Hot Fetish and Kink — Without Being Lit

by Luke Adams

Photography by InkedKenny

Luke Adams ( is a certified sexual health specialist with the American College of Sexologists, offers relationship advice and other psychotherapy, and is a lifetime member of the Association for Transpersonal Psychology.


Those of us who do clinical work with sexually active people often hear and see high levels of stress associated with a personal connection between drugs and sex. Discussions among my colleagues in the field indicate a growing client base of those who seek us out to help them stop or restrict their use of mind-altering drugs. Often, these clients have internal emotional fears and struggles about sex. They tells us they fear they will never have fulfilling sex again, or that they cannot have sex and intimacy the way they want them. Sometimes, they have pathologized their sexual interests to the point of leading them back toward the substances for the sake of the “hot” sex. All of that can be deadly.

For a collection of people who often perceive ourselves and others as rule-breakers, participants in kink/fetish networks also experience this same internal struggle. I have a dual role as both a caring professional and a members of these networks. We may indeed break normative “rules” about sexual orientation, gender masks, sexual personae, gear and drag, relationship configurations, procreation, power exchange, and sensation play. Historically, our camaraderie and play has connected at some times with the use of alcohol and/or other mind-altering drugs.

Our play and play spaces may be more likely to also break certain social conventions about the use of mind-altering substances. The temptation/tendency to misuse such drugs might be greater when it seems part of that “sexual outlaw” persona. This can lead players into a difficult conundrum.

We may have explored our fetishes and kinks through the help of getting high. These crutches may have aided us in pushing limits we wanted to push. It may have helped us to get past shame and false guilt instilled in us by oppressors.

The substance user may reach a point in the use-cycle that volition (the power of choosing through reasoned will) is impaired, and the user is dependent. The point may also arrive when some players do not believe they can have fulfilling play without the substances as an integral part. The substance use may so impair thought and feeling that an adult cannot give adequate consent. Fetish/kink sex that does not insist on consent is traumatic abuse. Kink/fetish play in that state often leads the individual to behavior for which that person feels terrible remorse or self-loathing.

Our friends over at Daddyhunt have been producing an online serial drama for the past year. in the first part of Season 2, the lead characters encounter a kind of “vanilla” version of the conundrum, and it leads to some distress (

The existence and awareness of this emotional and physical tug-of-war can seem like a woeful crucible. The process of overcoming it is not easy and it doesn’t occur overnight. Still, there are many people who have successfully become sober kink/fetish players.

There have been sound, noteworthy, scientific studies about the frequent link between the use of lots of alcohol (more than five drinks over a couple hours more than twice per week) — or between use of opiates/opioids, powder cocaine, crack, meth, and MDMA — and sexual behavior that can feel out of bounds (Rhodes, 1996). Unfortunately, there has not been much good research evidence published about helping these users detangle their sex lives from their drug use, once they make the decision to seek recovery. In more casual observation, those of us working in the field have seen broad evidence of relapses that were brought on by the lack of tools for untangling the sex-drug connection.

Arnold M. Washton released a workbook in 2008 through Hazelden Publishing titled, Quitting Cocaine: Your Personal Recovery Plan. In this workbook, he developed a list of 10 tips to break the sex-drug connection, and those of us who were David Letterman fans can vouch for the impact of a Top Ten list. Some (myself included) have suggested that Washton’s version is not only judgmental, but also both sex-negative and heterosexist. It reflects similar ineffective notions trapped in the boxes of distorted cultural thinking that still dominate many of our schools when they’re addressing this health issue (Ley, 2012).


Understanding a need more visibility on the concept of breaking the link, in 2013, I began an series of efforts to shine more visibility, starting with an

article in the Bay Area Reporter about breaking the sex-drug link. This thinking was reinforced during the three years I was working on a federal grant administered through the San Francisco Department of Public Health. Joining that to my previous work led me to focus on how people had successfully chosen to remove mind-altering drugs from the equation of their sex play and other intimacies, and had gone on to have healthy and hot sex lives and fulfilling relationships.

As a result, I started the process of writing notes and an outline for a forthcoming book on the subject, tentatively titled, “Sobersexual: How to be dirty when you get clean.” My objective to writing the book was to show how a diverse group of people had actually achieved this, and to shed more light on the state of research and theory about how their processes worked. The book will include at least seven case studies, as well as my clinical observations and ideas, along with an assessment of where present treatments and ideas about this matter stand.

