Agency,sex and drug education: Examining the response-ability of education responses to consumption,sex and harm

Abstract

This article examines how drug education professionals understand and respond to the relationship between alcohol and other drug consumption, sex and harm. While recent research examines how these issues are addressed in drug education curriculum, little is known about the perspectives of professionals involved in education design and delivery. Research suggests that agency is centrally important for understanding experiences of harmful, pleasurable or ambiguous sexual encounters in consumption settings. I analyse understandings of the relationship between agency, drug consumption, sex and harm generated during in-depth interviews with drug education professionals. Informed by Karen Barad’s relational concepts of agency and response-ability, I examine the agencies that these professionals constitute as the locus of harms related to consumption and sex. Some focus on individual human agency, while others position alcohol and drugs as the primary agents of harm. Throughout the analysis I argue that both approaches offer an impoverished account of drug consumption and sex and inform education approaches that struggle to respond to other significant agencies such as gender. I also examine accounts that grapple with agencies beyond people and drugs. Overall, I argue for drug education approaches that are more response-able to the multiple agencies that together constitute experiences of drug consumption and sex.

Introduction

Youth alcohol and other drug consumption is a significant policy concern in Australia, with those aged 10 to 24 identified as a “core priority” of the current Australian National Drug Strategy 2017–2026 (Commonwealth Government of Australia, 2017). Reflecting this, school-based drug education, is considered crucial in supporting young people’s wellbeing. In Australia, 73% and 64% of school-aged young people reported some education about alcohol and illicit drugs, respectively, in the last year (2022–2023) (Scully et al., 2023). While ostensibly about alcohol and other drug use, recent analysis suggests that much Australian drug education curriculum also contains lessons about sex and sexuality, with sex presented as a key risk of consumption (Farrugia, 2017, 2023a). Given intoxicated sex is common in countries such as Australia (Lawn et al., 2019) and a recent national survey indicates that 17.2% of young women and 11.1% of young men aged 16–19 report ever experiencing unwanted sex related to intoxication (Carter et al., 2021), it is important to understand how drug education handles issues related to sex. While young people are already attempting to establish consent when having sex in the context of alcohol and other drugs, using strategies such as communication prior to and during consumption and attempting to assess levels of intoxication (Goodyear et al., 2023; Hunt et al., 2022), the often-ambiguous character of intoxicated sexual experiences (Petersen et al., 2023) presents an especially complex challenge. Recent Australian research has examined how sex is addressed in drug education curriculum resources (Farrugia, 2023a), however, very little is known about how professionals involved in designing and delivering drug education approach this issue. This article addresses this through an analysis of how 20 Australian drug education professionals understand the relationship between drug consumption, sex and harm (in my analysis, the term ‘drug consumption’ refers to the use of licit drugs such as alcohol as well as illicit drugs).

Working with Barad’s (2003; 2007) conceptualisations of agency and response-ability, my analysis contributes to a broader body of research addressing the implications of examining alcohol and other drugs as co-constituted phenomena rather than stable pharmacological entities. I contend that attributions of agency are central to understanding how drug education responds to issues related to sex. As I argue, drug education professionals constitute the relationship between drugs and sex as intrinsically harmful, a worrying “consequence” or “risk” of consumption often equated with non-consensual sex and sexual violence. When seeking to address this risk, professionals are preoccupied with individual human agency, especially that of the young people who may experience the potential harms that can stem from drug consumption and sex. I also examine a different trend that positions alcohol and other drugs as wholly agential and, therefore, the primary cause of harm that may occur in conjunction with sex. Throughout the analysis, I argue that both approaches offer an impoverished account of drug consumption and sex and result in education approaches with limited scope. Most importantly, I suggest that these approaches take part in a troubling gender politics that results in efforts to govern the consumption and comportment of the targets of sexual violence and, at other times, de-genders the character of this and other harms. Turning my attention to a less common trend in the data, I examine drug education professional accounts that attempt to grapple with forces beyond people and substances in their approach to sex. Building on these efforts, I conclude by exploring the potential for a drug education that is more response-able to the multiple agencies that together constitute experiences of drug consumption and sex and no longer reifies individual people or the substances they consume as the only agencies that require attention.

