What sexual problems does alcohol cause?

Several problems of sexuality arise from alcoholism. The first is increased libido because alcohol lowers inhibitions. Although this may not be a problem, it can lead to consequences that are clearly problems, notwithstanding unwanted pregnancy or sexually transmitted diseases from unprotected sex. Another potential problem is that alcohol intoxication can cause a phenomenon euphemistically referred to as "the brewers droop," making it difficult to achieve and/or maintain an erection. These two problems of increased libido and decreased performance can lead to behaviors that may not only be troublesome but also downright dangerous. Intoxication leading to increased libido increases the probability of sexual assault. Intoxication leading to impotency increases the probability of physical assault. Why? Because studies have shown that alcohol is related to sexual jealousy, which can reach pathological proportions when one is intoxicated and then feels rejected by the woman either because of his intoxication or because of his inability to perform. Compounding that fact is the poor judgment resulting from intoxication, leading to misinterpretation of facts and acting irrationally based on the misinterpretation. This is particularly true in troubled marriages in which suspicions often lead to and are, in turn, fueled by intoxication. These are the potential consequences of acute intoxication. What about any long-term consequences of alcoholism, however?

Alcoholism can do one of three things to potentially ruin one's sex life in the long run. First, alcohol lowers testosterone, which is the hormone primarily responsible for libido and sexual performance. Second, alcohol can raise blood pressure and cholesterol, which are major risk factors for the development of vascular disease and, in turn, another cause of impotency. Good circulation is essential for male sexual performance. Poor circulation is also a cause of sexual difficulties among women. Finally, alcoholism can cause peripheral neuropathy, damaging the nerve supply to the genitalia, again leading to impotency and anorgasmia.

When I stopped drinking, I started smoking a lot more. I'm afraid that if I try to quit smoking I may go back to drinking. What can I do?

Research supports the aphorism "smokers drink and drinkers smoke." The heaviest drinkers are also often the heaviest smokers. This significantly increases the risk of heart disease, stroke, emphysema, and cancers of all forms. For example, the approximate risks for developing mouth and throat cancer are 7 times greater for those who use tobacco, 6 times greater for those who use alcohol, and 38 times greater for those who use both substances. Most drinkers started smoking first and adolescents who smoke are three times more likely to begin using alcohol. Smokers are 10 times more likely to develop alcoholism than non- smokers! What is the link? Both drugs increase the pleasant effects and ward off the unpleasant effects of each other. Nicotine involves many of the same neurochemical mechanisms of the brains reward system that alcohol involves. Nicotine can lead to tolerance, which is the need for ever-increasing amounts to achieve the same desired effects. Some level of cross-tolerance may exist between nicotine and alcohol as well. In other words, the need for ever-increasing amounts of one substance leads to the need for ever-increasing amounts of the other substance and vice versa. Crosstolerance may partly develop from one drug mitigating the negative effects of the other, such as nicotine's ability to lessen the sedative effects of alcohol and alcohol's effects in calming the potential anxiety of smoking too much tobacco. Animal studies have born this out, where nicotine has been shown to mitigate against the cognitive and motor effects of alcohol.

The heaviest drinkers are also often the heaviest smokers. This significantly increases the risk of heart disease, stroke, emphysema, and cancers of all forms.

Historically, addiction specialists did not address the issue of nicotine addiction, fearing that asking an alcoholic to quit tobacco at the same time would be asking too much and thereby risking relapse. Research has not confirmed this. One study compared two alcohol programs, one that added a smoking cessation program and one that did not. Abstinence differences after 1 year between the two groups were no different, but in the group engaged in smoking cessation, 12% had quit smoking. Another study suggested that smoking cessation actually enhanced motivation to stop drinking. As a result, following along with the prevailing culture, many addiction programs are now smoke free.

Some caveats are as follows: It appears, because of cross-tolerance, that alcoholics who engage in smoking cessation may require higher doses of nicotine replacement than the normal smoking population. Depression and being female are risk factors working against one's ability to give up tobacco. Because nicotine induces liver enzymes, antidepressant and mood stabilizer blood levels may be lower than expected, making the medications less effective, which could contribute not only to continued depression, but also to continued nicotine dependency. Thus, keep these factors in mind if you are about to quit. The motivation to stop drinking should be used simultaneously to stop smoking, as the outcomes for both problems and the health benefits are many times greater than either alone! Find a program that is at least smoke free and secondarily offers a smoking cessation program. If no program is available, work with the medical director of the rehabilitation center or your primary care physician to provide nicotine or other medications such as Zyban (Wellbutrin) to assist you.

Cocaethylene a chemical produced by the liver when processing cocaine and alcohol (ethanol) simultaneously that has many pharmacological properties similar to cocaine except that It stays in the body longer and is potentially more toxic to the nervous and cardiac systems.

I got into a vicious cycle using alcohol to come down from cocaine. The doctors tell me that I'm an alcoholic, but my drug of choice has always been cocaine. Do I need to be concerned?

Alcohol and nicotine are but one common combination that appears to work together synergistically to increase each other's pleasurable effects and decrease each other's unpleasant effects. Another combination that is quite popular is alcohol and cocaine. The feelings generated from the combination is beyond what is felt by either drug alone. Again, the negative effects of alcohol such as learning and motor performance are "improved" with the addition of cocaine, whereas the anxiety and paranoia that cocaine generates are "improved" with the addition of alcohol. People don't realize the high cost that is associated with this combination. Both are metabolized by the liver, which leads to a metabolite known as cocaethylene, a potent drug in and of itself that has significantly more cardiotoxic effects than using either drug alone. This new "drug" also appears to cause violent thoughts and behaviors that would not necessarily be present if either drug were used alone. This new "drug" is thought to be the most common cause of drug-related deaths because of cardiac effects and violence. Finally, cocaine may cause liver injury independent of alcohol.

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