Abstract

As the social consent for seeking help in the area of psychosexual health increases, specialists observe the current socio-cultural changes and the new phenomena they give rise to be reflected in their patients. One of these relatively new phenomena is chemsex. It is a distinct form of combining highly specific psychoactive substances and sexual activity, practised almost exclusively by men. Due to the heightened health risks, connected both with the drugs used and the frequent lack of protection during sexual activity, international public health institutions consider chemsex a health problem of men who have sex with men (MSM). Although the introduction of MSM as a category in the 1990s - mainly in the context of HIV - was based on important epidemiological premises (the behaviour, not the identification, is what is important in the context of risk), it is neglecting sexual identity that may be one of the missing links in the intersectional understanding and appropriate addressing of problematic chemsex. The article is addressed especially to psychiatrists, psychologists, psychotherapists, addiction and sexologists working with this group of patients.

Highlights

  • Combining psychoactive substance use and sexual activity is by no means a new social phenomenon, until recently it was not an area of special interest for clinicians

  • The psychoactive substances most commonly cited in those cases are alcohol, MDMA, amphetamine, and cocaine, and the sexual activity undertaken under their influence is thought to be a side effect of lowered control rather than a result of

  • Sexualized drug use (SDU), that is intentional use of substances before or during sexual activity aimed at facilitating its initiation or enhancing the experience, has emerged as a new topic of discussion

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Summary

Summary

As the social consent for seeking help in the area of psychosexual health increases, specialists observe the current socio-cultural changes and the new phenomena they give rise to reflected in their patients. One of these relatively new phenomena is chemsex. It is a distinct form of combining highly specific psychoactive substances and sexual activity, practised almost exclusively by men. Due to the increased health risks, associated both with the drugs used and the frequent lack of protection during sexual activity, international public health institutions consider chemsex a health problem of men who have sex with men (MSM). The introduction of MSM as a category in the 1990s – mainly in the context of HIV – was based on important epidemiological premises (the behavior, not the identification, is what is important in the context of risk), it is neglecting sexual identity that may be one of the missing links in the intersectional understanding and appropriate addressing of problematic chemsex

Introduction
Characteristics of chemsex
Who has a problem with chemsex?
Substances used
Key population
The missing links
Problematic chemsex is not a surprising phenomenon
Findings
Challenges for comprehensive psychiatric and psychotherapeutic care

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