Literature review

Very little is known about how drug education professionals such as teachers, private education providers or related researchers approach youth drug consumption and the goals of their work. The available scholarship generally examines practical concerns about conducting drug education such as issues related to insufficient time to address the topic (Fletcher et al., 2010). Beyond this, some research with secondary school health teachers has documented a focus on “responsible” drinking, resisting peer pressure and making good decisions in alcohol education (Davies, 2016). Our ignorance about professionals investments in drug education is especially significant given recent research demonstrates that curriculum often operationalises troubling understandings of the relationship between sex and alcohol and other drugs (Elliott, 2008; Farrugia, 2017, 2023a). Most recently, Farrugia (2023a) analyses how Australian drug education positions young people’s impaired judgment while intoxicated as the key cause of sexual assault, placing the responsibility for addressing such violence onto its targets. In a context in which drug education classes are rarely recognised sites of sexuality education (Farrugia, 2024), there remains a dearth of research on the perspectives and concerns of the professionals involved in designing and implementing these initiatives and their approaches to sex.

Most research on young people, drug consumption and sex focusses on potential harms, especially sexual violence (e.g. Cowley, 2014; Jozkowski and Hoffacker, 2024; Stefansen et al., 2023). Reflecting the centrality of notions of agency in definitions of consensual sex (e.g. Kukla, 2021) much research examines how drugs, especially alcohol, impact how individuals seek and consent to sex. According to Alcohol Myopia Theory (Steele and Josephs, 1990), for example, men can become myopically focussed on perceived signals of potential sexual interest when they are drinking and disregard indications that consent is not present. Importantly for my analysis, attributions of the agency of drugs such as these are gendered. For example, the implication of theories such as the alcohol myopia theory is that the substance contributes to violence by overriding or, at least, compromising men’s agency. This is a complex view of agency; it’s one in which the substance is having apparent agentive effects (overriding or compromising men’s agency) while also heightening men’s agency in very specific, unidirectional ways. Here, alcohol is understood to enable a release from constraints, a form of “liquid courage.” But importantly, men also somewhat become more agentive here, as more active, desiring and assertive sexual subjects. Contrastingly, in the case of women, for example, intoxication is often thought to straightforwardly diminish their ability to assess potential dangers and, as such, drug consumption is understood to make them less agentive and more likely to experience sexual violence (e.g. Testa and Livingston, 2009). They become more passive and vulnerable sexual subjects. Both approaches can be criticised for reproducing stereotypes about men’s apparent “natural” aggression and women’s “vulnerability” and for using intoxication as an explanation for violence, especially sexual and family violence, in ways that diminish perpetrator responsibility and inequitably focus on the comportment of targets of this violence (e.g. Knountsen, 2023; Seear and Fraser, 2016). These dynamics emphasise the need to examine how understandings of alcohol and other drugs effects shape responses to drug consumption and sex.

Qualitative research on intoxicated sex and consent also points to the importance of agency. Focussing on heterosexual dynamics, (Cowley, 2014) suggests that much research positions either alcohol or gendered processes as the primary cause of sexual violence in consumption settings. Finding both approaches insufficient, Cowley (2014) argues that researchers need to examine how gender norms and alcohol “co-construct and feed off of one another” (p. 1264) in ways that make sexual violence more likely. Focussing on how young people understand and negotiate intoxicated sex and consent, Hunt et al. (2022), examine contractual understandings of consent along with the concept of “intoxication parity,” where the importance of negotiating consent is reduced when all participants are perceived to be equally intoxicated (see also, Goodyear et al., 2023). In this sense, where human agency is thought to be similarly impacted by alcohol and other drugs, explicit consent is less integral to a sexual encounter. Specifically investigating the views of young men (including heterosexual, gay, bisexual and queer individuals), Goodyear et al. (2023) analyse accounts of drunk sex that, alongside careful and explicit efforts to establish consent, at times, also centre alcohol intoxication as a way of ‘deflecting and denying the role and responsibility of men’ in sexual violence (p. 11).

Research on young women’s experiences of intoxicated sex points to related dynamics. Petersen et al. (2023), for example, offer a close analysis of the way women’s experiences of pleasurable intoxicated sex often relates to agency and regrettable experiences to a lack of agency (p. 530) (also, Knountsen, 2023). Given the varied and complex character of these practices, approaching agency as a straightforwardly individual capacity is thought to be insufficiently nuanced, unable to properly account for power such as gender dynamics and often leads to victim blaming in understandings and experiences of sexual violence (Knountsen, 2023). Further, while much research approaches intoxication as a form of diminished agency, it is crucial to consider, as Bogren et al. (2023) do, that alcohol and other drug consumption can co-constitute new capacities or forms of agency, including ways to contest gender expectations. Research on sexualised drug consumption among LGBTQ people specifically demonstrates related processes. Pienaar et al. (2020), for example, examine instances of sexualised drug consumption that have the potential to constitute new agentive subjectivities. Such research emphasises that drug consumption can form part of practices that generate new and meaningful forms of agency, including, importantly for this article, sexual agency.

