As chemsex evolves, information and support are key

Chemsex is becoming more popular and more dangerous, according to Monty Moncrieff MBE, Chief executive of London Friend, a charity dedicated to the health and mental wellbeing of LGBT people and a participant of AFEW Autumn School in Bishkek. He spoke to us about how chemsex is changing and spreading around the world, and how best to provide support to those who are doing it.

Monty, why is chemsex such a serious issue?

Chemsex is characteristic of a distinct change in the way gay and bi men are using drugs to enhance sex. In the late 2000s we started to see a shift towards three new drugs in the UK: methamphetamines, mephedrone, and GHB/GBL. Previously, these drugs were not widespread – mephedrone wasn’t even known before then – so we don’t have a good understanding of their risks. They present a greater risk of harm than drugs that were being previously used recreationally and for clubbing, so we’ve seen a big increase in the number of people experiencing problems with them. There are sexual health, physical health, and especially mental health harms that can affect people who engage in chemsex.

How do we know when chemsex is becoming a problem for an individual?

We look at this quite holistically. It doesn’t have to be dependency on the drug itself that is an indicator of when things become problematic. It might be that you’re starting to miss work on a Monday morning, or that arguments with your partner or friends are increasing. It might be causing financial difficulties, or it might be having a negative impact on your mood, motivation or mental wellbeing generally. You might be starting to use alone, or feel you can’t have sex without chems, or you might be finding it difficult to form emotional bonds with a sexual partner. Lots of different things could suggest a problem.

How can we increase social awareness about chemsex and its consequences?

I think we need to talk about it frankly and factually. The media likes to sensationalise chemsex – ‘Sex! Drugs! Danger!’ – but that isn’t going to resonate with people who are doing it and might be beginning to experience difficulties. Gay men have had access to factual, objective information about sexual health and HIV for years, so they want their information about drugs and chemsex to be factual and objective too. They need to feel they are informed and are making choices from a place of knowledge. We know that the types of campaigns that simply emphasise the dangers of chemsex aren’t effective.

Good harm reduction works – we know this because the number of people becoming physically dependent on GHB/GBL has dropped, thanks to effective information about how to reduce the risks of this happening.

So how can we create a supportive environment for those who are doing it?

For us at London Friend, the most important thing is to avoid stigmatizing people. There’s already enough stigma around being gay or living with HIV, and this can be a real barrier for those who might otherwise seek support.

At Antidote, our LGBT drug and alcohol support service, we work really hard to create positive, welcoming environments, so that it’s as easy as possible for someone to ask for help. People need to feel they can be open, honest and frank when talking about these issues, and that they won’t be judged in any way. It’s really difficult for people to talk about these very intimate things and it might bring up feelings of shame or embarrassment. It’s vital that we can have honest discussions about everything that’s connected to their chems use and the sex they’re having. The workers and volunteers that provide support need to be fully informed about the issues related to chemsex, about the newer drugs that are being used, which may still be unfamiliar to a lot of healthcare workers, and the issues that affect gay and bisexual men. It’s vital that the cultural competence is there, so people feel understood when they ask for support – otherwise they might not come back.

Is chemsex widespread in the Eastern Europe and Central Asian region?

Chemsex still feels relatively new in many parts of the EECA region, but it’s clear that it is becoming more common. There’s a lot of awareness of it in western Europe and other parts of the world, like the USA, Australia and so on. People working in the EECA region can familiarise themselves with what’s happened there, so they’re not starting from zero in their own local areas. However, chemsex isn’t the same everywhere – there are different drugs being used, depending on what’s available locally. Organisations need to monitor what is happening in each region and tailor their approach so that it’s culturally appropriate for the way gay and bi men access information and support in their own areas.

I’m already seeing some great resources in Russian, Polish etc. from local groups, and we’ve had more people from the EECA region attending and speaking at the European Chemsex Forum events that have been bringing health workers and activists together since 2016. There’s an active online group that has developed from these events, where a lot of resources and experience are shared. You can join up at https://chemsex.groups.io/

Finally, what precautions should people take during the COVID-19 pandemic?

During COVID-19 in the UK we’re encouraging people who don’t live with a sexual partner to avoid hooking up with new or casual partners to help reduce the risk of exposure to the virus. If people are already thinking of taking a break from chemsex, or stopping completely, this could be a good opportunity to do so.

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