Sexualised drug use and associations with addictive behaviors in a broad sample of Canadian adults: A mixed-methods study.

Sexualised drug use (SDU) is the intentional use of psychoactive substances to enhance sexual experiences. SDU has been primarily studied in samples of men who have sex with men (MSM), with a focus on health outcomes (i.e., HIV). Research on SDU in samples other than MSM is sparse, in particular regarding processes which may be associated with SDU engagement, consequences of SDU, and associations with addictive behaviors. This mixed-methods study surveyed 3627 Canadians on their engagement with SDU, as well as addiction, mental health, and psychosocial variables. Open-ended text responses probed motivations for engaging in SDU and positive and negative consequences resulting from SDU. Participants were grouped according to their engagement with SDU in the past year: never (n = 3262), or during the past year (n = 365). A total of 9.6 % of heterosexual and 17.1 % of LGBQ + participants had engaged in SDU. The most robust associations were found between SDU engagement and problematic cannabis use severity, compulsive sexual behavior, and several psychosocial risk factors for addiction (i.e., childhood adversity, sensation-seeking). Participants most often engaged in SDU to increase sexual pleasure and enjoyment and reported that SDU could enhance the sexual experience, but was often followed by negative effects. Results indicate that SDU occurs among Canadian adults of varying genders and sexual orientations and has implications for well-being. Because SDU has been primarily attended to in MSM, these results may inform the scope of future research and prevention strategies.