Drugs and sexual health are recurrent concerns in the field of psychiatry.Changes in clinical and social definition have shifted present psychiatric concern to more aggressive forms of sexuality and their relationship to drug abuse. The AIDS epidemic has played a stimulating role in providing a new challenge for psychiatry in the field of sexual health and drugs. Recent research is uncovering underlying psychosociological and biological dimensions of psychopathology that are common correlates and pathways to sexual and drug abuse disorders. The investigation of early life course factors and experience is postulated as especially important in further specifying these dimensions. Future clinical practice research may be aided by applying a neurosociological paradigm that has appeared in the study of schizophrenia.