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Family History and Addiction Risk: What You Need to Know to Beat the Odds

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You grew up in a family of substance users. You know that your risk for developing an addiction to drugs or alcohol is greater because of this hereditary factor. But what exactly are your risks? And is there anything you can do to reduce your risk?

According to the National Council on Alcoholism and Drug Dependence (NCADD), the single most reliable indicator for risk of future alcohol or drug dependence is family history. In an article written for NCADD, Robert Morse, MD, former Director of Addictive Disorders Services at the Mayo Clinic and member of NCADD’s Medical/Scientific Committee, says, “Research has shown conclusively that family history of alcoholism or drug addiction is in part genetic and not just the result of the family environment…millions of Americans are living proof. Plain and simple, alcoholism and drug dependence run in families.”

How Family History Affects your Chances for Addiction

Family history affects your chances of addiction in many ways. Genes are one important factor. But alcoholism and drug addiction are “genetically complex.”

Recent research has identified numerous genes, and variations within these genes, that are 005associated with the addictive process. One way genes affect a person’s risk for addiction involves how genes metabolize alcohol. Another is how nerve cells signal one another and regulate their activity. Such changes in genes can be passed down from one generation to another.

Perhaps the strongest evidence for heredity’s role in addiction comes from twin studies and adoption studies. Studies of twins found a 60% rate of similarity regarding addiction in identical twins vs. a 39% rate of similarity in fraternal twins. Studies of children adopted in infancy and studied for addiction risk in adulthood found that biological sons of alcoholics were four times more likely to become alcoholics, even when the adoptive parent had no issues with addiction, so the l factor of family environment was minimal.

But genetic predispositions are not the only factor in predicting the role of family history in addiction risk. Environmental aspects also play a role, even though they may be less significant in some cases.

Researchers have identified several family-related risks for increased vulnerability:

  • Family dysfunction (conflicts or aggression)
  • A parent who is depressed or has other psychological issues
  • One or more parents who abuses or is addicted to drugs or alcohol

Additional social and personal issues that contribute to risk include:

  • Limited social skills
  • Fragile self-esteem
  • Minimal or no support system
  • Personal history of impulsivity, aggression or difficulty managing emotions
  • A history of trauma or abuse (high risk for post traumatic stress)
  • Other psychiatric disorders such as depression, anxiety or bi-polar disorder
  • Friends or acquaintances who are regular users and who provide easy access to drugs or alcohol

Addressing and Reducing Risks

An alternative viewpoint regarding a family history link for addiction comes from a National Institute of Health (NIH) meta-study of 65 published papers documenting 766 study participants who were college or university students. Controlling for alcohol consumption and use disorders, family history was reviewed as the variable. The meta-study found that students who had family histories of alcohol or drug problems did not drink more but they were likely to be more at risk for problems that are associated with drug or alcohol use (ex: causing shame or embarrassment to someone; passing out or fainting; or having problems with school).

The bottom line is that there are still a lot of uncertainties when it comes to assessing drug and alcohol risks as they relate to family history. The good news is that even if you come from a family with a troubled history, or a history of addictions, that does not mean you will automatically become an addict. The risk is higher, but there are ways to prevent that from happening. You can choose to be proactive and greatly reduce your addiction risk.

Here are a few suggestions to reduce your addiction risk:

  • Avoid under-age drinking or substance use; early-onset of use increases risk
  • Choose abstinence or carefully monitor your consumption
  • Avoid associating with heavy drinkers or substance users
  • Manage your psychological health; seek assistance from a mental health provider if you are highly stressed, anxious or depressed
  • Participate in workplace or school prevention programs

Intervention Strategies

Should you already find yourself dealing with an alcohol or drug issue, here are some intervention strategies provided by the National Institute of Health, in their publication, Alcohol Alert:

