‘Better safe than sorry’: Women’s stories of sex and intimate relationships on the path out of drug abuse

Abstract

This article focuses on the role of sexuality and intimate relationships during women’s exit processes from drug abuse. Drawing from qualitative interviews with Swedish women the article explores how their sexual practice is played out both during drug use and in the new drug-free life situation. The conflictual transition process evolves around the individual’s attempts to adapt to various sexual scripts made available to them. An element of shame regarding past sexual experiences is enforced by a strong desire to create a new identity as ‘ordinary’. The safest option then is to abstain from sex even if it may lead to frustration and longing. To some, toning down sexuality is a welcome respite, to others a meaningless wait. Why does the beautiful, lovely sexuality never come?

Keywords

Body image drug abuse exit processes female sexuality sexual desire

Introduction

The image of drugs as a stimulus for sexual desire is full of contradictions. Some narratives romanticize the effects of drugs and their significance for sexuality, while others demonize this. In an earlier article, we distinguish between hedonistic and the escapist narratives (Skårner and Månsson, 2008). The hedonistic narrative associates drugs with festivity and joy – a carefree celebration centred on pleasure, play and adventure. The credo for the life of the rock star – ‘sex, drugs and rock ‘n’ roll’ – is typical of this narrative. On the downside, there are the problems of unrestrained use, dependence and loss of control. The history of rock music offers countless examples of this (Shapiro, 2003).

In contrast, in the escapist narrative, sexuality is almost entirely absent. Instead, we are presented not only with the picture of drug use as a time out from external pressure, stress and strain, but also the attempt to resolve, if only temporarily, a more or less serious underlying cluster of problems.

The concept of the potential for pleasure, stimuli and sexual desire inherent in certain drugs is closely related to the hedonistic narrative. Amphetamine and cocaine are the substances that are considered to have the strongest connection to sexuality. In the case of these drugs, popular and subcultural accounts are at least partially supported by science. Several studies highlight the sexually stimulating qualities of amphetamines (including a reputation as a ‘sex drug’ in the subculture), regardless of gender amphetamine users report much more drug use connected to aspects of sexuality than users of any other categories of drugs (Rawson et al., 2002). Amphetamine eliminates sexual inhibition and increases sexual desire and stamina (Rhodes et al., 2000), but also sexual risk-taking, such as engaging in unprotected sex and having multiple sexual partners (Käll, 1995; Semple et al., 2004). However, as has been pointed out in several studies, the relationship between drug use and sexual behaviour, including sexual risk-taking, is complex and multifactorial. For example, it is far from clear whether drugs cause sexual risks or whether those who take more sexual risks also are more predisposed to take drugs (Ostrow, 2000; Ross and Williams, 2001; Stall et al., 1986).

Further, amphetamine reduces hunger, which makes it an effective dieting measure; however, abuse may lead to extreme emaciation, which, in turn, has a negative impact on physical health and sexual desire. Most studies in this field are clearly focused on the risks and problems of the drug; for example, they emphasize the consequences of unrestrained use, addiction and loss of control. Thus, it is uncommon to find studies, which have conducted in-depth analyses on the users’ personal accounts of how amphetamine affects sexual pleasure and activity, especially when it comes to studies on women with a more problematic drug use. However there are some exceptions, for example Lorvic et al. (2012) who found that amphetamine use brought increased sexual desire, pleasure and release of inhibitions. Furthermore the drug helped the women to cope with uncomfortable sexual situations (see also Skårner and Svensson, 2013). A related research field is youth-cultural studies of young women in the rave scene where the association between drug use, sexual agency and increased sexual pleasure and intimacy is often highlighted (cf. McRobbie, 1993; Pini, 1997).

In contrast to amphetamine, drugs like heroin and other opiates have a sedating effect on the central nervous system, and hence, on sexual desire and sexual activity in general, especially when used regularly (Holmes, 1999; Palha and Esteves, 2002). Empirical studies show that people who use opiates rarely associate their drug use with sex (Rawson et al., 2002). As a result, amphetamines may sometimes be used during sexual intercourse to counteract the sedating effects of heroin (Käll, 1995; Skårner and Svensson, 2013).

It needs to be pointed out that there are other drugs, such as cannabis and ecstasy (MDMA), which are used for enhancing sexual pleasure and intimacy. However, since these drugs are most commonly used for recreational purposes and since our study primarily focuses on sex and intimate relationships on the path out of drug abuse, they are not taken into consideration here.

No clear-cut or simple connections exist between different substances and sexual desire and performance. Regardless of the drug, it is difficult to discern the effects of the drug itself from the user’s expectations, experiences and interpretation of the drug-taking situation (cf. Zinberg, 1984). Even when the sexual act is consciously manipulated by using drugs, the wide variety of individual differences, which characterize people’s sexual experiences in general, still remain (Meston and Buss, 2007; Svensson and Skårner, 2014). The positive effects are particularly connected to the initial phase of using drugs, whereas long-term abuse, with its negative impact on health, often reduces sexual interest and sexual performance regardless of the type of drug (Peugh and Belenko, 2001).

