Amphetamine & Sex
Amphetamine was widely prescribed until the mid 1960s
as a stimulant and appetite-suppressant, until the dependence-potential
of amphetamine (and other stimulants) led to a falling
out of favour among the medical profession. Amphetamine,
although a controlled drugs, is still prescribable for
certain conditions (e.g. narcolepsy)[i], and appears in Schedule 2 of the
Misuse of Drug Regulations 1985, meaning that it can be
prescribed for medical treatment subject to proper monitoring
and reporting criteria.
Amphetamine is a powerful central nervous system stimulant
drug, used recreationally for the euphoriant effects,
as well as "functionally" to ward off fatigue
and increase energy and capacity for physical activity.
The effects of amphetamine are similar to those of cocaine,
both affecting the same neural systems, amphetamine stimulates
catecholamine release, and cocaine reduces reuptake -
expressed simply, if the level of alertness were to be
represented by the water level in a bath, amphetamine
would act by turning on the taps, whereas cocaine would
act by putting in the plug.
The effects of amphetamine have been studied for over
a century, although since it became a controlled drug
in most countries of the world, opportunities for research
on the effects on humans have been limited.
There have been several studies of heterosexual and homosexual
behaviour, including high HIV-risk practices, among chronic
amphetamine users, with conflicting results. In a clinical
review, Miczek & Tidey[ii]
found "Most often...
amphetamines disrupt social, sexual, maternal, and aggressive
behavior patterns in a dose-dependent manner; neither
tolerance nor sensitization appears to develop to these
Our own IDMU surveys have found enhancement of sex by
amphetamine to be a commonly reported "best drug
experience". However these results have yet to be
analysed in detail and, as open ended questions, provide
qualitative rather than quantitative data, and are of
the nature of anecdotal reports.
In a study of 200 injecting drug users in Sweden, Kall[iii]
injectors, who constitute the majority of drug injectors
in Stockholm, reported a higher frequency of intercourse
on drugs with regular partners than did the heroin users",
from the same study, Kall & Nilsonne[iv]
found "Sexual activity
was reported as the preferred activity on amphetamine
by 51% of the male and 20% of the female amphetamine injectors",
and concluded "preferring
sex on amphetamine may be viewed as a marker of high risk
behaviour, both sexually and with needles, for HIV among
male but not among female amphetamine injectors".
Kall"s pilot study[v]
had earlier found "Of the 29 men, 27 had experience of sexual activity while
using amphetamine. Of these, 23 reported that they became
more sexually excited when on amphetamine, 21 reported
intensified orgasms, and 23 reported that the drug prolonged
intercourse. All 29 men had been sexually active, but
only 6 of the amphetamine users had had more than 10 partners
during the last 3 years. Condom use was very low; it was
reported by only 3 men during their last intercourse with
a causal partner."
In a study of female intravenous drug users in the UK,
Klee[vi] reported "Marked
differences were observed in sexual behaviour, amphetamine
injectors reporting greater interest in sex and greater
frequency of intercourse. However, more of them perceived
their personal risk to infection through unprotected sex
as negligible." In Hawaii, Laidler &
quote one woman: "God what sex we had, Go! Go! Go!... It gave me more courage, it made me
braver" In Switzerland, Muller[viii] reported "The
influence of drug abuse on sexuality is usually felt to
be negative (decline in libidinal energy, impotence),
and often brings about a decrease in sexual contacts.
This is equally true of both opiates and stimulants (cocaine,
amphetamine). Promiscuous behaviour is rare as such and
does not occur with any greater frequency than among the
average population". In Australia, Hando
& Hall[ix] found "Sexual
risk-taking was not related to needle-sharing or amphetamine
In the USA studying methamphetamine users, Morgan &
Beck[x] found a range of
opinions and experiences, suggesting sexual energy and
released inhibitions common among gay men "I was running around trying to have sex with everybody",
heterosexual users reported sexual pleasure from the drug
rush itself "when
a woman does a bit of crank she comes, climaxes",
others reported extremely heightened and prolonged sexual
activity á a 30 year old woman was quoted "I had
no idea it was two weeks! It was a lot of sex, listen
to the stereo, more sex, do dope, talk, more sex, for
two weeks. I could a went for more, my kids missed me,
days turned into nights and nights into days"
Worm & Steentoft[xi]
studied drug-positive arrestees in Denmark, and found
"In 194 of the
amphetamine-positive cases where relevant information
was available, 56% were cases of violation of the traffic
laws, 17% were cases of violence, 3% were cases of sexual
offence and 9% were cases of robbery."
