Strategies for healthy and safe chemsex

Chemsex is a mode of sexual experimentation associated with the use of substances. In 2015, a group of practising clinicians published an article on the phenomenon in the British Medical Journal, stating that chemsex ‘needs to become a public health priority.’ The article then continues to discuss the dual dangers of chemsex, the sexual health risks, as well as the potential for addiction that accompanies any drug use.

This concern raises the question: is it possible to practise chemsex safely? What substances are usually involved in chem sex? What’s the likelihood of developing an addiction to one of these drugs? What can you do to keep yourself safe during chemsex, and what sources of support are available if things do not go to plan?

What is chemsex?

Chem sex is described as ‘intentional sex under the influence of psychoactive drugs.’ This has historically been associated with men who have sex with men (sometimes referred to as MSM). This does not mean that only men who have sex with men use drugs during sex, however. The term ‘chemsex’ is used to describe a specific and ‘uniquely gay cultural phenomenon.’ Chemsex is sometimes also referred to through the terms ‘party n play’ (or PnP) or ‘high and horny’ (HnH).

Author and advocate David Stuart explains that chemsex became popular due to three key events:

  • new technologies leading to online hook-up culture in gay communities
  • the role of HIV/AIDS on gay sexual interactions (both in theory and in practice)
  • changing social attitudes (and laws) around gay sex and sexuality

Just like with other instances of drug use, the motivations behind engaging with chemsex can vary.

What drugs are used for chemsex?

Chemsex typically involves the use of psychoactive drugs. However, the term usually refers to the use of three specific substances:

In the chemsex context, these drugs are known as ‘chems.’ These drugs can be used independently or alongside one another. It is also common for other substances to be used, such as alcohol, Viagra, cocaine, ketamine and poppers. These drugs, however, are not considered to be chems.

The use of chems has a range of effects, including:

  • prolonging sexual activity (for hours or even days)
  • providing ‘stamina’ to engage with multiple partners
  • helping to achieve more satisfying or ‘better sex’
  • decreases anxiety and improves confidence
  • increases sensation and feeling of pleasure
  • helps to manage internalised homophobia


GHB (gamma hydroxybutyrate) is a sedative drug. GBL (gamma-butyrolactone) is a similar substance. Both GHB and GBL are Class B drugs, which means that the possession, sale or manufacturing of these substances can lead to legal repercussions.

GHB is sometimes known as ‘liquid ecstasy.’ Its high is characterised by:

  • feelings of euphoria
  • drowsiness
  • relaxation
  • increased interest in sex

These substances are usually taken in liquid form or as a powder, which can be added to drinks.

GHB and GBL are often used in combination with other substances to enhance the effects of other drugs. They are used in chem sex as they can relax muscles, making specific types of sex more comfortable.

GHB has been nicknamed the ‘date rape drug’ due to its connection with its use in spiking to facilitate nonconsensual sex. GHB/GBL were reclassified from Class C to Class B to reflect the harm potential associated with this. However, this does not mean that all uses of GHB are related to this type of activity; chemsex is a consensual act.



Mephedrone is a stimulant. It is sometimes known by the names Meow Meow, MCAT and Plant Food. Like GHB/GBL, mephedrone is a Class B drug in the UK, meaning that owning, selling or making mephedrone are considered to be illegal acts.

Mephedrone stimulates the body, catalysing the following sensations:

  • increased heart rate
  • increased blood pressure
  • bursts of energy and positive mood
  • increased interest in sex

Mephedrone can be taken orally, snorted, injected, or through ‘booty bumping,’ a type of rectal administration that can itself be part of chem sexual interactions.


Like mephedrone, methamphetamine is a powerful stimulant. Meth, however, is a Class A drug. This indicated that its risk factor is considered to be higher than the other substances typically linked with chem sex.

Meth has a range of street names, such as crank, crystal meth, glass and ice. Meth has similar effects to mephedrone, such as:

  • feelings of euphoria and excitement
  • increased heart rate
  • increased blood pressure
  • reduced inhibitions

However, it can also be associated with less pleasant experiences, such as disorientation, paranoia, tremors and confusion.

Meth can come in a crystalline structure. This can be smoked. In its powder form, meth can be snorted or diluted to create an injectable substance. This substance can also be used via rectal administration.

What are the risks associated with chemsex?

There are two key types of risks associated with chem sex:

  1. risks associated with drug use
  2. risks associated with unsafe sex

An additional risk to consider in this context is the danger of developing a sex addiction.

Chemsex and drug use: Potential risks

Just like with other substances, using the substances associated with chemsex can lead to the development of a drug dependency. GHB/GBL, mephedrone and methamphetamine all have addiction potential.

This can lead to the need for drug intervention alongside a range of other health and social consequences, including:

  • the development (or worsening) of mental health conditions such as anxiety, depression, paranoia or psychosis
  • the development (or worsening) or general physical health
  • an increased risk of sharps injury
  • an increased risk of developing infections due to sharps injury
  • social withdrawal and disconnection
  • difficulties at work or school
  • conflict in relationships
  • difficulty maintaining personal hygiene and care
  • financial issues

It is not possible to identify a ‘safe’ level of drug use. This means that even ‘dabbling’ with these substances during chemsex carries a genuine risk of developing addiction. This can lead to the need for urgent drug rehab.

Unsafe sex: The risks

There are a range of risks associated with unsafe sex – both in and outside of the presence of drug use. These are not limited to but include:

  • the development of STIs
  • the development of HIV/AIDS
  • unexpected or unplanned pregnancy
  • sexual violence (including nonconsensual sex)

There are also specific risks that can be associated with particular types of sex. For example, anal sex carries a higher likelihood of contracting an STI due to the thin lining of the anus. As chemsex is related to the activity of men having sex with men, this is a particular risk to consider in the context of sex under the influence of drugs.

Strategies for healthy and safe chemsex

Despite the risks associated with sex under the influence of drugs, there are ways to practise chemsex that mitigate these potential dangers. Some of these are rules that apply to all instances of safe sex, whilst others are specific to the act of chemsex.

Some of the ways to practise safe chemsex include:

  • using condoms
  • changing condoms in between sex acts and partners
  • having discussions whilst sober in order to establish boundaries and rules (including setting safe words)
  • be open about sexual histories
  • avoid using other substances alongside chems (meth, mephedrone and GHB/GBL)
  • try to ensure someone you know and trust is present
  • ensure you are aware of your location beforehand
  • have a way to contact someone you trust if this is not possible
  • remember that you can stop or say no at any point
  • ensure you have a way to leave if you do not feel safe or comfortable
  • use PrEP (a drug that can limit the risk of contracting HIV)
  • do not inject drugs where possible – administer them in different ways
  • if you do administer chems via injection, do not share sharps
  • dispose of sharps safely and responsibly after use

When drugs are being used, there is always a level of risk. The same can be said for engaging in sex acts. When the two are combined, there are extra risks to consider. However, taking the above precautions can ensure you manage these as much as possible.

Chemsex and drug addiction

If you are concerned that your engagement with chems has led to drug addiction, then there are treatment options available for you. UKAT is a specialist provider that prides itself on its non judgemental, open and professional approaches to all. We offer confidential support for GHB/GBL, methamphetamine and mephedrone addictions.

Our treatment centres offer bespoke options at both affordable drug rehabs and luxury drug rehabs alike. Addiction treatment with UKAT aims to provide holistic support that puts you at the centre. Tailored to consider your physical and psychological health and general wellbeing, we are confident that we offer the type of support best suited to you.