Approach

To develop an analytical approach that effectively handles the complex relationship between drug consumption, sex and agency, I work with feminist science studies theorist and physicist Karen Barad’s “agential realist” ontology (Barad, 2003; 2007). In working with agential realism, my analysis contributes to a growing area of sociological research that mobilises what can be broadly categorised as new materialist, post-human or, most generally, relational conceptual resources to approach alcohol and other drugs as performatively co-constituted phenomena rather than pharmacological entities (Fraser and Moore, 2011). Within this field, Barad’s agential realism has proven especially valuable for researchers examining, among other things, the relationship between space, time, agency and “drug effects” (Dilkes-Frayne et al., 2017; Fraser, 2006; Fraser and Moore, 2011; Seear, 2013) as well as gender, embodiment and harm reduction (Dennis, 2019; Fomiatti et al., 2022; Pienaar et al., 2017). While agential realism is proving valuable in some related education research such as that on sex and sexuality (Allen and Rasmussen, 2017), my analysis introduces it to drug education with a focus on the implications of its relational approach to the agency of drugs and the people who consume them (see also, Farrugia, 2014).

The role of matter, its agency and impacts on research methods and findings are primary concerns for Barad. While Barad’s work draws on the central insights of post-structuralism in rejecting biological determinism and positivism, they argue that many theoretical approaches, especially those categorised within the “cultural” or “linguistic” turn have forgotten matter altogether stating that “there is an important sense in which the only thing that does not seem to matter anymore is matter” (2003: 801; see also, 2007). Barad develops the notion of agential realism by drawing together several theoretical resources such as physicist Niels Bohr’s insights about the performative implications of research instruments and methods and Judith Butler’s theorisation of gender performativity. In doing so, Barad offers a conceptual approach that can handle the role of materiality in the production of reality without naturalising it as unchangeable and wholly determining. Overall, agential realism approaches both materiality and discourse as performative, with neither taking primacy in the manifestation of reality. This approach is especially important given debates that separate gender discourses and substances in effort to identify the primary cause of sexual violence where sex and drugs coalesce (e.g. Cowley, 2014). Working with agential realism, determining individual causes like this does not make sense:

That material and discursive constraints and exclusions are intertwined points to the limited validity of analyses that attempt to determine individual effects of material or discursive factors. (Barad, 2003: 823)

In focussing on co-constitution, agential realism offers a relational account of the world. For Barad (2003; 2007), primary ontological units are not distinct entities or “relata,” usually understood as defined prior to their encounters with other forces, but “phenomena.” Unlike discrete individual “relata,” phenomena are constituted through relationships of material-discursive practices, subjects and objects (Barad, 2007). This approach emphasises that the character and effects of different forces such as people, substances and discourses, of gender for example, emerge relationally or through “intra-action”:

The neologism ‘intra-action’ signifies the mutual constitution of entangled agencies. That is, in contrast to the usual ‘interaction,’ which assumes that there are separate individual agencies that precede their interaction, the notion of intra-action recognizes that distinct agencies do not precede, but rather emerge through, their intra-action. (2007: 33; original emphasis)

Examining what the concept offers alcohol and other drug research, Fraser and Moore argue that approaching drug effects as intra-actions means we cannot work with “orthodox causal chains” that assume drugs have inherent properties, effects and, therefore, require obvious responses (e.g. prevention) (2011: 5). In this way, agential realism has important implications for how we understand causality. Seear (2013) explores many of these in her mobilisation of agential realism for examining “doping effects” in sport. As she argues, depending on how alcohol and other drug-related phenomena are approached, drugs can be understood to “either cause or be causally related to a vast range of problems, including crime, illness, injury, psychosis and death” (202; original emphasis). However, the exact relationship between alcohol and other drugs and harms is highly contested. For my purposes, alcohol and other drugs may be implicated in agentive pleasurable sex in some instances (e.g. Pedersen et al., 2017; Pienaar et al., 2020) and sexual violence in others (Prego-Meleiro et al., 2020).

