Every generation finds a new way to get laid, get high and scare the authorities. Now the British Medical Journal has warned us that the rise of chemsex means it is no longer an alleged media scare story, but a public health priority. The recipe varies, but chemsex typically involves some combination of crystal meth, mephedrone, GHB and GBL, with multiple partners having sex that can go on for three days – Friday night to Monday morning. The prevalence of risky, unprotected sex – a natural outcome of being high and impulsive – is worrisome, as the result (aside from hangovers, comedowns and exhaustion) is leading to a rise in HIV, syphilis, gonorrhea and hepatitis C.
“This is a public health timebomb,” says Dr Richard Ma, a London GP and part of the Royal College of GP’s Sex, Drugs and Blood Borne Virus Group. “Physicians need to know how to spot the symptoms, and learn to extend the normal conversations they might have with patients about alcohol to include drugs and sex.”
Of course, inebriated group sex has always been with us, from Roman orgies to coked-up 70s wifeswapping parties. What makes chemsex different from taking a load of cocaine or MDMA and hooking up with a stranger (or a few) for a wild weekend?
The main difference, says Ma, is taking a specific combination of drugs that aid the ability to have sex for a phenomenally extended period of time. The ready availability of synthetic chemical uppers, combined with a growing culture of similarly minded people ready to meet up with the express purpose of having sex for as long as possible, has led to an explosion in the gay scene; one that a new film by Vice claims is leading to chemsex addiction. The problem is that doctors and researchers know very little about the practice, the risks and the long-term consequences. Few people go to their GP about drug-related problems, plus the stigma surrounding sexually transmitted infections compounds the problem.
So what symptoms should GPs look out for? The BMJ editorial advises GPs to keep and eye out for anxiety, depression, panic attacks and fatigue. But of course, not all chemsex enthusiasts will look worse for wear – just as not all alcoholics will be found on a park bench.
Given that the “new demographic” of chemsexers – young, affluent professionals – probably know how to manage their health in other respects, the prevalence of the behaviour is likely to go undocumented. So what preventative actions can GPs – or chemsexers – take? Same as before: if you’re going to mix sex and drugs to have fun, take sensible measures to reduce any risks – and use condoms.