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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.

PRISMA is the only example of a co‐ordinated‐type model to be developed and fully implemented with a process and outcome evaluation. The PRISMA model was implemented in three areas (urban, rural with or without a local hospital) in Quebec, Canada and an implementation evaluation was carried out using mixed (qualitative and quantitative) methods. Over four years, the implementation rates went from 22% to 79%. The perception of integration by managers and clinicians working in the various organisations of the network shows that most interactions are perceived as at the co‐operation level, some getting the highest collaboration level. The perception of the efficacy of case managers was very high. Implementing such a model is feasible, and the decision to generalise it was made in Quebec. This model might be more appropriate for a universal publicly funded health care system like those in Canada, the UK and the Scandinavian countries.