Given the centrality of agency for experiences of consensual/non-consensual or pleasurable/unpleasurable sexual encounters in intoxicated settings (e.g. Knountsen, 2023; Petersen et al., 2023), the implications of Barad’s notion of intra-action and account of causality for understanding agency is crucial for my analysis. Barad offers a relational notion of agency that does not attribute it solely to human intentionality. Rather than an attribute or a characteristic of “someone or something,” for Barad, agency is an ‘enactment’ that emerges from intra-actions (Barad, 2003: 826–827). In this approach, the agency of people or substances like alcohol and other drugs are not determined before their encounter. Instead, the agency of both, how they impact a particular (sexual) encounter emerges through their intra-action. From this position, agency is not defined by notions of individual autonomy central to drug education initiatives (Farrugia, 2023b) but is a relational achievement (Dennis, 2019), a quality of phenomena. Unlike Alcohol Myopia Theory (Steele and Josephs, 1990), for example, this approach does not reduce alcohol effects to diminished human agency. Rather, drug effects are approached as emergent, as having multiple agential implications (Fraser et al., 2023) in sexual and other encounters.

Barad’s focus on the performative dimension of our responses to phenomena is especially useful for developing new education approaches to drug consumption and sex (for Barad’s influence in sexuality education, see Allen and Rasmussen, 2017). Engaging with Donna Haraway’s work, Barad theorises the notion of “response-ability” in contrast to the liberal humanist concept of responsibility that remains invested in the bounded autonomous human agent who, for my purposes, is ontologically distinct from the substances that they may consume (see Fraser, 2024 for examination of the implications of response-ability for alcohol and other drug research methods):

According to agential realism, ‘responsibility’ is not about right response, but rather a matter of inviting, welcoming, and enabling the response of the Other. That is, what is at issue is response-ability—the ability to respond. The range of possible responses that are invited, the kinds of responses that are disinvited or ruled out as fitting responses, are constrained and conditioned by the questions asked, where questions are not simply innocent queries, but particular practices of engagement. (Kleinman and Barad, 2012: 81)

Inspired by this, my analysis examines the responses to drug consumption and sex that are made possible and impossible or, at least, likely and less likely by drug education professional’s approaches to agency. In a context in which drug education is often a site of sexuality education (Farrugia, 2024), I seek to respond by examining the political implications of what forces are made agential by drug education professionals in their efforts to understand and respond to drug consumption and sex. Overall, this analysis examines how centring such limited agencies as the cause of harms related to sex shapes the response-ability of drug education in ways that primarily target individual young people or their consumption as the only locus of attention. This is a pertinent task given that health promotion and drug education strategies with such limited purview may not only generate scepticism (Brown and Gregg, 2012; Farrugia and Fraser, 2017) but actively limit young people’s capacity to assemble safe consumption events and reduce harm more generally (Farrugia, 2020).

Method

This analysis stems from research conducted for an Australian Research Council-funded project on how gender and sexuality shape young people’s alcohol and other drug consumption, their relationship to school-based drug education and how related issues are addressed in drug education. The project includes three datasets: a corpus of drug education resources; 40 interviews with young people; and 20 interviews with drug education professionals. In this article, I analyse data generated from in-depth, semi-structured interviews with drug education professionals working in four of Australia’s most populous states: New South Wales, Queensland, Victoria and Western Australia. The dataset includes perspectives from 11 women (including one trans woman), eight men and one non-binary person. All participants were provided with plain language information explaining the project and their consent was recorded orally at the onset of the interview. While all participants were offered an AUD$50 gift card as reimbursement, only eleven took up the offer. Participants included: five private drug education providers; five academic researchers designing and informing drug education programs; four secondary school teachers with experience conducting drug education classes; three youth-focussed alcohol and other drug treatment providers; two policy professionals with roles related to youth-focussed drug education and health promotion; and one harm reduction professional with experience conducting drug education in community settings. Private providers, academic researchers and policy professionals were purposively selected to reflect a range of professional experiences, genders and roles in Australia’s relatively small drug education field, including responsibilities for designing and/or delivering education initiatives. Many of these participants were individually identified and invited based on my knowledge of drug education research and practice in Australia. Other participants were recruited via targeted social media activity and promotion and snowball sampling. Interested participants were required to register via a project website and I contacted them for screening. All participants were assigned a pseudonym and all identifying material was removed from the transcripts. In the analysis to follow, participant quotes are identified by their pseudonym, gender (woman, man, non-binary, trans woman) and a generic description of their professional role (teacher, private drug education provider, research, policy, treatment). Interviews addressed understandings of the purpose of drug education; understandings of effective drug education; youth alcohol and other drug consumption; the relationship between young people’s gender and sexuality and potential harms or pleasures associated with alcohol and other drug consumption; and discussion of drug education paradigms such as abstinence or harm reduction approaches.

