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Treating addictions: Sex and alcohol

Sometimes people ask me in my private practice whether they can successfully end one addiction but keep another one going. The short answer is no.

An example I wrote about in an earlier blog post is whether someone can successfully stop using cocaine but continue to drink alcohol.

The question I will address today is whether someone can successfully stop drinking alcohol but remain a sex addict.

Information in the following stories has been altered to protect privacy.

I have had a couple of clients that I felt completely ineffective with as a psychologist. Each time, the thought I have had has been, “Why am I unable to help this person? Why is what we’re doing not working?”

In one of these cases, my client couldn’t stop drinking. She was attending A.A. meetings as well as seeing me, but was doing nothing to address her sex addiction. In fact, she hadn’t shared that she was a sex addict with me.

So let’s talk about sex addiction. Can someone successfully stop drinking but keep their sex addiction going?

The simple answer to that question is that addiction… is addiction… is addiction. People can’t gain any sort of mastery over one addiction unless they work to gain mastery over all of their addictions at the same time.

It seems obvious that people can’t successfully give up one substance but keep using another one when the problem involves alcohol and drugs, so let’s take our discussion there for a minute.

When I worked at an outpatient drug treatment centre, I completed an initial intake interview with a new client one day. This fellow told me that he had used alcohol to stop using steroids. And then used crystal meth (methamphetamine) to get off the alcohol. Then pain pills to get off the crystal meth. And then heroin to get off the pain pills.

When I suggested that he had never been clean over the ten year period he had just described, he looked shocked. He was a bright guy so he was able to grasp the concept I was introducing pretty quickly. He said he had successfully gotten himself off each previous substance by using the next substance. He said, however, that he had never thought about whether he had gotten himself clean or not.

But that’s how it works. This client had successfully replaced one drug with another, but he had never gotten himself clean.

Now let’s weave sex addiction back into the discussion. Whether it’s alcohol, methamphetamine, pain pills, heroin, cocaine, crack cocaine, gambling, or sex, addiction is addiction. People can’t give up one substance without giving up everything they’re using simultaneously if they want to get clean. If they simply substitute one substance for another, they’re not clean.

So the short answer to the question of whether people can give up using alcohol but not address a sex addiction is that they can’t. If they keep abusing one substance, including sex, then they’re not clean. To get clean, they have to give up everything they are addicted to.

The reason they can’t call themselves clean is that they’re still using. They’re just fooling themselves, like the fellow at the outpatient drug treatment centre did. They’re still using a substance to self-medicate so they can escape their pain for a while.

The only way people can get clean is if they fully commit, and give up all the substances they are using at the same time.

Dr. Patricia Turner, Registered Psychologist, Calgary, Alberta 

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