Chemsex, or taking psychoactive substances to enhance or extend a sexual experience, is growing in popularity in many parts of the world. Often, the substances used for this purpose are referred to collectively as “chems,” but they include crystal methamphetamine, cathinone (mephedrone, 3MMC, 4MMC), GHB/GBL (gammahydroxubutyrate/gammabutyrolactone), and freebase cocaine (or “crack”).

There is much concern among public health officials and health care workers about the potential adverse side effects of chemsex, particularly when it comes to addiction, engaging in unsafe sexual practices, and accidental overdose. As such, there has been research aimed at illuminating the risks and possible harmful effects of chemsex for its participants. However, less research has been done regarding the subjective experiences of people engaging in chemsex and their motivations for trying it and continuing to practice it.

The authors of a recent Journal of Sexual Medicine study completed semi-structured phone interviews with 31 Italian cisgender men who have sex with men who have had at least one chemsex experience to better understand the self-reported effects of chems on sexual response, motivations for engaging in chemsex, and how it compares to sober sex.

After reviewing the interviews and coding shared ideas and concepts, several themes emerged, but the authors noted that there were significant differences among the participants’ motivations and experiences with chemsex. Nevertheless, the following is a summary of the most referenced themes in the interviews.

Effects of Chems on Sexual Experience

• Increased sexual desire and arousal: many of the participants said that chems allow them to feel extremely aroused for long periods of time.
• Disinhibition: several of the interviewees reported feeling more relaxed, liberated, and uninhibited during chemsex than they would during sober sex.
• Increased sexual pleasure: some individuals perceived a significant increase in their sexual pleasure when using chems.
• Erectile difficulties: having trouble getting or maintaining an erection while using chems was common among the participants.
• Variety of sexual behaviors: given the prevalence of erectile difficulties during chemsex, many of the participants reported engaging in other sexual behaviors that do not involve an erection.
• Prolonged sex and delayed ejaculation: because chems can affect the time it takes for a person to ejaculate (or impede their ability to ejaculate at all), the respondents explained that chemsex generally lasts considerably longer than sober sex.
• Intimacy: several of the interviewees described a feeling of intimacy with new partners during chemsex, but some acknowledged that this feeling of intimacy was “different,” “false,” and “not lasting.”
• Comedown: most of the individuals in this study experienced a psychological and physical comedown after chemsex with negative symptoms such as fatigue, dizziness, irritability, insomnia, difficulty concentrating, depression, and negative thoughts.

Motives for Engaging in Chemsex

• Sexual motives: many of the participants cited feelings of increased arousal and sexual pleasure as their primary motives for engaging in chemsex.
• Social motives: others stated that social pressure from peers was their main reason for trying and continuing chemsex.
• Changing motives over time: while many of the interviewees reported trying chemsex for the first time because of curiosity and desire for a new experience, some acknowledged that they continued to engage in chemsex because of the desire and craving for the substances themselves.

Relationship to Sober Sex

Many of the men interviewed expressed that they ultimately find sober sex more intimate and rewarding than chemsex, even though it may not last as long and can feel more “obvious” and “predictable.” Some men, however, voiced a preference for chemsex, finding sober sexual experiences to be “diminished” and “less satisfying.” In some cases, this has led to problems with sober sex for participants who are unable to enjoy sex without chems.

Gaining a deeper understanding of the effects of chems on sexual experiences and people’s motivations for trying them can help guide efforts toward harm reduction including the promotion of safe sex practices.

Resources:

• Nimbi, F.M., Rosati, F., Esposito, R.M., Stuart, D., Simonelli, C., & Tambelli, R. (2021). Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. The Journal of Sexual Medicine, 18(12), 1955-1969. DOI: https://doi.org/10.1016/j.jsxm.2021.09.013