Shabu and sex: the truth behind the “endless energy”

8Why do people who use crystal meth link it with sex?

“The first time, I felt like someone else: energy, staying up all night, confidence.” This is how some patients describe their start with crystal meth, and it is the same start that leads many people to link the drug with sex. But the story rarely ends with that feeling, and what comes afterward is what brings them to the clinic.

Crystal meth, or methamphetamine, is a powerful stimulant that raises dopamine sharply in the brain’s reward centers, as the crystal meth (shabu) guide explains. The US National Institute on Drug Abuse (NIDA) states that its effect on desire and confidence can lead to changes in sexual behavior, such as multiple partners and neglect of protection. In other words, much of what the person feels as “energy” is really impulsiveness and poor judgment of consequences.

This page does not repeat what the sexual-effects section of the harms of crystal meth already covers. Instead, it goes deeper into three questions: How do the sexual effects change over time? What are the risks to the partner and the marriage? And what happens after stopping?

9How do the effects of crystal meth on sex change over time?

In a qualitative Iranian study published in 2016, researchers carried out in-depth interviews with 45 people, 35 of them men who used methamphetamine, along with family members and doctors. Participants described a recurring pattern:

1. The first few times
   A sense of control and longer duration

   Many described longer sex and a feeling of pleasure and control.

2. With repeated use
   The effect fades

   The effect gradually weakened, and desire became tied to the drug more than to the partner.

3. With continued use
   Reduced desire

   A dulling of sexual desire appeared outside the times of use.

4. With addiction
   Multiple problems

   Erectile dysfunction, premature ejaculation and loss of control during sex.

The researchers concluded that the person’s perception of their own performance may itself be affected by the mental changes crystal meth causes, so they may believe they perform better than they actually do. This is a small qualitative study that describes experiences and does not measure percentages, but it is consistent with what the US institute reports about declining sexual function in men with long-term use.

10Why does crystal meth weaken erections and desire?

Several causes come together, some in the blood vessels and some in the brain:

Some people who use crystal meth add erectile dysfunction drugs to make up for the weakness. The US National Library of Medicine (MedlinePlus) warns that sex can strain the heart of a person with heart disease, and against taking sildenafil with nitrate medicines. When a stimulant that raises blood pressure and heart rate is combined with pills of unknown origin, the danger to the heart becomes far greater.

11Crystal meth and sexually transmitted infections

The US institute explains that crystal meth raises the likelihood of HIV and hepatitis B and C in two ways: sharing injection equipment among those who inject it, and changes in sexual behavior caused by its effect on desire and confidence. It also notes that crystal meth reduces the effectiveness of HIV treatment in people who have the virus.

• Get tested for HIV and hepatitis B and C after any risky behavior, because early treatment protects both the person and their partner.
• Tell the doctor about the drug use. Doctors are bound by confidentiality, and the information changes the testing and treatment plan.
• Protect your partner until the results are back.

12Crystal meth and married life: suspicion and violence

The hardest thing wives describe is not the sexual dysfunction but the suspicion. Crystal meth can cause paranoid thoughts and hallucinations, which turn into accusations of infidelity, searching, and threats. The page on pathological jealousy explains how suspicion becomes a certainty that cannot be discussed.

In an Australian longitudinal study published in 2014 that followed 278 people dependent on methamphetamine, violent behavior increased during periods of use compared with periods of abstinence in the same individuals, and the increase was greater the more days they used, even after accounting for psychotic symptoms and alcohol.

13Does sexual ability return after quitting crystal meth?

In many cases it improves gradually, but not immediately. The first weeks after stopping can bring exhaustion, depression and disturbed sleep, all of which temporarily weaken desire, as the page on crystal meth withdrawal symptoms explains. Sexual recovery needs regular sleep and nutrition, treatment of depression if present, and a medical assessment if the problem persists, to rule out other causes such as heart disease or diabetes.

Going back to crystal meth to “test” sexual ability is not advisable, as it is one of the most common routes to relapse. Many couples also need family therapy sessions to rebuild trust after months of suspicion and sleepless nights.

14When should you ask for help?

If sex has become tied to crystal meth, if suspicion and accusations have appeared, or if use continues despite fear for the marriage, this is the time for an assessment, not for waiting. The page on crystal meth addiction treatment sets out the stages of care, and treatment can begin with residential treatment if there is psychosis or violence. At Eradah, the first consultation is free and confidential.