harm reduction - Dr. Jen's Recovery Readings

Chemsex Interventions Succeed by Not Targeting Drug Use

Dr. Jennifer Weeks — Tue, 09 Jun 2026 13:01:18 +0000

The Search for Solutions

“Chemsex,” the use of psychoactive drugs to enhance sex, is a recognized public health concern due to its association with increased risks of HIV and other sexually transmitted infections (STIs).

In response, a range of programs, from counseling to medication, have been developed to address these risks. The common assumption is that the primary goal of these programs is to help individuals reduce or stop the drug use associated with chemsex.

However, a major new systematic review and meta-analysis that synthesized the results of 12 different studies challenges this assumption, revealing a more nuanced and surprising picture of what “success” actually looks like in this area.

Takeaway #1: Chemsex Interventions Target a Specific Risk, Not the Drug Use Itself

The single most effective outcome identified by the review was a clear and significant victory for public health: bio-behavioral interventions were found to substantially decrease the number of episodes of unprotected anal intercourse (UAI) with serodiscordant partners, or partners with a different HIV status, a result so strong it was highly statistically significant (p<0.001).

However, in what may be the most counter-intuitive finding, the review also concluded that the interventions did not lead to a reduction in the use of psychoactive substances during sexual activities.

This is a significant finding because it reframes the goal of these interventions from one of drug abstinence to one of harm reduction. The data shows that the programs are succeeding at reducing a primary risk factor for HIV transmission, even if they don’t stop the underlying drug use itself.

They are making a high-risk behavior safer.

Bio-behavioral chemsex interventions reduce the risk of UAI with serodiscordant partners, a high-risk factor for HIV seroconversion.

Takeaway #2: The Evidence is Narrower and More Fragile Than It Appears

While the primary finding is promising, the review also reveals critical limitations in the current body of research, suggesting the evidence is not as robust as it might seem.

Geographic Bias: All 12 studies included in the meta-analysis were conducted in the USA. This raises what the review calls “concerns regarding the generalisability of these findings to other countries” in Europe, Asia, and Australia where chemsex is also practiced.
Drug-Specific Focus: Chemsex is known to involve several drugs, including mephedrone and GHB/GBL. Yet, 11 of the 12 studies focused exclusively on methamphetamine use. The review notes this highlights a “dearth of research” for interventions targeting other relevant substances.
Risk of Bias: The quality of the evidence is a concern. The majority of the studies (67%) were rated as having a “high risk of overall bias.” Key issues included a reliance on participants self-reporting their behaviors and high drop-out rates, which tempers confidence in the overall conclusions.

Are you exploring your trauma? Do you feel your childhood experiences were detrimental to your current mental or physical health? Utilize this free, validated, self-report questionnaire to find out.

Take the Adverse Childhood Experience (ACE) Questionnaire

Takeaway #3: Beyond a Single HIV Risk Factor, the Benefits Remain Unclear

While the interventions successfully reduced UAI with serodiscordant partners, their impact on other risky behaviors was more ambiguous.

The review found that interventions led to a decrease in the total number of sexual partners and the number of partners with whom UAI occurred, but these reductions were not large enough to be statistically significant.

Specifically, the review could not establish a statistically significant link between the interventions and outcomes such as the total number of sexual partners, the number of partners where UAI took place, the overall number of episodes of UAI, or the frequency of sex involving substance use.

This finding does not mean the interventions are failures. Rather, it suggests they are highly targeted in their effect, acting on one very specific, high-stakes behavior rather than serving as a “magic bullet” for all behaviors associated with chemsex.

Conclusion: Reframing the Success of Chemsex Interventions

This comprehensive review sends a clear message: chemsex interventions show tangible promise for reducing a critical HIV risk behavior, even if they don’t reduce drug use itself.

At the same time, the scientific evidence supporting these interventions has significant gaps, including a narrow geographic and substance focus and a high risk of bias in the underlying studies. The review presents a paradox: the most successful interventions are the ones that ignore the most obvious target: drug use and, instead, focus on mitigating its most dangerous consequences.

As we move forward, should the goal of public health be focused less on abstinence and more on providing tools that demonstrably make risky behaviors safer?

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses? stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

Are you a Licensed Professional Counselor seeking engaging, unique Continuing Education courses? Dr. Weeks offers accredited courses on her practice website on the effects of Pornography Abstinence and other unique topics!

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Are you looking for more reputable, data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

The post Chemsex Interventions Succeed by Not Targeting Drug Use first appeared on Dr. Jen's Recovery Readings.

