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Men who have sex with men (MSM), including gay, bisexual, and trans people and their sexual partners, have cultivated a distinct subculture of sexualized drug use (SDU), commonly referred to as "chemsex." [1] Chemsex refers to the use of specific drugs to facilitate and enhance sexual experiences.
It is known as Party ‘n’ Play (PnP) in the United States and Canada. In Europe, parts of Africa, and Asia, it is called chemsex, while in Hong Kong, it is referred to as chemfun. This behavior is influenced by various factors, which are mediated by the use of geospatial dating/sex and hookup apps (like Grindr), and that facilitate connections within these communities.[1] Encounters range from recreational settings (like sex parties) to transactional experiences involving sex workers and their clients (like escort services).
This article briefly looks at the different layers of cultural, social, and psychological complexity surrounding chemsex, focusing on the drugs involved, the culture it fosters, and the associated health risks.
- Chemsex involves using drugs like methamphetamine and GHB to enhance and prolong sexual encounters, often among MSM and trans individuals.
- The practice poses risks, including HIV transmission, substance use disorders, and overdose.
- Education, harm reduction, and access to support networks are critical for reducing adverse outcomes.
What is sexualized drug use?
Sexualized drug use (SDU) refers to the use of any drug just before or during sex. This can range from having a glass of wine to take the edge off before having sex with someone for the first time to participating in consensual drug use that may improve or alter the act of sex.
What is chemsex?
Chemsex is a subset of SDU.[1] Chemsex behaviors are usually described as involving the specific intention to use particular drugs (usually stimulants and also known as “chems”) within sexual contexts, specifically those that are commonly practiced among gay, bisexual, other MSM, and trans people, to facilitate, initiate, prolong, sustain, intensify, or enhance sexual encounters.[2]
Although there is no universally agreed-upon definition of chemsex in the literature, most agree that it involves the following:[3]
- Sex between mostly men or trans people
- Drug use to facilitate, prolong, and enhance sex
- Use of a specific set of drugs known as chems
- Casual sexual partners that often involve group sex
- Sexual encounters that often last an extended time (hours–days)
- Often facilitated by digital technology
- Many times associated with condomless anal intercourse
What kind of drugs are used during chemsex?
The specific drugs commonly referred to as "chems" in the context of chemsex include mephedrone, crystal methamphetamine, and GHB/GBL (gamma-hydroxybutyrate/gamma-butyrolactone).[3]
While other substances have been noted, these three are the most prevalent both in the literature and in chemsex practices.[3]
Crystal meth is the most commonly used drug in chemsex globally. It is primarily smoked in these settings but can also be snorted or injected—the latter, a practice referred to as “slamming”.[2] When crystal meth is injected/slammed, the practice is sometimes referred to as “slamsex.” Boofing, booty bumping, or squirting drugs up into the rectum is another form of administration.
GHB/GBL is usually carefully measured, mixed with a soft drink, and ingested orally.[2] However, in some instances, boofing of GHB/GBL occurs; however, this practice has not been well described in some parts of the world. GHB/GBL and crystal meth are frequently used together during chemsex.
Furthermore, mephedrone is more common in Europe and less so in North America. It is a synthetic cathinone that acts as a stimulant, and it can be injected/slammed and snorted.[2]
Additionally, cocaine, ketamine, MDMA, cannabis, and alcohol all can be found in PnP and chemsex scenes. In South Africa, especially in Cape Town, Mandrax (methaqualone) is also used, especially after chemsex, as a “comedown”.
Common during chemsex/PnP settings is the use of erectile dysfunction (ED) drugs (like Viagra and amyl nitrates, also called “poppers”) to assist with the sexual encounters. These work by counteracting the potential erectile dysfunction effects that chems may have and by enhancing and sustaining sexual performance, as chemsex may last for longer than 24 hours for some MSM who engage in chemsex.
