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Published on May 6th, 2014 | by Healthy Gay Lifestyles

Chemsex and Substance Use in the Gay Community

by Saint Jude Retreats

Research points to increased substance use in general among the gay community. It is estimated that 20-30% of those identifying as gay and transgender report substance abuse compared to 9% of the general population. 25% of gay individuals abuse alcohol as compared to 5-10% of the general population. MSM (men who have sex with men) are 3.5 times more likely to use marijuana, 12.2 times more likely to use amphetamines, and 9.5 times more likely to use heroin than males who are not sexually active with men. [1] There does seem to be clear evidence that substance use is more prevalent among gay individuals.

It has been accepted that ongoing stressors and factors such as sexual orientation discrimination in the culture, workplace, and familial relationships undoubtedly play a role in men choosing to use and, at times, abuse substances at a greater number and rate. Stress, trauma, and discrimination are ongoing issues and men may choose to use substances to cope with these experiences. Substance use is, however, always a behavioral choice and not a necessary result of trauma, discrimination, or stress. Substance use can also be managed or moderated successfully as a choice without harboring the stigma of addiction or abuse. A recent study from Europe shows an interesting perspective on “chemsex” or the use of substances coinciding with sexual activity.

The EMIS study released in March of 2014 of European Men Who Have Sex with Men Internet Survey [2] was conducted from 2010-2014 with in depth follow up interviews among a sample of 30 gay men living in three boroughs in London (Lambeth, Southwark and Lewisham) with large gay and bisexual male populations. This survey looked into chemsex and the related motivations and factors for using during sexual activity. Chemsex tends to revolve around the use of crystal methamphetamine, gamma-hydroxybutric acid (GHB) and gamma-butyrolactone (GBL), mephadrone, cocaine, and ketamine.

The men living in these London boroughs were twice as likely as men elsewhere in London to use GHB/GBL and mephedrone. When compared to men living in other parts of England, men in these boroughs were 4 times more likely to use cocaine and mephedrone; seven times more likely to use GHB/GBL; and eight times more likely to use crystal meth. All of these drugs are stimulants except for ketamine. Men felt drug use helped them with self-esteem and confidence issues. Drug use also seemed to increase the length of time of sexual activity and having more intense and adventurous sex. Most of the men reported feeling unhappy with a chemsex lifestyle as they desired a chance at committed relationships which they believed they were unlikely to find in the chemsex world.

Of the 30 interview participants, the researchers determined 4 distinct scenarios for chemsex:

1) More than 25% of MSM who were HIV + were “Serosorting”, or making deliberate decisions to engage in unprotected anal intercourse with other HIV+ partners. These men were at risk for other sexually transmitted infections as most tended to not practice safe sex in these circumstances.

2) Others reported chemsex as simply more enjoyable and promoting a feeling of greater control and pleasure.

3) Almost 33% of MSM used chemsex as a way to avoid sexual decision-making or safe sex negotiation. Some men felt chemsex increased risky sexual behavior engagement and afterwards this group was more likely to have regrets over their sexual behaviors.

4) A minority of MSM in the interviews acknowledged a relationship between participating in chemsex and their ability to explore sexual fantasies and push boundaries.

Overall the men interviewed did not see their drug use as an issue but some were open to establishing more control of their use overall. Concerns expressed about substance use centered around overdosing, most prevalent among GHB/GBL users; the threat of sexual assault while under the influence; and the amount of time devoted to chemsex and the recovery required after. Men felt time lost could have been used for developing long term relationships and career opportunities.

The majority of the men hadn’t sought help with their substance use but those that did looked to local centers, helplines, and counseling for information and support. Based on the interviews, the researchers suggested that local gay-friendly health centers and hospitals were recognized in their community as avenues to seek help and information. Researchers also suggested personnel of saunas and other venues could be educated to be aware and responsive to signs of overdose and sexual assault. Lastly, amid the explosion of sexual networking and apps, nonjudgmental content could be added to apps and networking sites for users seeking help.

The issue of chemsex is one that has not been as widely studied as a factor in increased substance use in the gay community. Chemsex may contribute to the numbers of those using substances within the gay community, but not necessarily as a problem use. The men in the survey did not, as a whole, report that they were concerned with their substance use. Some did state they would like to gain or maintain better control over their use. Others were clear that their substance use was pleasurable and not causing problems in their life. In those cases, substance use didn’t appear to cross any boundaries and was an activity of choice.

Substance use is always a behavioral choice and determining it to be a problem is something only the individual may decide. If substance use promotes risk taking behaviors that are ultimately uncomfortable or regrettable to the user, if he feels compelled to use, or if he is experiencing unwelcome problems with aspects of his life due to use, these are signs a substance user may want to consider seeking help. Substance abuse issues,as outlined above, are opportunities for support in addition to the more recognized substance abuse seen as coping with discrimination, trauma, and stress episodes. Community supports for those who are not abusing but wanting to maintain control and/or moderate their use may need to be considered as avenues to circumvent future issues of substance abuse.

1. Hunt, J. (2014, March 9). Why the gay and transgender population experiences higher rates of substance use: Many use to cope with discrimination and prejudice. American

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2. Bourne,A. et al. (2014, March). The chemsex study: Drug use in sexual settings among gay and bisexual men in Lambeth, Southwark and Lewisham. Sigma

Retrieved from


Bio: The above is a guest post by Saint Jude Retreats, an alternative to traditional substance use treatment. Saint Jude Retreats provides a program for people with substance use problems that concentrates on self-directed positive and permanent change. Through the program, we offer the opportunity for individuals to self-evaluate and explore avenues for life enhancement. http.//

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