But what happens when drugs are not used anymore? This study focuses on women who have broken out of drug abuse.¹ The aim is to explore their experience of sex, both during the period when they were using and after having stopped using. How do they view the connection between drugs and sexuality? We aim to address a gap in the knowledge because, despite the strong connection between some drugs (above all, stimulants) and sexuality, there have been only a few studies that focus on how sexual practice is experienced and played out in former users’ new drug-free lives.

Methods and material

The article builds on a qualitative study of sexuality, intimate relationships and drug use in the context of the exit process from drug abuse. The study, which was approved by the Regional Ethical Board in Lund (Reference number 2010/93), was conducted in two large cities in southern Sweden. A total of 16 women were interviewed in depth, constituting a heterogeneous sample, both with regard to experiences of drug use and general life circumstances. The age span stretches from 26 to 55 years, with the average age being 37 years. The time span of their drug use varies from between 3 and 35 years, with half of the women having used drugs for more than eight years. Half of the women used amphetamine as their main drug, and the other half used heroin. With one exception, all used amphetamine for shorter or longer periods, and specifically in connection with sexual activity. Drugs such as cannabis, alcohol and benzodiazepines were also common in combination with the main drug. The time span from previous drug use to the interview varies between 1.5 and 13 years. All of the participants described their soberness as stable, and with one exception, all the women interviewed had received treatment to stop using, including methadone maintenance as well as various forms of psychosocial treatment. Seven women were still patients in maintenance treatment or had continued counselling. At the time of the interview all lived in their own residence. Eight of the women worked, mainly in the service sector, or studied at university, while two were on long-term sick leave, and six were unemployed. In total, seven women had at some point been enrolled in a university course or program.

All the women identified as heterosexual, and at the time of the interview, nine of them were living in long-term, heterosexual relationships. Furthermore, in all cases except for one, the male partner also had a history of drug abuse.

Ten interviewees were recruited through snowballing, which entails one person providing contact to another, and six were found through clinics and social service agencies. The selection criteria was a previous history of daily or almost daily illicit drug use for at least one year. The interviews lasted from one to three hours, and written, informed consent was gained. Each interview was recorded and transcribed verbatim although, in the quotations used in this text, the names and biographical data have been altered and some of the language has been edited to increase readability and ensure anonymity. The interviews were conducted in free form, with an interview guide functioning as a checklist. The purpose was to capture the interviewees’ own constructions of meaning; that is, how they describe and interpret their intimate and sexual relationships and experiences, past and present, especially in relation to their drug use.

It is necessary to bear in mind that an interview is the result of interaction between two people who react to each other and mutually impact upon each other (e.g. Holstein and Gubrium, 2003). Thus, it is important to realize that each woman’s understanding of her own experience and life, as it is created in dialogue with us, is not a description of reality. It is one among several possible versions of reality. Furthermore, the women look back upon a time they have left behind. And one part of adjusting to a ‘drug-free life’ can be to emphasize negative aspects of the old life, in retrospect, which may influence the narratives, something that we discuss in our analysis.

The analysis of the data was through the ongoing interaction between the theoretical perspectives guiding the study and the emerging categorization of the data, with an emphasis on the search for themes and patterns in the interviews and on identifying essential features and relationships (Coffey and Atkinson, 1996: 9). Each researcher has carefully reviewed the interview transcripts. A synopsis of each interview was put together with key words and quotations as well as tentative ideas and reflections of a more spontaneous nature, noted and discussed. The material has not only been analyzed according to each individual interview, but also thematically across the whole sample, including, for example, examining sexuality relating to amphetamine and heroin use before, during, and after stopping drug abuse. The interview quotations were selected by virtue of how well they represented a typical, or otherwise illuminating, response.

Limitations

The results of this study need to be considered in the light of some limitations.

First, as we point out, the women in our study mainly identify as heterosexual and the results cannot be generalized to people with another sexual orientation. Second, as the selection criteria of the study is daily or almost daily illicit drug use for at least one year, the results do not automatically apply to those with a more recreational drug use. And, finally, although many of the women used alcohol in their social life, we have in our analyses focused on the relationship between illicit drug use, especially amphetamine and heroin, and sexual practice. The use of alcohol or cultural sexual scripts related to alcohol use has not been a part of our analysis.

Theoretical approach

Our analysis of the role of sexuality during the exit process from drug abuse is guided by the terms and ideas found in the interactionist tradition. From this point of view, the exit process can be seen as a renegotiation of one’s identity, which takes place through interaction with the people one encounters (Biernacki, 1986; Fuchs-Ebaugh, 1988). The process is characterized by tension between the past, present and future. To liberate oneself from the remaining pieces of the old identity, while at the same time, creating a new one, often includes complicated psychological and social processes. Fuchs-Ebaugh (1988) particularly emphasizes the management of new intimate relationships as a sensitive stepping-stone on the way towards a new role in life. Biernacki (1986) speaks of the ‘moratorium’ that takes place when a person leaves behind the social context and personal relations connected to drug use without fully having reclaimed anything old or established anything new. For many, the transition between identities leads to a marginal conflict, characterized by vulnerability, excessive self-consciousness and fear, as well as ambivalence towards their new, drug-free situation and the surrounding expectations and demands (see also Hedin and Månsson, 1998).