The research received approval from human research ethics committee at La Trobe University (approval number HEC22188) and all participants provided audio-recorded informed consent to be interviewed.

Analysis

The drug education professionals interviewed in this research almost uniformly approached sex as an intrinsically negative “risk” (Zoe, W, research), or “consequence” (Bridget, W, private drug education provider) of intoxication. It was also the result of impaired judgment (Linda, W, teacher) or equated with assault (Teresa, W, teacher). The role of different agencies in generating this risk was contested with, as discussed, most centring the agency of humans or drugs in explaining the dangers posed by sex.

Responding to individual human agency

For many of these drug education professionals, the agency of young people was the primary focus of intervention. In a discussion about how her drug education program addresses sex as a “risk” and “consequence” of consumption, Bridget (W, private drug education provider), for example, described a hypothetical “risky scenario” that students might work through to explore these issues:

So, you know it could be that [. . .] you’ve got ‘Max’ or you’ve got ‘Janine’. Janine is 18, she’s in this particular setting, set the room, set the tone [. . .] It could be that, you know, she’s been given a drink from a stranger or given a drink from someone she’s only just met and then really getting [young] people to think through [. . . what might happen] if Janine went ‘yeah, okay I’m going to take this drink’. What would that look like? What could potentially happen? What might not happen? You know, it’s not about ‘this will happen’ it’s kind of like really just getting people to think through the different pathways that [taking the drink] could lead to.

In this hypothetical lesson, young people are instructed to focus on Janine’s decisions, that is—her individual agency—when considering the potential implications of taking the drink. While Bridget explains that she does not seek to present a simplistic causal chain about what “will” happen, the activity nevertheless focuses on and seeks to intervene in the actions of a young woman who is the potential subject of harm. Importantly, the “stranger’s” motivations are not offered up for the same scrutiny. Also focussed on individual agency, Terra (W, teacher) described her approach to addressing the relationship between sexual consent and alcohol with her students:

I was thinking of the decision making with regard to consent as well and the decision making surrounding the consequences of actions if choosing to have excess alcohol or drugs. So yeah, definitely, definitely, that came into [my lessons. . .] I mean, consent now is such a big area that is, you know, that teachers have to deliver in that [. . .] You know, your decision making is impaired [when you’re intoxicated. . .] Then we related that back to that sense of self [. . .] So just instilling that resiliency [and] sense of self-worth.

Positioning non-consensual sex as stemming from impaired decision making, Terra centres human agency as the primary concern. She also offers a moral judgment that subtly suggests intoxicated sex is unlikely to be motivated by agential desire or pleasure but instead stems from compromised self-worth.

While most participants focussed on individual agency in this way, it is crucial to state that some pointed to limitations in this approach, including their propensity to “victim blame.” Explaining her approach to drug education, Anna (W, research) sought to avoid these issues:

We put the [students] in the way of trying to think through how you could positively support a peer or a close person not to be a perpetrator [. . .] So what we are trying to do is construct a situation that won’t flip them into overly moralising, getting back into a gender war, getting back into alcohol blaming, getting into victim blaming – all of those traps which we know from the sociological literature need to be then pedagogically translated into the classroom.

Speaking about how to have a “balanced” approach to addressing the harms and potential fun of alcohol and other drugs with young people, Ashely (non-binary, treatment) also discussed the issue of sexual assault and potential victim blaming. Working in a LGBTIQ-focussed alcohol and other drug counselling and treatment role, Ashley explained that they are more likely to encounter the more severe side of these issues:

I might be too deep in seeing the bad stuff, but the vulnerability of young people, particularly of young women and queer people, in terms of either being pressured socially or physically into things that sexually they don’t want to do [is a concern. . .] Trying not to victim blame, but when you’re not being somewhat vigilant in having the knowledge to keep yourself safe because of a lifetime of trauma, not to say that the person won’t overcome it, but that’s what it is.