Culture surrounding chemsex
Some chemsex participants view chemsex as a form of liberation or community bonding; for example, João Florênciore imagines the role that chemsex, in both its imaginary and its material dimensions, may play amongst gay men, specifically as a form of subcultural reproduction, as opposed to the negative connotations often attributed to this practice.[4]
However, it has become a pressing public health concern due to its association with risky sexual behaviors and the transmission of infectious diseases, like HIV and hepatitis.[5] Key populations—MSM, sex workers, people who inject drugs, and trans people—face heightened risks of contracting HIV, making this an important topic for discussion.[6]
According to harm reduction activist David Stuart, chemsex is more than just drugs and sex—it's a cultural phenomenon specific to gay men.[7]
He identifies several factors that have shaped queer culture around drugs and sex, especially with the rise of chemsex as a way to address “complex issues that inhibit the enjoyment of gay sex, such as societal internalized homophobia, the impact of the HIV/AIDS epidemic within gay cultures, and religious or cultural shame that is often associated with gay sex.”[8] He further attributes the rise in chemsex’s popularity to:[7]
- Gay hookup apps and body-shaming tendencies
- Gentrification
Stuart cautions that authorities who fail to understand the cultural importance of chemsex risk harming those within the scene. “If the cultural uniqueness [is] whitewashed out of a public health response, there are worse health outcomes for these communities,” he warns.[7]
Who engages in chemsex?
The historical narrative of chemsex and PnP often centers around white cisgender gay men. For example, in the early 2000s in New York City, a demographic—known as “Chelsea Boys”—used meth in the highest proportions, according to city health data.[9]
This has since shifted, with Black and Latino gay men now leading in meth use. Black queer filmmaker Michael Rice highlighted the rise of PnP culture among gay men of color in his 2017 documentary parTyboi.
Trans women, who also use crystal meth and other drugs at high rates, remain under-recognized for their participation in chemsex and PnP by public health.[10] This may be partly due to the unique circumstances of their involvement.
“For many, there’s a huge survival element,” says Vivian Veronica from Project Neon, which is a harm reduction organization, and who is a trans woman active in Seattle’s PnP scenes. She notes that many women initially turned to crystal meth in connection with sex work, often as a way to cope with sex work. Over time, its use became more widespread. For sex workers, crystal meth acts as a performance enhancer, increasing energy, heightening libido, and reducing anxiety, assisting them to do their jobs—particularly for those facing limited options to secure necessities, like food.
A common misconception is that women engage in sex work for drugs; however, like long-haul truck drivers using stimulants, it is often a means of managing demanding work conditions.
Risks involved with chems
During chemsex encounters or parties, polydrug use is the norm. Additionally, the different drugs used are consumed via different methods of use/administration. For example, a person might drink GBL/GHB, then move on to inject/slam crystal meth while inhaling poppers, and then snort mephedrone later on.
The table below outlines the most commonly used drugs in chemsex settings, their effects, and associated risks. While this information provides a quick reference, remember that drug interactions and individual health factors can greatly influence outcomes. Understanding these risks can help promote safer practices and reduce harm.
| Drug | Chemsex-specific effects | Risks in chemsex |
|---|---|---|
| GHB/GBL | Enhances relaxation and sexual disinhibition | Unconsciousness, overdose risk during group sex, increased HIV/STI risk, date rape |
| Methamphetamine | Prolonged stamina for extended sexual sessions | Overamping (agitation, paranoia), dehydration, heart strain |
| Mephedrone | Increased sociability and heightened sexual arousal | Overheating, serotonin syndrome, compulsive behaviors |
| Ketamine | Pain desensitization and dissociation during sex | Bladder and reproductive damages, risk of sexual assault while dissociated |
| Sildenafil (Viagra) | Facilitates erections for protracted sexual activity | Sudden blood pressure drop with poppers, headache |
| Poppers (Amyl Nitrite) | Brief sexual euphoria and muscle relaxation | Dangerous blood pressure drop with ED drugs, fainting |
Overamping on stimulants
Since chemsex mainly involves the use of stimulants, the chances of overamping, sometimes referred to as overdosing on stimulants, are high. Even a tiny amount of a stimulant can cause overamping and can lead to heart attack, stroke, seizure, or overheating.[11]
Physical symptoms of overamping could include:[11]
- Nausea and vomiting
- Falling asleep/passing out (still breathing)
- Chest pain or a tightening in the chest
- High temperature/sweating profusely, often with chills
- Fast heart rate/ racing pulse
- Shortness of breath
- Convulsions
- Hypertension (elevated blood pressure)
- Teeth grinding
- Insomnia
- Tremors
Psychological symptoms of overamping could include:[11]
- Panic and severe anxiety
- Paranoia (severe)
- Hallucinations
- Extreme agitation, aggressiveness, restlessness, and irritability
- Hypervigilance (being aware of your environment, sounds, people, etc.)
