Sex’s Paramount Effect in Co-Occurring Disorders

December 2nd, 2020 | Posted by Kristina Padilla, MA, LAADC, ICAADC in Addiction | Behavioral Health | Mental Illness

CCAPP’s 7th Annual Conference kicked off its four-day adventure with the phenomenal Dr. Rob Weiss, PhD, LCSW, as the keynote speaker. Dr. Weiss is a sexologist, author, and educator. He began the wonderful Thursday morning discussing, “Understanding Why and How to Assess and Treat Co-Occurring Disorders: Sex and Drugs.” His presentation was nothing short of exceptional and highly informative for his audience that discussed a riveting topic more people should be aware about.

 The theme of significance that Dr. Weiss had stressed was the fact that sex was a taboo topic for counselors and patients in treatment programs. It was something “uncomfortable” that counselors didn’t want to discuss because of how it was supposedly inappropriate or not the “normal” conversation to have. However, that is the opposite of what treatment centers should do. In fact, it is super valuable to ask such questions pertaining to the patient’s sex life. The reality is that those in recovery struggle with relationships and intimacy just like everyone else. When assessing someone it is important to a variety of questions including:  What’s your family life like? What do you eat and how many times a day do you eat? Where did you go to school? How do you feel about yourself? Equally as important is to ask if they masturbate, if they have had a broken heart, what their sexual behavior is, what their sexual orientation is, etc. These questions are just as critical to individuals in recovery because what they do in their sexual lives overlap with their substance use habits/lifestyles.

It’s bewildering how treatment centers don’t go that route because of the stigma behind asking these “unusual” sexual questions that pertain to the person’s health. People don’t realize that sex is a huge factor in our lives. It’s one of our basic needs as human beings and if it is not being addressed correctly, then it can possibly drive addiction, relapse, etc. We miss and don’t see the signs that the patients are waving right in front of us when we don’t ask and get to know their basic needs for intimacy, love, and relationships. These “small things” that we gloss over are actually huge in the way we treat, for example, a patient’s meth addiction. One small thing that is glossed over can lead to another possible relapse. However, that can be prevented if we just simply sparked that conversation and treated it like any other medical examination. Dr. Weiss, an experienced sexologist, states that patients are not uncomfortable answering these kinds of questions because they know they’re supposed to talk to professional help. It is the professional help that doesn’t know to take the initiative to ask questions pertaining to the patient’s sexual health that are vital in the person’s overall behavioral health.  

Dr. Weiss makes the point that sexual secrets are the ones that cause us shame and we hold them close so don’t speak on them. Also, he notes that when practitioners are silent, it shows the clients that they should be too and therefore do not jump into such topics. He wants counselors and treatment facilities to know that we must connect with those that we are treating and be thorough with asking patients the mandatory questions no matter how uncomfortable. It begs the question; why haven’t people been doing this? Well, there’s nothing we can do but simply advocate for practitioners and programs to look at their patient as a whole – mind, body (including genitals), and soul so that they can get on an appropriate road to recovery for their struggles in addiction. Once one demon has been conquered, the next can be too.

The treatment you receive is not about getting “through it” and checking out of the facility – it’s all about building yourself a safe social circle and establishing a sense of community around you. A group of people for support is monumental in helping individuals zone in on working on themselves. Talk to your patients about adult sex, porn, and relationships through the standard assessment questions that will essentially broaden someone’s knowledge in building, creating, and maintaining healthy intimate relationships.. Sex is a trigger that shoots out unhealthy addictions whether it be sexual or substance related, or a combination of both. Remember to address a patient’s sexual health in order to have a fuller understanding of what works best for them. A deep understanding of a patient goes a long way in providing thorough treatment that can prevent relapses and create long-lasting recovery. Healing is not about avoidance – talk, discuss, and share everything to build connections and create relationships.

If you are interested in learning more about the topic discussed during Dr. Weiss’ presentation, please check out his website: Or, write him anytime if you have any questions at:

Kristina Padilla, MA, LAADC, ICAADC
Vice President of Education and Strategic Development at CCAPP | Website | + posts

Kristina Padilla is a leader with the California Consortium of Addiction Programs and Professionals (CCAPP), where she serves as the Vice President of Education and Strategic Development overseeing CCAPP’s Education Department. Additionally, she travels throughout California and the nation bringing addiction focused businesses together to promote the profession, increase access to services and improve the quality of AOD service provision through education, business development, and investment in quality programming.  Mx. Padilla has a Bachelor’s of Science in Criminal Justice Administration and a Master’s Degree in Counseling Psychology. Mx. Padilla is a Licensed Advanced Alcohol and Drug Abuse Counselor (LAADC), and an International Certified Advanced Alcohol and Drug Abuse Counselor (ICAADC).

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