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Drug abuse can have a significant negative impact on sex and sexual performance in men. After men quit their use of cocaine, alcohol, heroin or other addictive substances, many wonder whether they will experience a return of their libido and sexual function. Several recent studies have explored this issue. First, however, let’s look at the effects of drug abuse on a man’s sexual performance.
Drug Abuse And Sex
Marijuana is a commonly used drug among young men, but how can its use affect sexual health? A study published in the Journal of Sexual Medicine in January 2011 reported that men who partake of marijuana may cause stimulation of certain receptors in the penis, which can result in erectile dysfunction.  And if you think cocaine is an aphrodisiac, think again. Use of cocaine can cause impaired or delayed ejaculation. 
Alcohol abuse (alcoholism) is well associated with erectile dysfunction. A representative study entitled “Prevalence of sexual dysfunction in male subjects with alcohol dependence” reported that 72 percent of the 100 men in the study had at least one sexual dysfunction. The most common were erectile dysfunction, premature ejaculation and low sexual desire.  Another drug, heroin, reduces sexual desire and sexual feelings while also causing ejaculation problems and erectile dysfunction. 
Studies On Drug Abuse And Sexual Performance
At the University of Granada in Spain and Santo Tomas University in Colombia, researchers evaluated the long-term effects of drug abuse on men’s sexual performance after these men quit their drug(s) of choice.  The study group included 905 men: 549 had a history of alcohol, cocaine, cocaine plus alcohol, heroin, marijuana, or cocaine and heroin (speedball) addiction. The remaining 356 men were included as controls.
The men were assessed in four areas concerning sexual performance: libido, sexual arousal (achieving an erection), orgasm and sexual satisfaction:
- Orgasm was most commonly impaired by the use of heroin, cocaine, alcohol and speedball.
- Sexual pleasure was most affected by cocaine and speedball use.
- Cocaine and speedball use had a slight impact on libido.
- Alcohol abuse had the most significant impact on sexual arousal.
- Overall, recovering drug abusers had worse sexual performance than did controls, even after a long period of abstinence (one year).
What happens to sexual performance among men who use heroin and then enroll in a methadone maintenance treatment program? Another recent study explored this question.  The sexual function of 30 men was evaluated both before and after they completed a six-month methadone treatment program. Before treatment, 69 percent of men reported mild to moderate sexual dysfunction, and 23 percent said they had severe problems. The remaining 8 percent reported no difficulties with sexual performance.
After six months of treatment, sexual dysfunction showed some improvement: 61 percent of men had mild to moderate sexual dysfunction and 20 percent reported severe difficulties. The men scored higher on intercourse satisfaction and sexual desire, but lower on orgasmic function. Overall, however, the majority of men who had used heroin still experienced sexual dysfunction even after abstaining for six months.
Cleaning up from drug abuse is a challenging but critical step toward better health. Men who have a history of drug abuse often experience sexual dysfunction during their recovery. Help is available, however. Men facing this challenge are encouraged to seek help from medical professionals, drug rehabilitation counselors and sex therapists to assist them in regaining their sexual function.
 Prevalence of sexual dysfunction in male subjects with alcohol dependence. — Indian Journal of Psychiatry
 Effect of drug use and influence of abstinence on sexual functioning in a Spanish male drug-dependent sample: a multisite study. — The Journal of Sexual Medicine
 Sexual dysfunction in male crystalline heroin dependents before and after MMT: a pilot study. — Archives of Iranian Medicine