This conflicting process of transition revolves around the individual’s attempts to go along with the various sexual scripts made available to them (Wysocki, 1998). Gagnon and Simon (2005: 125) describe these scripts as a ‘repertoire of acts and statuses that are recognized by social groups, together with the rules, expectations, and sanctions governing these acts and statuses’. For the women in our study, the transition from the subcultural drug context into a life without drugs presents a real challenge, especially in managing to decipher the rules and expectations in sexual matters. Basically, this includes everything from flirting to post-coital behaviour. Being unaccustomed to managing the different codes in sexually charged situations can create confusion and insecurity and ultimately threaten the individual’s sexual confidence and self-esteem.

In the particular context of our study, it is of interest to observe the rules and sexual expectations placed on the women as active drug users. The informal drug economy is structured according to traditional gender relations. Within these lies men’s power over women, since it is the men that control the sought-after drugs (Joe, 1995; Svensson, 2007). In sexual matters this power relation is played out in different ways. As shall be seen, one can speak of a heterosexual male-oriented pornographic script that steers the women’s male drug-using partners’ expectations of how the women are supposed to act sexually. This is something that the women are expected to adapt to, for gaining access to drugs (Löfgren-Mårtenson and Månsson, 2006; Skårner and Svensson, 2013).

It is also important to remember that all this occurs in a contemporary cultural context or scenario which provides the information from which our women piece together the knowledge and conceptions about sex and the ideas and fantasies for their personal, intrapsychic sexual scripts. This can be especially challenging as the subject of sexuality occupies so much space in the public eye of contemporary society. The expression ‘sexualization of public space’ is sometimes used to describe how the portrayal, codes and language of sexuality infiltrates and imprints upon everyday life and culture (Löfgren-Mårtenson and Månsson, 2006; McNair, 1996). Fashion, advertising and entertainment are permeated by norms and expectations, which point to the importance of sexual desire and expressions, and are strongly linked to certain bodily ideals and health. This situation, which may be experienced as a type of liberating sexual openness, can also be a pressing demand for sexual performance and to be physically and sexually attractive. If, and in what way, this ambivalence surrounding the function and significance of sexuality and bodily ideals in our time affects the women in our study will be discussed in our analysis.

Results

The results are presented in two sections. The first section focuses on the women’s sexual experiences during their time of drug abuse and how, after breaking away, they look upon and value themselves and their past life. The second section focuses on the women’s sexual strategies during the exit process.

I. The past in the present

‘Sexual desire was there by chemical means’ – On sexual practice during drug use

In order to understand how the women managed their sexuality during the exit process, we utilize the experiences women bring with them from their time of active drug use as a starting point. In the amphetamine environment, drug use and sexuality are often strongly interwoven. Wholly in accordance with previous research, our interviews show how amphetamine is used to maximize sexual experience.² The women describe how intercourse could go on ‘for ever’, sexual variations were more plentiful and orgasms more intense: ‘It felt like I was totally up in heaven when we had sex. It was something special. It was very sensitive “down there” in any case. If one is allowed to be that explicit’ (Jenny).

A recurrent theme in the interviews is the positive effect of amphetamine on self-esteem which, in turn, impacts on sexual experience:

I wasn’t as inhibited. I think it’s really connected to self-esteem and that the drug has that effect of making you feel less awkward. You can get this funny notion that you’ve lost ten kilograms since yesterday. (Carola)

Amphetamine use and a more permissive attitude towards sex made it easier for the women to be less inhibited, to have a more positive body image and to experience a sense of sexual agency to a greater extent than when in a drug-free state.

If you’re not on something, you might be really dull. It’s all missionary position and over pretty quickly. But if you’ve got drugs in your system, you can keep going for hours, and you’ll try everything, all positions and yeah, blow-jobs and the sorts of things you wouldn’t do otherwise. One takes initiatives, and that is not something I do otherwise. (Carola)

A contrasting theme is that men have the upper hand in formulating the rules for sexual interaction. Several of the women describe amphetamine culture as an unbounded, unsafe and unpredictable world where it is not always easy to maintain one’s personal integrity (Skårner and Svensson, 2013). Intimate relationships in the world of amphetamine users are often described as close-knit, intense and passionate, but also as stormy, changeable and ambivalent, and sometimes characterized by physical and psychological violence (e.g. Neale et al., 2012; Skårner, 2001). Some of the women also spoke of feeling forced to ‘agree’ to sex in order to ‘keep the peace’.