- Suspiciousness
How to avoid overamping
You can reduce your chances of experiencing an overamp or overdose by:[11][12]
- Pacing your consumption/use
- Being aware of any risk factors, like high blood pressure, existing heart problems, or mental health issues, including psychiatric history
- Getting enough sleep or potentially bylaying in a dark, cold room and resting to avoid overstimulation
- Staying hydrated
- Maintaining adequate nutrition
- Ensuring you and who you are with know the signs of an overdose or overamp so emergency medical attention can be sourced quickly if needed
Overdosing on GHB/GBL
In addition to overamping and due to GHB/GBL's narrow therapeutic index, it is also possible to overdose on GHB/GBL in chemsex settings. The signs of a GHB or GBL overdose include:[13]
- Vomiting
- Shallow breathing
- Making snoring-like, gurgling noises
- Passing out (“G-sleep”)
- Confusion or disorientation
- Seizures or muscle spasms and twitches
- Respiratory arrest
- Choking or aspiration
How to avoid overdosing
The following are some practical tips that may help prevent GHB/GBL overdose in chemsex settings:[13]
- Measure your GHB/GBL dose accurately by using a syringe or dropper to measure. Start with a small amount and wait at least 2–3 hours before taking more.
- Never mix GHB with alcohol or other depressants (like benzodiazepines); this is dangerous and can cause breathing to stop.
- Hydrate and rest.
- Have a sober spotter.
- Know overdose signs.
- Be ready for emergencies.
Aspiration (choking on vomit) is a significant contributor to some fatal overdoses involving GHB/GBL. If you suspect someone is experiencing an overdose, turn them on their left lateral side (known as the rescue position) to help reduce the risk of this happening.
Chemsex and substance use disorders
While there is a lot of research on chemsex and infectious diseases, there is surprisingly little research from public health institutions into the possible substance use disorders (SUDs) that may be or become an issue for people who engage in chemsex.
The risk of developing problematic drug use isn’t universal or equally distributed across communities. For example, some MSM may engage in chemsex recreationally without developing a problem, while others, due to different factors, may develop an SUD.
According to the American Psychiatry Association, SUDs involve:[14]
- Loss of control over substance use
- Social problems due to substance use, meaning that one cannot fulfill one’s social obligations
- Physical dependence on a substance, otherwise known as tolerance
- Substance use in high-risk scenarios and despite associated harms
Resources for MSM who engage in chemsex
If you’re looking for support, information, or guidance about chemsex, these resources are here to help, whether your focus is harm reduction, community connection, or recovery. Explore the options below:
Self-assessment tools
- Controlling Chemsex Self-Assessment: Take this interactive self-assessment to better understand your relationship with chemsex/PnP. If you want to chat about your results, get advice, or find reliable information, their team is ready to help. Email them at support@controllingchemsex.com or visit their self-assessment tool at controllingchemsex.com.
- David Stuart’s Chemsex Care Plan: This is a video tutorial in which David walks through the online prompts of his "ChemSex Care Plan." It is a plan to make changes to chem use, take a break, stop altogether, or play more safely.
Harm reduction resources
- Gay Men’s Sexual Health Alliance: This platform offers real-life testimonials from men across the chemsex/PnP spectrum, practical harm reduction advice, and resources about drugs and safer use practices. It avoids abstinence-focused approaches and offers information tailored to your goals. Visit partyandplay.info.
- Your Party Play Field Guide (CATIE): This is a comprehensive harm reduction guide developed in collaboration with the Gay Men’s Sexual Health Alliance. It covers safer drug use, HIV/STI prevention, hepatitis C, and self-care tips for partying safely. Designed for gay, bi, trans, and queer men, as well as any men who use drugs. Access the guide at: catie.ca/resource/your-party-play-field-guide.
Counseling and support services
- Terrence Higgins Trust: For those seeking professional support, the Terrence Higgins Trust offers counseling services that are specifically for chemsex-related issues. Register through their site, and their team will contact you to assess how they can help. Learn more at chemsex.co.uk/chems.
Community forums and networks
- The Chemsex Forum: Join an international platform fostering dialogue and support among chemsex participants, including community organizers, clinicians, researchers, and peers. To join, send an email to main+subscribe@ChemSex.groups.io and follow the instructions. This forum is coordinated by ReShape, which also hosts events and projects worldwide.
Abstinence-based recovery options
- Rehab directory: If you’re committed to an abstinence-based approach and are ready to stop your chem use, explore rehab options designed to support your recovery. Contact us for more details.
You are not alone
No matter where you are in your journey, help is available. Whether you’re looking for advice, harm reduction resources, or recovery support, these organizations are here to assist you. Reach out to take the first step toward the support you need.
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