CHEMSEX CULTURE
What To Know & Staying Safe
Let’s Talk About (chem)Sex
Gay and bisexual men deserve the freedom to make their own choices about sex, pleasure, and connection, as consenting adults. Autonomy is essential, and no one is here to take that away. Many men engage in chemsex for reasons that are deeply personal, and those choices deserve understanding.
But informed consent means more than just saying “yes.” It means having access to the full picture - the risks, the realities, and the support systems available, so that decisions are made with clarity, not social pressure or misinformation. When a practice like chemsex becomes so widespread that it’s mistaken for “gay culture,” we must ask: Are these choices truly informed? Are they truly safe?
This isn’t about judgment. It’s about honesty, safety, and community care.
We must be able to talk about chemsex openly - without shame, without stigma - so that gay and bisexual men can make truly informed decisions about their sexual experiences. That means:
Access to accurate information about the risks and realities of chemsex
Access to addiction support for those who feel trapped or dependent
Access to trauma-informed care for those carrying deep emotional wounds
Access to mental health resources that understand the unique pressures faced by gay and bisexual men
Because informed consent isn’t just about saying “yes”, it’s about knowing what you’re saying yes to, and having the freedom to say “no” without fear, stigma, or isolation.
What Is Chemsex?
Chemsex refers to the use of specific drugs (‘chems’) - often crystal meth, GHB/GBL, and mephedrone - to intensify and prolong sexual experiences. These are often taken in conjunction with crack/cocaine, ketamine, ecstasy, poppers, and Viagra. It often involves:
Long sessions with multiple partners - often continuing for an entire weekend (Friday night to Monday morning) with tens or even 100+ sexual partners
Condomless sex
Mixing substances (poly-drug use)
Meeting through apps like Grindr or Scruff, which allow for anonymous/pictureless profiles
This is usually followed by consumption of alcohol, benzodiazepines and cannabis to help with the resulting physical and psychological come down from the mixture of substances and the prolonged sexual experiences.
In cities like Dublin, it’s estimated there are up to 30 chemsex parties, often known as ‘chills’, every week. And this isn’t just happening in Ireland — it’s a growing trend across Europe, the UK, Australia, and beyond.
A Dublin study by Gay Men’s Health Service found that 27% of gay men had engaged in chemsex, and 31% of men aged 25-39 had used ‘chems’ during sex. In the UK, it is estimated that up to 29% of men who have sex with men engage in chemsex, with even higher prevalence in urban areas such as London or Manchester.
Watch our conference discussion on chemsex, the risks associated and the driving factors below
What Are The Risks
It’s important to say clearly: you have the right to choose what you do with your body, your relationships, and your pleasure. Many gay and bisexual men engage in chemsex for a variety of reasons. This page is not here to tell you what you can or can’t do.
But informed consent means knowing the risks. It means understanding the full picture including the serious physical, emotional, and psychological potential consequences, so that your choices are grounded in truth, not pressure, misinformation, or silence.
Chemsex is often portrayed as a normal part of gay culture, but that framing can obscure the very real harms some men experience. Whether you’re curious, actively participating, or trying to step away, you deserve access to clear, compassionate information and supportive resources. Because your safety, your wellbeing, and your autonomy matter.
GHB Overdose and Loss of Consciousness
GHB (gamma-hydroxybutyrate) and its analogue GBL are powerful sedatives commonly used in chemsex. The difference between a “fun dose” and a fatal one can be just a few drops. Overdose can lead to unconsciousness, seizures, respiratory arrest, and death.
In London, emergency services respond to at least one chemsex-related call every day, and three deaths per month have been linked to GHB use in sexual settings. These figures reflect a growing concern among health professionals about the unpredictability and lethality of GHB when used recreationally.
The withdrawals or ‘come down’ from GBH can last up to six hours and can include nausea & vomiting, anxiety, tremors, paranoia, memory and brain impairment, seizures, delirium, hallucinations and in extreme cases, death. With regular use of GBH, dependency often develops.
‘Going under’ is a term often associated with use of GBH, which refers to taking a dosage that has slowed brain function to the point of unconsciousness, which can lead to bodily functions such as heart rate and breathing to slow or even stop. GHB overdose is the leading cause of death among people who engage in chemsex.