While encountering the paucity of published evidence of how people had broken the sex-drug link and formed healthy, hot, happy sex lives, I found a considerable amount of published material claiming the existence of “sex addiction” and “porn addiction,” but with even flimsier evidence. More often than not, these notions were conflated with ideas about severe substance use disorders by disciples of Patrick Carnes, PhD, who has launched an industry promoting such concepts. Pointedly, Dr. Carnes’s academic training degree is in developing organizations and training counselors, from which he makes a great deal of profit.

Consulting with colleagues in the field, we noted that these concepts were actually harming clients, rather than helping them to build a life of sexual health when they had been experiencing distress about “sex that seemed to them to be out of control.” Unlike with severe substance use disorder (actual “addiction”), or obsessive-compulsive process disorders (e.g., severe gambling problems), the evidence does not show volitional impairment in people whose sexual behavior has reached a point of great distress for them. Instead, the brain scans simply show that such people experience both pleasure and distress, without indicating loss of volition.

Changes in understanding sexual behavior that feels “out of control,” and of what role mind-altering substances can play, have been slow but they are happening. I became one of 18 mental health practitioners to co-author a research article ( in The Therapist, the journal of the California Association of Marriage and Family Therapy. The American College of Sexologists, of which I am a member, had never been on board with the idea of an “addiction” to sex. Then, after our article, coming on the heels on considerable review of studies and of Dr. David Ley’s book, The Myth of Sex Addiction, our colleagues at the second major Sexology organization in the United States issued this statement:

AASECT recognizes that people may experience significant physical, psychological, spiritual and sexual health consequences related to their sexual urges, thoughts or behaviors. AASECT recommends that its members utilize models that do not unduly pathologize consensual sexual behaviors. AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy.

There are deeper concerns at work when individuals choose to use sex in ways that are not healthy for them.


Claims that pleasure registered in the brain by eating cheese, or watching porn or a video game, or by the endorphins from a long run, or by eating cake, is the same process at work as that induced with a mind-altering substance (which can result in dependency), are misleading and deceptive. Present neuroscientific evidence does not prove such claims. Some followers of Carnes in the field of addiction medicine argue that our focus on the deeper issues, either physical (e.g., brain injury), or psychological (e.g., trauma, systemic problems of attachment and boundaries, impulses and development, personality issues, emotional dysregulation), or both, are “dismissive.” Instead, their approach pathologizes and isolates individuals who need real help to figure out what healthy sexual behavior means for them.

Sometimes, in addition to or in place of those deeper concerns, is the fact that distressing sexual behaviors (or else sexual activities that one convinces oneself will never be as enjoyable otherwise) are driven by the use of mind-altering substances. Let’s first define terms. What makes a substance “mind-altering”? The use of it results in suppression of impulse-control and inhibition, activates the reactive-volition-pleasure center of the brain (the mesocorticolimbic pathway, or “MCLP”), and ends with a splash of the “feel-good” neurotransmitter dopamine in the frontal lobe.

As a professional, with more than a passing interest in seeing kink/fetish folk move toward an ever-healthier understanding of sex and sobriety, it remains clear to me that moralizing doesn’t serve as an effective treatment strategy (MacCoun and Reuter, 2001). Historically, characterizing the misuse of mind-altering substances as a moral failing, or as merely an illogical thought and behavior pattern, and then isolating alcoholics/drug-addicts, has never helped people with a severe substance use disorder. Instead, solidarity in community helps, along with cognitive-behavioral restructuring that recognizes liabilities as well as assets of character and reasoning, and modifies rational-emotive behavior. Much of the treatment for severe substance disorders, and mutual-support groups (with their own programs) such as Twelve Step Fellowships, SMART Recovery, Refuge Recovery, LifeRing, and others, are based (more or less directly) in this framework.

Similarly, pathologizing consensual sexual behavior and adopting false forms of abstinence has resulted in suicides, relapses and overdoses on substances, behavioral recidivism, judgmentalism, relapse into other mental disorders, and internalized oppression sickness in many who have undergone such methods of “conversion therapy.” Additionally, though a few have found help and solace by seeking to apply 12-step methods in groups that characterize problematic sexual behavior as an “addiction,” there is precious little evidence of long-term success in dealing with problematic sexual behavior in this way. Even acolytes of Patrick Carnes suggest barely a 5% success rate for this (Grant, et al., 2010).

