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Chemsex is a phenomenon that has gained increasing attention in recent years. The purpose of this paper is to differentiate chemsex from other sexualized substance use, and clarify differences between recreational and problematic chemsex use. Despite plentiful publications, little has been published on underlying determinants that predispose individuals to chemsex, and their process toward problematic chemsex use.

During the second European Chemsex Forum, people who engage in chemsex, community organizers, researchers, clinicians, therapists, social workers and (peer) counselors discussed potential pathways to problematic chemsex. In this manuscript, we translate findings from these discussions into a framework to understand the initiation and process toward problematic chemsex.

Six stages (loneliness and emptiness, search for connection, sexual connection, chemsex connection, problematic chemsex and severe health impact) and a set of factors facilitating the transition from one stage to the next have been identified.

It is hoped that this “Journey towards problematic chemsex use” will stimulate reflection and debate, with the ultimate goal of improving prevention and care for people engaging in chemsex.

The purpose of this paper is to understand the dynamics of pleasure related to chemsex from the perspective of French gay men and other men who have sex with men (MSM). Recognising that participants in chemsex are social actors, the authors diverge from the prominent “pathology paradigm” used in public health.

In-depth interviews were conducted with gay men and other MSM engaging in chemsex via snowball sampling (n=33). The authors explored the definitions of pleasure and the role of stimulants, sexual activity, smartphones and partners in chemsex pleasures.

Chemsex pleasures encompass multiple dimensions that go far beyond bodily pleasures, such as love or romantic relationships, socializing with significant others and sexual discovery through disinhibition. Narratives of pleasure were also, simultaneously, stories of suffering and distress. This dissonance can pose challenges to the participants in chemsex, their entourages and care providers.

Given that the focus of care for gay men and other MSM is on risk behaviors, the findings of this paper help nurture discussions where pleasure is integrated into a new, value-neutral framework of care that incorporates chemsex pleasures.

This study examined the perspectives of those actually participating in chemsex, allowing gay men and other MSM to relate the entirety of their experiences, in which pleasure is often at the forefront, without restriction.

Chemsex constitutes a significant public health concern among gay and bisexual men (GBM). Using the identity process theory, this study focuses on GBM’s motivations for engaging in chemsex and the functions that the practice performs for constructing a positive sense of self and for coping with psychological stress.

Sixteen GBM were interviewed, and the qualitative data were analyzed using thematic analysis.

Individuals reported facing various stressors, such as homonegativity, rejection and HIV stigma, which were threatening for self-esteem and distinctiveness. There was habitual use of deflection (e.g. denial and self-concealment) for coping with these stressors. Chemsex enabled some interviewees to engage in more elaborate forms of deflection, such as transient depersonalization, compartmentalization and fantasy.

In contrast to the risk-focused analyses of chemsex, this study provides a novel identity-based approach to understanding GBM’s motivations for engaging in chemsex and focuses on the functions that chemsex may perform for identity processes.

The purpose of this paper is to clarify the origins, use and meaning of the term “chemsex”.

The approach used here is one born of personal experiences and reflection.

The term chemsex has a definition and a purpose that promotes culturally competent care for a marginalized group of vulnerable people.

This is a qualitative, personal, point-of-view piece which may be of value in broadening understandings and responses amongst public health and academic activities.

The findings can be used to develop a sense of community and support amongst men who have sex with men in a chemsex setting, and to provide some background and context for professionals working in this field.

This paper is amongst the first, if not the first, of its nature to be published in an academic journal.

The purpose of this paper is to document the experience of current and former methamphetamine users on their crystal meth use patterns and on their use of services related to their chemsex practice.

For qualitative component, two focus groups were formed with nine current users of methamphetamine and eight former users. Thematic analysis was performed to know their experiences.

