Does Sex Addiction Function Like Drug Addiction In The Brain?

A new study suggests that sex addiction may work a lot like drug addiction in the brain. There’s been a long debate about whether compulsive sexual behavior – including frequent thoughts about sex, having sex, or watching pornography – really falls into the family of addictions. It was recently rejected for inclusion in the DSM-V, so right now it’s not technically a disorder. But the authors of the new study report that the same areas of the brain involved in drug addiction are activated when “sex addicts” watch sexually explicit films. So maybe it’s not so separate from addiction after all.

“There are clear differences in brain activity between patients who have compulsive sexual behaviour and healthy volunteers. These differences mirror those of drug addicts,” said study author Valerie Voon of the University of Cambridge, where the study was conducted. 

BRAIN (Photo credit: geezaweezer)

She and her team looked at 19 men who had compulsive sexual behavior (CSB), including excessive use of online pornography, and compared their brain activity to men without the behavior.

 “The patients in our trial were all people who had substantial difficulties controlling their sexual behaviour and this was having significant consequences for them, affecting their lives and relationships,” explains Voon. “In many ways, they show similarities in their behaviour to patients with drug addictions. We wanted to see if these similarities were reflected in brain activity, too.” 

So they had the men undergo MRI scans to see which areas of the brain were active in response to different videos – sexually explicit ones or films of sporting events.

What they found was that in men with compulsive sexual behavior, three areas in the brain – the ventral striatum, dorsal anterior cingulate and amygdala – “lit up” much more in response to the sexually explicit videos than the the sports videos. These areas are noteworthy because they’re also active when drug users anticipate using drugs, and are involved in processing reward and motivation, and in craving drugs and anticipating rewards.

Along these lines, what was more telling was the participants’ own ratings of how they felt while watching the videos. Like drug addicts, they rated sexual desire as being high while watching the videos, but what wasn’t so high was how much they liked the videos.

This is interesting because there’s a theory of addiction called incentive motivation, which came from the finding that people who are addicted to drugs may feel extreme desire for the drug, but don’t necessarily feel a lot of pleasure while taking it. In other words, addiction may be much more about the craving of the thing than the thing itself. And this is exactly what the current study found in the young men with compulsive sexual behavior.

The results were more pronounced for younger men, in their 20s. This is not surprising, since the frontal areas of the brain – those involved in filtering and controlling behavior – are still developing.

The study leaves lot of questions unanswered, and, obviously, women weren’t included as participants.  “Whilst these findings are interesting,” added Voon, “it’s important to note, however, that they could not be used to diagnose the condition. Nor does our research necessarily provide evidence that these individuals are addicted to porn – or that porn is inherently addictive.”

We can get addicted to just about anything – gambling, eating, exercising, and using the internet. So it’s not such a far leap that sex or pornography may be one of those things, since, just like the others, it provides that little neurochemical rush in the brain’s reward circuit that, under the right circumstances, can lead to addiction.

Whether or not the behaviors are compulsions or addictions may not even be the really important question. How to address and treat them is much more central, and much more elusive.