What is chemsex?

Chemsex means using certain drugs as part of your sex life. It describes using drugs before or during planned sexual activity to sustain, enhance, disinhibit or facilitate the experience. But chemsex comes with a lot of risks and can have long-lasting consequences.

The term chemsex is used in Europe and Asia. In America and Australia, it’s known as PnP, which stands for ‘party and play’.

It’s most common with men who have sex with men. But it does affect people of all genders and sexualities, including straight men and women, trans women and non-binary people.

Not everyone who uses drugs will try chemsex, and not everyone who has chemsex will experience problems. There are different levels of use, from experimenting once to daily drug taking.

We’ve worked with the experts at Controlling Chemsex to find out more about chemsex and how it can affect your sexual health.

Controlling Chemsex

Why do people do it?

People take part in chemsex for a lot of different reasons. And not all the reasons are related to sexual pleasure.

Reasons related to sex:

  • To make the pleasure more intense
  • To become more sexually adventurous, with fewer inhibitions
  • To be able to do things that could otherwise be uncomfortable or painful, like fisting
  • Because they find it difficult to enjoy sex without drugs involved
  • To manage stress and anxiety about sex, for example premature ejaculation or low sexual desire

Reasons not related to sex:

  • To increase their confidence if they have low self esteem
  • Escapism from reality and problems
  • Managing challenging emotions such as depression, stress, loneliness
  • Difficulties to experience joy without drugs involved
  • To meet new people to create a social network
  • Sense of belonging to a group, even if it’s a group of people who use drugs
  • The strong sense of connection can happen with someone who they use chems with

What drugs does it involve?

In the UK, chemsex typically involves 3 specific drugs, known as chems. These are taken before or during sex. These drugs are:

Crystal methamphetamine, also known as T, Tina, crystal, ice or meth

Methamphetamine is a very addictive stimulant. It’s one of the most common drugs used for chemsex all over the world.

It has an almost immediate stimulating effect on the central nervous system. Some of its effects include increased physical activity, increased wakefulness, and reduced feelings of tiredness. It can make you feel alert, sexually aroused, and incredibly confident and powerful.

Mephedrone, also known as M, Meow Meow, M-Kat, Drone or CAT

Mephedrone is also a very powerful stimulant. Its main effects include an increase in euphoria, talkativeness, alertness, and a very strong sense of connection and empathy with others.

GHB or GBL, also known as G or Gina

GHB and GBL are depressant or sedative drugs. In small doses, they can make you feel euphoric, and more confident, with a loss of inhibitions, higher libido and greater sensitivity to touch. The dose of these drugs is hard to get right because there’s a high risk of overdosing. The difference between a recreational dose and overdose may only be a matter of millilitres.

Chemsex and dating apps

A lot of chemsex activity is organised through gay dating apps such as Grindr, Scruff and Recon. It’s one of the most popular ways of connecting with others who use chems. People use specific terms, like a code, in messages and on their profiles to show they enjoy chemsex and to find partners.

Terms you might see:

  • HnH - short for ‘high and horny’, means someone is interested in chemsex
  • BB or raw - shows that someone is looking for anal sex without a condom, known as bareback
  • T - short for Tina, another name for crystal meth
  • G - means GHB or GBL
  • M - means mephedrone
  • V - interested in using Viagra

What are the risks?

These drugs can make you feel invulnerable to harm, supremely confident and not worried about consequences. This can mean that you might take risks that you usually would avoid.

Meth and mephedrone particularly can keep you awake for days, prioritising sex over anything else. This means you often neglect your most basic needs. Things like eating, hydration, and sleeping can be forgotten. And this has an effect on your health, career and relationship.

All of this can have a destructive impact on almost every area of your life. If you’re using chems, you might experience problems with:

  • Physical health, from accidents and injuries, nutritional issues, lung and heart diseases, dental problems and disrupted sleeping patterns
  • Mental health, including high levels of depression, anxiety, or psychotic episodes such as paranoia or hallucinations
  • Emotional health – issues like isolation, domestic and relationship issues, low self-esteem or inability to focus or make decisions
  • Sexual health – chemsex comes with a high risk of sexually transmitted infections (STIs) like HIV, hepatitis C, syphilis and gonorrhoea. If you’re living with HIV or taking other HIV-related medications (like PrEP), it can mean you forget to take your medication regularly.
  • Financial issues and unemployment
  • Personal safety such as drug overdoses or suicides
  • Chemsex-related crimes: sexual assault and robbery can take place at chemsex sessions
  • Legal issues – let’s not forget that these drugs are illegal to buy, sell and have in your possession

Reducing the risks

It might be obvious, but the best way to avoid the negative side of chemsex is to not get involved in chemsex at all. But this isn’t always what people want to do. Understanding the risks and how to reduce them can help you have a safer session.