He didn’t physically hit me, but he abused me mentally, and it was very scary. But then I did make a kind of deal with the devil, and that’s how it will be – at least he has speed and money. I suppose I fancied myself being in love with him as well and was quite successful at that. He told me once that ‘the good thing about you is that you never say no to sex’. I was always ready to do it and was like more or less comfortable, mostly not very comfortable towards the end. (Eva)

For several of the women, the use of amphetamines appears to have constituted a stage in an adjustment strategy with regard to the performance-focused, pornographic script that is common in amphetamine culture (Skårner and Svensson, 2013); for example, the affirmation of their own sexual desire was not central in these narratives, but rather the women were determined to live up to what they thought were the sexual preferences of men, heavily influenced by the messages and codes of heterosexual, male-oriented pornography. In exchange, the women hoped to gain confirmation, status, drugs and perhaps also love:

I experienced strong sexual desire when I was on something, but if it actually was sexual desire, I’m not really sure. But it was possible to have sex and even enjoy it sometimes. But there was a lot of acting going on. Sex was never mainly about me enjoying, but him enjoying it. In that lay my enjoyment. I did the porn-actress role as good as anything … boosting his ego by doing so and confirming him. And if that got him going, it was a confirmation for me. (Julia)

In the stories centred on heroin, the contrast with the sexual practices in the world of amphetamine is striking. Sex definitely seems to become a side issue. ‘When you’re off it, you feel too bad to even think about it, and when you’re on it, you feel too good to even think about it’, says Berit. The physical intimacy that is expressed in couple relationships in the world of heroin is described more in terms of tenderness and safety:

Heroin completely cuts off sexual desire. You don’t experience any desire or need at all, but are just lying close and hugging and cuddling and such is, like, enough. But to go as far as sex is quite rare if both take heroin. (Berit)

Tanja who, during the major part of her drug-using life, was engaged in a long-term relationship with the same man, described how their sex life changed when the couple transitioned from using amphetamine to heroin:

With heroin, you don’t come at all. You could lie for an hour, and I felt like, ‘I’m actually drying out, I’m fucking chafing. Cut it out, like’. So that was a big difference. Like, ‘What’s sex?’ Even men struggle to orgasm. Desire faded slowly, slowly and particularly when I pulled myself away from him.

Looking back at the sexual experiences and practices during drug use, the stories we were told differed in relation to drug type. For women on heroin, pleasure first and foremost derives from the drug itself; to them sex is a non-issue. Feelings of pleasure from physical intimacy without sex with a regular partner seems to be ‘enough’. For women on amphetamine sex was a positive experience, the drug eliminated sexual inhibition and provided them with a greater sense of sexual agency to push limits and transgress borders, to enjoy things they wouldn’t dare to take pleasure in when sober. However, their stories also seemed to indicate a shift over time. What was initially regarded as a positive and sometimes adventurous and unbounded broadening of one’s sexual repertoire gradually transformed into something repetitive, diminishing and mechanical. Their sometimes quite vague and ambivalent statements implied a tension between the women’s intrapsychic scripts and the dominating scripts in the subculture. The women’s sexual relationships were structured along traditional patriarchal lines; it was the men who had the upper hand in formulating the rules.

On the other hand, it is important not to exaggerate gender-related differences in comparison with the relationships between men and women outside the world of drugs. Sanchez et al. (2012) emphasize that despite an increase in equality over time, empirical research shows that traditional sexual roles, for the most part, continue to dominate heterosexual relationships. Stereotypical gender norms, as illustrated through women’s subordinate position and male dominance, are shown to have a negative impact on sexuality in so-called ordinary intimate heterosexual relationships, such as reduced possibility of orgasm and arousal (Sanchez et al., 2012). The difference lies, above all, in the inferior position women hold in the world of drugs, which is conditioned by whoever in the relationship controls the drugs (Svensson, 2007). A female drug user in such a male-dominated social setting is more or less forced to adopt strategies to handle her relatively subordinate position in the power structure (Measham, 2002; Taylor, 1993); these strategies largely lose their purpose and relevance after the breaking away from drugs, particularly if the woman wishes to enter into more equal relationships with men.

After leaving drug use

Leaving the drug environment and attempting to re-enter society caused the women to feel lost in many areas, particularly for those whose lives were dominated by their belonging to the drug culture and with few links to conventional life. They felt disoriented and unsure in relation to the rules governing the new environment, and one of the most sensitive questions was how sexuality would function without drugs. Signe had been clean from amphetamine for four years, yet she still found sex and intimacy hard to manage:

I feel a bit damaged when it comes to sex. I expect more, perhaps. It was pretty amazing and all that, but now that you’ve become well again … I’m terrified of sex. When you are using, you gained a bit of confidence and could think, ‘Damn, I look hot’. You didn’t have any inhibitions. But today, I’m not quite sure how you’re supposed to do it. How do I look? Oh God, now I’m going out and flirt … Get completely nervous. If you’ve made love in the most strange places and have had that kind of sex life which makes you go ‘ugh, how embarrassing’ even afterwards, like this. To then end up in the bed with someone who you don’t know what … perhaps I’m doing this all wrong … do things which they don’t …

Signe expressed what several of the other women also conveyed: the reminiscence and loss of guilt-free sexual experiences during the time of drug use mixed up with feelings of insecurity in relation to which sexual scripts were valid in the new situation. In addition, there was the fear of not being attractive enough in the eyes of the other.

