ChemSex is the term now widely used to describe a specific type of sexual behaviour and drug taking, where three drugs; Mephedrone (meow meow), GHB/GBL (‘G’), Crystal Methamphetamine (Meth, Tina) are taken simultaneously for the express purpose of enhancing sexual enjoyment and reducing inhibition. In addition to these three drugs, often referred to as the Unholy Trinity, Cocaine and Ketamine (‘K’, Special K) are often also used.  

Whilst the combination of these drugs increases sexual arousal and libido, the side effect can be devastating and include increased transmission of HIV, STI’s, sexual dysfunctions, sexual assault and even death caused by overdose. In 2005, these three drugs were responsible for 3% of all presentations among gay and bisexual men to the drug service Antidote, but by 2012 that figure had risen to 85%, an increase that has resulted in sexual health services being overwhelmed with calls for help. So why is ChemSex use exploding so fast? And what can we, as therapists, do to help?

ChemSex is about much more than drugs and sex, it’s about the community that uses them and why they use them.

ChemSex can occur in a variety of ways. Whilst chems are sometimes used for lone masturbation and at ChemSex parties, often referred to PnP (Party and Play) and widely advertised in gay social media, they are most commonly used during partnered sexual encounters. These encounters are usually arranged on gay hook up apps such as Grindr, with either one or multiple partners and can extend over a 24-36 hour period. For many gay and bi-sexual men, with a history of being socially shunned and sexually rejected, ChemSex loosens inhibitions to facilitate hooking up where the sharing of drugs, as well as sex, builds connection and intimacy and offers sexual affirmation and validation. For men with low sexual self confidence and/or low body self esteem, it’s a safe place for sexual expression and experimentation.

But as the drugs wear off, many regret the weekend’s events and experience confusion and shame as well as physical withdrawal, such as anxiety, depression, paranoid and insomnia. Physical come down. During the come down many delete or block any sexual partners they acted out with as a way of disconnecting and denying the events took place. The high of ChemSex may create a sense of community and shared experience, but what follows is often a greater sense of isolation and feeling desperately alone.

Is this addiction?

People in the ChemSex community rarely see themselves as having a problem with drugs and many may not recognise their sexual behaviour as compulsive. Historically, those who visited sexual health services for support rarely wanted to give up their behaviour, but rather to receive treatment for sexual health concerns. But a growing number are increasingly reporting negative consequences and a desire for change.

Extensive research has highlighted a number of areas of concern, some relating specifically to drug use, especially fears of ‘G’ overdose and managing withdrawal, while others focussed on sexual health and sexual functioning concerns, particularly losing the ability to enjoy sex without chems. People have also struggled with the impact on other areas of their life such as not seeing family and friends and not having time to spend on other previously enjoyed activities. Perhaps of most concern, many people reported having witnessed, or experienced sexual assault and/or significant violations of sexual boundaries. When you combine the power of sexual dis-inhibition and raging libido, with lowered pain threshold and losing consciousness, a regular consequence is an inability to give consent, or know if a partner has consented. This can cause considerable inter and intra psychic conflict when the drugs wear off and the community is left wondering if everyone involved was truly a willing participant.

As someone who has been working in men’s sexual health for over 20 years, I’m acutely aware that helping people trapped by ChemSex requires a multi-disciplinary approach. As well as competent drug awareness and educated sexual health support, therapists need to be trained in Gender, Sexuality and Relationship Diversity (GSRD) issues and psycho-sexually trained to help clients develop sober sexuality. Regrettably for many in the ChemSex community, there is a belief that sex can no longer be enjoyable without drugs and that experiencing the joy, validation and intimate connection sex can bring, is impossible without them. It is my sincere hope that my work at the Laurel Centre will complement the work of others in this field and that by providing a ChemSex recovery community, we can help clients to discover their beliefs are wrong.