In their account, Ashley reproduces increasingly influential understandings that position drug-related harms as stemming from a relationship between gender and trauma (see Fomiatti et al., 2023). While the relationship between trauma, gender and harm is contested, it is Ashley’s reference to gender inequality in approaching sexual assault that is most important for my analysis. However, even while recognising these forces, Ashley’s response focusses on individual “knowledge” and the agential capacity to keep oneself safe. Like Anna, Ashley has concerns about the limitations of such approaches, especially the potential that a focus on individual agency leads to victim blaming.

For these professionals, the actions and agency of young people are the primary forces to consider when designing and implementing drug education responses to consumption and sex. For some such as Bridget and Terra this results in an intervention focus on the target of potential violence and, reproducing responsibilising dynamics, they seek to convince young people—often young women—to change their actions to avoid harm (Farrugia, 2017, 2023a). Centring agency in this way de-emphasises other issues such as inequitable gender power arrangements that shape harm. While Anna and Ashely also centre human agency, they expressed some frustration with the limitations of approaches that inequitably focus on “victims.” These frustrations are challenging to overcome within an ontological position that holds different agencies as separate, distinct entities. Such approaches have implications for our response-ability in that by approaching individual people as “relata” whose agency can only be compromised by their drug consumption, they struggle to account for how agencies take shape relationally, or how they intra-act to generate specific effects. When held separate like this, it seems difficult to imagine a response that does not centre the agency and comportment of those who experience harm. In this context, ontological distinctions of this kind encourage responses that seek to protect and intervene in one agency—individual human agency—as the central agent in harms that can emerge in relation to drugs and sex, effacing the work of many other agencies.

Responding to alcohol and other drug agency

I now turn to accounts that are primarily occupied by the agency of alcohol and other drugs. Many of the professionals in this research, for example, expressed concern about consumption “compromising” young people’s ability to “make decisions” related to sex (Elissa, trans woman, treatment). In these accounts, alcohol and other drugs are thought to override the agency of young people, leading to sexual harms.

Working in a private single sex all girls secondary school, Linda (W, teacher) explained that the year 10 students (ages 15 and 16) had recently learnt that consent is not possible “under the influence of alcohol and other drugs,” an especially important lesson given the effect of alcohol on decision making:

We talk about how [. . .] alcohol in particular affects your decision making, impairs your judgement and so it can lead to things that you wouldn’t ordinarily do. Using another drug, for example, [or] being intimate with someone that you ordinarily wouldn’t, you know. As far as you are actually not able to give consent and find yourself in an assault situation or assaulting somebody else because your judgement is impaired.

For Linda, given alcohol, that is its agency, impairs judgment, actions that one would not do “ordinarily,” such as having sex with someone new, are constituted as potentially harmful. Of course, consensual and pleasurable drug consumption and sex can and does occur, so questions might be asked about how alcohol and individual agency might intra-act differently depending on the amount and character of consumption (Goodyear et al., 2023; Hunt et al., 2022). However, while Linda’s account leaves room for these possibilities to occur in some circumstances, they are overshadowed by an emphasis on harm and, most importantly for this analysis, she mobilises a positivist account of drug effects in which consumption impairs human agency in ways that constitute sex as likely to be harmful.

Also focussing on harm, Teresa (W, teacher) explained that while she is not sure whether sex should be a significant part of drug education, it should be presented as a “potential outcome” of consumption:

I don’t know that it’d be a massive part. I think it’d just be [included. . .] when you’re looking at impacts on the body or what are the potential outcomes of consuming a drug, you know, you might look at sexual assault, but that would probably be it.

Importantly, Teresa clarified that drug education classrooms will include students who have not experienced harm and instead had “good fun” but at the same time others will have had “terrible outcomes.” Even in offering this complexity, Teresa centres the agency of the substance, which is understood to causally produce particular “outcomes,” including sexual assault—the only sex-related possibility Teresa states is relevant to drug education. Articulating a similar causality, Zoe (W, research) explained that drug education should address several harms, often linked to the way consumption compromises young people’s “impulse control,” that is, their agency and rationality.

I think that impulse control stuff that comes from, you know, drinking that then gets you into those bad situations, like sexual behaviour that you don’t want to be [in] . . . that you wouldn’t partake in otherwise [. . .] Risky behaviours are for me, are in the same realm. Like drug and alcohol use, sex, they are all in the same kind of realm of risky behaviours, so we touch on them, more than touch on them, like, they are a big part [of our program. . .] People doing things they didn’t want [to do and] regretting things after they’ve drunk or taken drugs.