Negative sexual experiences during the time of drug use were a source of unease. We have shown how sexual practice is often shaped on men’s terms. Another example of how the past casts a shadow over the present was conveyed by Marit, who described how unpleasant memories from her many years spent in prostitution and chasing money for heroin imposed upon intimate relations with her new partner. ‘I don’t think I would’ve had the same aversion if I hadn’t been a prostitute. It’s haunting me’, she said. The experiences of prostitution made it difficult to accept one’s own body and to experience sexual desire, and the consequences of prostitution often led to a contemptuous attitude towards men in general, which was hard to erase. In Hedin and Månsson’s book about women breaking away from prostitution, one of the interviewees says, ‘It is all too easy to see “the John” in the man!’ According to her, ‘the John’ is a man who is only interested in satisfying his own needs and using women for his own pleasure, without getting involved emotionally or caring (1998: 224).

The insecurity surrounding what ‘sexual scripts’ were valid in the women’s new life situation went hand-in-hand with feelings of shame and guilt about what they had been through. Marit spoke of a passionate, but stormy, relationship where she and her partner used amphetamine when they were having sex, an experience she had now revaluated:

It got, like, twisted or too much or inauthentic somehow. Afterwards, I find it disgusting, dirty. That it went on for so long, that there was so much of it … that it turned out the way it did. It is not normal to get stuck like that. Now, I can’t have sex at all. It won’t work. I can’t. I don’t want to.

Characteristic of the conflict in transition from one world to the other was an ambivalence towards the new, which in turn, was connected to a striking general social insecurity. One way of dealing with this ambivalence was to ‘reframe’ previous sexual experiences as something completely negative. The fact that drug abuse in our society is strongly associated with stigma probably contributes to the meaning that the women attribute to sexuality in different social worlds. When looking back, some of the women described how they were stuck in a sexuality that they now considered ‘sick and unhealthy’, ‘twisted and inauthentic’. Instead of risking a repeat of this ‘unhealthy’ pattern, sex was put on hold or banished completely.

The ugly body

In the interviews, stories of baggage which had affected the women’s body image appear: trauma after sexual abuse, eating disorders and self-harm were common. The women acknowledged that drug use had been their way of handling a complex life situation, and sexuality was also often described in terms of ‘addiction’. ‘And that very thing of not knowing the boundaries’, Julia said, ‘I’ve also abused sex and food, and I’ve cut myself. There have been loads of destructive behaviours, one after another.’

Problems surrounding one’s own body and body image commonly occurred in our empirical material. Almost all of the women spoke of having gained weight after giving up drugs, sometimes more than 30 kilograms. For some, this was an eating disorder from their teens which had re-emerged. For others, it was related to the side-effects of medication like methadone, no longer using the appetite-reducing amphetamine, a change in lifestyle, and that food functioned as a consolation in a dull and lonely existence. These women shared a sense of feeling unattractive since they did not conform to male images of the idealized feminine form which is fat free and thin (Ettore, 1992). This meant that they felt uncomfortable about the idea of sex. That low self-esteem and a negative body image may impact negatively on women’s sexuality is well known, both from research on sexuality and from clinical experiences in sexuality therapy (e.g. Graham et al., 2004; Leiblum, 2010). Furthermore, the women emphasized feelings of repulsion and shame connected to their bodies as an obstacle for having and enjoying sex:

I’m ashamed of my body. It is ugly and gross. I have a giant belly and I’ve gone up several sizes and I don’t dare to show myself naked. I’m probably grossing myself out a lot, I think. (Jenny)

It feels dirty somehow to … like be horny, to want something for myself. I find it very hard to be naked. All my eating disorders have made it very difficult … to show myself. I’d like to have sex and not give a shit. To not have to think, ‘I can’t lie in this position because it might make me look fat’ or that I don’t want him to look at me when we’re having sex. (Sara)

The interviews showed how issues surrounding sexuality and one’s body were kept hidden or in check during the time of drug use. These re-emerged when drugs were no longer in the picture and complicated sexuality by blocking the ‘contact’ with sexual desire, which in turn, led to a restrained and uncomfortable approach to sexuality in their new, drug-free lifestyle. A pattern of accumulated negative experiences also became visible in certain interviews where early trauma and abuse appeared to play a part, especially when the women placed themselves in degrading and difficult situations which reinforced their already low self-esteem (cf. Lorvick et al., 2012).

What is striking is the extent to which the women thought about their bodies: the disproportionate self-consciousness and sensitivity with regard to how they appeared in the eyes of the other (the man) – from thinking that they did not look good to feelings of repulsion, contempt and shame, especially in intimate and sexual situations.

