The use of mind-altering substances can be found in very different cultures and traced back thousands of years; the same is true for the searching of drugs that could increase sexual functioning. In this text, we explore the relation between drugs of abuse and sexuality in three domains: drugs and sexual dysfunctions, drugs and risky sexual behavior and drugs used as sexual aids. Although some drugs can increase sexual response in the early stages of the addiction career, particularly in those with a previous sexual dysfunction, the chronic use of substances tends to deteriorate all stages of sexual response in both male and female abusers. There is sufficient evidence for considering that drug use before or during sexual intercourse can, in certain circumstances, elevate the risk of unwanted pregnancy or sexually transmitted diseases. Specific prevention strategies should be addressed to this population. Some psychotropic drugs are sometimes used as sexual aids. This can have some risks and should alert the therapist to a possible underlying and undiagnosed sexual problem.
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