5 Hidden Ways the Gambling Industry Engineers Harm

Dr. Jennifer Weeks — Tue, 06 Jan 2026 18:54:18 +0000

Introduction: The Illusion of Choice

For many, gambling is seen as a form of entertainment, a voluntary activity where personal responsibility is paramount. We’re told to gamble responsibly. But, if things go wrong, the blame is often placed on the individual’s lack of self-control.

But what if that entire narrative is a dangerous fiction?

A new public health study reveals gambling harm is not an unfortunate side effect of a few people’s poor choices. Instead, it is the calculated outcome of a powerful and deliberate “gambling ecosystem” designed to maximize profit at a severe human cost.

This system operates using tactics that public health experts call the “commercial determinants of health.” The same strategies used by the tobacco and fossil fuel to drive profit by undermining public wellbeing.

This post will reveal five of the most impactful insights from the study, exposing the hidden truths of an industry that has mastered the art of engineering harm.

1. The “Responsible Gambling” Slogan is Designed to Blame YOU

The familiar phrase “gamble responsibly” is not a genuine public health message but a strategic discourse meticulously promoted by the industry. The primary function of this narrative is to shift the focus, and the blame, onto the individual consumer.

By framing harm as a personal failing, it deflects attention. It deflects it from:

Predatory industry practices
Unsafe products
A system that profits from addiction

This blame-shifting has severe consequences, creating a culture of shame that prevents people from seeking help and isolates them when they are most vulnerable. As the study’s authors note:

This emphasis on individual responsibility diverts attention from the practices of the industry. It generates stigma and shame for those harmed. It downplays serious harms caused by gambling. Worst of all: it contributes to the suicide toll.

This psychological framing is so damaging because it convinces individuals that their suffering is their own fault, making it harder to recognize the external forces at play and seek the support they need.

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

2. The Gambling Industry’s Goal is For You to “Play to Extinction”

Behind the glamorous advertising and messages of entertainment lies a stark and chilling internal objective. The study highlights a term used by gambling industry representatives to describe their core aim: “playing to extinction.”

This isn’t an exaggeration; it’s the industry’s own vocabulary for its business model:

“…gambling industry representatives describe their aim is to maximise revenue per available customer (revpac), and encourage ‘playing to extinction’, the point at which a customer has exhausted all available funds.”

The phrase has a chilling double meaning.

It refers to the financial extinction of a customer’s funds, but in the context of gambling-related suicide, it acquires a much darker significance.

The industry’s profit model depends on pushing customers into the exact states of financial ruin and profound despair that are known precursors to suicide. It is a business model that treats human crisis as a key performance indicator. Rather than a tragic crisis.

3. Products are Engineered to Undermine Your Control

Modern gambling products, especially digital ones, are not simple games of chance. They have been intentionally intensified with features like:

Increased speed
High complexity
“Frictionless” transactions

All designed to encourage extended use and bypass a person’s executive function.

The industry also employs digital tactics like sludging. Deliberately designing interactions to make it difficult for customers to act in their own best interest. Such as withdrawing funds or closing an account. This tactic also manifests physically. For 15 years, the Australian industry has resisted modern, universal pre-commitment systems that allow users to set binding loss limits. Instead, it has relied on a form of physical sludging: “manual, paper-based self-exclusion” that requires a person to fill out separate forms for every single venue they wish to avoid.

Product design also deploys psychological tricks to encourage overspending.

The study points out that a single ticket in the Australian “Powerball” lottery can be priced as high as AUD$46,249.65. This serves as a psychological anchor. While few would buy it, its existence makes spending smaller—yet still exorbitant—amounts like hundreds or thousands of dollars seem reasonable by comparison.

Need support and not local to the Lehigh Valley? Check out the LGBT National Help Center.

4. “Good Causes” are Used as a Smokescreen

A common defense of the gambling industry is that it funds worthy causes, from sports teams to community charities. The research argues this is a calculated strategy to create an “‘alibi’ to legitimise gambling operations” and procure a “social license” to operate.

This linkage creates a “symbiotic, reflexive relationship” where community groups become financially captured. Reliant on gambling revenue, these beneficiaries become powerful allies in resisting reforms that could threaten their funding, even if those reforms would reduce harm. This insidious dependency creates a powerful barrier to reform.

As one researcher observed, the dynamic is inescapable:

… at first the lottery was primarily dependent on the good cause and then, gradually, the good cause became increasingly dependent on the lottery.