II. Navigating in an unknown sexual landscape

Single life – without room for sex

One strategy for handling the worry about how to manage sexual togetherness in the new life project was to avoid or completely abstain from sexual contact. The interviewees gave different – sometimes overlapping – reasons for this choice: fear of not being good enough, feeling ashamed of the past, being scared by past relationships, grieving for a former partner, feeling emotionally unready to enter a sexual relationship – or simply not knowing where, or for whom, to look. Eva had not had sex at all during the seven years since quitting a long-standing amphetamine abuse:

It feels really shitty not to be able to have a normal relationship. I’m scared of not being good enough … to get into the same behaviour as when I was abusing drugs. The submissive and well … lose myself and my own will. But sometimes I feel so darn lonely. I don’t want to grow old alone, suppose no one does. You want a life companion. I tell myself that things will happen in their own time, and if they don’t, I’ll have to live with that. It depends on who you meet, but I’ve got so much shit left, fear and well … everything.

Vulnerability, subordination and lack of control were recurring themes when women looked back on their relationships with men, whether these were established intimate relationships or casual sexual encounters (cf. Burke et al., 2005; Skårner, 2001). Ulla had been sober for three years, but was still afraid of relapsing into old patterns which she associated with her time in the amphetamine environment. She argued, ‘It is better to live alone’:

I realize more and more how horrible it is – a very distorted view of men. I do know that all men aren’t the same as those I’ve been involved with. There is an abundance of nice men, but I’m not drawn to them … the betrayals linger on somehow. I’m scared of letting go of control. I’ve tried to adjust to the men who have been present in my life, and if I were to get involved in a relationship today, where will I find myself in that process then? Will I act the same way? What will happen to my sobriety? There are a lot of fears in there.

She also expressed a fundamental insecurity with regard to how to approach an ‘ordinary’ man:

I’ve had a very strange way of getting involved in relationships which I hope most people don’t have. But how do you get someone now? If I should fancy someone, I can’t go, ‘Wanna move in with me?’ A man who’d say, ‘Sure, I haven’t got a place, so I’ll move in with you’ – such a man I wouldn’t want to have today.

For some, single life was a sad defeat; for others, it was liberation from the demands associated with sex and living with a partner. But, common to most of the women, irrespective of which drugs they had used, was a wish to establish a stable intimate relationship – when the time was right.

Going for the easy option?

One question that occupied the women is whether they should try to find new paths or follow old familiar tracks. In the re-orientation, which a drug-free lifestyle involved, sex partners who represented the old lifestyle no longer really fit, but several of the women described how they – reluctantly – were drawn to the same type of men they used to be with, which caused mixed emotions:

I have bloody unhealthy taste in guys. I go out with the same ones that I did when I was active. But then I feel, I’m a mum. I’m turning 28. I’m sober. I’ve been pregnant. I’m studying at university, and still I go for a guy who’s been sober for half a year, who’s still involved in crime, has very many ‘issues’, and then I have sex with him. It feels like I go for the easy option, not putting so much at stake. I know them. I know what they want, and I know I can have them. (Sara)

Fuchs-Ebaugh (1988) emphasizes that withdrawing from one social role and entering into another involves tension between the individual’s past, present and future. The previous identification with a certain social category lingers on (which Fuchs-Ebaugh refers to as hangover-identity), gives a sense of security, but it also involves a burden when striving to form something new. Julia had started an intense relationship with a man she met at a Narcotics Anonymous meeting, and she described how old, destructive patterns from her time in the amphetamine environment were reproduced in their sexual interaction:

He was still involved in crime. One foot in the past. I never got any confirmation from him, and that continued making him exciting. We had an amazing sex life. There was rape sex, where he pinned me down and … well, we were both in on it. I found it hard to accept that it excited me. I thought it might be connected with what I’ve been through and that it was a bit sad that it had made me, like, twisted … That was my general pattern, to like it dangerous. To be attracted to destructiveness, to be in love with pain somehow. When it hurts, I feel that I’m in touch with my emotions. If someone’s nice, I’m almost like … ‘yuck’, like I get my self-loathing confirmed.

Of course, one way for the women to confirm and expand their new drug-free identity was through making a complete break with their old ways. Thus, they deliberately looked for a partner who represented a conventional life. Sara described a relationship with an ‘ordinary’ guy, handsome, kind, well-educated and quite taken with her. At the same time, she talked about their sexual relationship as a complete failure:

He was in love with me. He wanted me for who I was. I thought that was damn hard. I wanted us to fuck the whole time so we didn’t have to, like — [I: Cuddle?] Yeah, that I don’t like. But he didn’t want to have that much sex, and he was so bad in bed that it was painful. I got very insecure. He didn’t even want to fuck me. Then something is really wrong. Am I so unsexy that he doesn’t even want me?

Lisa described a relationship with a guy she met on the internet, but when the contact materialized ‘IRL’ (in real life), her hopes were dashed. Despite feelings of uneasiness and contempt, she nonetheless continued to see him because she wanted to fulfil the social norm of ‘having a boyfriend’:

Even the first time, I felt disgusted by him. I thought he was a jerk. However, he was pleasant and nice, well I guess this is how it’s supposed to be. So we got together even though I felt so disgusted. I felt that he likes me and like ‘this is my boyfriend, now I’ve finally got someone’. But the sex was some of the worst I’ve had. He didn’t know what to do … But then I felt that this is not working, now I’ll go back to what I was before. Now when I had the chance to have normal sex and build a relationship, it didn’t work out.