  • There’s no quality control or ingredient lists when it comes to chems. Try to avoid problems with the quality by choosing a dealer who you trust and who knows what they are selling.
  • Go to sessions with someone who you know and trust. Agree to look after each other if either of you is having a bad time.
  • If you invite people you don’t know to your place, keep your money and valuables in a safe place. Unfortunately, not everybody is trustworthy, and it’s always better to be cautious.
  • When you’re sober, think about your boundaries. What do you want to do and what don’t you? Are there chems you don’t want to take, or people you don’t want to be involved with? How long do you want to stay out partying? Setting boundaries when sober makes them easier to stick to when you get high.
  • Before playing, get together everything that you might need for a long session. Pack lots of condoms and lube. If you’re injecting or slamming chems, take needles of different colours. Then everyone can use a different colour and you won’t accidentally share needles.
  • After 2 days without sleeping, you can start to experience paranoia, hallucinations and psychotic episodes. To avoid this, don’t play for too long.
  • To take care of your mental and physical health, it’s better not to do chems regularly.
  • It can be difficult, but remembering to eat food and drink water is really important. Your body will be VERY thankful if you take care of it.
  • If you’re regularly having chemsex, it can be a challenge to have sober sex. To avoid this, make sure chemsex is not the only sexual activity you have. Mix it up with dates and sober sex encounters as well.
  • If you're going out for a session, get your favourite food ready at home. Tidy up and make your home as welcoming as you can. Sometimes it’s not easy to go back home, and you can stay out for longer than you want to. Knowing your home is a safe and welcoming space makes it easier to leave sessions that you're not enjoying.
  • If you’re on regular medication - whether it be HIV treatment, PrEP or medication for anxiety and depression - take your medication with you when you go out. And set labelled reminders on your phone so you don’t forget to take the pills you need at the right time.

Chemsex and sexual health

Using drugs during sex can make you feel more sexually adventurous. And they can lower inhibitions. This means you might do things sexually that you wouldn’t usually do. This could be sex with multiple people, not using protection, and having sex for long sessions. All of this puts you at a higher risk for STIs and other problems with your sexual health.

Studies have shown that men who have sex with men and take part in chemsex:

  • are 4 times more likely to be diagnosed with a sexually transmitted infection
  • are 5 times more likely to be diagnosed with HIV
  • are 9 times more likely to be diagnosed with hepatitis C

Remember that chems allow people to stay awake and horny for longer than usual. This can lead to having sex with more people than usual. And the more people you’re with, the higher the risk of STIs. Also, sex that lasts for a long time can lead to broken skin around the anus and genitals, which can increase the risk of STIs, HIV and hepatitis C.

Some people are HIV positive but don’t know it. And STIs like gonorrhoea and chlamydia often don’t show any symptoms.

Having unprotected sex, without PrEP or condoms, with someone just because they’ve said they are negative is an unnecessary risk. Using condoms and latex gloves will reduce your risk of getting HIV and other STIs.

Regular STI testing means you can stay informed about your HIV status and treat any STIs early. Taking a test every 3 months allows you to stay on top of any STIs, be treated early and reduce the number of people you need to inform.

You can get tested in your local sexual health clinic. Or you can order a test kit to do yourself, at home.

If you don’t have HIV and are having lots of sex, find out about how to protect yourself before having sex using PrEP or after having sex with PEP.

If you’re living with HIV

Your HIV diagnosis doesn’t have to change your sex life. Getting treatment soon after diagnosis means you can get your viral load to undetectable levels. Undetectable means the virus cannot be transmitted, or passed on to any other people.

Another benefit of starting treatment early is helping you have a long and healthy life. People who take effective treatment can expect to live a normal life expectancy, free from complications or infections related to their HIV.

Where can I get support?

