Jeff van Reenen MFDAP

ATP Manager The Priory Hospital Chelmsford

From the sexual revolution of the 1960s through to the present day, drugs and sex have been entwined. This is represented across a broader swathe of society, but a recent subsection within the gay men's community is chemsex. While chemsex is appearing with growing frequency in the media, it is important to note that the phenomena of chemsex is not the norm for most gay men in Britain, even in major urban areas like London where chemsex practice is relatively prevalent.

What does chemsex mean?

The origins of chemsex originate on sexual networking apps for gay men, the phrase coined by the gay men's health sector, referring to the use of any combination of drugs that include crystal methamphetamine, mephedrone and/or GHB/GBL by men who have sex with men (MSM), before or during sex. The result or aim is sex that can sometimes last for several days. There is little need for sleep or food (Reshape). Chemsex is characterised by the easy availability of these drugs through geo-sexual networking sites.

Due to the sexually disinhibiting nature of the 'high' provided by the chems it is often associated with multiple partners and a sense of invulnerability to harm/risk. This can translate into reduced concern for safer sex practices and feelings of confidence, being sexually adventurous, heightened sense of pleasure, stamina, and endurance that may last for days without sleep. Unwanted side effects while under the influence can include aggression, paranoia, hallucinations/perceptions of persecution and overdose.

Does chemsex represent a risk of addiction?

The opportunity to get hold of the substances is a key component of addictive behavioural problems. As the substances involved with chemsex are so easily available (predominantly through networking on geo-sexual sites like Grindr) then dependence and addiction to the substances as well as the sexual acting out is hugely increased in this population of users.

Tolerance and withdrawal can occur with frequent and excessive use of Crystal Meth, GHB or Mephedrone, thus the user could become dependent. As a physical dependence grows, so does the likelihood of risky behaviours, such as sharing needles and ignoring safe sexual practices. Due to the increased likelihood of risk-taking, participants may be exposed to HIV or Hepatitis C. Sexual health clinics are also vital to helping gay men stay safe.

Obtaining substances becomes easier by the creation of esoteric language. 'PnP' is shorthand for 'Party and Play', often used to arrange meets online, and 'parTy' means the use of crystal methamphetamine (which is smoked or injected). Unfortunately, these and other terms are often lumped together which isn't conducive to gaining a fuller understanding of what's happening.

The chemsex phenomenon is still unfolding and the long-term social implications for those involved are yet to be completely understood. However, while the use and easy availability of hard drugs remains at its centre, the healthcare industry needs to be watchful for potentially complex, longstanding consequences for those taking part on a social, psychological and physical level.

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