5. The Gambling Industry Distorts Science and Influences Policy

Like the tobacco and fossil fuel industries before it, the gambling ecosystem actively works to control and distort the scientific evidence base to protect its interests. The study identifies two key tactics:

Funding “safe” research: The industry funds and promotes research focused on the individual, such as the influential “pathways model.” This model frames gambling harm as an artifact of pre-existing conditions like “antisocial personality disorder,” thereby shifting blame from the addictive product to the flawed consumer.
Discrediting effective solutions: The ecosystem publicly casts doubt on proven harm-prevention tools. The paper cites an industry-linked researcher who claimed that universal pre-commitment systems might have a “detrimental effect and may aggravate the problem.” Crucially, the study notes that a subsequent review of the evidence cited for this claim found “no support for this conclusion,” noting the studies had significant “methodological limitations.” This reveals a pattern of distorting weak evidence to undermine effective public health measures.

This distortion of science is coupled with political donations and the “revolving door”—where politicians and staff take industry jobs after leaving office—to block or delay meaningful reforms that could save lives.

Conclusion: Shifting from Individual Blame to Systemic Accountability

The evidence is clear: gambling harm is not a simple story of poor individual choices. It is the predictable and profitable result of a commercial system meticulously designed to addict users, shift blame, and protect its revenue streams at all costs. From manipulative product design to the distortion of science, the gambling ecosystem functions as a commercial determinant of health, actively generating and sustaining harm.

This reframing moves the problem from one of personal responsibility to one of systemic accountability. Seeing the deliberate system that drives these harms, what does real responsibility—from our governments, communities, and the industry itself—truly look like?

Are you looking for more reputable, data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

Do you feel your sexual behavior, or that of someone you love, is out of control? consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

The post 5 Hidden Ways the Gambling Industry Engineers Harm first appeared on Dr. Jen's Recovery Readings.

Holiday Gambling: Why You Bet Matters More Than How Much

Dr. Jennifer Weeks — Tue, 23 Dec 2025 13:00:00 +0000

The Surprising Psychology of Sports Gambling

Are you thinking about placing a little wager on a football game this holiday season? With the rapid growth and normalization of sports gambling across the United States and Canada, betting on a game is more common than ever. But what are the real reasons people gamble?

Most would assume it’s simply for fun, to make a game more exciting, or for the chance to win money. But what if the most important metric for gambling risk isn’t on a bank statement, but in the unseen emotions driving the bet?

A recent study of over 900 sports bettors reveals a more complex picture, uncovering deeper psychological motivations that separate casual fun from problematic behavior. The findings challenge our basic assumptions about gambling risk. This article will break down the five most impactful takeaways from this research, revealing that the “why” behind a bet is far more important than the “how much.”

1. Your Reason for Betting Matters More Than How Much You Spend

One of the study’s most unexpected findings was the relationship between mental health, betting habits, and gambling problems. The research showed that greater anxiety and depression were strongly linked to the severity of a person’s gambling problems. However, these emotional states were not significantly related to the total amount of money a person spent or the total number of bets they made.

This insight reframes how we should think about risk. It’s not just about the financial footprint of betting, but the emotional impetus behind it.

According to the study, the true indicator of risk isn’t found in a bettor’s bank statement, but in the emotional state that drives them to bet in the first place.

This is a critical distinction. It shifts the focus from a purely financial view of problem gambling to a psychological one, suggesting that the “why” you bet is a more telling sign of risk than the “how much” you spend.

Are you exploring your trauma? Do you feel your childhood experiences were detrimental to your current mental or physical health? Utilize this free, validated, self-report questionnaire to find out.

Take the Adverse Childhood Experience (ACE) Questionnaire

2. The Crucial Difference: Gambling for Fun vs. Betting to Escape

The study identified two key motivations that drive people to bet, each with vastly different outcomes:

Enhancement Motives: Betting to increase positive emotions. This is the classic reason—placing a wager to add to the thrill and enjoyment of watching a game.
Coping Motives: Betting to reduce or escape from negative feelings, such as anxiety, stress, or depression.

The results linked to each motive were counter-intuitive.

This revealed a fascinating paradox: while betting to enhance the fun of a game was linked to placing bets more often, it was simultaneously associated with fewer gambling problems. This suggests a clear psychological dividing line between frequent, low-risk engagement and problematic, high-risk behavior.

In stark contrast, betting to cope was the single strongest pathway linking pre-existing anxiety and depression to serious gambling problems.

Crucially, this connection held true even when the researchers accounted for other potential drivers like betting for social or financial reasons, isolating ‘coping’ as the most dangerous motivation. This finding strongly supports the “emotionally vulnerable pathway” model of problem gambling, where individuals use gambling as a maladaptive strategy to manage emotional distress.