One of the strongest messages my colleagues and I learned was that shaming or “one-size-fits-all” models about sexual behavior almost always backfire. As part of another series written on prevention and sexual health over the past several years, my co-author, activist Race Bannon, and I wrote in the BAR on September 9, 2016 ( We noted:

To stand up for our own sexual health, we have to be knowledgeable, go to the doctor or the clinic openly, get our shots, take our meds, reduce or eliminate the harm from all the drugs, test and treat, and openly talk about what’s going on. Finger-wagging about either barebacking or condom-coding, or the structure of our relationships (polyamorous, open, monogamous), or the frequency of our sex, or how we like to play, cannot be tolerated among queer men, unless we want to consign each other to sickness and death. Stop the madness of shaming about sex.

While that article had a focus on gay and other non-heterosexual men, the conclusion just as clearly fits any cisgender or transgender person of any sexual orientation and of any relationship configuration.

It was with that in mind that I agreed to share as part of the panel, Recovery, Risk, and Responsibility, that the San Francisco Leathermen’s Discussion Group held on April 26, 2017. I served along with my colleagues: psychologist Richard Sprott, PhD; somatic sex educator/coach and hypnotherapist JoJo DeRodrigo; and multi-disciplinary artist Al Rahm Lujan, who is Mr. 2017 Bay Area Sober in Leather. Video from that panel is available currently on the LDG Facebook page.

Part of that sharing involved discussion of a Top Ten List for beginning to break the sex-drug link that reflects a ground-tested and results-oriented approach.


10. No matter what, do not give up.

Whether it is small incremental ways to reduce harm by limiting your use or being in one of many forms of treatment and mutual support, keep at it and keep moving forward. Once you surrender to the process, don’t allow that pull toward walking backward get you to give up on a good life.

9. Not enough “lead in your pencil” or “oil in your engine?” Don’t let it get you down.

It is pretty normal for people to have little or no sex drive after they stop using drugs: This too shall pass. For most people, it can take several weeks to months for their sex drive to kick back in as something they might feel is normal for them. Your brain chemistry may not even return to baseline for one to two years, so expect you will be working on this for a time. Hint: this then becomes a great time to explore sensuality and different kinds of intimacy.

8. Again, it will not happen overnight.

You are probably going to feel frustrated and afraid that sex without alcohol or other mind-altering substances will be boring and unsatisfying. Learning how to enjoy sex without using drugs is a process that may take some time and practice.

You may want to consider developing a safe-feeling friendship (or a few) with whom you can practice. Getting through the vulnerability of finding such friends without creating new emotional baggage is part of getting better. Practice, practice, practice.

Three touchstons for very early recovery that many people use: (1) “Fuck but don’t send flowers” — you have awhile before you get a better handle on yourself, and taking a hostage in the process isn’t fair to you or the other person; (2) “Don’t play with anybody crazier than you” — you know if someone still has a lot of work to do before they don’t feel like a commodity or they’re still too fragile or dysfunctional; (3) You are entitled to bring on yourself as much misery as you would like in your early recovery, but you are not entitled to drink or use over it, so be careful.

7. Take stock of your sex life — including taking your own sexual inventory.

Take stock and reassess what good sex could look and feel like for you now. What stimulates you? What brings you a sense of joy or fulfillment? You can choose now to move away from rote sexual thinking, towards engaged conscious pleasure.

Clean house. Consider where in your sexual behavior you had been selfish, dishonest, or inconsiderate. Did you unjustifiably arouse jealousy, suspicion, or bitterness? Where were you at fault? What could you have done differently?

Examine any possible fear you may have of intimacy or rejection, and any attitudes you may have toward others or yourself that take value away from sex.

Serve others as well as yourself. Ask yourself what you want out of many kinds of relationships — from possible casual sex partners to friends to friends with benefits to partners to whatever else might be in between, with or without sex. Have you set realistic standards to aim for?

For example: What is your ideal for the kind of sex you want? What is your ideal for the kind of relationships you want? Where (if ever) do those overlap?