All participants were already engaging in chemsex with various substances before they first started using methamphetamine. Methamphetamine use led some to slam (methamphetamine or mephedrone injection). Some participants report that their sexual experiences were intensified early in their chemsex practice. They reported feeling more confident with their partners, feeling like they are sexually attractive and overcoming their barriers to sexuality. The intensification of methamphetamine use and, in particular, injection change the positive perception of sexual life. Thus, for some participants, substance use takes more space and their sexual experiences become less satisfactory.

Participants report the services that address the phenomenon of chemsex are still scarce in Quebec province. In addition, the few services available aim to relearn a sober sexuality. However, the mourning of the positive aspects of chemsex on sexual experiences seems still very little discussed. Greater consideration of positive chemsex experiences is needed in services that address this issue.

This project documented the perception of pleasure related to sexual practices among regular methamphetamine users. Their perception of pleasure will help develop services adapted to their reality.

The title of this paper is a statement made by a man at the end of his treatment following conviction for several sexual offences. It is powerful in conveying a simple and accurate meaning of consent. Legally, consent is not complicated and can be simply defined as: permission for something to happen or agreement to do something. The context of consent, however, is complicated and complex none more so than when it becomes an issue within chemsex. If we are to gain a full appreciation of consent-related complexity, we must also gain an understanding of the wider picture concerning chemsex and crime. The purpose of this paper is to provide that wider picture. With the exception of breaching of drug-related law, not all men who engage in chemsex are committing offences but, as we are discovering, a not insignificant percentage are and this needs to be cause for concern.

This study is a review and a personal perspective of the development of a criminal justice response to crime within the chemsex context.

This was a personal viewpoint, not a research project; therefore, there were no definitive findings.

This paper addresses lack of awareness within the criminal justice system in relation to chemsex, and the associated vulnerabilities. This work is original because there is a shortage of published work on the rise in chemsex-related crimes.

The purpose of this paper is to explore the larger picture of chemsex in a hope to understand how to best work with clients therapeutically. The paper’s aim is to acknowledge not just the risk and “negative” aspects but also what might be gained by men engaging in chems use. How can the chemsex space act as a container for emotions and experiences?

This is a paper based upon cases from within the author’s private practice plus anonymous interviews with men. It comes from a sex positive therapy approach and explores ideas formed within the author's work as a practitioner.

The findings within this paper showed just how complex an issue chemsex is with many layers to it. The author also found that the most important aspect to bear in mind is that this is a very human issue, with aspects many can relate to such as intimacy, self-esteem, desire for connection and dealing with difficult emotions. By seeing what part it plays in the life of men involved then it is possible to can understand how seductive it could be.

This paper takes a more in-depth look at the psychological roots of chemsex and how these play a part. As this field is explored more, this paper aims to look at chemsex from the idea of pleasure, community and connection so that it is possible to provide the support that is best suited.

Whilst chemsex is a relatively new phenomenon, trauma is not. Freud borrowed the word from physical medicine, where it was used to describe tissue damage, and applied it, for the first time, as a metaphor to a psychological process by which the protective functioning of the mind can too be pierced and wounded by events. The chemsex environment hosts a myriad of potentially traumatising scenarios and experiences, though perhaps disguised as exhilaration or excitement. The paper aims to discuss these issues.

The paper is a practitioner’s experience.

These experiences piled on top of childhood experiences of being “less than” for being gay, can be responsible for widespread undiagnosed post-traumatic stress disorder (PTSD) among those who engage in chemsex. This paper explores this possibility and offers solutions.

Compounded trauma and PTSD symptoms amongst MSM who engage in chemsex has to date, not been researched.

The purpose of this paper is to provide the first definition of sober sex and recommendations for health care professionals who work therapeutically with patients who struggle with intimacy after experiencing chemsex.

The recommendations are based on the clinical experience of a psychosexual therapist working with men having sex with men (MSM) in a Sexual Health clinic in central London.

The paper concludes that having a clear definition of sober sex and specific tools, such as healthy masturbation exercise, could prove helpful for health professionals who work with this cohort of patients.

This paper provides the first definition of sober sex and a clear set of guidelines for health professionals based on the clinical experience of the author.