The Complicated Relationship Between Drugs, Sex and Consent

Findings from the first ever study looking into consensual sex following drug taking.
Simon Doherty
London, GB
couple holding hands
Photos: Emily Bowler

"If someone has had too much and their inhibitions are reduced, none of it is really consensual," says one interviewee in the first study investigating what happens to consent during drug-fuelled sex, "but then none of it is against anyone's will."

Spearheaded by Lauren Smith, a 27-year-old Psychology lecturer at Leeds Beckett University, and published recently in The Journal of Sex Research, this was the first study of its kind. There are already a bevy of studies into alcohol and sexual consent, especially in the context of sexual violence, but none on consensual sex on drugs. This is surprising, because – let's face it – some drugs are good for sex, a theory borne out by the fact people have sex while on drugs all the time.


"We know that drugs impact motor and cognitive function," Smith explains. "So I was surprised by the lack of studies focusing on how drugs might impact people's ability to consent to sex, whether verbally or non-verbally."

Initially, Smith trawled databases to find around 19,000 studies referring to sex and consent, before whittling those down to around 100. Then, after a deeper analysis, she eventually arrived at a core of 21 papers containing the most useful and relevant data. She set about establishing common themes, mining them for new insight.

woman underwear suspenders

Of course, there are those who'd insist that someone on drugs can never consent to sex in any meaningful way. However, this study suggests that, for many, illegal drugs expand sexual boundaries in ways that sobriety never could. "I would like to regularly have the kind of sex that I imagine," one participant explained. "And I need drugs for that."

Drugs don't just help singletons embarking on one-night stands, either. One woman spoke about how chemicals had improved the sex life she shared with her partner long after the comedowns had worn off: "We find, a lot of the time, the things we do when we are high … can spill into our sober sex life," she recalled. "The meph[edrone] opened doors."

This, Smith believes, could be partly rooted in drugs' effects on the senses – decreasing pain, for instance. Beyond that, it could also reflect the way society polices the sexual lives of certain groups – notably gay and bisexual men and straight women – often producing in them low self-esteem and sex-related anxiety: "These groups often have their sexuality aligned with risk and danger, the threat of exposure to STIs, unwanted pregnancy or sexual exploitation."


"We found drugs often helped such people express themselves more sexually, and feel more able to engage in sex that they perhaps desired when they weren't using drugs, but felt unable to engage in," Smith continues. "To me, it seems quite unsurprising that it was gay men, bisexual men and heterosexual women reporting this. We don't tend to see as many narratives of sexual pleasure for those pockets of people – we have to provide those narratives if we want individuals to feel like they can have sex without using drugs."

Of course, drugs don't always improve people's sex lives, and are often hugely problematic with regards to consent. The study found that particular drugs – such as the ultra-heady mix of G, crystal meth and mephedrone, the holy trinity of chemsex – were associated with impaired judgement when it came to informed consent.

"It's like, 'I'm gonna get this orgasm and that's all that matters,'" a male participant reported. "I'm not thinking about what I could catch." Other participants described "partial or complete unawareness" of what was going on when they were fucking on these drugs. "I'm like, 'Who the hell is this?' If I become coherent, I'll stop," a male participant noted. "There are times when I'm just so fucked up that I'm like, 'OK, whatever.'"

One heterosexual woman shared a similar experience. "He loved it when I was high," she remarked. "We had sex in a way that I didn't really want to have sex. Like, I don't like anal sex, but when I'm high I can do it." On the other hand, some reported that drug use didn't affect their decision-making at all. "I don't think being high has ever made me more likely to do anything I consider risky," one said.


Another man described situations where, despite being high, he was still wary of the risks, saying to his partner: "'No. No condom, you cannot have this [pointing to his asshole].' He then picked up the condom reluctantly, and I put it on [for him]."

In around one-fifth of the findings, participants argued that being high actually improved their decision making. "I'd say you have more control on E [MDMA] than if you were pissed," one asserted. "I think you're much more conscious of what you're doing."

The findings were a mixed bag; some felt they were in a position to consent on drugs, whereas others were less convinced. Other conclusions included a perception that, if someone was high, they were automatically horny and therefore more "sexually available", despite the fact desire obviously doesn't equal consent. Understandably, reports also varied with different substances and different combinations. Since a lot of people are poly-drug users – consuming a bunch of stuff in the same sesh, often throwing legal drugs like alcohol into the mix, too – more research in this field is needed.

vodka wine and cocaine

Photo: Emily Bowler

So what does all of this mean when you've hooked up with someone at a club and both of you are getting higher by the minute?

The "affirmative consent" model – getting an enthusiastic verbal "yes" at every stage, from touching, to oral, to full penetrative sex – is widely considered one of the most solid consent cues. But the research concluded that, in the context of sex while under the influence of drugs, it could be insufficient. After all, someone could verbally consent while being so cognitively splintered from reality that they aren't fully aware of what they're agreeing to.


"Some people are giving consent, but I mean is it really consent when someone is literally on the verge of passing out?" one participant in the study, a man who's into chemsex, pondered.

Smith argues that our definition of consent needs reassessing. "The affirmative consent model is the one we see prevailing, but I'd argue that we need to take a lot of steps back in this context. The Mental Health Capacity Act [2005] uses a much broader range to assess capacity, things like: can someone hold on to and use information? Can they effectively evaluate risks and consequences? Can they communicate their decision effectively?"

The relationship of sexual consent to illegal drug use remains a dubious grey area. At the very least, Smith's study represents a first focused foray into the subject that is long overdue.

You can read the study here. Lauren Smith has more research about sex and drugs in the pipeline, follow her on Twitter.