If you witness someone passed out on GBH:
put them in the recovery position
call 999 or 112 - do not delay
Do not assume they will sleep it off
Don’t let anyone near them sexually
Non-Consensual Sex and Sexual Assault
Consent becomes complicated, and often impossible, when drugs are involved. A study from Manchester found that 42.9% of men who had participated in chemsex reported experiencing non-consensual sex, often while unconscious or unable to communicate clearly.
Some ‘chills’ can involve a ‘russian roulette’ with GBH, where one dosage is enough to cause the consumer to be rendered unconscious, while the others have a dose just enough to have the euphoric effects, and these other participants will perform sexual acts with the unconscious man. While it is easy to brush this off as ‘he knew what he was participating in’, it means that he has no knowledge of what is happening to his body and can lead to sexual and psychological trauma, and sexual injury.
This is not just a legal issue, it’s a human one. Many men don’t realise what happened until later or don’t recognise what has happened as sexual assault, and feelings of shame, confusion, or fear can prevent them from seeking help and supports. Creating safe, non-judgmental spaces to talk about these experiences is essential.
Addiction and Dependency
Chemsex addiction is complex. It’s not just about the drugs, it’s about the intertwining of substance use and sexual behaviour, which creates a powerful psychological loop. The anticipation of intense sexual pleasure while high can itself become addictive. It can also make it difficult or near impossible to engage in sex without the use of substances, as the dependency on ‘chems’ can become linked to ability to become aroused.
Let’s look at the substances involved:
Crystal Meth (Methamphetamine) is a stimulant with one of the highest addiction potentials of any recreational drug. It increases energy, libido, can boost confidence and make you more sociable, but long-term use can lead to paranoia, psychosis, memory loss, and severe dependency. Withdrawal is often prolonged and emotionally destabilising. Long term use and dependency on methamphetamine can cause teeth to grey and fall out, skin lesions and ulcers from picking, ‘meth bugs’ (hallucinations that bugs are crawling under your skin).
Mephedrone is a synthetic stimulant that produces euphoria and sexual arousal. It’s known for its rapid onset and short duration, which can lead to repeated dosing and binge use. Users often report intense cravings and emotional crashes. It can also lead to hallucinations, anxiety, insomnia, and rapid dependency.
GHB/GBL are sedatives that lower inhibitions and increase feelings of intimacy. They are physically addictive, and withdrawal can be dangerous including confusion, hallucinations, tremors, and seizures. Some users report withdrawal symptoms after just a few days of use.
In the UK, up to 1,000 deaths over the past decade may be linked to chemsex-related harms. Many people struggling with chemsex addiction and chemsex-related substance abuse issues, fall through the cracks because support services often treat drug use and sexual behaviour as separate issues, when in reality, they can be deeply connected.
Many people also fall through the cracks because the language and terminology used within chemsex culture, such as referring to injecting drugs as “slamming”, often differs from mainstream substance use discourse. This creates a psychological and cognitive distance for some participants, making it harder to recognise their behaviour as dependency or addiction, or to seek support through conventional services.
Infection and HIV Transmission
Chemsex is strongly associated with high-risk sexual behaviours, including condomless sex, group sex, and injecting drugs (“slamming”). These behaviours significantly increase the risk of sexually transmitted infections (STIs), including HIV.
PrEP (Pre-Exposure Prophylaxis) is a powerful tool for HIV prevention. When taken consistently, it can reduce the risk of acquiring HIV through sex by up to 99%, and through injecting drug use by at least 75%. It has transformed HIV prevention and saved countless lives.
However, PrEP only protects against HIV — not against other STIs like gonorrhoea, chlamydia, syphilis, or hepatitis. Many men rely on PrEP as their sole form of protection, which leaves them vulnerable to a wide range of other infections. This is especially concerning in chemsex contexts, where condom use is often low and exposure risk is high. Among PrEP users, those who engage in chemsex have a 32% higher risk of contracting STIs like gonorrhoea and chlamydia.
A recent study found that 68% of STI cases among PrEP users were reinfections, with chemsex participants disproportionately affected. Among men who engage in chemsex, rates of gonorrhoea were 38%, compared to 21% in non-chemsex participants. Syphilis rates were also significantly higher (17% vs 5%).
