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Q. In your practice, how often do you find that alcohol or drug abuse plays a direct role in sexual dysfunction? My partner’s total lack of need or desire for sex was a direct result of her alcoholism.

A. While alcohol or drugs may have a positive effect on sex at first, the long-term effects are almost always negative. That’s because the most important sex organ is really the brain, and so any type of substance abuse that has long-term ill effects on the brain, like alcohol, will, in the end lead to a lessening of sexual pleasure and desire.

I most definitely do see clients who have lost their desire for sex because of an addiction, and I always have to tell them that there is nothing that I can do for them until they give up whatever it is they are addicted to.