Chemsex: Understanding the Risks, Realities, and Resources for LGBTQ+ Communities
Have you heard the term “chemsex?” Maybe you’ve seen phrases like “party and play” or been asked, “you PnP?” or “parTy?” Perhaps during a late-night scroll, you’ve noticed a “🎉” next to a Grindr profile and questioned what it meant. Whatever the coded language, it all boils down to one thing: getting high and having sex.
Let’s talk terms and definitions:
Chemsex: refers to using drugs to enhance and intensify sexual experiences. While “chems” can include substances like poppers, marijuana, or alcohol, the term primarily centers around four main drugs: ketamine, GHB/GBL, cocaine, and of course, crystal methamphetamine.
Ketamine is a dissociative anesthetic used medically for pain relief and anesthesia, and recreationally for its hallucinogenic and euphoric effects, with emerging applications in mental health treatment.
GHB/GBL: GHB (“liquid ecstasy”) and its stronger cousin GBL (a cleaning solvent-turned-party drug) are used for euphoria and relaxation—but mess up the dose, and it’s less party, and more falling out of consciousness…and possible death.
Cocaine: OK, we probably all know a little about coke, but for the sake of argument, let’s define. Cocaine is a powerful stimulant that gives a quick energy boost and heightened alertness, but can quickly lead to intense crashes and cravings once it wears off.
Methamphetamine: We’ve all seen Breaking Bad, right? Meth is a supercharged stimulant that hijacks your brain unlike any other stimulant, flooding it with an insane rush of dopamine. A high to remember, but a steep price to pay each time. If you’re a millennial, I know you’ve seen the Montana Meth Project, you know what this drug can do to a human.
Prevalence
Anthony Munger, community health manager for the Louisville Pride Foundation, said there is a lack of data focusing on substance use within the LGBTQ+ community in the United States, particularly concerning methamphetamine use and chemsex activities.
“Accurate data about LGBTQ individuals and substance use, particularly around chemsex, is essential because our experiences are unique yet often universal within our community,” he said. “Substances as a coping mechanism against daily discrimination, and without data, policies and resources can’t effectively help us. This data makes our struggles visible and helps create safer practices that are tailored and evidence-based.”
According to the 2020 National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration, approximately 3% of lesbian, gay, or bisexual adults aged 26 and older in the U.S. reported using methamphetamine in 2020.
Adam Neff, M.D., internal medicine and pediatrics primary care physician, Baptist Health, says he sees several LGBTQ+ patients and only a small number of them have come forward about their addictions or participation in chemsex and methamphetamine activities.
“It’s something we don’t ask about as providers whether it’s from a lack of knowledge or hesitancy,” he said. “There is a lot of shame that comes along with this and it can be hard for patients to open up.”
Neff adds that general education to the community, but especially providers would benefit those struggling with chemsex and addiction.
“It’s a tricky area to navigate without the patient feeling super shamed,” he said.
According to a 2023 report from the Kentucky Office of Drug Control Policy and Kentucky Agency for Substance Abuse Policy, methamphetamine was found in 1,095 drug overdose deaths, representing 55.2% of the total drug overdose deaths and out of those overdoses, 840 involved Fentynal. What does this mean? Meth is being cut with fentanyl…allegedly.
Health Risks
Chemsex poses significant physical risks, including a heightened likelihood of sexually transmitted infections (STIs) and HIV due to impaired judgment and condomless sex. Prolonged sexual activity, which can happen while under the influence, can cause physical trauma, such as tearing or bleeding, increasing infection susceptibility.
Neff noted that individuals engaging in chemsex may make it more likely to neglect essential routines like taking daily PrEP or HIV treatment, which reduce the risk of acquiring or transmitting HIV, respectively, or using doxy-PEP, which reduces the risk of gonorrhea, syphilis, and chlamydia.
“Set an alarm to ensure you don’t miss medication doses as you come down,” he advised.
Drugs like GHB and GBL carry additional risks due to their narrow safety margin, increasing the likelihood of overdose, unconsciousness, or death.
The mental health impact of chemsex can be as severe as its physical consequences. The highly addictive nature of chemsex can lead to dependency, creating a cycle that is difficult to break. The comedown from these drugs often results in anxiety, depression, or even psychosis and paranoia, contributing to ongoing mental health struggles.
Harm Reduction and Resources
If someone is going to participate in chemsex, there are a few things they can do to reduce the harm that can occur during the experience:
Plan Ahead: Set boundaries around substance use, sexual activity, and time limits.
Know Your Substances: Understand the effects, dosages, and interactions of the drugs you’re using. Avoid mixing substances, especially depressants like GHB/GBL and alcohol.
Utilize PrEP, Doxy-PEP: Stay consistent with preventive medications to reduce the risk of HIV and STIs.
HIV treatment: If HIV-positive, stay consistent with medications.
Inform a Trusted Friend: Let someone know your plans and check in periodically.
Stay Hydrated and Nourished: Drink water regularly and eat light meals to maintain energy levels.
Use Protection: Use condoms and lubricants to reduce the risk of STIs and physical trauma.
Use clean supplies: Supplies like syringes and water should be sterile to reduce the risk of HIV, Hep C and other bacterial infections.
Monitor Doses: Keep track of how much and how often you’re using substances to avoid overdosing.
Have Naloxone and fentanyl test strips on Hand: If opioids are involved, ensure someone knows how to use naloxone in case of an overdose. Test strips can help identify if fentanyl is present.
Set Alarms for Medications: Don’t skip doses of PrEP, antiretrovirals, or other necessary medications.
Practice Aftercare: Rest, rehydrate, and nourish your body. Plan for mental recovery, including coping with potential anxiety or depression.
Seek Support: If struggling with dependency or mental health, reach out to harm reduction organizations or support groups.
If you are seeking support in quitting chemsex / methamphetamine or practicing harm reduction please know that there is help locally and internationally.
The Louisville Pride Foundation has a “Queer Men and Meth” support group that meets every Thursday at 7 p.m. at 1244 South Third Street (The LGBTQ+ Center)
Harm reduction supplies including fentanyl test strips and narcan can also be obtained at the LGBTQ+ Center. They will also connect you with therapists and substance use disorder treatment if desired.
Crystal Meth Anonymous Meetings
Harm Reduction Services in Louisville (Syringe exchange and more)