  • Motivational Interview: This strategy focuses on enhancing your motivation and commitment to changing your behavior, if you are currently abusing drugs or alcohol. Typically you would work with an addictions counselor or mental health professional and discuss your beliefs, choices and behaviors associated with substance use. The purpose of the interview is to help you develop a realistic view of your use, problems associated with it and your treatment goals and expectations.
  • Cognitive–Behavioral Interventions: These strategies are taught by a counselor or therapist, or they can sometimes can be accessed via an online self-help program. They help you change your behavior by helping you recognize when and why you drink excessively or use illegal substances. Cognitive-behavioral approaches challenge irrational expectations about substance use and raise your awareness of how drugs or alcohol affect your health and well-being. They provide tools for mentally and emotionally addressing denial, resistance, self-criticism and shame.
  • Drug-Free Workplace programs: Many workplaces now help their employees who are abusing alcohol or drugs. Lifestyle campaigns encourage workers to ease stress, improve nutrition and exercise, and reduce risky behaviors such as drinking, smoking, or drug use. Other programs promote social support and volunteerism. Many Employee Assistance Programs offer employees referrals to substance abuse or other treatment programs, and may help pay for treatment.

Remember, the risk for alcohol and drug addiction does run in families. But you can manage the risk and avoid an addiction problem in your own life. Be proactive in monitoring your substance use, manage your mental and emotional health and seek support if you need it. The final outcome will depend on you and the choices you make today, not on your history.
Complete Article HERE!

Hold on there, girlfriend!

Name: Joanne
Gender: Female
Age: 25
Location: Toronto

I’m 25, 5-foot-7 and weigh 105 pounds. I take care of my body by eating right and exercising regularly. My problem is that I hate the way I look. I am actually repulsed by my body. I take very brief showers and avoid the mirror as much as possible. I’m not a prude. Others being nude is fine with me. But my body image issues are hindering my sexual encounters. I always want to wear a shirt or have the lights off.

My current boyfriend says that if I trust him enough to sleep with him I should trust him enough to let him see me naked. He also has told me that we can’t continue seeing each other if this doesn’t improve. But I let him see every part of my nude body — just not all at once. So he knows I’m not hiding some monstrous deformity or anything. I guess I thought my boyfriend would be more sensitive to my fear and let me stay covered up. Do I owe him nudity?

Hold on there, girlfriend, you think your boyfriend is being insensitive because he wants to enjoy your body in the buff? You think that he’s sticking around just to needle you about your phobia? Honey, get over yourself! Do you honestly think that your body-positive BF oughta facilitate and participate in your pathology? Yeah, like why don’t we all just sink to the lowest common denominator? And here’s a tip: you do have a monstrous deformity. Perhaps it’s not a physical deformity, but it sure enough is a psychological one.

I concur with your boyfriend; your relationship is on the line here. You need to get a handle on your hang-ups, darlin’, or you can just say good-by to whatever sex and intimacy you may currently be enjoying.

Listen, I have a thing about sex and intimacy being a gift one gives to another. So I ask you, how can you give yourself as a gift to anyone if you are disgusted with the gift you’re giving? And you’ll never convince me that your body issues aren’t seeping into and sabotaging the sex you may be having with your long-suffering BF. I’ll betcha you don’t let him get too close to the body parts you’re willing to expose to him when the lights are out.

Joanne, like I suggest above, being repulsed by your own body is a sign of a much deeper psychological problem. I’d suggest you get to the bottom of this with a sex-positive therapist right away. When I encounter this sort of thing in my practice, inevitably my client and I discover a past body related trauma to be at root of his or her current disgust. Left untreated, this aversion could easily morph into a desire to do yourself harm, if it hasn’t already. It’s a common enough phenomenon; so don’t let that happen.

And to your closing question about do you “owe” him nudity; what the fuck is that? Is your sexuality and the intimacy you share with your partner something to be bid and bargained for, like beads in a bazaar? Sex and intimacy is either a gift freely given or it’s coerced. If you’re feeling coerced about being naked with the man who loves you, you’d better set him free and get thee to a nunnery.

Good luck.

Consider the beauty of the female form

An (extremely long) Tale Of Woe

First Name: Sam
Age: 22
Gender: Male
Location: North Carolina, USA
Wow, where do I even begin….

