By: Jerry P. Abraham, MD MPH CMQ
Photos by: Tomnex | Dreamstime.com
You may have heard the term chemsex floating around in conversations, on dating apps, or in online communities. But what exactly is it?
What is Chemsex?
Chemsex refers to the use of specific drugs, such as methamphetamine, gamma-hydroxybutyrate “GHB/GBL”, or mephedrone before or during sex. People often utilize these substances to enhance pleasure, lower their inhibitions, and increase stamina. However, though this can sound exciting for some, chemsex also comes with potential physical and mental health risks.
An important note is that the goal here is not to shame anyone, this is about health, awareness, and giving you the tools to make informed choices. Everyone deserves to enjoy their body and their sexuality safely, and that means understanding the risk in an action before agreeing to partake.
The Physical Risks
Using drugs during sex can have a serious impact on your body:
• Dehydration and overheating: Drugs like meth can raise your heart rate and body temperature. Combine that with hours of sex and not enough water, and you could end up in the ER with heat exhaustion or dehydration
• Higher risk of STIs and HIV: Because these drugs can make you feel invincible or reduce inhibition, you’re more likely to have condomless sex or sleep with multiple partners. This can increase your chances of catching or perpetuating STIs, including HIV.
• Injuries and soreness: Some people don’t realize they’re hurt until the high wears off. Without feeling normal levels of pain, you might not notice if you’ve torn skin or caused internal injuries.
The Mental and Emotional Side
Drugs like meth and GHB interact with brain chemicals like dopamine and serotonin, the stuff that makes you feel good. Over time, though, this can lead to:
• Addiction: It’s easy to chase the intense highs of chemsex, especially if sex without drugs starts to feel boring or less satisfying.
• Depression and anxiety: When the high fades, some people experience a “crash” or comedown, which can include feelings of guilt, shame, sadness, or paranoia.
• Chemsex dependency: Some people begin to associate sex only with drugs, and may struggle to enjoy sober intimacy again.
Staying Safer
If you choose to participate in chemsex, there are ways to reduce your risk. This isn’t a green light, but a realistic approach for those who are already engaging or considering it:
1. Set limits before you start. Know what you’re okay with and stick to it. Don’t let drugs push you into situations you’re not comfortable with.
2. Use one drug at a time. Mixing substances, especially depressants like GHB with alcohol, can be deadly.
3. Hydrate and rest. Drink water and take breaks. Long sessions without rest can be dangerous.
4. Use protection. Condoms and PrEP, also known as “pre-exposure prophylaxis,” help protect against HIV. Regular STI testing is also key.
5. Have a buddy system. Make sure someone you trust knows where you are and checks in on you.
6. Measure doses carefully. GHB in particular has a very small margin between a “fun” dose and an overdose. Never eyeball it.
When to Seek Help
If you notice you’re using more frequently, can’t enjoy sex without drugs, or your relationships and daily life are being affected, it might be time to talk to someone. There is no shame in needing help, chemsex addiction is real and treatable.
Here are some resources:
• SAMHSA’s National Helpline (USA): 1-800-662-HELP (4357) – Free, confidential, and available 24/7 in English and Spanish.
• Latino Commission on AIDS: www.latinoaids.org – Offers culturally relevant sexual health resources and HIV prevention programs.
• Trevor Project: www.thetrevorproject.org – Support for LGBTQ+ youth, including those dealing with substance use or mental health issues.
• Línea Nacional contra la Adicción (México): 800 911 2000 – Offers information and support for people facing substance use challenges.
You Deserve Pleasure, and Health
Sex is a powerful and beautiful part of life. But like anything powerful, it comes with responsibility. If you or someone you care about is navigating chemsex, education is the first step to staying safe and empowered. You don’t have to give up your sexuality to protect your health, but knowing the risks, and how to manage them, gives you control.
If this article brought up questions or feelings for you, don’t ignore them. Reach out, talk to someone, and remember: you’re not alone, and your health matters.
Remember, you can visit Dr. Jerry P. Abraham and the whole JWCH-Wesley HIV Street Medicine Team at Tempo Nightclub every Sunday night. Come get HIV-tested, PrEP’d, and your LGBTQ+ health questions answered. Play Safe and See You Soon!