Unveiled: The Sex Industry and Drug Use

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“The reason why we’re strippers, is invariably more boring, more grounded in nonexistential needs like money – and pragmatic concerns, like money.” ~ Ruth Fowler It is a popular (or, at least, often repeated) opinion that there is a clear connection between the sex industry and drug use. Whether dealing with pornography, strip clubs, or sex workers, the industry is notorious for the almost constant use of drugs and alcohol. But how much of this is sensationalism and how much is rooted in fact and research? This is the major question that this discussion attempts to address. The short answer is that there is an empirical connection between the sex industry and drug use. More specifically, at least half of the prostitutes are drug users. But what does this picture look like in fuller detail? No matter what the substance of choice, there are many types of addiction treatment to choose from; however, this option for drug rehab is often unavailable for those working in the sex industry. In this way, the interaction of sex work and drug use is as much about advocacy as it is about building effective policies to combat the heavy use of illicit substances in the industry. It is difficult for anyone to overcome substance addiction or alcohol. For those working in pornography, in strip clubs, or as prostitutes, it can be even more difficult to detox and enter rehab because they do not receive the help that they need to recover. One of the most important, and often overlooked, aspects of the connection between the sex industry and drug use is the role of social isolation and stigmatization. If drug and alcohol addiction is associated with stigma and social isolation, one can only imagine that this is doubly true for addicts and alcoholics working in the sex industry. They face the stigma twice over. As one board member for the Global Network of Sex Work Projects states, belonging simultaneously to two marginalized communities is more than a struggle:

  • It is a constant battle
  • It is a constant balancing act
  • It is a constant challenge
  • It is a constant act of solidarity
  • It is a constant responsibility

Recognizing this perspective is a crucial element of addressing drug and alcohol addiction within the sex industry. It is not about policy, it is not about shame, and it is not about prosecution. Instead, it is about recognizing the stories of individuals and recognizing that they need help, just like any other addict. With this perspective in mind, this post unveils the connection between the sex industry and drug use, answering three major questions:

  • What does drug abuse look like in the sex industry?
  • Why does drug abuse occur in the sex industry?
  • What is being done about drug abuse in the sex industry?

What Drug Use & Abuse Looks Like in the Sex Industry

While the topic may sound sketchy, the interaction between the sex industry and drug abuse is an important manifestation of addiction to address. Thankfully, there is a great deal of research that examines what it looks like when sex work and drug use overlap. The report from Harm Reduction International addresses both the intersection between sex work and drug abuse as well as what can be learned for reducing harm within the industry. It is a great resource for understanding this topic from start to finish. This idea of harm reduction is more specifically applied to drug abuse and addiction within the sex industry, rather than sex work itself since many of those within the sex worker community take issue with the idea that sex work is inherently harmful. For this reason, the discussion here is centered on reducing substance abuse and addiction. According to Harm Reduction International, sex workers and injection drug users were high-risk groups for HIV transmission in the early years of the epidemic. The intersection between the two is likely to only make this risk higher. Both illicit drugs and the sex industry play an active role in nearly every single region of the world. Because of this high penetration, the interaction between illicit drug use and sex work is also high all around the world. The motivations for using drugs are just as complex as the motivation for selling sex or working within the sex industry. It is at the intersection of these motivations that the reasons for simultaneous drug use and sex work become more specific. There could be a whole host of reasons that individual works in the sex industry and uses (or even abuses) addictive substances. However, some of the most common motivators for this interaction include the following:

  • Financial motivations, such as needing to sell sex to pay for drug habits
  • Trading sex for drugs (also associated with riskier behaviors like unprotected sex)
  • Independent motivations, meaning there is no intrinsic link between working in the sex industry and drug use
  • Similar life circumstances or psychological events that can be risk factors for both drug abuse and sex work

More specific, sustained reasons for the intersection of the sex industry and drug use are discussed below. Not only do the underlying factors of drug use and sex work look different from person to person; the interaction between the sex industry and drug use can look slightly different depending on the type of drug in question. One of the most dangerous intersections of sex work and drug addiction is with injecting drugs. Individuals who work in the sex industry and use these types of drugs are more likely to use unsafe injecting practices, have sex with HIV-positive clients more often, use condoms less, and have a higher risk of other STDs like syphilis and HCV. The use of non-injecting drugs, like crack or crystal meth, is considered less dangerous for sex workers but still increases the risk of transmitted HBV and HCV. Even using amphetamines as a sex worker can increase the likelihood of contracting a sexual disease. Similarly, alcohol consumption is usually higher among sex workers, since they tend to drink along with their clients. As with the overconsumption of any substance, this makes for a more dangerous situation for the sex worker. Despite the evidence linking the sex industry and drug use above, the health impact of this overlap is often overlooked when it comes to responding to both drug addiction and sex work. In policy and programs, the focus is often on one or the other, rather than both simultaneously. This is detrimental to those who fall in the intersection between the sex industry and drug use – particularly for injection drugs like heroin. As the report from Harm Reduction International goes on to state: “The limited data available on coverage of HIV prevention for sex workers suggest that while it may be higher than service coverage for people who inject drugs, it remains poor in many countries. Many of the countries with low coverage also lacked legal protection for sex workers.” Given the doubled stigma of drug abuse in the sex industry, in both the United States and around the world, this is not necessarily surprising. However, both policy and practice would benefit from understanding why there is such an overlap of the sex industry and drug use, not to mention what can be effectively done to mitigate the overlap.