I am a 22-year-old gay male and believe that I may have SOME form of erectile dysfunction. I emphasize “some” because it is possible for me to get hard, firm erections, but I’m ALWAYS by myself when I do.

I have been able to give myself orgasms since I was in preschool. I did not masturbate the “traditional” way that men do (or ejaculate) until I was in 6th grade. Before that, I would lay down with my hands cupped around my crotch area and would “hump” into them until I felt an orgasm sensation and would then stop. In 6th grade I began to look at gay internet porn, and, seeing how most of those men masturbated, began to emulate the process. I even practiced “edging” often, beginning in 6th grade, as I had read on the internet at that time that it built up sexual stamina and led to powerful orgasms.PERFORMANCE_ANXIETY_pic_02_3

I would say that since I’ve been able to have orgasms (beginning in preschool), I would have one usually at least once a day. There were days here and there where I wouldn’t, but I guess an average would be 6 out of 7 days per week, with an average of twice per day. Of course, it’s hard to average them out since I’ve been having them for so long.

I did not start having sexual intercourse until my freshman year of college when I was 18, with my roommate at that time. Even that first time, I had problems maintaining my erection. I also had to use my hand and masturbate in order to have the orgasm, which took much longer than when I’m by myself. My roommate and I engaged in sexual intercourse regularly for the latter 2 and a half months of my freshman year, and every time, I had to have an orgasm by masturbating. Oral sex would not work, his hand would not work, and we did not engage in anal sex.

From ages 19-20, I had very little intercourse, but regularly masturbated (almost always to porn), and had no problems maintaining an erection and achieving orgasms. I hooked up with older men occasionally during this time, and again, could not have an orgasm unless I masturbated. It was also slightly more difficult to get an erection than by myself watching porn, and always took me longer to achieve orgasm than by myself. I had my first experience with anal sex (as a “top”) during this time as well, and could not ever reach orgasm, same with oral sex and hand-jobs.

When I was 20 I met and began dating my first boyfriend. We were together for 10 months, and while I enjoyed my time with him, our sex life was poor. We did not engage in anal sex except once, because we both considered ourselves tops. The one time we engaged in anal sex I tried to be the bottom, but did not enjoy it at all and had to stop. We did engage in oral sex, but I could never achieve orgasm that way. Again, I had to masturbate in order to have an orgasm. Not only that, but I began to have significant trouble sometimes to get an erection. Also, it took a lot longer for me to reach orgasm when I masturbated with him. By myself with porn, I could reach orgasm as quickly as 5-7 minutes. With him, it often took me at least 20 minutes, and it was usually 25-35 minutes.

loving legsAfter we broke up, I began to hookup a little more frequently then I had in the past, but it was not that often. Whenever I did, again, I always had to masturbate to achieve orgasm, and it took me a long time to do so. AND, during some of these hookups, I simply could not even achieve orgasm myself, as I started to have difficulty maintaining or even getting an erection. I highly doubt it was because of my sexual partners, because I would not hookup with someone I was not sexually attracted to. Also, I usually could have erections during foreplay, but when it came to the “big finish” my erection would start to wane or just become completely soft, and nothing I did or thought about changed that. Once, I achieved orgasm from barebacking (which I have not done since and luckily did not contract HIV or an STD), and there was also only one time where I hooked up with a guy and achieved orgasm from him giving me oral sex, although I believe this was because I refrained from masturbating for the past few days beforehand.

I am 22 now, and am starting to worry that I will not be able to ever have any good sex with someone else other than myself. In almost all of my most recent hookups, I have had to use a cockring to get an erection, and even then sometimes it doesn’t even help. Also, in almost all of my most recent hookups, it either takes me around 30 minutes to masturbate to orgasm, or I simply can’t have an orgasm because of lack of an erection. However, if I am by myself watching porn, I do not have any trouble getting and maintaining “rock-hard” erections and reaching orgasm.

