What are the Most Effective Treatments for Sex Addiction as Part of a Dual Diagnosis?

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Calendar icon Last Updated: 06/25/2021

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It is very common for those diagnosed with compulsive sexual behaviors, sometimes referred to as sex addiction, to also be substance abusers and drug addicts. According to the journal Psychiatry (Edgemont), “Comorbidities include substance use disorders and co-occurring impulse control disorders.” How, then, can these two disorders when diagnosed in the same person be treated together?

Behavioral Therapy

One of the best treatment options for both disorders is behavioral therapy. This option is extremely broad, and the approach of cognitive-behavioral therapy can be especially beneficial for both disorders. Psychiatry (Edgemont) states, “CBT in compulsive sexual behaviors borrows greatly from treatment with substance use disorders, focuses on identifying triggers to sexual behaviors and reshaping cognitive distortions about sexual behaviors… and emphasizes relapse prevention.” In addition, the dangerous behaviors that are associated with drug abuse can also be identified and changed. CBT can focus on changing all behaviors that can lead to compulsive drug use or sexual activity, allowing the individual to make real changes to their life.

Psychodynamic psychotherapy can also be used to treat both disorders. The reasons behind a person’s compulsive sexual behaviors are often discovered and assessed with this treatment option, as well as the behaviors themselves. This can help to determine whether the substance use was an attempt to deter oneself from dangerous sexual behavior or if the second issue came later as a response to the individual’s drug use and desire to participate in risky acts. This type of treatment can also help uncover trauma, like physical or sexual abuse, that often leads to these addictions (National Institute on Drug Abuse).

In addition, family and couples therapy are extremely helpful to drug addicted patients, and these programs can also help to restore trust and minimize feelings of guilt and shame when it comes to treating compulsive sexual behaviors. Any of these therapies can be used to treat both disorders simultaneously, and more than one may be utilized in the course of an individual’s treatment.

Pharmacological Therapy

As stated by the Journal of Sex and Marital Therapy, “Medication treatment, when indicated” can be part of the healing process, and antidepressants are sometimes used to treat sexual addictions. Naltrexone has also been evaluated for its ability to minimize sexual impulses, and the treatment is also a strong pharmacological option for opioid addiction recovery.

However, it is very important that, if a patient begins taking a medication for the treatment of either disorder, they understand the possible side effects of that medication and the doctor is aware of any other drugs, supplements, or herbal remedies the patient may be taking. Medications can sometimes react poorly with other drugs or products so this is important to anticipate. It is absolutely necessary that the patient does not take a medication that is a benefit to the treatment of one disorder and a detriment to the other.