Cocaine use has long been tied anecdotally to impulsive behavior, including risky sex, but scientifically rigorous evidence of the link has been hard to find.
Now, a small study in the journal Psychopharmacology points to cocaine-induced “sexual impatience” as a reason those sexually aroused on the drug may not bother with condoms.
“…if a condom isn’t available, cocaine makes people less willing to postpone sex to get a condom.”
“Our study affirms, and may help explain why, people who regularly use cocaine are more willing to partake in risky sex when under the influence of cocaine,” says Matthew Johnson, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.
Cocaine is addictive and, among other effects, creates feelings of euphoria, high energy and hyper-alertness. People who use it regularly are more likely to have HIV or other sexually transmitted infections. According to a 2014 survey, about 1.5 million people in the United States had used the drug in the previous month. Most were between 18 and 25.
Researchers recruited otherwise healthy regular cocaine users through advertisements and word of mouth. Potential participants seeking to quit cocaine were excluded and given resources and contacts to get treatment instead. Twelve participants completed the study. Eight were male, eight were white, two were African-American, and two were multiracial. The average age was 27; all had some education beyond high school.
For 24 hours prior to each session, participants abstained from drugs, including alcohol. In the presence of a research assistant, each took a pill with either no cocaine, 125 milligrams per 70 kilograms of body weight or 250 milligrams per 70 kilograms. They stayed in a controlled setting for about 4.5 hours until blood pressure readings indicated their cocaine “highs” had worn off.
Every 10 minutes, participants separately rated the effect of the drug and their sexual desire. Both factors rose together and peaked around 45 minutes after taking cocaine; the larger dose resulted in both greater drug effect and more sexual desire.
Participants were asked to look at photographs and select persons with whom they would be willing to have casual sex. Then they selected the person they thought would be least likely to have a sexual infection and read a short description of a hypothetical sexual encounter with that person.
Wait 5 minutes or an hour
Participants then rated their likelihood of using a condom if one was immediately available and their willingness to wait to get a condom before sex for two minutes, five minutes, 15 minutes, 30 minutes, an hour, three hours, or six hours.
Subjects had a similarly high likelihood of condom use if one was immediately available—80 to 87 percent—whether they were on cocaine or not. But the longer a participant on cocaine had to (theoretically) wait for a condom, the more willing they said they were to have sex without one.
Participants on the highest dose of cocaine were on average 40 percent likely to wait an hour to use a condom; the same participants were 60 percent likely to wait that long when given the zero-dose pill.
“The bottom line is that cocaine appears to increase sexual desire,” Johnson says. “Even though users who are on cocaine report being likely to use a condom if they had one in a risky sex situation, if a condom isn’t available, cocaine makes people less willing to postpone sex to get a condom. They become more impatient when it comes to waiting for sex.”
Applies to sex, not money
Johnson says the results are similar to a study his group published in 2016 on decision-making during alcohol use. Like cocaine, alcohol use made people less likely to wait for a condom, though alcohol did not strongly increase sexual arousal.
To learn if cocaine user “impatience” extended to nonsexual situations, researchers offered a hypothetical choice between a small amount of money that day or waiting to receive more. Users reported no less willingness to wait when on cocaine than when they were not.
“This experiment suggests that the impatience is specifically with sex and not with other activities, such as monetary reward,” Johnson says.
The researchers acknowledge that their study was dependent on hypothetical situations, not real-life circumstances, and that participants swallowed the cocaine in pill form instead of snorting or smoking it, as is more typical with street use. The National Institute of Drug Abuse funded the study.
Source: Johns Hopkins University