Chemsex works much the same way for gay and bi men and LGBTQ+ individuals. Typically, three specific drugs (chems) are involved: Methamphetamine (Crystal Meth), Mephedrone (Mcat, Meth), GHB and GBL (G, Geebs or Liquid Ecstasy). Ketamine and cocaine are sometimes also considered chems. These drugs facilitate sustained arousal and induce feel-good emotions and a feeling of instant rapport with sexual partners. Sex can last for hours, or even days with multiple sexual partners.

Chemsex mostly takes place in private sex parties, in someone’s home, behind closed doors. Currently, chemsex is so prevalent among gay men and MSM that health professionals call it an epidemic affecting much of the gay community.

However, Chemsex is not just a quick party high, it has deeper underlying issues:

• Gay, bi and LGBTQ+ people often try to cope with the burdened life history of loneliness, shame and emptiness in various ways, including casual sex encounters, fuelled by chems
• Other reasons for taking part in chemsex are associated with feelings of stigma and issues around self-esteem, worries about sexuality and HIV status and internalised homophobia
• Chemsex creates important issues around consent during sexual encounters, as often individuals lose their capacity to consent under the influence of drugs
• There are mental health issues emerging which include sadness, anhedoniae., the inability to experience pleasure, irritability, undue anxiety, intense suspiciousness, emotional outbursts, social anxiety, and, in more severe cases, hallucinations, paranoia and psychosis
• Chemsex can start off as being an intense, exciting or even liberating experience at the beginning, but as it involves very potent and addictive substances, it can lead to a state where substance use may become the major source of pleasure, connection and coping
• The risk of being infected with HIV, hepatitis B and C, as well as other sexually transmitted diseases is many times higher for individuals taking part in chemsex

As therapists, for us to be able to help our clients who take part in chemsex to:

• avoid the damaging physical and mental consequences
• to understand the ethical issues around consent
• to work with harm minimisation
• to explore and heal from the underlying issues of shame, stigma and loss of self-esteem

It becomes vital for us to create a non-judgmental attitude and cultural competency in communication with our clients which includes:

• Using biopsychosocial and sexology-informed approach, including a GSRD (Gender, Sexual and Relationship Diversity) aware method to assess chemsex in our clients
• Building a therapeutic collaboration with clients and gradually helping them with safer use for stabilisation and grounding
• Learning how to treat the underlying causes of Chemsex with the trauma-informed 3-phase model: stabilisation, processing and integration

At this intellectually-stimulating and practically-oriented seminar, we will explore the mental and emotional issues around chemsex, substance and alcohol use during sexual encounters, and reflect on strategies for harm minimisation so as to create opportunities for our clients to lead healthy, fulfilling lives with confidence in their sexual identities and practices.

In this seminar, delegates will learn:

• The aetiology of Chemsex
• How to assess Chemsex in gay and bi men, and MSM – The assessment will comprise a biopsychosocial and sexology-informed approach to understand clients’ erotic mind and sexual behaviours. This assessment will also include a GSRD-aware method, challenging heteronormativity
• How to work with harm minimisation. This is a sex-positive method in helping clients reduce the risk of Chemsex rather than an abstinence method. Drawing on the work from Chemsex pioneer David Stuart, therapists will learn how to build a therapeutic collaboration with clients and gradually help them with safer use for stabilisation and grounding. Behavioural techniques, as well as psychological resourcing will be used
• How to treat the underlying causes, including shame, using the 3-phase model. Once clients have enough grounding in safer use, therapists will learn how to treat the underlying causes of Chemsex with the trauma-informed 3-phase model: stabilisation, processing and integration. Therapists will also learn how to work effectively with shame, throughout the treatment plan

This training will be interactive.

Learning Objectives:

• Discuss how to assess Chemsex in gay and bi men, and MSM
• Explain how to work with harm minimisation
• Explain how to treat the underlying causes, including shame.

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