I have become particularly concerned about this problem now, because I have begun to date someone and engage in sex with him for the past few weeks. When we first had sex I topped him anally and had a good erection. But we still masturbated together to completion. Ever since the first time though, I have had a LOT of difficulty just getting an erection period. Cockrings do not help, and oral sex and foreplay don’t really help either. Sometimes when we make out for a while I’ll start to get kind of hard, but then when I try to get ready to penetrate him or simply masturbate with him, I’ll go soft again. I’ve been able to reach orgasms sometimes when I masturbate with him, but my penis is usually semi-soft when I reach orgasm, and again, it takes more effort and certainly more time to do so then when I’m alone watching porn. He is incredibly good FleshJacklooking, good at sex, and very passionate, so I know it is not him. Luckily, he does not mind when I cannot perform, he says he likes me for me and that everything is fine, and he thinks that I shouldn’t worry about it. But at this point, I really can’t help but worry about it…

The last time this problem happened I had willingly decided to not have an orgasm for three days beforehand, hoping that it would help the issue. But unfortunately, it did not help or change anything. I’ve decided to completely stop viewing or watching any pornography whatsoever, and have also decided that when I masturbate I will avoid as much contact with my hand and, instead, use my FleshJack (the gay version of FleshLight) with the “Squeeze” texture (their most “realistic” anal texture). I have not had sex with him since I decided this (which is the day I’ve written this question, May 27, 2015).

I apologize for this EXTREMELY long inquiry, but I didn’t want to leave out any details of my sexual history in case they were important. I’m wondering if masturbating regularly since preschool has anything to do with my poor performance. And I’ve considered that I’m “overthinking everything” when I engage in sex and maybe that’s preventing me from getting erections with other men, but I’m such a sexual person that I can’t think of anything but dirty, sexual thoughts when I’m with another man, yet it just doesn’t seem to work. I do start to focus on not being able to get an erection if I’m not getting one for 5-10 minutes, but during that time beforehand, I’m not thinking about anything other than the pleasure, so I don’t see what I’m doing wrong. The problem is beginning to be REALLY embarrassing and I’m concerned that if I’m already having these problems at only 22 years of age, I’ll likely have the worst of erectile dysfunction problems in the future.

I suppose my main questions are:
1) What could be causing this to happen?
2) Is my proposed method of completely avoiding porn and masturbation via my hand an appropriate solution?
3) Do you have any specific suggestions or general advice that can help me with this problem and/or my sex life?

Again, I apologize if this is way too long; I’ve just never been so concerned about it before. I’m 22, I should be able to get rock hard erections easily, but I feel like a 70 year old man who just “can’t get it up.” ANY advice you can give me will be sincerely appreciated.

Whew, Sam, that was like the War And Peace of sex advice questions.

It’s perfectly clear that you are worried about your sexual response. But I’m gonna guess that your worry is actually making things worse. Before I respond to your three questions, I want to say; get thee to a therapist! You need to sit down with a sex-positive therapist and work through this stuff with him/her. This is super important, don’t just blow it off. If you need a referral, see the Directory of the American College of Sexologists to find someone in your neck of the woods. I also offer remote therapy via Skype or phone. See my Therapy Available page.

whewNow to your questions in the order you asked them…
1) What could be causing this to happen?
Everything you tell me points to performance anxiety. I’ve written and spoken a great deal about this issue over the years. Use the CATEGORIES pull down menu in the sidebar to your right. Scroll down till you find the main category, Sex Therapy. Under it you will find the sub category, Performance Anxiety.  You’ll find tons of information.

2) Is my proposed method of completely avoiding porn and masturbation via my hand an appropriate solution?
It might be, but not for the reason you suspect. Again, you need to discuss this with a therapist. It’s important and more involved than I have time and space to lay it out for you.

3) Do you have any specific suggestions or general advice that can help me with this problem and/or my sex life?
Yeah, chill the fuck out! Honesty, that’s the best thing you can do right now. Then, with the help of a therapist, work through your problems, put in place a program to rebuild your partnered psychosexual response one step at a time. You’ll probably begin with sensate focus training, stress reduction, and relaxation exercises.

Dribblin’ Instead of Shootin’?

