Editorials

What is chemsex and why does it matter?

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h5790 (Published 03 November 2015) Cite this as: BMJ 2015;351:h5790
  1. Hannah McCall, senior nurse, genitourinary medicine/sexual and reproductive health 1,
  2. Naomi Adams, head of sexual health psychology 1,
  3. David Mason, specialist substance misuse practitioner2,
  4. Jamie Willis, outreach and training manager3
  1. 1Central and Northwest London NHS Foundation Trust, London WC1E 6JB, UK
  2. 2Camden and Islington NHS Foundation Trust, London, UK
  3. 3Antidote Service, London Friend, London, UK
  1. Correspondence to: H McCall hmccall{at}nhs.net

It needs to become a public health priority

“Chemsex” is used in the United Kingdom to describe intentional sex under the influence of psychoactive drugs, mostly among men who have sex with men. It refers particularly to the use of mephedrone, γ-hydroxybutyrate (GHB), γ-butyrolactone (GBL), and crystallised methamphetamine. These drugs are often used in combination to facilitate sexual sessions lasting several hours or days with multiple sexual partners.1 2

Mephedrone and crystal meth are physiological stimulants, increasing heart rate and blood pressure, as well as triggering euphoria and sexual arousal. GHB (and its precursor GBL) is a powerful psychological disinhibitor and also a mild anaesthetic. Anecdotal reports and some small qualitative studies in the UK find that people engaging in chemsex report better sex, with these drugs reducing inhibitions and increasing pleasure. They facilitate sustained arousal and induce a feeling of instant rapport with sexual partners. Some users report using them to manage negative feelings, such as a lack of confidence and self esteem, internalised homophobia, and stigma about their HIV status.3 …

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