This report takes a comprehensive look at the connections between alcohol, drug use, and sex. Two national data sets on more than 34,000 teenagers and two sets on arrested and incarcerated sex offenders were analyzed. A review of the literature, interviews with experts, and an examination of programs aimed at prevention of abuse were included in the analysis. Chapter 1 presents an introduction and executive summary of the report. Chapter 2 describes the connection between substance use and sex. It includes discussion of religious beliefs, cultural and family values, and media messages and entertainment containing sexual images. Chapter 3 discusses how alcohol and drugs can affect sexual performance and pleasure. Chapter 4 discusses the relationship between alcohol, drugs, and dangerous sexual activity. Individuals using alcohol and drugs are more likely to initiate sex at earlier ages, have more sexual partners and more casual sex partners, and have sex with higher risk partners. Chapter 5 presents specific problems associated with substance abuse and sex among America's teens. Chapter 6 discusses how substance abuse is related to sexual violence. Chapter 7 reviews information concerning sex offenders, recidivism, and treatment. Chapter 8 details substance abuse among prostitutes. Chapter 9 presents ideas for improving policy and practice by summarizing prevention programs already in place. Chapter 10 provides suggestions on how to break down the connection between substance abuse and sex. (Contains 9 appendixes, 14 figures, 19 tables, and over 400 references.) (JDM)