Chemsex: drugs, sex, and Rock 'nd Roll!

Even though it is not a new term or practice, chemsex is gaining more and more popularity, and its risks and implications remain largely unknown. To deepen into the topic I contacted the nurse, travesty, and narcofeminist Translocura, who explained me better the concept.

As the name suggests, 'Chemsex' comes from the union of chemicals (or chems) and sex. It was coined by recently late David Stuart, an HIV activist and researcher who led global efforts to reduce the harms of this practice: “If your definition of chemsex comes from mass media, I’d forgive you for believing that it has to do with the usage of drugs or alcohol in order to engage in sexual practices by any population”.

As Translocura, a nurse, travesty, and activist on the risk-reduction approach to drugs explained to me, “Chemsex as a concept is defined when using, at least, two of the three main substances: methamphetamine, mephedrone and other catenones, and GHB or GBL in order to engage in prolongated sexual intercourse”.

The usage of other types of drugs during sex is not considered to be chemsex. For instance, a straight couple that goes on a holiday and has sex under the effects of wine and cocaine, won’t be ‘chemsexing’. In fact, Stuart defined Chemsex as a practice carried out only by gay men.

Metanfetamine is the strongest synthetized stimulator used to date. “Two hits of that can lead to a non-sleep for 30 hours”, tells me Translocura. “This doesn’t only mean a lack of sleep, but the obtention of sufficient energy to maintain a heavy and sporty activity on the meanwhile”.

Mephedrone is an empathogenic –like MDMA or ecstasy–, which makes communication with others way more receptive. “This substance may or may not be present during chemsex, because without empathy, people can still have sex” clarifies Translocura. “Especially between men who have sex with other men, because empathy isn’t socialized to males”.

On the other hand, GHB acts as a depressor that works as a disinhibitor. It is a dangerous substance to mix with alcohol, but as Translocura explains, people tend to drink water during chemsex encounters. “GHB or GBL lowers alertness to enter a state of relaxation, predisposes to sex, and sensitizes the erogenous parts”. Under its effects, “skin feels nice at the touch, and body mucose are ready for oral or anal sex, as pleasure gets multiplied”.

These substances are stimulators that prolong sexual intercourse. And because when using any illegal substance it is harder to reach an orgasm and erectile dysfunction can be present, some people even mix them with viagra or popper. “Phallocentrism is very present during chemsex, even though younger generations are more and more caring less about having a boner during sex”, she clarifies.

To those who practice receptive anal sex, Popper serves as a dilatator “if they want to last up to three days, having a proper dilatation helps to avoid anal fissures or muscular problems”.

As Stuart defines, more and more people are practicing chemsex since the appearance of new technological tools like gay dating apps, HIV’s impact on society during the late 80s and 90s, and new social and legislative changes towards homosexuality.

For Translocura, “chemsex has long been associated with men who have sex with other men, or with people who perform feminity like trans women or sex workers, due to the stigma they carry”.

Why do people have chemsex?

The biggest study conducted so far about Chemsex was done in 2020 by a group of researchers from the Department of Psychology and Psychotherapy in the Faculty of Health at Witten-Hendecke University. When exploring the reasons why men take part in chemsex, they came up with answers relating to internalized homophobia and body image issues.

“Interiorized homophobia doesn’t lead to chemsex, but a big part of people who engages in this practice do it in order to have an idealized sex that leads to a pleasant situation”, tells me Translocura.

Not all Chemsex practices are problematic, and this is an important footnote. Recreational usage of drugs has to do with the sporadic and moderated use of the substance, usually in party environments and in a friendship context, where dependence is not an issue. However, certain internal and or external conditions can lead to a problematic usage of drugs. Here, contextual vulnerability plays a big role.

At the root of problematic chemsex, the substance is seldom. The causes of the problem, when it becomes one, reside with underlying discomfort, when the substance becomes a relief tool to evade or deal with internal and or external problems.

When the effects of these substances are gone, the connection with the Chemsex group goes away too. “I don’t want to stigmatize” clarifies Translocura, “but generally, the problematic usage of chemsex comes when the practice itself becomes the only way of socialization of its practitioners”.

Chemsex becomes problematic when people involved “end up in a vicious circle where they engage in long and empty sexual sessions where sex and pleasure are prolongated, yet there’s a lack of human connection”, as Translocura describes.

That’s why feelings like loneliness, social rejection, interiorized homophobia, and body issues can be linked to Chemsex. When Stuart comments on the profile of chemsex practitioners, he also mentions the difficulties of HIV-positive people having sex, because of the stigma and misinformation this sickness carries within.

When is chemsex problematic?

“When there’s a presence of interiorized homophobia or feelings of rejection from the family, chemsex practitioners enter into a vicious cycle where the only way their sexuality can be freely expressed is through substance disinhibition in a group of people who, as well, feel lonely or suffer from interiorized homophobia”, argues Translocura.

