Where are we now with Chemsex?
Chemsex has been around for years now, but more recently the conversation has opened up and provided us with more information about this often stigmatised issue.
What is chemsex?
Chemsex is often referred to as Party-and-Play, or simply PNP. You might also see references to High-and-Horny, or HNH.
Over the years, Stuart has become a prominent figure when it comes to educating both the public and healthcare professionals about chemsex.
“Chemsex is most commonly understood to be the use of specific drugs, used specifically for sex, by gay and other men who have sex with men,” explains Stuart.
“The drugs most commonly associated with chemsex are crystal methamphetamine, cathenones and GHB/GBL.”
These drugs are referred to as ‘chems’. These are drugs that make you horny, they help you lose your inhibitions, and they let you feel like you can have sex like a porn star.
Stuart says that other drugs, including Viagra, alcohol, ketamine, cocaine and poppers might also be used in the context of chemsex, but don’t fall under the ‘chems’ umbrella.
“It is the specific ‘highs’ associated with crystal methamphetamine, cathenones and GHB/GBL that provide the desired pleasure and disinhibition,” develops Stuart, “and that drive and define the chemsex phenomenon.”
The downsides of Chemsex can include an increased risk of sexually transmitted infections, as well as wide-ranging health and social impacts. The drugs involved in Chemsex are highly addictive, and their use can sometimes lead to an endless chase of the next high and an unquenchable thirst for even more intense sexual satisfaction.
Who is taking part in chemsex?
Chemsex is a sex-plus-drugs experience that’s specific to men who have sex with men.
While the connection between drugs and alcohol and sex is nothing new, what makes Chemsex something that is unique to queer men is the cultural factors that impact the enjoyment of guy-on-guy sex.
These factors include systemic homophobia, cultural and religious attitudes, internalised homophobia, and the way that hook-up apps and location-based smartphones have shaped our experience of sexual encounters.
The combination of these factors can see queer men taking risks they may not otherwise take – risk-taking in pursuit of pleasure.
Chemsex isn’t just about the drugs, Chemsex is a sexual phenomenon fuelled by the highs and lows of the queer experience.
“Chemsex is not exclusive to big cities, and I’ve seen guys from small rural villages struggling with chems use,” remarks Dr Sean Cassidy, a sexual health doctor in London. “I guess it’s generally more of a problem in places like London and Manchester, because there’s a higher concentration of other gay men easily connected by dating apps.”
Dr Cassidy also says that there is an argument for Chemsex being on the rise due to the closure of LGBTQ bars and clubs, resulting in gay and bisexual men having fewer places to socialise.
“Whether that’s true or not, men who may feel isolated and lonely within the scene often turn to chems to feel more connected to something,” argues Dr Cassidy.
One of the interesting things about Chemsex is that this is generally something that happens in private spaces, behind closed doors. You’re most likely to be exposed to a Chemsex situation at a private party in someone else’s home.
The consent question
One of the problematic aspects of having drug-fuelled sexual encounters – or being at a private party where the drugs are out and everyone is getting a bit loose – is that boundaries and judgement all tend to get a bit blurred.
In studies about Chemsex, it’s clear that there’s a considerable number of guys who don’t really remember what went down when the drugs came out. One of the consequences of this is that guys who take part in Chemsex also report high numbers of incidences of non-consensual sex.
If you are high on drugs that enable you to lose your inhibitions, how does that impact your ability to consent to who you have sex with and how you have sex with them? What responsibilities do we have to the men that we are sharing our Chemsex encounters with? If you’re at a private Chemsex party, what are the rules when it comes to consent?
For sexual health professionals, the aim is to help people taking part in Chemsex to practice it safely, and if they want to, move away from Chemsex altogether.
Encouraging people who take part in Chemsex to test regularly for STIs, not share needles and reducing the length of Chemsex sessions are just some of the ways clinics are helping people practice Chemsex more safely.
That being said, there are some serious health implications with chemsex.
As well as physical health problems linked to chemsex, there are also mental and psychological health consequences of taking part in chemsex.
Anxiety, depression and paranoia can be both short and long term effects of using chems.
There can also be psychosexual impact of using chems and other drugs when having sex, such as becoming dependent on drugs in order to have sex.
This might include being unable to get or maintain an erection when not using drugs.
What about sexual health and wellbeing?
Although some gay, bisexual and trans men who engage in chemsex don’t describe their use of ‘chems’ as problematic, others struggle with various physical and mental health consequences.
Some have argued that chemsex is linked to an increase in the number of people testing positive for a sexually transmitted infection or STI.
It’s hard to say that a rise in STIs and the number of men taking part in chemsex are linked, says Dr Cassidy.
“Chemsex is likely to be an important factor in this, but it’s difficult to ascertain exactly how much it has contributed and probably goes hand-in-hand with other factors like the rise of dating apps,” explains Dr Cassidy.
“We know that rates of chemsex have been steadily increasing over the past decade, and that men who use chems tend to have more sexual partners and also tend to use condoms less often.”