Despite the ideal of being a couple, which the women aspired to, it did not seem altogether easy to meet a partner who fitted into their new life project. Attempts to meet ‘ordinary’ men appear to have not ended well. At the same time, the women strove to avoid the hard and turbulent relationships that characterized their earlier life. From their stories – Julia and Lisa are just two examples – deeply embedded issues with closeness and intimacy emerged. Sex without intimacy was the only situation they felt safe with and which turns them on, but at the same time they longed for something else. Or as Ulla says, ‘Mr Average was too dull, but with the other category, there was too much dynamics!’ Their stories illustrate the ambivalence of the new situation. The expectations, norms and behaviour patterns of the old life are placed in opposition to that which is new. It is difficult to find a mode to be comfortable with.

Togetherness – without room for sex

Another strategy was to look for a man with his own history of drug abuse, where the shared experience constitutes a safe foundation for the relationship. At the same time, the women may have wanted to avoid the kind of ‘macho men’ that they used to be drawn to. A relationship based on friendship and safety, rather than passion and infatuation, is what the women strove for. Sexuality tended to get marginalized in the relationship, which was not only due to the woman; quite often, the man also had sexual difficulties which he brought into the relationship (cf. Svensson and Skårner, 2014). Thus, sometimes there was a silent and mutual agreement to tone down sexuality – at least temporarily. Marit lived in a relationship that she described as stable and loving, but without the strong infatuation and attraction that she had experienced in previous relationships:

One can say that I’m vaccinated against falling in love. I don’t have those feelings for my current partner, unfortunately. I have very tender feelings, and I feel that he is my life companion, my kindred spirit. There is a lot of tenderness and closeness, we kiss and hug and hold hands and embrace. But it is not the violent passion, and I don’t miss it either. I wouldn’t even want to have it, because it eats you up in an entirely different way.

Her partner had his own problems to wrestle with, and she felt it was difficult to manage their sex life:

It’s a sensitive issue, we can get all shy around each other. When all masks are off, we are like two teenagers, not knowing how to behave, what to do and not to do. And being as insecure as he is, he leaves me be, and it just doesn’t happen. I don’t think I’ve ever been without sex for as long as I have now. And it’s such a relief not to have to do it! It is pretty much an unspoken rule that we should wait with it, we’ll deal with it further along the way.

Hence, one way to satisfy the need for belonging and safety, while at the same time avoiding the uneasiness associated with sexual relations, was to choose a partner who did not express high sexual demands, in other words, a partner who acted according to a similar intrapsychic script. The women described how little it took to upset the fragile mental balance in their new situation. The break from sex, and sometimes also from men altogether, could be more or less drawn out. The risk with a new man was that he did not perceive or respect this transition and that the physical contact, the way he touched her, brought the past back to life. Also, she may not have entirely trusted herself: because she may not have felt ready, but still wanted to please him, there was a great risk that she would catch herself playing the ‘porn game’ (cf. Hedin and Månsson, 1998).

Discussion

Most people meet their love and sexual partners in a pool of social equals who are involved in similar social activities. As Allan (1993: 18) points out, meeting a potential partner is ‘already socially and economically sorted’. For the women in our study, the transition from the drug context to another social context presented a real challenge, especially in managing to decipher the rules and expectations in sexual matters. Being unaccustomed to managing the different codes in sexually charged situations created confusion and insecurity and ultimately threatened their sexual confidence and self-esteem.

Experiences differed between the women in our study; they varied over time, in relation to what type of particular drug experiences they had had and according to their choices of sex partners. But despite these differences, we can identify some common patterns. Few were content with their present sex life, and the interviews reflected much insecurity about how they should handle sexuality both within and outside of a long-term relationship. A common denominator in many of the stories was the sense of being damaged by and exposed to circumstances outside of one’s own control at the same time as feeling ashamed and fearing not being good enough –having a nagging suspicion of having permanently consumed one’s respectability in the eyes of others. Further, feeling disgust and being ashamed of the old life contributed to blocking sexual desire in the women’s new lives. The ‘lovely and intimate’ sexuality associated with a drug-free lifestyle may be waiting far away in a distant future, but will one ever be ready for it?

The issues surrounding sexuality and their bodies, which the women have carried with them throughout their lives, were partly managed by using drugs. By doing so, they had been able to regulate and control their bodies; the drugs had occasionally been used as an instrument to numb the pain within. Some had been ‘turned on’ sexually by danger and pain. In the absence of a functional script of how to act in the new situation, there was an insecurity about the expectations of their partner and what they themselves could demand, especially when it came to uniting physical desire and emotional intimacy. In many of the stories, emotional closeness was portrayed as almost separate from sexuality: ‘We are close when we hug and hold hands – but not when we have sex’. Furthermore there was an insecurity in relation to the norms and expectations of the contemporary sexual culture surrounding them, where sex to a large extent infiltrates public space and where the importance of sexual desire and performance is emphasized. This came out in the interviews, not least in the women’s concerns about how they look when having sex, emphasizing emotions of repulsion and shame connected to their bodies as an obstacle towards opening up to sexual enjoyment.