Greaves[xii] reported "sexual
disturbances" among chronic amphetamine
In Thailand, Melbye et al[xiii]
STDs were associated with amphetamine use: gonorrhea (OR
2.3) and genital warts (OR 2.4), and any STD (OR 1.9).
In multivariate analysis, use of heroin (OR 3.1), soft
drugs (OR 4.9), and a history of gonorrhea (OR 2.0) were
independently associated with amphetamine use in northern
Thai men." Von et al[xiv] reported clients
using methamphetamine "to enhance sexual experience". In a study
of amphetamine use among youths infected with HIV, Rotheram-Borus
et al found "Compared
with those who have never used (never-users), users...
had more sexual partners and more sexual encounters."
In a comparative study of heroin and methamphetamine injectors,
Zule et al[xv] noted "Of
methamphetamine users, 71% had more than one sex partner,
compared to 39% of heroin users."
Gay Men: In a study of gay and bisexual US males,
McNall & Remafedi[xvi] noted "Significant
univariate associations were found between drug use before
or during sex and unprotected anal intercourse for the
following substances: alcohol, marijuana, cocaine, amphetamines,
barbiturates, heroin, LSD, volatile nitrites, tranquilizers,
and methaqualone. In multivariate analyses, however, only
cocaine use predicted failure to use condoms during anal
intercourse." Stone et al[xvii] found heavy amphetamine
and alcohol use was associated with higher rates of condom
use, and condom failure, in insertive and receptive anal
sex. Semple et al[xviii] noted "Previous
research has documented an association between methamphetamine
(meth) use and high-risk sex among HIV- men who have sex
with men", finding that "meth
use was associated with high rates of anal sex, low rates
of condom use, multiple sex partners, sexual marathons,
and anonymous sex. Personal motivations associated with
meth use included: sexual enhancement".
Shoptaw et al[xix]
a drug used at alarming rates among gay/bisexual males
in the West, is often combined with sexual activities,
thereby increasing HIV-related risks in an already high-risk
group". Halkitis et al[xx] reported "Methamphetamine
is often used by gay men to initiate, enhance, and prolong
sexual encounters. Use of the drug is, therefore, associated
with particular environments where sexual contact among
gay men is promoted, such as sex clubs and large "circuit"
parties. Research with gay and bisexual men indicates
that methamphetamine use is strongly associated with risky
sexual behaviors that may transmit HIV. This relationship,
coupled with emerging evidence that methamphetamine use
is on the rise among gay men, suggests that the drug could
exacerbate the HIV/AIDS epidemic among this community."
Other stimulant drugs: McBride et al[xxi]
found crack cocaine use to be associated with a significantly
higher number of sexual partners. In Ethiopia, Taffa et
found "alcohol use and khat (amphetamine-like substance) consumption
predicted the likelihood of engagement in sexual activity."
In a reviewarticle Schiorring[xxiii]
noted that stimulant drugs "prolonged sexual intercourse without ejaculation"
In rats with cerebral cortex lesions, Agmo et al[xxiv] found amphetamine reduced mounting
latencies, but had no effect in healthy (intact) animals.
They earlier noted[xxv]
male (rats) are critically dependent on stimuli from the
female in order to initiate sexual behavior, and catecholamines
are known to modulate interactions with environmental
stimuli. It was found that D-amphetamine, 0.5 and 1 mg/kg...
reduced mount and intromission latencies.".
In female rats, Nance et al[xxvi]
found an increased level of lordosis (sexual display/behaviour)
in rats with septal lesions, but found "amphetamine was found to reduce the high levels of lordosis
behavior of septal lesioned female rats to control levels".
Nojcar et al[xxvii] noted "Appetitive
behavior for drug and sexual reward is enhanced in animals
with a history of amphetamine-experience."
