Consumption of psychoactive substances and sexuality among youth: an overall vision of the sexual sphere
Despite the consensus about the importance of addressing all life dimensions of young people with a substance abuse problem, sexuality remains excluded. This article aims to portray the state of the art about sexuality in young adults with substance abuse in order to make recommendations on the provision of services, therapeutic care and future research. A narrative review of the literature is conducted on the relationship between drug use and risky sexual behaviour, sexual dysfunction, sexual orientation, sexual activity and sexual satisfaction. The findings highlight the need to consider a number of factors that goes beyond sexual activities in order to assess the presence of risky sexual behavious associated with substance abuse. While it is likely that substance abuse leads young people to experience problems with their sexual functioning, this dimension is rarely the subject of assessment or interventions. Moreover, young adults with substance use problems seem to use drugs to improve their sexual satisfaction. As such, their substance use could be strongly associated with sexuality to the point of constituting a relapse risk factor. Among the practices recommended for young adults from sexual minorities with a drug problem, it is suggested to adopt a multidimensional view of sexual orientation and a set of specific attitudes related to sexuality. Different suggestions are proposed for the deployment of a service supply that includes sexuality in drug rehabilitation programs, the use of assessment and the referral, and the adoption of a global and positive view of sexuality. Research should integrate the multiple dimensions of sexuality and consider its potentially complex relationship with substance use.