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Chemsex 101: definitions, risks, and how to stay safe

Chemsex refers to the practice of using drugs to enhance or facilitate sexual experiences. Initially prevalent among men who have sex with men, it is now increasingly seen in heterosexual and LGBT+ communities.

This article sheds light on chemsex addiction, exploring its prevalence, causes, and impact on mental health and relationships. It highlights the signs of addiction, the importance of overcoming stigma, and available support resources.

gay couple kissing with neon lighting

Whether you're a concerned individual, a friend, a family member, or a mental health professional, this article offers valuable insights into understanding and addressing chemsex addiction.

Understanding chemsex and its prevalence

The term 'chemsex' emerged in the UK in the early 2010s, describing the use of drugs like GHB, mephedrone, and crystal meth during sexual encounters.

Predominantly found within the LGBTQ+ community, particularly among gay men, chemsex often occurs at parties or social gatherings. These substances enhance sexual pleasure and endurance but pose significant health risks. Due to its covert nature, the exact prevalence of chemsex is difficult to determine.

However, studies suggest that it's a growing concern, particularly in urban areas with large LGBTQ+ populations.

Understanding the implications of chemsex is crucial in addressing the associated risks and providing necessary support and resources.

Why do individuals engage in chemsex?

The reasons why individuals engage in chemsex are complex and multifaceted. For some, it's a way to enhance sexual pleasure and overcome inhibitions. The drugs used can increase libido, prolong endurance, and intensify sensations, making them more gratifying.

For others, chemsex is a means of coping with social pressures and feelings of isolation. The LGBTQ+ community, particularly gay men, often face stigma and discrimination. This can lead to feelings of loneliness and a desire for connection, which chemsex can seemingly provide.

However, the temporary relief and pleasure often come with significant health risks and the potential for addiction. It's important to understand these risks and seek help if needed.

What are the risks associated with chemsex?

Chemsex involves the use of drugs such as GHB, methamphetamine, and mephedrone, which can significantly alter consciousness, ranging from a loss of inhibition to severe outcomes such as coma.

Although studies are limited, some research exists. For example, the German Chemsex Survey examined the mental health impact of chemsex on 1,583 men who have sex with men. Published in 2020, the study found that chemsex is linked to negative mental health outcomes.

One significant mental health issue related to chemsex is the "comedown," which tends to be more severe than a typical hangover. After prolonged drug use, individuals often suffer from intense ‘coming down’ symptoms such as body aches, headaches, extreme fatigue, depression, and anxiety.

These symptoms are not the only concern. Long-term effects can include chronic depression, anxiety, other mood disorders, and addiction.

Additional risks identified by sexual health experts include:

  • Increased STI risk: Impaired judgment can lead to risky behaviours, raising the likelihood of contracting infections like syphilis, gonorrhoea, chlamydia, HIV, or hepatitis C.

  • Reduced inhibitions: Drugs used in chemsex often reduce inhibitions, resulting in decreased condom use, increased sharing of drug paraphernalia, and higher-risk sexual activities.

  • Missed PrEP doses: Forgetting to take PrEP (pre-exposure prophylaxis for HIV) or delaying medical care after exposure can significantly increase the risk of HIV infection.

  • Immediate health crises: Stimulants like methamphetamines can overload the cardiovascular system, potentially causing strokes, heart attacks, aspiration pneumonia, overdose, and death.

  • Impact on chronic illnesses: Chemsex can exacerbate chronic conditions such as HIV, depression, asthma, high blood pressure, and diabetes by leading to missed doses of medication.

  • Violent behavior: Drugs used in chemsex can induce paranoia, hallucinations, and distorted thinking, which can result in violence, sexual assault, robbery, and even death.

Recognising the signs of chemsex addiction

Recognising chemsex addiction can be challenging as it often starts as a social activity. Key signs include an increased focus on chemsex, overshadowing other interests and responsibilities, and continued use despite negative consequences like health problems, relationship issues, or legal troubles.