Becker et al[xxviii]
found significant sex differences in the behavioural responses
of male and female rats to amphetamine, and in female
rats, Diaz-Veliz et al[xxix]
found differences in behavioural responses to amphetamine
at different times within the oestrus cycle, with reduced
effect in the dioestrus (post-ovulation ) phase.
In hamsters, Bradley & Meisel[xxx] found "sexually
experienced animals responded sooner to amphetamine than
did sexually naive animals. These data indicate that female
sexual behavior can activate neurons in the nucleus accumbens
and that sexual experience can cross-sensitize neuronal
responses to amphetamine." Studying the
effect of amphetamine withdrawal on sexual behaviour of
male rats, Barr et al found[xxxi] "Withdrawal
from the drug was associated with decrements in several
motivational components of sexual behavior, including
decreased anticipatory locomotor and increased postejaculatory
intervals, while consummatory measures remained largely
unaffected. This pattern of sexual deficits resembles
those seen in human depressive disorders"
Fiorino & Phillips[xxxii]
a 3-week post-drug period, d-amphetamine-treated rats
exhibited facilitated sexual behavior, as indicated by
shorter latencies to mount and intromit, and a greater
percentage of rats copulating. These rats also exhibited
a general increase in the amount of copulation. Furthermore,
sensitized rats displayed a facilitated acquisition of
sexual behavior (i.e. mount and intromission latency <300
s for 3 consecutive days). After repeated sexual experience,
rats pre-treated with d-amphetamine also showed an augmented
increase in level changes made in anticipation of the
presentation of a receptive female. Finally, enhanced
sexual behavior was independent of the environment in
which repeated administration of d-amphetamine occurred,
indicating that facilitation was not a consequence of
conditioned associations between drug and test environment."
Carter et al[xxxiii]
(2.5 mg/kg) did not potentiate lordosis in ovariectomized
hamsters after either 2 or 6 days of EB priming... Lordosis
in the female rat is more readily elicited both by drugs
and estrogen. It is proposed with regard to female sexual
behavior that species differences in estrogen sensitivity
may underlie apparent differences in drug sensitivity",
having earlier noted[xxxiv]
not interrupt either male or female sexual behavior".
Dallo et al[xxxv] found "Amphetamine
(2 mg/kg) (exerts a moderate aphrodisiac effect in sexually
sluggish rats) with a... rapid onset and offset of the
effect." Saito et al[xxxvi] concluded "methamphetamine
inhibits the intromitting and ejaculating behavior in
In male macaque monkeys, Bellarosa et al[xxxvii] found "d-Amphetamine
increased vocalization, self-grooming, playing (low doses),
social grooming (low doses), and aggression (low doses).
At higher doses most forms of social interaction (playing,
social grooming) were greatly decreased. Presenting behavior
was increased by all doses under both treatment conditions.
Mounting was increased to a much lesser extent and only
after concurrent dosing. The increased presenting and
mounting may be a result of sexual stimulation or perhaps
more likely, an indication of increased submissive behavior
directed toward more dominant animals."
Summary- Amphetamine and Sexuality
There are a large number of human studies finding an association
between chronic or heavy amphetamine use and increased
sexual activity and/or high-risk sexual behaviours, and
use of amphetamines is considered a high-risk factor for
HIV infection. However none of these studies have resolved
the issue of whether amphetamine use causes such behaviour,
or whether such behaviour and amphetamine use are both
symptoms of an underlying risk-taking or sensation-seeking
Animal studies provide conflicting and confusing evidence,
some finding amphetamine to "normalise" sexual
behaviour in lesioned animals, others to find a reduction,
and others an increase in sexual behaviour following administration
of or pre-treatment with amphetamine.
There is some evidence from animal studies that sensitivity
of females to the effects of amphetamine may vary over
the menstrual cycle, with enhanced sensitivity in the
pre-ovulatory period and reduced sensitivity in the post-ovulatory
The evidence suggests that chronic amphetamine users may
be more likely to engage in sexual activity than users
of other drugs (e.g. opiates). Although the effects of
amphetamine on the libido of a nave user are unclear,
the evidence suggests that enhanced energy, stamina and
appreciation of sex are commonly sought by users of amphetamine.
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