While recent research explores the complex relationship between drug consumption and sex, including, for example, positive sexual experiences that exceed normative scripts of heterosexual encounters (Petersen et al., 2023), for Zoe and Linda above, this is unlikely. Approaching alcohol and other drug agency as a threat, they understand sexual experience in this context, and especially those that differ from established practices, as “risky” and most likely regrettable. In this account, non-consensual sex stems from the agency of alcohol and other drugs diminishing individual agency or, in Zoe’s words, the ability to avoid sexual situations “you don’t want to be” in.

The causal model these professionals deploy in their drug education practice presents harms such as sexual assault as drug effects. Significantly, the perpetrator of violence fades from view in this approach, replaced by a malevolent substance. At other times, the perpetrator stays in the picture, but their actions are explained as a drug effect, caused by their impaired judgment. In privileging the agency of the substance, these approaches operate within a highly partial account of the possibilities that can emerge from consumption and sex, including related harms. As did the earlier focus on individual human agency, this approach struggles to account for how different agencies and their “effects” will intra-act differently in moments of consumption and sex. Maintaining an ontological separation between these agencies is translated into drug education initiatives that, in being primarily response-able to the agency of drugs as a threat to human agency, place consumption and sex into a homogenous category of nonconsensual sex. As such, these initiatives are unable to engage with the diverse character of young people’s efforts to negotiate drugs, sex and consent (e.g. Bogren et al., 2023; Goodyear et al., 2023; Hunt et al., 2022) and result in well-trodden advice to reduce consumption as a way of addressing harm, a process that de-genders issues such as a risk, regret and shame as well as issues like sexual violence (Farrugia, 2023a).

Responding to agencies beyond people or alcohol and other drugs

While most participants focussed on human individual agency or the agency of alcohol and other drugs, others expressed misgivings about the potential shortcomings of these approaches. Gerard (M, policy/treatment) argued that while sex-related issues are an important part of drug education, sexual health must not be reduced to issues such as sexually transmissible infections (STIs) or pregnancy but should “encompass lots of things” including “gender and being comfortable” with oneself more broadly. However, Gerard argued that when these issues are introduced into drug education, they are reified and replaced with a myopic focus on harm:

I think when we talk about [sex, sexuality and gender] in the alcohol and drug [context], when you throw that lens into it, to me it seems to focus [or. . .] narrow straight down [. . . to a message saying] ‘you are going to get assaulted or [. . .] get an STI’ – it’s ignoring, you know, the greater stuff of the bigger picture.

For Gerard, reducing drug effects to harms negatively impacts the ability to discuss these broader issues with young people. Instead, like Ashley, he argued for a “balanced” approach that addresses the “positives” alongside “risk.” We might also consider whether issues such as power might be included in his focus on the “bigger picture.”

Working in a LGBTIQ-focussed alcohol and other drug counselling and treatment service role, Stefan (M, treatment) explained that discussing the relationship between sex and consumption is “crucial”:

Working through like what is it like to have sex when like under the influence, if you weren’t under the influence what would that be like? Where is the kind of, the guilt and the shame showing up like or body dysphoria? Like, what is it like when lights on or lights off? [. . .] Helping young people understand the nuances that [are] going on for them.

Thinking beyond people and the substances they consume, Stefan incorporates issues like guilt, shame and “body dysphoria” as part of efforts to address the relationship between drugs and sex (see Race et al. (2023) on disinhibition, minority stress and LGBTIQ drug consumption). While this focus reproduces familiar understandings of drugs and sex as stemming from suffering (guilt and shame), what is important for my analysis is the way that, rather than centring either individual people or drugs as distinct agencies, Stefan approaches the outcomes of consumption and sex as emerging from how several forces coalesce or intra-act to generate sexual practices and experiences (Pienaar et al., 2020). These accounts offer a sense in which drug consumption and sex cannot be approached solely as harmful (Gerard) or defined purely by the agency of individuals or the substances they consume (Gerard and Stefan). Alongside Anna and Ashley earlier in this article, Gerard and Stefan gesture toward an approach that is response-able to other material-discursive phenomena such as normativities of gender and sexuality. Rather than approaching drug effects or individual people as discrete relata, they articulate a response-ability to some of the broader forces that intra-act to shape young people’s experiences of consumption and sex.