Name: Alvaro
Gender: Male
Age: 21
Location: Mexico
Hi, I’m concerned because I never shoot when I cum. I dribble. I don’t like the way I cum, can you advice me how to cum shooting?? Is there anything I can do? Is it my fault or I was born with a less powered gun than others?? Sorry to bother. And thx for your help.

The problem you describe is a common one. And the solution is relatively simple. It lies in, of all things, muscle mechanics. An ejaculation is primarily a muscle contraction — built up energy being released — thus the spurt. No spurt, or a dribble most likely indicates poor muscle tone. But there’s an easy and fun solution, or more properly an exercise. Kegel exercises to be precise.

turkey-basterLet’s start at the beginning, which is always a good place to begin, don’t ‘cha know. Your prostate is the source of your ejaculate. You have a handle on that concept, right? Good! Now picture a turkey baster. Imagine your prostate as the bulb on the one end and your dick as stalk with a hole in it at the other end. Picture the baster pointed upward, like your cock with an erection. Imagine the bulb is full of fluid and you need to get that fluid out the bulb, up the stalk and out the hole…just like your spooge when you cum. How ya gonna do that? A firm grasp on the bulb and a hefty squeeze, that’s how!

So Alvaro, if you’re dribblin’ instead of shootin’, your muscles need to be strengthened and toned. And like I said, I have just the right exercises for you.

Anyone who is paying the least bit of attention to the ranting and raving of Dr Dick will fruit_genitalsimmediately be familiar with Kegel exercises. I talk about them a lot. And those who haven’t been paying attention — listen up, you monkeys! Kegel exercises serve to tone and strengthen the pubococcygeus muscle or as we in the know like to call it, the “PC” muscle, which is part of the muscle group at the floor of the pelvis. The health of this muscle group plays a vital role in getting you up and getting you off, as well as in other aspects of healthy genital functioning.

Kegel exercises help increase blood flow to the genital area (getting you up). And Kegel exercises strengthen and tone the muscles that are involved in ejaculation (getting you off). If you exercise this muscle regularly, you’ll gain greater control over the timing and strength of your ejaculations. Kegel exercises can also prevent incontinence and other problems associated with aging, but we’ll save that for another time.

male_anatomy.jpgSo you’re probably saying to yourself, “sure, Dr Dick, I’d like to strengthen my PC muscle, but I never even heard of that muscle, let along know where to fine it.”

Alrighty then, Alvaro, here’s what ya do. Work up a full bladder, the more full your bladder the better. Go to the john and sit on the toilet. (Yeah, just like a girl!) Now let the pee flow. As you’re doin’ that, I want you to interrupt the stream of piss several times before you empty your bladder. The muscle you are using to do this is your PC muscle. Look to distinguish between your PC muscles and your anal sphincter muscles. With a little practice you’ll become adept at separating out these two muscle groups. Actually strengthening all your pelvic muscles is a swell idea, especially for power bottoms, but again we’ll save that topic for another time too.

Now that you have located your PC muscle, you can exercise it at will, even when your bladder is completely empty. First, try squeezing your PC muscles as hard as you can for a count of three seconds. Then relax. Repeat this till you feel the muscles tiring. How fun is this?

I want you to work for both muscle strength and tone. For example, start with five strong prolonged squeezes (5 seconds apiece). Relax. Then do a series of 10 rapid contractions in a row. Doing three sets of each twice a day for a week is your goal. When you are ready to proceed try increasing this to three sets of eight to ten prolonged squeezes and 20 rapid contractions in a set. The advanced Kegeler will be able to vary the type and timing of his PC squeezing; slow clenches to quick flutters.PG-TrainingKitOnly-Promo

If you keep this up, you’ll be shootin’ jizz across the room in no time. And the beauty part of Kegel exercises is you can do them whenever and wherever you like. You can be sitting in a meeting with your boss and be doing your Kegel exercises. You can argue with your boyfriend/girlfriend and be doing your Kegel exercises. You can be watching reruns of Leave It To Beaver with your maiden aunt and be doing your Kegel exercises. Who would have guessed improving your sexual health would be such a pleasure?