Why Drug Use & Abuse Occurs in the Sex Industry

The discussion above makes it clear that there is an inherent connection between drug abuse and the sex industry. But why is sex work so interconnected with drug and alcohol use? As with many issues that arise from addiction and dependence, there is no easy answer to this question. Because there is no consensus regarding why drug use is so prevalent within the sex industry, there are many different theories regarding the link. Some of these are more valid and research-based, while others represent attitudes reminiscent of the stigma discussed above. It is important to avoid this kind of stigmatization when discussing how (and why) working in the sex industry tends to portend drug use. In short, if you are looking for one specific reason for the link between the sex industry and drug use, you will most likely be disappointed. Some of the factors that limit the ability for academics, policymakers, and social workers alike to get the full picture of this epidemic to include the following:

  • The stigmatization associated with both drug use and sex work
  • The fact that both illicit drug use and even sex work are illegal in many states
  • There is no uniform measurement for what constitutes drug or alcohol abuse as opposed to casual use
  • Information regarding drug use in the sex industry is often self-reported, which can prove unreliable
  • ‘Party service’ in the sex industry, which includes both sexual services and drug use
  • The pressure that some sex workers face for using drugs with their clients

Many academic articles on the topic make it clear that further research is needed in order to determine whether it is attitudes, behaviors or other factors that like drug use and sex work. That said, there must be some reason why drug use and abuse occurs so often in the sex industry. But what is it? “The real relationship and the link between drug addiction and sex work is much more complex than the simplistic causal attribution of sex work to drugs. Drugs and sex work are interconnected in a vicious cycle of violence and corruption and in most instances they affect the most vulnerable parts of society. This link between them does not imply that drugs are responsible for pushing women into sex work. Sex work and drug use can have a merely coincidental connection and both can be the symptoms of traumatic experiences in the lives of the women involved.” The explanation quoted above is not the only reason forwarded as being behind the link between the sex industry and drug use. In fact, this is quite the opposite of a specific explanation. The quote instead highlights the complex nature of the relationship between drugs and sex works, citing both structural and personal factors as playing a role in the link. Ultimately, the key point is that drug addiction does not necessarily cause individuals to begin working in the sex industry, just as working in the sex industry does not cause individuals to become addicted to drugs or other substances. However, once drug addiction becomes the norm, returning to or continuing in sex work can become a cycle. “The combined stigmatization and criminalization of sex work and drug possession increases the incidence of violence against sex workers who use drugs. People who sell sex while intoxicated are more likely to experience violence than those who are not intoxicated.” ~ Harm Reduction International, report on the intersection and harmful effects of the sex industry and drug use

What Is Being Done About Drug Abuse in the Sex Industry?

Clearly, there is a relationship between working in the sex industry and drug or alcohol abuse. The report from the Harm Reduction International, linked and quoted several times above, makes it clear that finding the community is the first step for those stigmatized both by addiction and sex work: “Living with stigma and discrimination is a bit like living in a war zone. You feel constantly under attack, on edge, prepared to run and hide whenever needed. Ready to protect your rights at any sign of attempts to disqualify your voice. Always vigilant, ready to keep the people you love out of harm’s, and stigma’s, way. The only external protection you have is the safety of your community, and in its midst, you can sometimes risk-taking a minute to relax and exhale.” This feeling of isolation arguably applies to both drug users and to sex workers and is only increased when the two combine. So what can actually be done to minimize this connection and help those within the sex industry overcome their dependence, substance abuse, or addiction? The answer to this question may depend on one’s personal or political views in terms of both the sex industry and drug use. However, because of the health implications of drug addiction and sex work, there is no question that public policies should not stand in the way of projects aimed at reducing the prevalence of drug addiction among those working in the sex industry. Unfortunately, this is not always the case. Harm Reduction International goes on to discuss the often-negative way that public policy, drug addiction, and the sex industry interact: “Policies on drugs and sex work affect public health when they enable law enforcement harassment of projects offering services through outreach to sex workers and people who use drugs. Anecdotal reports from projects include threats of arrest of outreach workers, interference with bad date list distribution for sex workers, and interference with the distribution of safer sex and safer drug use materials. Multiple projects have described threats of arrest effectively eliminating some harm reduction services (for example, the distribution of kits for safer drug use), and there are numerous examples of harm reduction organizations refusing to undertake anti-violence programming with sex workers who use drugs.” In short, public policy is not always on the side of rehabilitation and recovery. With this in mind, legal reform aimed at changing the way sex work and drug addiction are treated may be the first step toward taking action against the intersection of the sex industry and drug use. This does not necessarily mean complete decriminalization, but instead a form of public policy that recognizes drug addiction as a health condition and begins giving them the help that they need. One of the best examples of this is the decriminalization of sex work in New Zealand in 2003. The law in that country now “protects the human rights of sex workers, promotes their welfare and occupational health and safety, and is conducive to public health.” Ultimately, this form of public policy is aimed at harm reduction when drug addiction and sex work intersect. The connection between the sex industry and drug use is a decades-old topic, and it is difficult to summarize exactly what the full picture of the intersection is. Hopefully, this discussion has given you some insight into what this interaction looks like, why it takes place in the first place, and what can be done to mitigate the detrimental health impact caused by drug addiction within the sex industry. If you want to learn more about drug addiction, rehabilitation, and the recovery process, you can visit our homepage here. If you have any questions or further insight into unveiling the connection between the sex industry and drug use, as well as addiction and alcoholism, feel free to leave a comment below.