6. Get creative, get active — just get going.

A moving target is harder to hit. Develop a list of alternative activities to do immediately when confronted with urges to act out in ways that would potentially combine sex and drugs.

The Bay Area Reporter’s arts section lists many events that do not revolve around using alcohol or other drugs. The Castro Country Club ( provides a list of clean and sober community events and meetings. Gayalcoholics ( is a site that provides a list of LGBTIQ2 AA conventions, which is just the tip of the iceberg for 12-step-related social events. Leathermen’s Discussion Group ( offers many informative and social events that are open to men, women, transgender people, and intersex persons. The local kinky coffeehouse, Wicked Grounds, also has a social calendar ( There are several kink/fetish calendars in the San Francisco Bay Area (and elsewhere), and many events post clearly whether the events will turn away anyone who is clearly intoxicated, or whether the event is designed to be a sober space (

5. Be prepared.

Understanding the stuff that gets you to associate sex with drug use is one big part of knowing how to address it. What are your triggers? Develop an action plan to anticipate and respond safely to them. You cannot possibly always avoid all your triggers, and attempting to always live life in a covered bridge may leave you unable to maneuver on the open road. Learn how to put brackets of recovery tools around your sex and around your romance life. People who are sober and have a hot, healthy, happy sex life can give you suggestions.

4. Chill out and take a time out.

Consider taking a cooling off period from sex for a short while after your last use or after a major triggering episode (some say 30 days is a good goal to work toward) to let your thoughts, feelings, and fantasies wind down. Be careful of falling into the “virgin versus whore” trap of restricting so much in your sexuality (sexual anorexia) that you might binge in an unhealthy way (sexual bulimia).

3. Find good support for you.

Do you have a therapist? Do you have a group? Do you have a sponsor? Do you have some fetish/kink mentors? Do you have some friends you confide in? Take the initiative to be open and honest with these supporters about any secret desires you have to act out in a way that would potentially combine sex and drugs, and any time you want to use sex only for seeking validation.

If your choice is to be sober, is there someone who suggested to you that it would be helpful if you “only” used one mind-altering drug (such as only cannabis, or only alcohol, etc.) instead of other substances? This person is not advocating for your choice of sobriety. They are advocating for their own agenda. Sticking with your own plan instead of theirs is okay.

Recognize that everyone has sex problems and that, sometimes, people act out their own problems on you. Sometimes, that is with bad medical advice such as: prescribing “no sex for a year;” labeling you a “sex addict;” telling you that you should “just get over it;” declaring that your desires for either “vanilla” or “kinky” sex are “wrong” or “not sober;” insisting that only monogamy (or only celibacy, or only polyamory) is right for you. Nobody who is working a healthy recovery program will try to be the arbiter of your sex conduct. Learn to discern with your circle of wisdom providers.

2. Nurture the exchange with your wisdom circle.

Talk with those people about your thoughts and concerns about not being able to engage in the kind of erotic sex you want without getting high again. Don’t be afraid to dispute yourself about those thoughts. Remember, having support also means they don’t always have to agree with you; being able to dialogue is part of the learning process, as is navigating different opinions.

Ask yourself what you really want out of sex, and what it means to be satisfied (and those may be different things at different times). My colleague Frank Strona, health advocate, activist, and personal support coach at, likes to say that it’s allowable for a person to ask, “Am I looking for warm fuzzies and breakfast, or just looking to get my rocks off?’” Decide which sexual behaviors you may wish to keep away from, which sexual behaviors are those that could place you at risk if you are not applying your recovery tools, and which sexual behaviors enhance your life and recovery.

1. Broaden that circle of wisdom and use it.

Keep up the good work on finding, caring for, and nurturing a social and mutual support system to which you can turn. Add to it the writing and workshops that help you with your goals and objectives. Find a posse of players who you deeply trust, and work with them as your touchstones.

Here is a helpful starter reading list about these issues: Sex and the Sober Alcoholic, by Toby Rice Drews; The Ethical Slut, as well as The New Topping Book, and The New Bottoming Book, by Dossie Easton and Janet Hardy; Sexual Outsiders, by David M. Ortmann and Richard A. Sprott; The Myth of Sex Addiction, by David J. Ley; and Codependents Anonymous, by CoDA Inc.

If you have made the choice to get better, and you have not examined these issues, now is the time to safeguard your progress by taking a look at these helpful tips.