Treating Sex and Drug Addictions All at Once

Promises Treatment Center, a famously glitzy rehab in Malibu, California, now offers a new program tailored to treat patients suffering from sex and drug addictions that have "fused" together into a single hybrid. Addicts who use crystal meth, cocaine or other "party drugs" in conjunction with sexual activity often become simultaneously dependent on both drugs and sex, Robert Weiss, who designed the program specifically for this situation, tells The Fix. The five-week residential program currently treats six to eight male clients at a time, with an average age of around 38. Weiss says the hybrid condition affects straight and gay men in fairly equal numbers—but in different ways. "The straight guys are typically holding up in a hotel suite for a few days with cocaine, Viagra and prostitutes/porn, while the gay clients struggle with meth/sex/bathhouses/sex clubs etc," he tells us. "They act out in different venues and with a different gender—but have the same paired sex/drug disorder." Weiss says other recovery models, like AA, offer a too-simple solution of "just get sober and everything will be fine," but that his program at Promises offers a more nuanced treatment model, combing psychiatry with an interdisciplinary approach. "90% of the patients I see in treatment have an underlying psych issue," he says. "Most drug and alcohol treatment doesn't deeply address any issue other than the using itself. In my field we call that 'old school.'"

Relapse poses a particularly huge threat to stimulant addicts, particularly those with concurrent sexual addiction, Weiss continues. His program aims to target the two issues that he says are most likely to cause relapse: shame over previous sexual activity and difficulties adjusting to sober sex. "This population will already have likely tried and failed at previous (well intended residential and outpatient) treatments that avoided or simply missed fully looking at the paired and powerful sexual issues surrounding their drug use," he says. "I suspect we will do better than most with this very high-relapse population [stimulant addicts] as we are giving them more tools toward sobriety and doing more shame reduction around their sexual behaviors—acted out when high."