We can see how the women’s choices and coping strategies are interwoven with the exit process as a whole, and the transformation of identity and the new life perspective that is at the heart of the process. The disorientation experienced by the women sometimes caused them to revisit the well-known landscape of the past, at least for a while, until they realized this was not the way forward, but rather a reproduction of old patterns. In cases where they had a live-in relationship, sexuality was banished to a more hidden place or it was put on hold. Parallel to this, a picture of sexual stigma emerges; the sense of being sexually exhausted and worn out, which was experienced as having damaged their ability to have a so-called ‘normal and loving’ sexual relationship. Sexual expression – even by ‘chemical means’ – which previously had been an important aspect of their identity and lifestyle, was now exiled until they were able to find the tools to develop new, functional sexual scripts. For the women, the best and safest option was to abstain from sex even though it may lead to frustration and longing. Toning down sexuality by living alone or in a relationship where sexuality was not allowed to take up such a large space can be seen as an aspect of the moratorium (Biernacki, 1986) that often takes place during the exit process. To some, it was a welcome respite. To others, it was a meaningless wait for a new life: they wondered, why does the beautiful, lovely sexuality never happen?

Feelings of shame about their past were enforced by a strong desire to create a new identity as ‘ordinary’, where the significance of the ordinary corresponds to what others do. At the same time, we sense from the interviews that the women were not sure how ‘ordinary’ people actually act in sexual situations. There is the unspoken question: what is normal sexuality? Sexual practices in the drug environment, where drug use functions as a regulator both for desire and lack of desire, stands in sharp contrast to what is imagined to be intimacy including a ‘normal’ sexual repertoire. The stories partly take the shape of repentance for previous sexual promiscuity, which is experienced as shameful, abnormal, animalistic and beyond conventional human boundaries.

An important conclusion of our study is that a part of the adjustment process for a drug-free life appears to be to emphasize the negative aspects of the old life and thus draw a line between the life one has abandoned and the new existence one seeks to establish. This involves the re-evaluation of drug-related sex, particularly when it comes to the experiences connected to amphetamine use. A common theme is to distinguish between sexual practice during drug abuse, which is seen retrospectively as ‘non-authentic’ and more or less dirty, and a drug free, ‘more gentle’ sexuality. A complicating factor is that this sharp division of sexuality is not in accordance with the changes in our late modern times, which are characterized by parallel and contradictory norms and patterns of sexual and intimate behaviour, where more conventional conceptions of being a couple and ideals of fidelity are mixed with ideals of a free and open sexuality which every person has to grapple with in his or her own individual way.

However, in our interviewees’ stories, a clear dichotomy between these ideals is constructed, where free and unbounded sexuality is described as odd and anomalous and attributed to the subcultural sexual script connected to the drug-using context and where conventional sexuality is regarded as normal and desirable. At the same time, a certain ambivalence is implied, with sexuality during the time of using drugs portrayed as more uncomplicated, exciting and pleasurable. This ambivalence is strongest and most prevalent in stories about having sex while using amphetamine; that is, within a hedonistic narrative where drugs are associated with a carefree celebration centred on guilt-free pleasure, which makes it easier for women to ‘let go’ and maximize sexual experience.

Regardless of which drug was used, our results show that the women needed to gain perspective and the ability to process sexual experiences from their previous lives. As most research in the field suggests, leaving long-term drug use includes much more than just quitting the drug itself. It involves the questioning and reassessment of previous identities and lifestyles, and often turns out to be a drawn-out process with complex interaction between individual prerequisites, informal social support and treatment. It is our contention that the successful outcome of this process presupposes a non-moralizing approach to sexuality in order to avoid the risk of women being stuck with self-contempt and fear, and instead to develop functional and life-affirming sexuality.

Footnotes

Acknowledgements

The authors thank Anna Karlsson and Adam Gilbert for help with the translation from Swedish, and The Language Edit Group at Malmö University for editing the final version of the manuscript.

Funding

This research was funded by the Swedish Research Council, award no 2009–2066.

Notes

Anette Skårner is Associate Professor of Social Work at the University of Gothenburg. She has conducted several research projects in the area of drug use and applies an interactionist perspective in her research. Some of the themes focused on are the following: Social networks and social support, drug use and sexuality, treatment and clientship and affected family members.

Sven-Axel Månsson is Professor of Social work at Malmö University, Centre of Sexology and Sexuality Studies. His research interest lies in the field of gender and sexuality, especially commercial sexuality and internet and sexuality, in which he has published extensively.

Bengt Svensson is Professor of Social Work at Malmö University. His research areas are the everyday life of drug users, drugs and sexuality, coercive treatment and drug policy. He has published several articles and books within these fields.

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