What is chemsex? Here's what you need to know

10 years ago, on a warm night in Los Angeles, I found chemsex. Somehow, I went through four years of college without trying anything stronger than beer, so I was not prepared for it.

Sure, I had drunk hookups with guys I met at the local gay bar, but that was different from what I found in L.A. Being drunk made sex harder for me, not easier. The stumbling fog of booze made me clumsy and tired. I didn't know it then, but good sex is a feat of coordination, rhythm, and endurance. Beer just made it sloppy.

One night, I was invited to a sex party in West Hollywood. The guys were beautiful, and the drug they gave me delivered a completely new sexual experience, more intense than anything I had known before. That drug was crystal meth.

In a few months, I could not masturbate without feeling intense cravings to get high — a phenomenon called "euphoric recall," which is a warning sign of dependence. Meth stuck with me for years, through two cities and several relationships, until a queer therapist in a different city helped me sort it out.

Other friends were not so lucky. I've seen the thrill and wonder of chemsex, and the tragedy of it, too.

Is chemsex fun?

For many, yes — at least in the beginning. Here is a fact: Most drugs are fun. Why else would people do them? Sex is fun, too.

Humans have always enjoyed sex, and we've taken mind-altering substances since prehistory. So, the practice of putting these together likely predates all known language, law, and religion. We have evidence that humans have consumed plant medicine and mind-altering compounds for as long as we've been around, and we've always been a very sexual species. (If you want to know more about that sexual history, read Sex at Dawn).

Also, humans naturally do things that are unhealthy for us. We eat too much, do dangerous physical stunts for sport, and sometimes don't drink enough water. We have evolved to seek pleasure even at our expense, against our own well-being. Drug use is another expensive pleasure that humans continue to pursue.

In the world today, where cheap, synthetic drugs are widely available, a social person is nearly expected to encounter and experiment with them. If you do, you're not being stupid or irresponsible — you're being a human being in the real world.

Humans everywhere suffer and die from drug overuse and abuse, so, while an activity might be instinctive, that doesn't make it safe.

For many, yes: chemsex is fun. But all drugs result in tolerance and resistance in the body. Thus, over time, you will need to use more of any substance to get the same effect, which means usage tends to increase and becomes less fun with prolonged use.

Many MSM use chems to lower inhibitions, intensify sensations, and create a sense of connection with their partners. For some, they offer a sense of community — feelings of connection with others at a bar or club, or even just a sense of belonging with other people who use a certain drug.

Who enjoys chemsex?

If you had asked me this before I started using them, I would have said drugs are only used by people from farms and small towns, without college degrees, in dire situations. I believed the myth that drug use is distinguished by class.

Far from it. Though some demographics do have disproportionate struggles with abuse compared to the larger population (MSM, for example), people of all economic and ethnic backgrounds use drugs. It's crucial to point out that not all groups have the same access to support and care, which are more easily accessed by wealth and privilege.

Put in less stuffy terms: Everyone does drugs. Chemsex is common in queer circles but happens in other communities, too. Some use it to explore their desires or manage social anxiety in sexual spaces. While it is markedly prevalent among MSM, it's not exclusive to this group. Anyone exploring their sexuality or seeking intensified sex might try it. However, several studies indicate a higher prevalence in urban MSM communities.

Can chemsex be done safely?

Safer chemsex involves harm reduction: setting boundaries, staying hydrated, knowing doses, using clean syringes if injecting, and using with trusted people nearby.

The best thing you can do is stay informed. Understand the effects and interactions of the substances you're taking. Also, set clear boundaries and limits regarding drug use and sexual activities, and consider taking PrEP to prevent HIV transmission. If you are HIV-positive (like me), set reminders to take your meds.

If injecting, use your own needles to prevent infection. People who regularly enjoy chemsex need good healthcare providers who are familiar with chemsex and can offer personalized advice.

What are the long-term risks of chemsex?

The most damaging long-term risk is developing a dependence on drugs for sex and intimacy. Meth, for example, can profoundly change how the brain experiences pleasure, altering a person's ability to experience sex is a positive way, potentially for life.

Chemsex commonly results in mental health struggles like anxiety, depression, paranoia, and even permanent cognitive and psychological damage, including psychosis. Long-term physical effects are common, too, like weight loss, exhaustion, and organ damage.

How do you find people to have chemsex with?

Apps like Grindr, Scruff, Romeo, Recon, and others have long been spaces where chemsex can be arranged. Terms like "PnP" (party and play), "Tina" (meth), or "G" (GHB) often signal chem use. Many guys connect through dating apps, online forums, or specific social networks. That said, one is just as likely to encounter people doing drugs in public toilets at a gay bar or club. The internet and apps have just made finding chemsex easier.

What are things you can do if chemsex becomes a problem?

You're not alone. There are many ways to seek support related to LGBTQ+ addiction or harm reduction services. Many strangers — to date, all gay men — have reached out to me on social media and asked about my process into what is now: thankfully, a healthy relationship with drugs. That process involved a therapist (two, actually), and that is what I recommend. But there are other ways to find help and support, as outlined below.

• Talk to someone you trust.
• Seek out organizations like Controlling Chemsex and Antidote in the U.K., Gay Men's Health Crisis in New York, the Los Angeles LGBT Center, and others. Your nearest LGBT center can likely point you in the right direction, and many LGBT centers — across the U.S. and Europe — offer support services directly.
• Talk to healthcare providers who are familiar with chemsex-related issues can offer guidance and treatment.
• Find a support group. Both in-person and online communities are places where people can share experiences and coping strategies.
• Save the numbers of hotlines, which can offer immediate emergency support. Help.org is just one place to find text lines, hotlines, and other ways to receive help quickly.

What do the experts say?

I'm just a sex writer. Although I have written about sex, drugs, and nightlife for some time, I'm no expert source. Here's a list of expert opinions from notable individuals and organizations:

"Chemsex is a complex issue that requires a coordinated response across health, justice, and social care settings."

— Dr. David Stuart, the late, gay Substance Use Lead at the pioneering sexual health clinic 56 Dean Street in London, and possibly the person who first coined the term "chemsex."

"Chemsex is a public health priority due to its association with increased HIV and STI transmission, as well as the physical and mental health effects of the drugs used."

— Dr. Michael Brady, Medical Director at Terrence Higgins Trust.

"Sex under the influence can also be a negative experience. Because of the high combined with peer pressure, you may choose to have sex that you feel bad about afterwards. By establishing exactly what you are looking for in sexual contact ahead of time, you increase the likelihood of things going the way you want them to. It also makes you less likely to perform sexual acts that you later feel uncomfortable with."

— chemsex.nl, a harm reduction platform

There are many experts out there — clinic workers, doctors, researchers, therapists, and activists — who believe harm reduction works and can help you or point you in the direction of someone who can. Support is always closer than you think.