New insights help to understand how gay men are navigating drugs and sex.
Writing the The Lancet, Tony Kirby and Michelle Thornber-Dunwell have published an in-depth follow-up to their groundbreaking 2013 report that documented the high-risk behaviours of gay men in London and the emergence of the chemsex scene.
In the intervening ten years, much has changed but the risks and consequences of chemsex remain one of the biggest health challenges for gay men in London and around the world.
One way in which the chemsex scene has evolved over the past decade is the drugs being used to fuel sexual encounters.
In 2012, the cathinone drug mephedrone was extremely popular and the drug that most men using chems reported as their top problem drug. Today, it is much harder to acquire this drug, and few people list it as a problem drug for chemsex. MDMA, ketamine, and cocaine are still frequently used but not often reported as problem drugs in people needing support. Crystal meth was tightening its grip on the gay scene 10 years ago, and as its price has fallen and more people have experimented with it, it has now become the number one problem drug for chems users in London. Use of γ-hydroxybutyrate or γ-butyrolactone, collectively known as G, has also increased, and often co-exists together with harmful crystal meth use.
Ignacio Labayen de Inza is the Chief Executive of Controlling Chemsex, a charity offering online support to people struggling with chemsex issues.
According to Labayen de Inza, most people seeking support are having problems with crystal meth combined with G or crystal meth alone. Around one in five patients reporting problem use of crystal meth are now injecting the drug directly into a vein – this is known as slamming – resulting in a much more intense, extended, and incapacitating experience.
“The COVID lockdowns gave home chemsex parties a huge boost, as people were bored and had nowhere to meet…” explains Labayen de Inza. “Many who were in control of their chemsex and drug use before lockdown subsequently lost control; others had never even tried drugs until lockdown.”
The COVID-19 pandemic has also challenged access to chemsex support services – many specialist sexual health services were shut down and unable to operate during lockdowns.
The report’s authors conclude that the major risk that people engaging in chemsex face is the massive effect of crystal meth use on their physical and mental health, and – by extension – every part of their lives. The research indicates that a significant population of chems users are struggling to deal with the complex effects of crystal meth, and many have had their lives and livelihoods destroyed.
The report further highlights that chemsex support services need more financial support in order to help people who are struggling with chems.
What is Chemsex?
‘Chemsex’ is the term used to describe sexual activity between people who have taken specific drugs (chems) including crystal methamphetamine, mephedrone, gamma-hydroxybutyrate (GHB) or gamma-Butyrolactone (GBL) – these drugs can enable an enhanced sexual experience but they are highly addictive and come with significant health risks. These risks include:
- Physical health: Accidents and injuries, nutritional issues, lungs and heart diseases, dental problems, disrupted sleeping patterns.
- Mental health: High levels of depression, anxiety, or psychotic episodes such as paranoia or hallucinations.
- Emotional health: Issues such as isolation, domestic and relationship issues, low self-esteem or inability to focus or make decisions.
- Sexual health: High risks of transmissions and infections of HIV, HEP-C and other Sexually transmitted infections such as syphilis, gonorrhoea. Chemsex users are also at risk of poor adherence to HIV medication – potentially jeopardising their Undetectable status.
- Financial issues and unemployment.
- Personal safety: such as overdoses, sexual assault, theft, or self-harm.
- Legal issues – buying, selling, possessing and selling these drugs is illegal.
Tips on how to work towards a new relationship with chems
- Review your bio details on hook-up apps. Be explicit that you’re not interested in chems. Simply putting “No H&H” in your bio, for example, will limit the amount of temptation that comes your way.
- Set limits on your use of hook-up apps. We’re at our most vulnerable when we’re searching for intimacy – particularly when it’s late at night and we’re feeling alone and isolated. If you’ve set yourself a rule that you’re not going to look at hook-up apps after 10 PM, have a plan for other things you can do if you’re awake and can’t sleep. It could be as simple as having some good porn on standby so you can masturbate and get the horniness out of your system.
- Don’t forget that if you think it could be helpful you can disable your phone to block downloading and use of apps or websites with specific content (sexual, gambling, etc) using parental controls. You can find out how to do this by Googling ‘parental control iPhone’ or ‘apps parental control for Android’, or also downloading specific apps for this purpose, and prevent the cycle of deleting and downloading the apps.
- Know your triggers.The biggest risk of a relapse often comes from friends or fuck-buddies that we’ve had good times with in the past. Odds are, you’re going to get an unexpected WhatsApp message asking if you’re up for some fun. Knowing that this trigger is going to present itself, have your coping mechanism ready to go – have a “no thanks” reply saved in your drafts, have someone lined up who you can call, have some porn ready to watch.
- Keep a clear head – reduce your intake of alcohol. We tend to make poor choices when we’ve got a few drinks under our belt.
- Keep yourself busy. If we’re feeling isolated and alone, and it feels like there’s nothing to do, then a chemsex session will seem increasingly appealing. Set yourself a list of tasks for the day. It could be as simple as reorganising your sock draw or as complicated as making some fresh pasta. There’s always something to do, if you set your mind to it.
- If you do have a relapse, don’t beat yourself up too much. Slip-ups happen. Activate your support network and learn from it.
“We’re often contacted by friends or loved ones who are wondering how to help someone who is struggling with chems…” says Labayen de Inza. “You can’t help someone who doesn’t want to be helped, but if you’re worried about someone and you think chems might be the problem, keep the communication open – let them know that you’re on their side, listen and be supportive. Direct confrontations and arguments are counter-productive. Avoid being judgmental. You also need to set some boundaries for yourself – supporting someone who has issues with chems is an emotional roller-coaster.”
If you, or a friend or loved one, is struggling with chems, contact Controlling Chemsex to find out what support is available in your area.