If you’re struggling with chemsex and the issues it causes, reach out to Controlling Chemsex. They’re a specialised charity that can offer practical advice, reliable information and professional support for anyone who wants to stop or reduce their chems use.

Only you can say how much chemsex is affecting your life. If you’re worried or want to think about how chemsex is impacting different areas of your life, you can use the Controlling Chemsex self-assessment.

It’s completely confidential, your answers are not shared or stored. This tool helps you to look at all areas of your life to understand how chemsex is affecting you.

Your questions answered

Why is it called Controlling Chemsex?

Not everybody who seeks help for chemsex has the same goal. Some people want to stop altogether, while others are looking to reduce their use of chems. For some people, the idea of quitting can be daunting.

What’s clear to us when we’re supporting people, is whatever their goal, they come to us because they feel like they’re losing control. They might be taking chems when they know they shouldn’t, more often than they really want to or they can’t stop once they’ve started. Our name comes from the idea of taking back control.

Why are those 3 drugs specifically linked to chemsex?

These 3 drugs have very powerful effects that fit a sexual context, perfectly.

Crystal meth (Tina) can make people feel extremely sexually aroused for long periods. It can make them feel very energised, confident, horny, invincible, and less likely to feel pain. This can make people feel like sex on meth is much better than sex without it.

Mephedrone can make people feel euphoric and very connected to others. It also increases feelings of desire and confidence. GHB can increase the desire for sex and make people more sensitive to touch.

Is using Viagra also considered chemsex?

Viagra or similar can offer a quick solution for people who have problems with erections. Viagra is commonly used by people who don’t use illegal substances at all and so it’s not considered a chemsex drug.

People do use it to help them have sex, but it does not make people horny or cause instant erections - it works after people get sexually aroused. This sets it apart from other substances such as crystal meth, mephedrone and GHB.

Using drugs like crystal meth, mephedrone and MDMA can make it hard to get or keep an erection. So lots of people who use those drugs will also use Viagra to counteract those difficulties. But Viagra is not a mood-enhancing drug, it’s a prescription drug. It does not have the same health risks as chems.

Can any drug be used for chemsex?

Chemsex is not primarily defined by the substances used, it’s the reason why people are using the substance.

If someone is using a drug with the intention of having sex - where the drug will help them sustain, disinhibit and enhance sexual pleasure, or self-medicate issues that could make sex difficult (such as body image issues, trauma, problems with communication or intimacy), we’re talking about chemsex.

Using cocaine because you are going to meet friends, then meeting someone in a club and ending up having sex, is not chemsex. However, buying cocaine so you feel confident enough to have sex, is.

Or if you smoke marijuana (weed), and you were smoking with someone, you’re talking and you end up having sex - that would not be considered chemsex. If you met with someone specifically for sex and smoked together to help enhance that sexual experience, that could be considered chemsex. It comes down to the intention you have for taking the drugs.

Most people struggling with chemsex are using 3 specific drugs - crystal meth, mephedrone and GHB. But if your drug use is specifically linked to helping you have sex, whatever drug that is, it could be considered chemsex.

Are injuries during sex more frequent?

Yes. The 2 most commonly used drugs for chemsex (crystal meth and mephedrone) can make people feel invulnerable to harm, supremely confident and sexually adventurous. This can lead to taking more risks and not protecting themselves in the way they would when sober.

These drugs can also increase stamina and endurance and can keep people awake for many days. When this is combined with more risk-taking and less interest in personal safety, which can lead to consequences such as the transmission of STIs, as well as problems with consent and increased sexual assault.

Practices such as fisting and rough sex, which are often present in chemsex scenarios, can lead to pain and/or injuries that may go undetected when under the influence of these drugs. This can result in damage to the anal tissues or tearing abrasions to the penis from repeated friction This can cause problems such as anal fissures, haemorrhoids, etc, which also increases your risk of contracting STIs. Sex can often last longer when using chems and involve multiple partners - which can also increase the risk of injury.

The risk of overdosing on GHB is very high. People who have taken too much can often get injured if they accidentally fall over or hit their head, as well as the life-threatening consequences of an overdose.

People who inject chems (known as slamming) are at a higher risk of infections carried in the blood - like HIV, syphilis and hepatitis - if they share any injecting equipment.

What advice would you usually give for having chemsex safely?

Of course, the only guaranteed way to avoid the negative effects of chemsex is to not get involved in chemsex at all. But this is not always the option that everybody chooses.

