Intimacy in the Aftermath of Opioid Use Disorder

I had always been a deeply insecure person. Because of this, I often dealt with feelings of severe anxiety and being self-conscious when it came to intimacy and sex.

When I first started using opioids at 18 years old, I didn’t just feel more confident — I felt like I was the best version of myself that ever existed. The opioids lowered my inhibitions and the delusion of it made me believe that I was somebody with unwavering self-esteem. I knew nothing of what dopamine, endorphins, or mu-receptors were or how they related to my opioid use at the time.

How opioids affect the brain

I later learned about the brain's reward system, which helped me understand my experience. I read that dopamine is a motivational chemical that the brain releases when something feels rewarding. It is the culprit behind what propels us to “chase” the feeling repeatedly, like substances. I also learned that endorphins are the chemical the brain releases that offers us the feeling of calm and relaxation.

My personal research suggests that these two chemicals, when blended together, impact our mu-receptors. Substances, in this case, opioids, can take over the brain's mu-receptors giving us false feelings of euphoria. As I understand it, when the opioids wear off, the mu-receptors become burnt out, and the brain has a much harder time feeling that "reward" of calm, relaxation, or confidence organically.

This can devastate the brain's ability to feel sexual pleasure and even damage our ability for emotional connection beyond the physical. I believe that this burn out created a numbness that I have been healing my way out of for almost 8 years. This has been a very complex consequence of my many years of substance abuse. It is an ongoing fight that has been painfully slow.

Like a virgin

When I entered my recovery era, I felt like a literal virgin. For most of my sexual history, I was using substances. So, entering recovery, I didn’t just feel like a virgin — I felt like a terrified virgin.

Who was I without the added confidence that opioids offered me? Why was I so scared? Why was I now so uncomfortable in my own skin, when during my years of active addiction, that wasn’t the case? These are questions I pondered over for years until learning the science behind the issue.

Eventually, I realized I had lost the ability to WANT to be intimate without substances. I no longer wanted to be desired, touched, or even looked at because it felt extremely disruptive to my mental health. I have an incredible partner who loves me, is patient, kind, and continually interested in understanding my issues so he can better support me. For that, I am eternally thankful.

Retraining my brain to trust intimacy

I played games with my brain's chemistry through my long-term opiate dependency. When you spend years confusing your own brain's reward system, your brain, plain and simple, just doesn’t trust you anymore.

Even though I am approaching my 8th year in opioid use disorder recovery, my brain still struggles with registering intimacy in a healthy way. I devastated the chemistry of my brain and only recently began to truly understand the role that opioids played in my intimacy issues.

The good news is this: our brains can heal, and this can be completely turned around, starting with recovery. Undoing the damage doesn’t happen overnight — that has been made abundantly clear in my life. I believe that with commitment, patience, and honesty, we can rebuild those connections.

I am now more aware than ever that I did this to myself, and I am grateful it's something I can work on. There really is hope, love, and healthy intimacy on the other side of the work that I continue to do. For anybody that relates to this struggle, don’t quit retraining your brain to embrace intimacy again.