior
  • Orgasm
  • Sexual dysfunction