If you’re serious about all of this, I have else to share with you. This is The Private Gym. It’s the first interactive, follow-along exercise program that helps men strengthen the muscles that support and control our cock. As men approach age 30, the muscles that support erectile function begin to weaken. By age 40, more than 50% of men experience some form of erectile dysfunction and this number increases to more then 66% as men approach 60 years of age. And for all you bottoms out there, you know how important it is to keep anal muscles in tip-top, pardon the pun, shape. And, just in case you didn’t know, The Private Gym won the coveted Best Health Related Product or Toy of 2014 as compiled by the Dr Dick Review Crew. So how about them apples?

Good luck

Slut Shaming

Name: Martin
Gender: Male
Age: 50
Location:
Thanks in advance for your assistance, Dr. Dick.
Here’s my dilemma; I’m so in love with my partner, he’s actually the man of my dreams. We met much later in life, he being 45 and I’m 50.
I was married before w/children, out now as a gay man and all is well with my children’s relationship.
My partner has always known he was gay, has had numerable relationships, and was a sexual addict. He has wanted me to understand his past in relationship to his level of happiness now, stating that he was a bottom slut only because he was never truly in love or satisfied.
He wants me to believe that “I’m the one” that has changed his life-long addiction to strange dick up his ass.
I can’t seem to get past his past slut behavior, and oftentimes get so pissed off because he wants me to meet and develop friendships with many of these past fucks (primarily because they were military buddies also).
Why can’t I accept his slutty past and stop the suspicions?
Why do I get so upset just knowing that he was a total bottom slut??
How can I get him to understand that I have no desire to know any more about his sexual past and just focus on creating our lives???
Thanks,

Martin, Martin, Martin! How you do go on, darling.bullshit

Take a look at your language, why don’t ‘cha? Could you possibly be any more pejorative when speaking of the sexual experiences of someone who has lived a different lifestyle than you? I doubt it. Look at how many times you use the word “slut” to describe the man you say you love. I’m gonna call you out on that. You simply can’t tell me you love someone that you have so little regard for.

Your man wants you to understand his past, but you won’t take it at face value. You belittle his experience, possibly because it doesn’t match your own very limited, sexually exclusive, predominately heterosexual lifestyle.

circle jerkListen, lots of gay men (and some straight men) have loads of sex for lots different reasons. Sometimes just for the fun of it…or, as your man suggests, just to be a big old bottom slut. There’s absolutely nothing wrong with that. One can be happily sexual without loving each and every one of his partners. And the sex can be really good too. Just as one can have very unsatisfying sex with somebody one loves deeply. Sex, intimacy, and love are not necessarily dependent on the one another. No need to make such a tangle of it all, Martin.

I also want to reinforce my belief that there’s no such thing as a sex addict. Compulsive behavior? Sure! Out of control behavior? You betcha! Self-denigrating behavior? Absolutely! Sexual addiction? No way!

Try for just a minute to extricate yourself from your sex-negative mindset by exchanging the notion of eating when you talk about your friend’s sexual exploits. Would you have the same revulsion if your guy said he had shared food with lots of other guys? Some of it was fast food that didn’t satisfy all that much. Sometimes he ate just because he wanted to, not because he was hungry. And now he wants you and he, as a couple, to be friends with some of the men he ate with. Sounds perfectly reasonable to me!fingering his ass

Your man is inviting you to open yourself up and see life and sex as most openly gay men do. This is fundamentally different from how some formerly closeted men see life and sex. If you let him, he just might help heal you of your sex-negativity.

Finally, jealousy is one of the worst human emotions. It’s actually a kind of hatred, you know. Sometimes it’s hatred of another, but it is always self-hatred. You say you love this man; again, I challenge you on that. It’s clear to me that you have a much greater love of your provincial notions about sex then you have for this guy.

Here’s a tip, Martin. Jettison the unhealthy attitudes about sexual expression and give your guy a chance to be himself, not the idealized man you’ve made him out be, or think he should be. You’d be well served by working with a sex-positive therapist to help you get over this. Do it now, because if you hesitate you will surely ruin the very relationship you claim to treasure.

Good luck

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