3. “In-Play” Gambling Is a Different Beast Entirely

“In-play” sports betting, defined as making wagers during a live game, has exploded in popularity. The study’s findings on this specific group were stark. Compared to bettors who only place wagers before a game starts (single-event or traditional bettors), in-play bettors reported:

Significantly higher levels of problem gambling.
Significantly higher scores for both anxiety and depression.
A higher frequency of betting.

This raises a critical question for researchers: does the high-speed, constant-feedback nature of in-play betting actively create psychological distress, or does it primarily attract individuals already struggling with anxiety and depression who are seeking a powerful distraction?

As professionals, our time is valuable. Dr. Weeks created the Mitigation Aide Research Archive because there isn’t enough focused, data-backed research available in easily digestible formats.

4. For Sports Bettors, Anxiety and Depression Are Often Intertwined

The research observed that in this sample of sports bettors, depression and anxiety were “highly correlated.” In simple terms, participants who scored high on one tended to score high on the other.

The researchers noted that this suggests these conditions are more likely to be comorbid—or occur together—in people who bet on sports. The connection was so strong that the effects of anxiety and depression on gambling behaviors often overlapped. This reinforces the concept of a combined “emotional vulnerability” that can fuel problematic gambling, rather than a single, isolated mental health issue.

5. The Psychological Blueprint Is Surprisingly Consistent Across Genders

The study also examined differences between men and women, revealing a nuanced picture. On the surface, there were clear differences in behavior and emotional states:

Men engaged in sports betting on significantly more days than women.
Women reported significantly higher levels of anxiety, depression, and betting for social and coping reasons.

Despite these differences in emotional states and motivations, men and women reported statistically similar levels of overall gambling problems.

The more profound finding was that despite these surface-level differences, the underlying psychological model was the same for both groups.

The core pathways showing how anxiety, depression, and motives lead to gambling problems did not differ between men and women. This suggests that when it comes to the fundamental emotional drivers of problem gambling, gender may not change the blueprint. Interventions, therefore, can likely focus on these consistent psychological drivers for everyone.

Conclusion

This research cuts through the noise of wins, losses, and dollar amounts to deliver a clear message:

Understanding the motivation behind gambling is the key to understanding the risk of it becoming a problem.

While many people bet to enhance their enjoyment of a sport with few negative consequences, the data points to a clear red flag:

The strongest pathway to serious gambling problems isn’t rooted in how much money is spent, but in whether the bettor is motivated by a need to cope with or escape from negative emotions.

Before placing your next bet, it might be worth asking: am I doing this to enhance my fun, or to escape my feelings?

Drop a comment and let us know if you were able to identify any motivations you may have for acting out this holiday season.

Do you feel your sexual behavior, or that of someone you love, is out of control? consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

The post Holiday Gambling: Why You Bet Matters More Than How Much first appeared on Dr. Jen's Recovery Readings.

3 Reasons You Might Want to Block Porn

Mike — Tue, 30 Aug 2022 18:03:22 +0000

Why might you block porn?

You might want to block porn if you’re a parent of young children.
Pornography is a drain on time, money, and computers.
You or loved one has a compulsive desire to view pornography.

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

You’re a Parent of Young Children

Give Your Kids a Chance to be Kids and Block Porn

We all know kids will get into things they shouldn’t, it’s part of growing up.

With no guidance it’s very easy for them to fall down the rabbit hole.

But with the right mindset, frequent, open discussions with them, and some technological barriers you can help your child navigate the pitfalls of adolescence, defining their own sexuality, AND the internet.

Pornography is a Drain on Time, Money, and Computers

Pornography has always been a pervasive presence on the internet. From the early days of newsgroups through the modern “work-from-home revolution” that OnlyFans has brought, it can be tough to escape.

Blocking pornography for yourself and/or your loved ones can have a lot of benefits:

Simply put you’ll utilize your time better if you don’t lose time being tempted by and indulging in an idle pass time.
You won’t be tempted to spend money on memberships to pornography sites.
You’ll avoid the hassle of potentially infecting your computer with malware.

There are lots of other reasons to avoid viewing pornography too. Risk of divorce. Desensitization. Erectile Dysfunction. Just to name a few.

Do you believe you have an online pornography addiction? Then take this free Cyber Pornography Addiction Test (CYPAT) and have the results to speak with your therapist.

You Might Want to Block Porn if You or a Loved One Has a Compulsion

This one can be difficult, whether it’s you or a loved one.

If you recognize you have an addiction to online pornography it can be difficult to curb the behavior on your own. We’ll have some suggestions in future installments for handling this particular situation whether you’re truly alone in handling the compulsive behavior or whether you just need some tips in asking your significant other, partner, or parent for help.