Conclusion

The perspectives of professionals responsible for the design and delivery of drug education initiatives are not widely understood. Beginning to address this, I turned to Barad’s agential realism to examine how drug education professionals understand and respond to the particularly complex relationship between drug consumption and sex. Given the affinities between recent critical analysis of sex-related content in drug education curriculum resources (Farrugia, 2023a) and the professional accounts examined here, it seems that a focus on individual human agency or the agency of drugs as distinct forces tends to inform education initiatives primarily response-able to a narrow conception of harm. Importantly, this often translates into approaches that seek to govern the consumption and comportment of the potential targets of sexual violence as a way of reducing harm. My analysis suggests that these limitations emerge from approaches to drugs and sex that operate within a world of “relata,” rather than phenomena, where alcohol and other drug effects, that is, their agency, are approached as an intrinsically harmful threat to young people’s agential capacity. Of course, drug education is not uniform and will take shape differently depending on the experiences and perspectives of the educators who enact it and the young people who participate. Given this complexity and the many other forces that together generate the character and outcomes of drug education efforts, their productive power is unpredictable (see, Farrugia and Fraser, 2017; Leahy and Malins, 2015). While it is important to acknowledge such issues, the approaches examined here seem to offer little to young people who consume alcohol and other drugs in an agential or even enthusiastic manner (Brown and Gregg, 2012), which can reduce the credibility of their advice (Arnull and Ryder, 2019) and encourage scepticism (Farrugia and Fraser, 2017).

However, some professionals gestured toward drug education approaches that are more response-able to a broader assemblage of forces that shape drug consumption and sex. And it is as part of this project that I argue Barad’s agential realism has much to offer. Shared between many of the perspectives I have analysed and some of the troubling notions of consent identified in previous research—contractual approaches and “intoxication parity” for example—is an account of the agency of humans and substances as attributes that “someone or something has” (Barad, 2003: 826–827). This drug education approach assumes any level of consumption necessarily overrides human agency and causes non-consensual sex. Alongside offering little to young people who might already be trying to establish “careful connections” (Goodyear et al., 2023) when consuming drugs for the purposes of sex and for whom an exclusive focus on harm may have little resonance, this impoverished account of the forces that shape these practices also encourages victim blaming in understandings of sexual violence (e.g. Knountsen, 2023). If drug education approached agency as an intra-action rather than an attribute, it may address drugs and sex as a multiple, rather than solely harmful, phenomena. While a relatively straightforward difference at first glance, this move has significant implications.

Most broadly, by addressing agency as intra-active, this drug education approach offers a fuller account of the array of forces that together constitute how experiences of drug consumption and sex take shape. Such an approach refuses to position drugs or the people who consume them as solely responsible for the harms they may experience, thereby avoiding issues like victim blaming, and is willing to engage with topics beyond risk and harm such as pleasure and fun. In being more response-able to the potential for desire and pleasure, this drug education ambitiously does not address young people’s capacity for assembling fun as incompatible with reducing harm. This approach does not shy away from ambiguity but instead examines complexity by broadening the set of agencies that require attention in drug education. By addressing agency and the ability to consent as intra-active, drug education classes can address how, for example, gender and power shape drug consumption and harm (Hunt et al., 2022). Importantly, such a shift requires drug education to respond to the different ways young people might say yes to drug consumption and sex, rather than primarily offering them ways to resist them or say no (Jozkowski and Hoffacker, 2024). Alongside these issues, students could be provided the opportunity to critically explore the ethical and political implications of how and what are made agential in responses to intoxicated sex. For example, classes could analyse the often contradictory and damaging gender dynamics that inform attributions of agency in harmful media coverage of sexual assault (e.g. Clinnick et al., 2023). More broadly, this approach may also help young people develop a greater sense of their own agency and its relationship with the different forces that co-constitute it. The drug education I am arguing for would also examine the agency of the settings of consumption and sex, the role of objects, atmospheres and other phenomena active in shaping the affective texture of one’s capacities in each encounter. Attending to these issues can become fundamental to drug education, rather than optional extras generally cast aside for a focus on individual consumption and comportment. However, where such a narrow group of agencies are ascribed as causally harmful, more expansively response-able approaches such as these are difficult to develop. In struggling to address these forces, the drug education approaches examined here may not only offer an uncompelling account of sex but reproduce their own concerns by diminishing young people’s agency. By obfuscating and potentially constraining awareness of the many agencies that may shape desire, pleasure, harm and decision-making and, therefore, reducing those available to assemble safe consumption events, drug education may operate as a form of intoxication on its own terms, that is, it may diminish rather than enhance young people’s agential capacity to reduce harm.