Chemsex and Therapy (1/2): Understanding Chemsex
9 December, 2023
Chemsex is the term used when gay, bi men and men who have sex with men (MSM), including transmen, use psychoactive drugs before and / or during sex. The main motivation for using drugs for sex is to enhance sexual pleasure and to reduce the shame associated with sex.
Although heterosexual people of all genders may use drugs to enhance their sex lives, Chemsex is a term specifically used for gay, bi men and MSM because there are specific cultural and societal components involved in understanding the behaviour that only apply to these populations. According to David Stuart, the professional who coined the term, Chemsex should not be used for heterosexual sex as it would dilute the specific issues that MSM face and would erase the ongoing struggles of those populations who are already marginalised.
The term that is often used for drugs and sex in heterosexual population may be ‘pharmacosex’ or ‘sex/drug fusion’.
The most common drugs used in Chemsex are crystal methamphetamine, GHB/GBL (gamma-hydroxybutyrate / gamma-butyrolactone) and cathinones (mephedrone, 3MMC, 4MMC). The combination of these drugs is potent because it enhances sexual desire and pleasure, relaxes people and creates a chemically-induced connection with others. Sometimes, these drugs are taken alongside other substances such as ketamine, cocaine, alcohol, poppers and / or sildenafil (commonly known as Viagra or Cialis).
Chemsex is very popular because its pleasurable effects (enhanced sexual pleasure, stronger connections, less shame and no rejection) seem to be the perfect ‘antidote’ to temporarily combat minority stress (the ongoing stress of the expectation of prejudice for being a minority and marginalised person), society’s heteronormativity and homophobia, and the intra-community minority stress (the competition between MSM in the gay scene due to internalised homophobia).
Because of the potent effects of the various combinations of drugs, Chemsex is often discussed in the context of severe incidents as many MSM access sexual health clinics reporting that their Chemsex use has spiralled out of control. However, it is important to note that Chemsex is not systematically problematic. Many MSM have Chemsex in ways that is non-problematic for enhancing sexual pleasure and having strong connections with sexual partners.
The most important skills for having non-problematic Chemsex are to know the appropriate dosing of drugs, when to stop, and how to organise the week to make sure it does not interfere with the rest of life by allowing sufficient time for recovery, resting and protecting their sexual health with PrEP (pre-exposure prophylaxis), PEP (post-exposure prophylaxis), and regular STI check-ups.
In the second of these two blog posts about chemsex, I will discuss clinical presentations and therapist competencies.
Silva Neves, UKCP, is a COSRT-accredited and UKCP-registered psychosexual and relationship psychotherapist, and a trauma psychotherapist. He is a Pink Therapy Clinical Associate. Silva is a member of the editorial board for the leading international journal Sexual and Relationship Therapy and the author of two books: Compulsive Sexual Behaviours, A Psycho-Sexual Treatment Guide for Clinicians (Routledge), Sexology: The Basics (Routledge), and he co-edited two textbooks with Dominic Davies: Erotically Queer (Routledge) and Relationally Queer (Routledge), and he speaks internationally. Silva is the recipient of the Sexual Freedom Ally Award in 2023.
Speaker Disclosures:
Financial: Silva Neves maintains a private practice and receives compensation as an international speaker. She receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Silva Neves is a member of the College of Sexual and Relationship Therapists, the UK Council for Psychotherapy, the National Counselling and Psychotherapy Society, the British Association for Counselling and Psychotherapy, the EMDR Association UK & Ireland, the European Society for Sexual Medicine, and the UK Psychological Trauma Society.
