What do we mean by chemsex?

The term chemsex comes from the combination of the words chems and sex and refers to the use of drugs in a sexual context.  More specifically, it is described as “the intentional use of drugs to have sex for an extended period of time (lasting several hours to several days) between gay, bisexual and other men who have sex with men (GBHSH), and more recently, people with other sexual identities (trans women, non-binary people, queer people…) where the key element is time, because the longer the time, the greater the exposure to various risks or harms that can occur”. This is a predominantly urban phenomenon and there are major differences in relation to the type of drugs consumed. In the case of Spain, the substances most commonly used for chemsex include: GHB/GBL (gamma-hydroxybutyrate/gamma-butyrolactone), mephedrone (and other cathinones), cocaine, poppers, methamphetamine, ketamine, speed, ecstasy/MDMA and erectile enhancement drugs.  The term chemsex is now fully established in professional and scientific circles as the formula for referring to this particular phenomenon. However, people who engage in chemsex use other expressions to refer to it. Slang terms such as chill, session, high, vice, etc. are used in profiles on gay dating sites.

Available data, both at European level and in Spain, show that poly-drug use is a frequent practice in the field of chemsex and that it is more frequent among GBHSH men with HIV compared to HIV-negative men.

Where does chemsex take place?

In terms of where chemsex takes place, it most commonly takes place in private homes. Chemsex also occurs in a variety of gay-friendly businesses, such as saunas, sex clubs, hotels, private parties, darkroom venues and at festivals that have designated areas for sex. These practices have also been observed in cruising areas (areas where outdoor sexual encounters take place). The ways in which chemsex seekers contact each other can be very varied, with the use of contact applications based on geolocation and other information and communication technologies playing an important role. These can be used to make contact with potential sexual partners, or to buy, sell or share substances. In addition to these formulas, it is also common, as has just been mentioned, to go to spaces where one can meet directly with other users, as may be the case, for example, in certain saunas. Some sessions or chills take place anonymously, between participants who do not know each other. Other encounters may take place between contacts who already know each other, or in a mixed manner with previous contacts and new additions.

Motivations for chemsex

Bourne and Weatherburn point to three main motivations for drug use among male GBHSH: pleasure seeking, a sense of belonging to a community, and drug use as a coping strategy to deal with discomfort or problems in everyday life. Other authors such as Maxwell point to the search for behavioural disinhibition, the feeling of increased energy and muscle relaxation as motivations for chemsex. In relation to the sexual experience in particular, the intensification of sensations, increased self-confidence and awareness of one’s own emotions and those of others, as well as the ease of sexual practices involving receptive anal penetration stand out.

Mental health problems and chemsex

Not all people who use chemsex experience or perceive negative consequences from it. In other words, these practices are not necessarily problematic, nor are they pathological per se. However, the maintenance or increased intensity of chemsex use, or the presence of prior mental pathology, may increase the risk of associated health problems, or form the basis for the development of different mental disorders such as substance use disorders, non-substance addictions or induced mental disorders.

In terms of psychopathology, people who use chemsex may be affected by mental disorders at various points in their lives by mental disorders at various points in their lives: prior to the initiation of chemsex, during chemsex, or as a consequence of chemsex. In this way, we could consider mental disorders prior to the practice of chemsex as factors of vulnerability to the risks that chemsex can pose. On the other hand, there are symptoms or disorders induced by substances of abuse or that develop in association with addictive disorders. The main psychiatric disorders associated with chemsex are: anxiety, depression, psychotic episodes, suicidal behaviour and substance use disorders, as well as complex trauma and post-traumatic stress disorder (PTSD) as a biographical cross-cutting experience, which in many cases overlaps with the rest of the psychopathology.

The risk associated with this type of practice can be prevented thanks to the implementation of plans to spread awareness of the dangers of chemsex through educational awareness programmes, documentaries that talk about this trend or the organisation of support programmes for those participants who have suffered the consequences.

Links to further information on chemsex

If you want to know more about this phenomenon, you can consult the following links.

• Chemsex.info. https://chemsex.info/%20https:/www.chem-safe.org/
• Risk reduction annex. Secretariat of the National AIDS Plan. Ministry of Health. 2020.https://www.sanidad.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/chemSex/docs/Anexo.pdf
• Expert recommendations for the improvement of the management of the comprehensive approach to the chemsex phenomenon in Spain. Merck Sharp & Dohme de España S.A.;2020. https://profesionales.msd.es/static/medicos/pdf/Chemsex8.pdf

Laura Riera López

Psychologist Col. No B-03323