It should come as no surprise that the rates of substance abuse in the gay community are significantly higher than the general population. Whether this is a behavioral response to years of dealing with homophobia and discrimination, or a product of the party scene that has historically been highly integrated into gay culture as a means of meeting other men, this activity can destabilize relationships, threaten employment, and bring about other physical and mental health issues. The CDC adds that drug abuse also contributes to higher rates of HIV and other STIs within the gay community.

But where do we draw the line between long-term daily patterns of alcohol consumption and other drugs, and drug-driven sex benders lasting for days on end, pushing dangerous limits that sometimes result in multiple-drug overdoses? How can we try to understand the motivating behavior behind the people involved in this community without implementing harmful stigmas? What can we do to promote safer partying and safer sex?

Chemsex generally describes the act of using drugs to facilitate or enhance sex, <chem> used as an abbreviation to mean “chemical substances.” However, within certain samples of gay communities around the world, this term points out the frequent multiple-day sex parties that are made possible by a specific group of drugs.

For some members of these communities, sex no longer exists without drug use, or at least it is significantly less enjoyable. Breaking this cycle of dangerous behavior becomes an extreme challenge, just as the addiction to chemsex is as real as any addiction to drugs.

Whether you know nothing about the world of Chemsex, or you have a friend struggling with addiction, here are 4 things you should know.

1. Chemsex Usually Involves 3 Specific Drugs

GHB/GBL

Gamma-Hydroxybutyric acid. This drug is most commonly utilized for effects compared to a mixture of alcohol and stimulants, while it has also been observed to significantly increase a user’s libido. It is a central nervous system depressant, so it is considered dangerous when mixed with alcohol and other drugs in the same category, while overconsumption of this drug can also lead to death. It is widely used in Chemsex setting because it does not cause fatigue like alcohol does, while it is known to help relieve inhibition and induce a temporary increase in sex drive. Users typically administer doses of this drug in liquid form, continuing to dose throughout the night to maintain desired effects.

This can be dangerous when users forget when they had taken their last dose, or they forget to time out their “dose schedule” accurately. Heavy doses of GHB can depress respiration, or stop breathing altogether. Read more about GHB here.

Crystal Meth

Methamphetamine is a powerful stimulant that is known to cause a strong rush of energy and hyperactivity, similar to cocaine. Due to the extreme, immediate physiological effects it has on the user, and the terrible come-down that occurs hours later, it is highly addictive as users must continue to consume in order to maintain their desired effects. When combined with GHB, it is known to be the “engine” behind Chemsex parties, fueling users with energy to avoid sleep and continue partying. Although this drug is typically snorted or smoked, injection is a popular method among those who participate in Chem, as it is more immediate.

High doses of Crystal can result in cardiovascular collapse and heart failure, kidney damage, and dangerous levels of internal body temperature (especially when injected).

Mephedrone

Mephedrone is known to increase states of euphoria, functions as a stimulant, and can mildly increase libido. During sessions this increase in euphoria can create a sense of closeness with other participating members, acting as the third ingredient of “Chem.”

Like Crystal, Mephedrone can also cause overheating, heart failure, and other risks associated with high levels of stimulants.

Although these are the most commonly cited drugs used in a Chemsex setting, Cocaine and Ketamine use is also prevalent. With GHB used for enhancing libido and breaking down sexual inhibitions, Crystal to sustain energy, and Mephedrone to induce euphoria, substance cocktail is the perfect recipe for endless sex. It is also a dangerous recipe for potential overdoses.

2. “PNP” and Chemsex are Similar

Party N Play, or “PNP” is a term often used on gay hookup applications to indicate an interest or intention to have sex while using drugs. However, “PNP” seemingly most often directly implicates the use of Tina, while Chemsex can involve an array of substances. Listing or mentioning “PNP” on a gay hookup application also might not necessarily mean that the use of these drugs with sex would occur in a group setting like Chemsex, although oftentimes it does.

3. Medical Journals Recommend Chemsex Become a Public Health Priority

In a paper entitled “What is Chemsex and Why Does it Matter?” published in the British Medical Journal, the public health implications of Chemsex are outlined, revealing that this phenomenon poses an immediate danger to those who engage in this behavior. The writers outline shame and stigma as barriers to those who might otherwise access services, further perpetuating the cycle of addiction and unsafe sex.

Another study compiled the findings of several others that all indicate the fact that methamphetamine use is directly responsible for high-risk sexual behavior. The same study also measured HIV risk behavior between samples of men that consumed varying types of drugs, and this indicated that men who reported recent use of several drugs were much more likely to engage in risky behavior than those who only took one drug. Finally, data collected from several health service providers show that 60% of their gay male clients who are diagnosed with HIV report not strictly adhering to their medication while engaging in drug use during sex. Not only does this pose a health risk to that individual, but the potential increase in viral load raises the chances of transmission to others as well.

4. Vice’s Documentary Chemsex Reveals a Shocking Reality

Chemsex was released in 2015 and documents the lives of a community of gay men in London whose lives have been affected by this crisis. This film focuses both on the stories and authentic documentation of Chemsex parties, while also showcasing a community health provider service trying to aid these men. The viewer is presented with an underlying tone of desperation as these men seek intimacy in a setting that pushes their mental and physical limits.

David Stuart, the Substance Abuse Lead Counselor shown in the film, touches on the dire health crisis presented by Chemsex. He cites that 5 men in London alone are being diagnosed with HIV everyday, much of these cases attributed to involvement in Chemsex parties. Chemsex also dives into the issues of internalized shame, the need for validation, and other mental health priorities that are crucial in understanding the behavior of these men, and ways to provide aid and support. View the trailer for Chemsex here.