What is Chemsex?
Chemsex, a portmanteau of “chemical” and “sex,” refers to the practice of engaging in prolonged sexual activities under the influence of psychoactive substances, particularly among men who have sex with men (MSM). Commonly used drugs include mephedrone, GHB/GBL, methamphetamine, and ketamine, often combined. The goal is to disinhibit oneself, amplify pleasure, and extend sexual activity for hours or even days.
While the term gained popularity in London around 2010, its roots trace back to clandestine clubs of the ’90s where electronic music, ecstasy, and bodily exploration were used as forms of resistance and freedom. Over time, with the rise of dating apps and powerful drugs, the phenomenon became more widespread, intense, and risky.
Who Practices Chemsex?
Although it can occur in various contexts, evidence suggests that chemsex is more prevalent among young MSM in urban settings with access to technology. In some cases, individuals may have a diagnosis of HIV or backgrounds of internalized homophobia, trauma, social exclusion.
A 2020 study published in The Lancet HIV revealed that up to 30% of MSM in large European cities had engaged in chemsex within the past year. Factors such as the pandemic, social isolation, increased anxiety, and easy access to drugs online have contributed to the amplification of this practice in recent years.
Why is it Important to Discuss Chemsex?
Chemsex not only increases the risk of sexually transmitted infections but also carries significant psychological consequences, including addiction, psychosis, severe anxiety, depression, emotional dependence, progressive isolation, and profound existential crises.
Dr. Adam Bourne, a researcher at Sigma Research and a pioneer in chemsex studies, warns: “Many men start seeking connection and pleasure but end up trapped in a dynamic that pushes them further away from themselves and others.”
Other experts, like Spanish psychiatrist José Luis Pedreira, highlight the dopaminergic deregulation caused by methamphetamine—a genuine euforia explosion that leaves the central nervous system in ruins after the “crash.”
Some have advocated for addressing chemsex through empathetic listening rather than judgment. Activist David Stuart (†), one of the earliest voices to bring attention to this practice, emphasized the need for safe, supportive, and dialogical spaces for those ensnared in a cycle of desire, dependence, and loneliness.
A Psychiatric Integrative Perspective
From an integrative psychiatry viewpoint, it’s worth asking: what does the body seek when craving chemsex intensity? What does the soul cry out for in hyperconnected, chemical, and physical experiences?
This phenomenon should not be approached solely through abstinence or regulatory norms but with a broader perspective that considers the body’s, emotions’, and life experience’s profound meaning reconnection.
- Heal the body connection: Body-conscious practices like therapeutic yoga, somatic breathing, or compassionate meditation can help restore the body’s safe pleasure source and presence rather than a consumption or performance stage.
- Nourish the nervous system: Chronic stimulant and depressant use leaves marks on the hypothalamus-pituitary-adrenal axis and gut microbiota. Accompaniment with adaptogens, functional nutrition, supplementation (magnesium, omega-3, L-theanine), and sleep restoration are crucial for sustaining recovery processes.
- Review trauma and shame: Often, substance use in sexual contexts is linked to prior wounds: rejection, violence, abuse, dissociation. Somatic therapies, EMDR, psychotherapy assisted by psychedelics (where legal), or emotional integration groups can pave healing paths.
- Regain the sense of community: Chemsex usually emerges from isolation. Creating secure networks for contact, expression, art, or spirituality can offer more sustainable and nourishing belonging alternatives.
- Rethink pleasure: Not as escape but as a legitimate path to connection, joy, and embodied spirituality. Because pleasure shouldn’t hurt or come with subsequent silence and guilt.
What’s unspoken repeats in silence. Discussing chemsex isn’t about condemning or simplifying; it’s facing a complex reality that touches deep themes: the desire to belong, pleasure pursuit, fear of loneliness, and accumulated pain in bodies rejected or rendered invisible.
I appreciate that patient for their courage in naming their practice. Only when something is named can it be transformed.
I welcome your questions or related experiences regarding this topic. Let’s continue the conversation; you can email me at [email protected] or reach out to me on Instagram at @dra.carmenamezcua.
