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Sex, drugs and self-control: why chemsex is fast becoming a public health concern
  1. Alastair Macfarlane
  1. Medical Student, King's College London, London, UK
  1. Correspondence to Mr Alastair Macfarlane, King's College London, 71 Etchingham Park Road, Finchley, London N3 2ED, UK; alastair.macfarlane{at}kcl.ac.uk

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Introduction

The sexual landscape of the UK is ever changing. Taboos and norms are in constant fluctuation, and what was perceived as odd 10 years ago is now commonplace. One growing practice in recent years, especially in the community of men who have sex with men (MSM), has been chemsex: intercourse under the influence of psychoactive substances, in particular gammahydroxybutyrate (GHB)/gammabutyrolactone (GBL), mephedrone and crystal methamphetamine or ‘crystal meth’ (Table 1). These drugs heighten sexual arousal and facilitate longer sex sessions, paving the way for chemsex parties: events based in clubs, saunas or private accommodation whereby weekend-long drugs binges fuel a quick turnover of sexual partners.

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Table 1

Summary of the ‘party drugs’ commonly used at chemsex parties

Recently, various authors have called for chemsex to become a public health priority.1 There are various reasons for this, including the possible link with HIV and other sexually transmitted infection (STI) transmission, the physical and mental health effects of the drugs used in chemsex sessions, and the unwillingness of many MSM to seek help because of the perceived stigma and shame associated with their lifestyle.

This essay will discuss the most recent literature on chemsex in the UK, including epidemiology, health effects and why it should become a public health priority. I will argue that there are various approaches that the medical community and other parties can take to tackle the issue, and offer my opinion as to which might be the most effective.

Epidemiology

The European MSM Internet Survey (EMIS) was an online study carried out in 2010 across 38 countries in Europe, on over 180 000 men, to determine knowledge, attitudes, needs and behaviour regarding STI transmission among MSM.2 A large amount of research into chemsex in particular, however, has been focused on the UK. Areas in London such as Lambeth, Southwark and Lewisham (LSL) …

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