Other factors, such as antibiotic resistance or a reduction in the number of people using condoms when having sex with new partners, might also be driving up the rates STIs.
Is there still a stigma?
The stigma that continues to shroud the conversation around chemex is doubtless putting off people from talking about their chems use, with either friends or healthcare professionals.
People who decide to take part in chemsex may come from different backgrounds and cultures, but a collective ignorance of this might be preventing some men from accessing chemsex services.
“I’ve had patients who are lawyers, teachers, doctors using chems and still manage to hold down their jobs and function normally,” recalls Dr Cassidy. “But there is a lot of misinformation and maybe a perception that guys taking part in chemsex are ‘chaotic’ and make bad or unsafe choices.”
Misinformation around chemsex is arguably continue to fuel stigma towards people who take part in chemsex.
“There’s a lot of really good quality balanced information about chemsex out there but I’m worried that sometimes the messages aren’t getting through or people don’t know how to access this info,” says Dr Cassidy.
Do you want to have sex without Chems?
Mindfulness seems to be a bit of a buzzword when it comes to talking about mental health and well-being, but it could be one way to tackle a dependence on Chems.
Mindfulness is all about paying attention to what is going on in our minds and bodies, as well as the environment around us. In such a busy world, it can sometimes be challenging to pause and experience what is happening ‘in the moment’ – mindfulness seeks to help us do just that.
The practice can be used to help people manage their stress, anxiety or low mood. Overall, the activity attempts to allow participants to become more in touch with themselves and their experiences.
Mindfulness Based Chemsex Recovery (MBCR) is a course which allows men to either change their chemsex habits, or quit altogether.
“Both myself and co-facilitator Bex have long-standing meditation practices and we wanted to share the benefits mindfulness practice can bring to what is a real and substantial problem for many of the people we work with,” says Ben Hoff of Spectra, the charity behind MBCR.
Ben is the Clinical Lead (Mental Health) for the charity, and says that the success behind the course might be that it allows participants to put in the foundations of mindfulness practice.
This in turn may allow people to autonomously manage their mindfulness practice themselves, without the need for input from a healthcare professional.
He is keen to stress that MBCR will work well alongside already established support for chemsex users.
“We see MBCR as complementing other excellent high-intensity interventions offered by 56 Dean Street and Antidote.”
“Recovery will mean different things to different people,” says Ben of how the course might help those who attend. “Total abstinence for some, reducing use for others.”
It seems clear that he believes passionately about giving people back choice and control over their decisions, rather than dictating to them what people should and shouldn’t be doing.
“In mindfulness practice, we meet ourselves where we’re at,” explains Ben. “The emphasis is on giving people back choice. Because when conscious choice has dissolved into a habit, we feel compelled to satisfy our cravings at any cost.”
In fact, Ben hopes that the course will give participants the opportunity to regain “power and freedom” when it comes to making decisions about sex and chemsex.
The discourse about chemsex still seems to be soaked in stigma and misinformation about those who might choose to engage in this sexual activity.
It could be argued that the stigma results in people feeling unable or reluctant to access appropriate support, through fear of being judged or labelled.
“It definitely has an impact, there’s no doubt,” agrees Ben of how stigma could be a barrier to accessing support services.
“Indeed stigma,” Ben continues, “and the feelings of low self-worth that can trigger in us, tend only to make us reach for very things we’re trying avoid, to give us some short term comfort or relief.”
Yet he thinks that the tide might be turning. “I think things are slowly changing, however,” Ben says optimistically.
Although, it might be very much to do with where you live when it comes to getting support.
“In some of the big cities, there are more specialist services emerging that can meet the specificities of chemsex addiction in a way, that perhaps a generic addictions service can’t,” explains Ben.
He is confident that his organisation’s long history in helping the LGBTQ community will demonstrate to men fearful of accessing support services that they won’t be judged.
“[Spectra] has gone a long way to building trust amongst LGBTQ communities and breaking down barriers,” justifies Ben.
Ben seems hopeful that this new initiative will make important positive impacts when it comes to helping men who engage in chemsex.
In fact, Spectra’s strong links with local organisations has been the secret to recruiting early participants: “Nearly all the participants who attended our first taster workshop in Soho found their way onto the programme either through contact with an outreach worker, or referral from a partner agency already working with them.”
“My advice to someone struggling with chems is, don’t suffer alone,” makes clear Dr Cassidy. “Even telling a friend you trust can mean that you have support there when you really need it.”
And if people want more support? “If you feel chems are causing problems in your life and that you might need professional support, you can go to a GUM clinic and ask to speak to a Health Advisor,” advises Dr Cassidy.
Your local sexual health clinic may be able to sign-post you to either local or national resources about chemsex.
This could be with a health advisor, but also a support group, one-to-one counselling sessions, or charitable organisations in your local area.
In addition, 56 Dean Street have developed an online resource for anybody looking for more information about their chemsex use.