These reinfections are not just inconvenient, they contribute to a growing public health concern: antibiotic resistance.
The overuse of antibiotics - including self-prescribed or preventive use among chemsex participants - is contributing to the emergence of antibiotic-resistant bacteria, also known as superbugs. These are strains of bacteria that no longer respond to standard treatments, making infections harder, and sometimes impossible to cure.
One particularly concerning example is antibiotic-resistant gonorrhoea, sometimes referred to as “super gonorrhoea.” It has become increasingly difficult to treat and is spreading rapidly among sexually active populations, especially where condom use is low and STI reinfection is common.
Chemsex environments (where multiple partners, condomless sex, and frequent antibiotic use intersect), create ideal conditions for these superbugs to thrive.
Always speak to your healthcare provider before taking PrEP and antibiotics, to ensure these are right for you and your circumstances.
Mental Health Impacts
Chemsex can take a serious toll on mental health. A study in Rome found that 28.7% of chemsex participants showed symptoms of depression, and 42.6% had anxiety. Other studies link chemsex to possible paranoia, psychosis, memory loss, and suicidal ideation.
A recent review found that gay and bisexual men who engage in chemsex may be at significantly increased risk of suicide, especially those with histories of trauma, HIV stigma, or social isolation. The emotional and physical crash after a session, especially when combined with shame or loneliness, can be devastating.
If you’re struggling with your mental health, please know that support is available. You don’t have to go through this alone - reaching out can be the first step toward feeling better.
So Why Are So Many Turning to Chemsex?
We need to talk honestly and compassionately about why so many gay and bisexual men are turning to chemsex. Many gay and bisexual men turn to chemsex not just for pleasure, but to cope with isolation, shame, and emotional disconnection. For some, it offers a temporary sense of relief - a way to feel confident, desired, or close to others in moments when those feelings are otherwise hard to access.
In the heat of the moment, chemsex, can offer:
A greater sense of personal, social, and sexual confidence
Increased sociality and identity, as you are with your peer group (same-sex attracted men)
Escape from anxiety, shame, or trauma surrounding sexuality, HIV status, sexual proclivities etc.
Connection and intimacy
Only 58% of chemsex participants in a Dublin based, Gay Men’s Health Service study were Irish-born, highlighting the diversity of those involved and the particular vulnerabilities faced by migrant gay and bisexual men. Research from Barcelona and other European cities shows that migrant gay and bisexual men may be more likely to engage in chemsex as a way to find connection, especially when navigating language barriers, cultural isolation, or limited access to gay spaces. These experiences are shaped by broader social and emotional contexts - not misunderstanding.
Research shows that chemsex is often used to manage the strain caused by stigma, discrimination, and internalised homophobia. A 2022 review in the International Journal of Environmental Research and Public Health found that identity-related stressors, including HIV stigma and social exclusion, were common drivers of chemsex use.
Another study identified six stages in the journey toward problematic chemsex use: beginning with loneliness and emptiness, followed by a search for connection, and eventually leading to chemsex dependency and health impacts. This framework highlights how emotional vulnerability and isolation, not just desire, often drives engagement in chemsex.
A 2025 article in Psychology Today echoes this, noting that chemsex often masks long-standing shame around desire and identity. Many gay men grow up receiving messages that their bodies, their attraction, and their pleasure are wrong. Substances can temporarily silence that shame, allowing people to feel wanted, confident, or free - even if only briefly.
These motivations don’t make chemsex inherently wrong but they do highlight the need for compassionate, trauma-informed support, especially when chemsex becomes the only way someone feels safe, connected, or seen.
These experiences are real, and they matter. But what chemsex often delivers in the long run is more complicated: emotional exhaustion, dependency, and health challenges that can be hard to face alone.
We must work toward creating accessible, inclusive spaces where all men who have sex with men - particularly those facing isolation, social or language barriers - can build meaningful connection outside of drugs, alcohol, or sex.
We are in contact with drug treatment centres, sexual health clinics, mental health services and health care providers to work towards providing holistic, trauma-informed care and harm-reduction supports across Ireland and the UK.
In the coming weeks we will be contacting Irish and UK parliamentarians to call for national strategies on harm reduction and compassionate supports.