By Andrea Nemerson

Dear Andrea:

My husband had been a secret methamphetamine user since the mid-1980s. He had issues with depression and repressed anger, but I had no idea that drugs had so much to do with everything that's happened in our lives. We've always allowed each other a lot of space, so it was easy for him to hide his use and the spending that went with it.

Six months ago he finally got tired of the lies and the fear (random drug testing at work) and started rehab, and I feel I'm starting to get the man I married back. However, his confidence, libido, erections, and our sex life are all gone. He recently confessed that he was high every time we had sex for the past 10 years or so, and now that juice is gone. Blood pressure medication is compounding the problem.

Considering the number of people who never had sex without drugs and are now sober, there is precious little information about sex after sobriety. Most of what I found was along the lines of "You just need to get over the fear." It was all pretty much about having to figure it out for yourself, and nothing mentioned prescription meds. Maybe everyone really does have to find his or her own way back?

Despite some of the drug- and depression-related behaviors my husband has exhibited over the years, he is a wonderful man with many wonderful qualities, and I love him very much. I could live without the sex — my libido isn't what it used to be either — but it does make me sad to think of leaving this world without ever making love with him again. The fact that it was drug enhanced didn't make it any less great.

Is there any good information out there about sex after sobriety, especially after uppers? My husband is afraid he burned out his circuits with the drugs. I don't know what to think. Maybe six months isn't enough time to expect a transition to "normal" functioning. Going back to drugs is certainly no solution. Is there anything that can help in this situation? Trying to have a sex life without meth and with high BP meds ... maybe it's too much to ask.



Dear After:

I could answer this myself — but why bother when My Friend the Therapist, whose practice consists largely of men whose sex lives were first fueled and then derailed by meth and subsequent sobriety, is willing to take it on? I warn you that My Friend is not given to sugar-coating things, but he does know what he's talking about.

There's a huge public health effort to convince people that sex without meth is great: "It's so much more (intense, intimate, meaningful, etc.) without drugs." The truth is that, for many folks, post-meth sex will be less compelling than sex on meth, and that's just the way it is. Brain chemistry versus ad campaigns: brain chemistry wins. If you start with that, you'll have better chances of having a satisfying (though possibly never again as mind-blowing) sex life. Modest expectations = better odds of success.

For some people, this improves after the first year or so. It takes about that long for your brain to get back on track making the appropriate endogenous chemicals, and once they're back on their own internal meds, a lot of folks experience a return of libido. If your partner is only six months sober, don't expect much yet.

I usually recommend starting really, really slowly. He can try jacking off a little, work up to jacking off together, and eventually do some oral. Go slow, and leave the intercourse until he really, really wants it.

Viagra can be helpful in a reverse kind of way.

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