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Chemsex: What You need to know about Substance use during Sex

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Dec 19, 2022 • 8 cited sources

“Chemsex” is not a medical term, but a colloquially term for when one uses drugs to enhance their sexual experiences. It has several dangers and risks associated with it. Chemsex can increase your risk of addiction, make sober sex more difficult, and/or increase the risk that something is done to you that you wouldn’t consent to while sober. 

What Is Chemsex?

According to Sexual Health Sheffield, “chemsex” is a colloquial term that some people use to refer to having sex or engaging in sexual acts while under the influence of substances. [1] This can refer to any substance, but common drugs used are methamphetamine, cocaine, LSD, ecstasy, cannabinoid, alcohol, mephedrone, and GHB/GBL.

The term chemsex is used to refer to any intentional use of drugs for the purpose of elevating one’s sexual experience. 

Why Do People Engage in Chemsex?

There are a number of reasons a person might engage in chemsex. Initially, many people will try chemsex to have a new sexual experience or to elevate the pleasure they get from sex. Over time, however, many people who engage in chemsex may have difficulty finding pleasure or orgasming without the use of drugs. Some people may also become addicted to the drugs they use for chemsex, or they may become addicted to chemsex itself, which can also cause them to engage in further acts of chemsex.

The Dangers of Chemsex

It’s possible to become addicted to chemsex itself, and/or to the drugs used during chemsex. [2] This issue isn’t well researched, with treatments aimed specifically at this type of addiction still in the relatively early development phase.

In addition to a risk of addiction, chemsex is also associated with health and safety risks, including:[3]

  • Increasing the likelihood that you engage in risky sexual behavior
  • Increasing the risk of exposure to sexually transmitted infections or infections transmitted by injection drug use 
  • Loss of natural libido or difficulties engaging in “sober” sex
  • Increased risk of sexual abuse or assault 
  • Risk of overdose, accidents and injuries

It’s also notable that individuals using drugs cannot always consent to sex acts, as drugs affect your judgment and can sometimes outright incapacitate you. The nature of consent between individuals who want to have sex while under the influence of drugs and consent to that kind of sex while sober is complicated and highly dependent on the specifics of the laws of where you live. 

Common Chemsex Drugs

Some drugs associated with chemsex are: [4]

Alcohol 

Even though alcohol is a legal substance, it is still a drug, and it is by far the most common drug used during people during sex. 

Mephedrone (Meow Meow, MCAT & Plant Food)

Mephedrone is a mood elevator, making users feel euphoric and friendlier toward others. It also increases sexual stimulation, making sex feel more pleasurable. 

GHB/GBL (G, Gina & Liquid Ecstasy)

Despite its street name, liquid ecstasy is not ecstasy, although it shares some similarities in how it makes people feel. This drug decreases a person’s inhibitions, increases their sex drive, and can make them feel euphoric. 

Methamphetamine (Crystal, Tina, Meth & Ice T)

Methamphetamine, generally just called meth, is likely the most well-known drug on this list. Meth is a stimulant/amphetamine medication and can cause a sense of euphoria in a user and boost their confidence. It can also give a person a spike of energy, making vigorous or long-lasting sex easier.

Ecstasy/MDMA

Also called “molly”, ecstasy stimulates MDMA receptors in the brain which are excitatory receptors that give the patient euphoria, increased sensitivity to sensory inputs, energy, and other “feel good” chemicals. MDMA can cause sweating, tachycardia, dehydration and cardiac problems if taken in excess.

Cocaine

Cocaine is a stimulant drug that can give people a lot of energy and euphoria. It is sometimes used for “chemsex” because it is a partial anesthetic so some people may use it to increase the duration of their sexual encounters. However, Cocaine is an illegal and highly dangerous substance. Abuse can lead to stress on the heart, fast heart rate, arrhythmias, elevated blood pressure and even heart attack and death. 

How Chemsex Can Affect Addiction 

It is hard to make generalizations about the risk of developing addiction from “chemsex” drugs because it depends largely on the drugs actually being used, their unique addiction potential, and the quantity and frequency of use. However, most of the drugs on the above list have a high addiction potential. If the drugs you are using for chemsex are addictive, a person is at risk for becoming dependent or addicted to these drugs regardless of the reason for which they are using them. 

Chemsex Harm Reduction

Most medical professionals agree that chemsex is best avoided. It carries a number of dangers and can reduce your ability to enjoy sober sex. 

However, experts also acknowledge that some people will still engage in chemsex regardless of the known risks and dangers. There are harm reduction steps that can be taken to reduce the risks associated with chemsex. 

Some tips to reduce the potential harm that chemsex can have include:[5]

  • Get regular STI screenings, especially when engaging in group sex or having sex with many partners.
  • When possible, only engage in chemsex activities with people you trust, as this can reduce the chance someone either accidentally or intentionally does something you wouldn’t want to do.
  • Avoid long chemsex sessions, as the drugs used may cause you not to get tired even after a day or more of being awake. Long drug use sessions can cause more severe side effects, especially episodes of paranoia and hallucinations.
  • Don’t let someone inject you with anything. Bring your own drug paraphernalia, and never share needles if you do choose to inject drugs. 
  • Mix regular, sober sex and other nonsexual activities in with your routine to help you better know your partner’s wants and needs and increase intimacy.
  • Know your limits and establish your boundaries ahead of time with those you intend to engage in chemsex and related activities with, making it clear that violating your consent while you are high will have serious consequences.

Resources to Consider

If you want to know more about chemsex from reliable sources, much of the information in this article comes from the work of Sexual Health Sheffield, a service provided by Sheffield Teaching Hospitals. While they’re a UK organization, the advice and information they provide is broadly applicable and useful.

Similarly, the LGBT Foundation provides useful information about chemsex.[6] Their advice is generally aimed at people in the LGBT community specifically, but most of what they say about chemsex is useful for anyone to know.

We also recommend reading this article on consent from RAINN, an organization dedicated to helping victims of sexual assault and working to prevent sexual assault.[7] 

Finally, if you feel addicted to chemsex or the drugs used during chemsex, seek professional help from an addiction treatment provider in your area. FindTreatment.gov is one easy way to find nearby treatment providers. You can also ask your primary care doctor for a referral to an addiction treatment specialist in your area.[7]

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

Sources
  1. What Is Chemsex? Sheffield Teaching Hospitals. https://www.sexualhealthsheffield.nhs.uk/info-and-advice/chemsex/what-is-chemsex/. Accessed October 2022.
  2. First Case Report of tDCS Efficacy in Severe Chemsex Addiction. Dialogues in Clinical Neuroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605017/. September 2020. Accessed October 2022.
  3. Chemsex Risks. Sheffield Teaching Hospitals. https://www.sexualhealthsheffield.nhs.uk/info-and-advice/chemsex/chemsex-risks/. Accessed October 2022.
  4. Drugs Associated With Chemsex. Sheffield Teaching Hospitals. https://www.sexualhealthsheffield.nhs.uk/info-and-advice/chemsex/drugs-associated-with-chemsex/. Accessed October 2022.
  5. Advice on Chemsex. Sheffield Teaching Hospitals. https://www.sexualhealthsheffield.nhs.uk/info-and-advice/chemsex/advice-on-chemsex/. Accessed October 2022.
  6. ChemSex. LGBT Foundation. https://lgbt.foundation/chemsex. Accessed October 2022.
  7. What Consent Looks Like. RAINN. https://www.rainn.org/articles/what-is-consent. Accessed October 2022.
  8. FindTreatment.gov. Substance Abuse and Mental Health Services Administration. https://www.findtreatment.gov/. Accessed October 2022.

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