Having a good understanding of how to reduce potential risks is a good place to start. That’s what we call harm reduction. Harm reduction is about identifying the risks and taking steps to reduce the chances of things going wrong. We suggest making a plan to reduce the risks before you take chems.

Get more information on harm reduction from Controlling Chemsex.

Is it safe? It is legal?

When participating in chemsex there are a number of things that can go wrong, such as overdoses, accidental injuries, robbery, and sexual assaults. There is also the risk of catching STIs and an increased chance of mental health problems from regular drug taking. We cannot say that chemsex is safe.

And it is not legal. In the UK, it is a criminal offence to own, supply, make or import any illegal drugs. It does not matter what you plan to use these drugs for.

What kind of support is available to help people struggling with the consequences of chemsex?

There are different programmes available, but it really depends on where you live; in some places, the support is more specialised while in others, chemsex support doesn’t exist at all. Among those programmes, we can find:

  • Programmes that deliver practical tools and strategies to be able to address the obstacles that are common to find when someone wants to make changes regarding their chems use. This is the kind of support provided by Controlling Chemsex.
  • Programmes that are based on the idea of group support: people who have gone through similar issues support one another. Examples are 12 steps programmes (Crystal Meth Anonymous UK, Narcotic anonymous, Smart Recovery etc).
  • Harm reduction programmes - they provide support for those who want to use chems in a safer way, minimising risks (such as needle exchange programmes). They are normally local services, for example a South London NHS needle exchange.
  • Rehab programmes: drug and/or alcohol treatment programme that is provided in a residential setting (however these are usually private)

What are the resources available at the NHS to help control chemsex?

It really depends on where you live. There are areas where there is specialised chemsex support (for example, The Club Drug Clinic in London offers chemsex support for people in the boroughs of Westminster and Kensington and Chelsea) while in others there is no support available at all.

Many people struggling with chemsex will go to their GPs for help. But many doctors are not familiar with the realities of chemsex. In the A&E departments of different hospitals, some will be very used to supporting people with chemsex-related emergencies. But others, maybe in rural areas, will not have the same knowledge and understanding.

I occasionally use G during sex and just wondered what harm it could be doing to my body, if any harm? I may only use it once every 6-8 weeks and limit its amount during a session too.

The main problems attached to the use of GHB and GBL are that it’s very easy to develop a physical dependency on it, and it’s very easy to overdose. GHB overdoses can lead to coma or even death.

In your situation, your risk of getting physically dependent on the drug is low, because you are not using it every day. A person needs to use GHB on a daily basis for a while to develop a physical dependency.

Unfortunately, overdose can happen at any time to anyone. It does not matter if you’re very familiar with the drug or do not use it often. You need to be incredibly careful to reduce your risk of overdose. Allowing other people to prepare your dose, drinking alcohol when you’re taking it, not allowing enough time between doses and not accurately measuring your dose can all increase the chance of an overdose.

The long-term effects of taking G regularly are not yet known for certain, however, some research suggests it can affect how your brain works, including your long-term and working memory and overall cognitive ability. As we’ve mentioned above, using G can have a significant effect on your mental health (anxiousness, lack of sleep, low mood) and for some people, these symptoms persist for a long time.

Is using poppers a part of chemsex?

When poppers (amyl nitrate) are used to enhance the sexual experience, they can be a part of the chemsex experience. And they’re actually very common in chemsex situations - though they are mostly used to complement other, higher-risk drugs and are therefore not usually considered “chems” (like GHB, crystal meth and mephedrone). Using poppers during sex can lower your inhibitions, which can put you at risk of sexual injury and catching STIs.

It’s very important to understand that not all drugs used in chemsex have the same effects and side effects. The high of poppers only lasts for a few seconds or minutes - other chemsex drugs can have intense highs that last for hours or days, and these are the side effects most commonly associated with chemsex.

Are poppers safe?

Using drugs always involves risks, and poppers (amyl nitrate) are no exception.

Poppers can be very dangerous for anyone with heart problems, high or low blood pressure, anaemia or glaucoma (an eye disease). They can also cause injury to red blood cells and reduced oxygen supply to vital organs. Additionally, when someone is using it while having sex, they may feel less inhibited and take more risks. This increases your chances of contracting an STI or getting injured during sex.