According to studies conducted in Spain, the number of people for whom chemsex becomes problematic represents a minority (between 10-20% of its users). However, most of these people never reach help from a professional. So the problem gets bigger.

Barcelona and the Netherlands are referents on a global scale for the risk reduction approach. Translocura is actively involved in several risk-reduction activist groups like Energy Control and Metzineres “we always try to work with both, physical and psychological risks” of drug usage.

Sexually transmitted infections (STI) and loss of risk perceptions due to the low alertness state induced by the substances are two of the main risk factors. "Because Chemsex usually involves a variety of people, STIs like Gonorrhea, Chlamydia, and Syphilis can (and might) be present".

But consent goes always first, even in chemsex. People taking PrEp (pre-exposure prophylaxis) might participate in chemsex, "but not because you're high and disinhibited everything is valid. In case of being HIV positive, communication, in order to receive and/or give consent, is super important”, claims Translocura.

Besides the physical risks, addiction is also entailed. “Chemsex can lead to a dependence circle, where it becomes the only way people socialize because the context of usage remains the same”. Furthermore, the prolonged use of methamphetamine can fetch psychotic attacks or delusions of persecution.

Another psychological problem comes when young boys are involved. Troubled sex workers from 18 to 20 years old, as Translocura specifies, use chemsex circles as the only way to escape from home. Inside the so-called chills (chemsex sessions), “they become the ‘fresh meat’ or the object of desire in a group of men who have sex with other men”.

Because during chills people can freely explore their sexuality without being judged, chemsex becomes, sometimes, their only safe environment. “They lose all other social interactions, and after four years of excessive consumption and sexual practices, almost reaching consensual rape, their bodies stop being the object of desire, and they become displaced inside their own chemsex circle”.

“We are speaking about people who end up in homelessness situations, not because of the lack of support or socioeconomic issues, but because they have lost all contact with the outside, and their reality becomes exclusively an exchange of sex for basic needs”, warns Translocura. To prevent this, it is vital that chills aren’t the only social activity endorsed.

How to reduce the risks?

Working out things like sexual and body self-esteem with a mental health professional is an important tool to avoid problematic chemsex. Having available alternative queer leisure, like LGBTI+ organizations, pubs or nightclubs can also help to reduce substance dependence.

Information, periodic tests, and maintaining other social interactions are a must. Besides, it is highly recommended to follow specific drug-intake security measures. “If you take a substance that you didn’t buy, it is important to make sure it comes from someone you trust, and never let yourself be administrated intravenous drugs by other participants”, recommends Translocura.

“We have seen lots of rape cases and chemical submission, especially on the young-boy chemsex beginner profile”. For Translocura, the moral responsibility resides on the drug administrator of the group, who needs to lab-check the substances and know where they come from.

That’s why information points and associations like Energy Control, Consumo Conciencia, and Échele Cabeza are available. “You can even check in Wikipedia the dosages and effects of every substance”, explains Translocura. “Chemsex should be a pleasant activity, not a torture”, she insists.

Carrying out regular STI tests and using barrier methods like condoms are also essential. "In Barcelona, there are some centers like Drassanes Express or Stop Sida where fast and free HIV and Syphilis tests are available". In Drassanes Express they also offer a complete test, in case of a risky sexual encounter. ‘Risky’ means receiving an ejaculation inside the body or having direct blood contact. “In chemsex, direct blood contact can appear without the necessity of sexual intercourse, when doing the mistake of sharing needles, or holding contact with blood and other mucose”.

According to Translocura, disinformation is one of the major risks. And even though consensual sex shouldn’t have limits, there are plenty of things we can’t simply do on a biological level. “I’ve seen people injecting themselves with other’s semen because that was erotizing for them, which lead to gangrene in the arm”.

For those who end up in a dependence situation, there are plenty of organizations that can help on a physical and psychological level. In Barcelona, there are different available phones like Energy Control (687 63 36 94) or CAS Baluard (93 342 68 92), and plenty of other associations of men who have sex with men.

There’s still not a network of trans women who practice Chemsex, but there are plenty for cis-gay men. That means that non-binary people and trans women who participate in chills will receive even less support because of the stigma they carry.

“I doubt that you’ll receive the same treatment in Stop Sida, for instance, if you are a trans woman and sex worker because they are used to receiving boys”. For Translocura, there is a problem of disinformation in help centers when it comes to fertility, pregnancy, human papilloma, or other sicknesses that don’t affect men. “In a way, health centers also have the responsibility to get in touch with this reality, that is more and more present”.

She insists that “the more we denounce and speak about this kind of thing, the more health centers will be able to treat their patients, and the better the answers to problematic chemsex would be” But as long as we keep silent about LGTBI+ sex, drugs, and chemsex, the taboo will long be perpetuated, and problematic chemsex will still remain unsolved.

If while reading this article you felt identified with any of the described situations, and/or in case of having any problem or detecting one in your circle, it is crucial you reach out to any of the centers enlisted below:

Energy Control (Spain)