Common indicators of chemsex addiction are:

  • Neglecting responsibilities at work, school, or home

  • Continued use despite knowing the harm it causes

  • Failed attempts to cut down or control drug use

  • Spending excessive time obtaining, using, or recovering from drugs

  • Abandoning important social, occupational, or recreational activities due to drug use.

The impact of chemsex on mental health and relationships

Chemsex can have a profound impact on mental health. It can lead to feelings of anxiety, depression, and isolation. The use of drugs to enhance sexual experiences can also create a psychological dependency.

This dependency can affect relationships. It can lead to a cycle of drug use and sexual activity that can strain relationships with partners, family, and friends.

It can lead to feelings of shame and guilt, making it harder for individuals to seek help. Understanding these impacts is crucial in addressing chemsex addiction and providing the necessary support for those affected.

Overcoming stigma and seeking help

The stigma associated with mental health challenges, such as addiction, often prevents individuals from seeking help. Reducing the stigma surrounding HIV is equally crucial, as fear of having contracted HIV can deter individuals from seeking support.

Since the HIV epidemic of the 1980s, medical advancements have dramatically improved the prognosis for those living with HIV. Effective antiretroviral therapy (ART) now enables individuals to lead long, healthy lives and eliminates transmission risk when adhered to consistently.

Dispelling outdated myths about HIV is essential, as understanding and compassion encourage treatment adherence and improve quality of life. Support from friends, family, and mental health professionals is invaluable, providing a safe, non-judgmental space for individuals to share their experiences.

It's also incredibly important not to view HIV as a "gay" issue. In 2022, figures for England from the UK Health Security Agency found that the number of new HIV diagnoses among heterosexuals was higher than for gay and bisexual men.

Chemsex recovery journey

Remember, seeking help is not a sign of weakness but a courageous step toward recovery and a healthier life. Reach out to professionals who understand chemsex addiction and can offer the necessary support and treatment.

At Schoen Clinic Chelsea, we provide specialised support for individuals struggling with chemsex addiction. Our dedicated team includes Psychotherapist Darja Lee, who has extensive expertise in guiding individuals through their recovery journey with compassion and care.

Consultant Psychiatrist Dr Tara Tofiq regularly assists patients in recovery from chemsex addiction. "People often feel a void after they have been through the difficult detox phase and started on the road to recovery. It can be a challenge to find new ways of being when chemsex addiction was an integral part of one’s lifestyle", she says.

We pride ourselves on offering a non-judgemental and LGBTQ+ friendly environment, ensuring that all patients receive the support they need in a safe and understanding space.

Recovery from chemsex addiction is challenging and requires commitment, resilience, and a strong support network. With the right resources, recovery is possible. The process often includes detoxification, therapy to address underlying issues, support groups, relapse prevention strategies, and ongoing care.

Each recovery journey is unique, so it's important to find a treatment plan that suits your needs. Chemsex addiction is complex and requires a comprehensive approach, addressing both physical and emotional aspects.

Community resources also play a vital role, including local health departments, LGBTQ+ organisations, public health initiatives, and accessible treatment options. Remember, it's never too late to seek help.

Sexual health support:


Darja Lee headshot

Darja Lee

Darja Lee is an Integrative Psychotherapist in London with over 10 years of experience in mental health. She specialises in treating adults with addiction issues and extends support to their families.

In addition to chemsex addiction, Darja also addresses anxiety, depression, trauma, compulsive behaviours, relationship challenges, and self-esteem issues. Her holistic approach integrates psychodynamic, attachment-focused, and relational methods, aiming to empower clients to achieve self-understanding, healthier relationships, and overall wellbeing.

Dr Tara Tofiq headshot

Dr Tara Tofiq

Dr Tara Tofiq is a leading Consultant Psychiatrist in London, specialising in anxiety, mood, and mental health disorders. With extensive experience in both outpatient and inpatient settings, she trained at the Maudsley Hospital and the Institute of Psychiatry.

At Schoen Clinic Chelsea, she focuses on work-related stress, relationship difficulties and burnout, offering a person-centred, holistic approach that integrates evidence-based treatments with mindfulness and CBT.

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