If you know a loved one is compulsively viewing pornography it can be a difficult and frustrating conversation to have but having some technical solutions in hand will be helpful.

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

Pornography Induced Erectile Dysfunction

I know, I mentioned Erectile Dysfunction above, but it’s important enough that I felt I should mention it again. This is a subheading that could definitely be it’s own reason for curbing your mature material intake. Consuming too much erotica can have severe effects on your brain and the way your body responds to stimulus; I’m not the expert though, so I’ll let Dr. Jen explain the details of Pornography Induced Erectile Dysfunction (PIED).

Conclusion

There’s lots of reasons to want to block pornography, these are the most common in our experience, but, what reasons do you have for wanting to block pornography? Let us know in a comment below!

In future installments in the series, we’ll cover:

The technology to block pornography.
What IS pornography?
How to discuss viewing pornography with your spouse/partner/significant other.
How to bring up discussions with parents or guardians if you’re a teen needing help with pornography habits.
And more!

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

Are you looking for more reputable, data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

For an in-depth guide on talking to your adolescents about cybersex and pornography, check out Dr. Jen’s book. Amazon | BookBaby

The post 3 Reasons You Might Want to Block Porn first appeared on Dr. Jen's Recovery Readings.

Let’s Talk About Sex Dolls

Dr. Jennifer Weeks — Mon, 18 Jul 2022 17:51:03 +0000

For me, the concept of sex dolls is fascinating and when my web guy told me that some people were searching for more information about it, I jumped at the chance to write about them again.

The first thing to do when talking about sex dolls is to forget that image of the plastic blow up doll with a permanently gaping mouth. Today’s sex dolls are high tech, sometimes robotic, really life like and nothing like what most people imagine.

Let’s talk about some of the controversies.

Child Sex Dolls and Sex Offenders

This one is a hot button issue with some people falling in either camp. Child sex dolls are manufactured outside of the United States and they are extremely realistic looking. This is pretty uncomfortable for a lot of people.

The two sides of the argument are as follows.

For individuals who have an exclusive attraction to prepubescent children, child sex dolls might be a way for them to have some sense of sexuality without harming children.

The other side of this camp thinks that allowing people who are attracted to children to have child sex dolls will actually increase their risk of harming a live child.

The trouble is, there is hardly any research on the topic to help people make an informed opinion.

For more thoughts on the topic, check out Prostasia Foundation’s blog on the topic.

Do you believe your sexual behaviors are compulsive or harmful to you or others? Then you should take the CSBD-19 free, validated self-assessment tool.

Sex Dolls and Adults

If we are talking about adult sex dolls, we can avoid the controversy that comes with child sex dolls, but you still get the stigma.

There are many reasons why someone might want a sex doll.

Perhaps they have difficulty meeting people, forming relationships, or hooking up with others for sex.

Perhaps they have a trauma history that makes sex with another person something they can’t engage in.

Or maybe, they just want to.

Looking for more on sex dolls and sexuality? These articles explore research on ownership, meaning, and broader questions about sexual behavior and attitudes.

There is even a sex doll rental company in Houston, Texas that has lawmakers up in arms. They have tried to block it but, to the best of my knowledge, it is still up and running.

In the sex therapy community, the use of sex dolls does not carry the same stigma that it might in other circles. Fundamentally, an adult who wants to have an adult sex doll should be able to do so without worry about what other people think.

However, some people worry that using a sex doll or a sex robot as a replacement for human interaction could be harmful.

Check out some other’s thoughts on the topic here:

Using Love Dolls As a Substitute for Human Intimacy (Psychology Today)
Sex Bot use ‘unrelated to healthcare’ (Medical News Today)

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

Answering Your Questions

Some of the google searches related to sex dolls that have landed people on my website have questioned whether or not sex doll use is addictive.

I will take this moment to remind people that when it comes to sex addiction or problematic sexual behavior issues, it is often not the behavior that is problematic but the person’s relationship to the behavior.

A sex doll is a sex doll. If you are questioning whether your use of the sex doll is an addiction, the better questions relate to your relationship with the doll.

Is it something that you cannot stop doing?

Is engaging with the sex doll interfering with your life, work or other relationships?

If your interactions with the doll do not meet the ICD-11 diagnostic criteria for Compulsive Sexual Behavior Disorder, the problem may be an issue of moral incongruence instead of addiction or problematic sexual behavior.

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

The post Let’s Talk About Sex Dolls first appeared on Dr. Jen's Recovery Readings.