LET’S TALK ABOUT CHEMSEX
This month in our continuing series, we look at chemsex and process addiction, and how gay men can be vulnerable when the two are combined. By Vanessa McQuarrie
This month we look at chemsex and process addiction, and how gay men can be vulnerable when the two are combined.
THE APPEAL OF combining sex and drugs is obvious: more intense sex, increased arousal, lower inhibitions, and enhanced intimacy.
People have been combining drugs and sex – as couples and in groups – ever since, well, ever since they could. The types of drugs involved change according to what’s popular at the time and available.
Chemsex or “Party And Play” (Pnp for short) is an iteration predominantly practiced by gay and bisexual men. Pnp has come to focus on a handful of illicit drugs which, combined with prescription medications such as Viagra, add longevity to its list of appealing attributes.
Simon Ruth, CEO of Thorne Harbour Health, an organisation which provides services to the LGBTQI community in Victoria, notes that while people are still using a range of drugs to enhance sex – from ice and ecstasy to cannabis and amyl – the biggest change over time relate to the circumstances in which they do so.
“The move from bars and clubs to apps and private spaces has had an impact,” he says. Using drugs in homes is easier than navigating use in more public spaces like laneways, crowded dancefloors and toilet cubicles. Meanwhile, hooking up using an app allows for almost instant gratification.
Along with the pros come the cons, like an increased risk of overdose: “Some of the drugs can have fatal consequences if you don’t know how to use them.”
The drugs may also inspire men to take on sexual roles they normally wouldn’t – tops become bottoms and vice versa – and this requires different approaches and preparation methods to stay safe. If safety is neglected, there’s an increased risk of acquiring HIV and STIs.
Men who practice chemsex frequently may risk addiction – and not only to the drugs. Process addiction is the constant scrolling through apps to the point that it’s detrimental to work, social and home life. Compulsively repeating the processes leading up to chemsex is a type of behavioural addiction. It affects the brain differently to substance addiction, but both types are characterised by the same law of diminishing returns: the more a person seeks out the experience, the less pleasure they derive from the action.
“As with all long-term drug use across any community, chemsex can have some serious impacts on people,” says Brent Mackie, Associate Director Of Strategy, Policy And Research at ACON, an LGBTQI health service in New South Wales. Men who are more dependent on chemsex are at greater risk of mental and physical health problems, he says, and may experience anxiety attacks, acute paranoia, sexual dependency, injection site injuries, and sexual consent concerns.
Mackie is one of the authors of the FLUX Study (Following Lives Undergoing Change) which collects data on drug use by gay and bisexual men. FLUX confirms that only frequent illicit drug use (including chemsex) is associated with poor mental health outcomes.
“For the most part, men who engage in such things as sex partying are no different in terms of mental health to other men; [they] may even have somewhat better mental health. Of course, a small proportion of men who engage in chemsex have problems, including mental health problems, and they deserve appropriate support,” says Mackie.
“The far bigger mental health issue for gay, bisexual, and other homosexually active men is that poor mental health is associated with internalized homophobia and inability to express one’s sexuality freely, without shame, and without fear.”
Both Thorne Harbour Health and ACON offer support services around drug use. ACON provides up to 12 free counselling sessions for clients who want to manage, reduce or quit using. “ACON’s drug and alcohol programs are peer led and have a familiarity with the gay community including the personal, social and sexual contexts of drugs use,” Mackie says.
Thorne Harbour Health currently offers two programs, including Rewired, which specifically addresses methamphetamine use. Simon Ruth is a strong advocate for LGBTQIspecific services and programs, having worked in mainstream drug and alcohol services for 25 years. “The work a queer service does is very different to mainstream drug and alcohol services.”
Unfortunately, tailored services are limited, and most are only available in major cities in NSW and Victoria. “We don’t have any LGTBQ residential programs in Australia at all and that’s a real gap.”
However, residential programs specifically for LGBTIQ people are available at Resort 12, part of The Cabin group in Thailand. Stu Fenton, a clinical lead and Gestalt therapist, treats clients at Resort 12 and says he’s seen an increase in the number of clients seeking help for chemsex.
Fenton agrees men who engage in chemsex infrequently “don’t need to do anything because there is no problem” but anyone who feels like they’re struggling would benefit from short-term interventions like counselling or case management. Such men are classified as “abusers” of chemsex who would benefit from harm reduction services where they can start to moderate and change their behaviours to become “engagers” again.
Those who have an addiction are likely to need a period of abstinence, possibly in a residential treatment facility. “A good amount of time in residential treatment is between three and six months,” says Fenton, who runs an abstinence project for men who have tried everything but can’t break free. A former addict himself, he’s put in the hard yards by committing to rehabilitation (including a 12-step program) and completing stints in residential therapy. Upon recovery, he began a career as a therapist to help others.
Those who work on the frontline of addiction see it all and Fenton admits that even now, he can still be shocked when he hears about the ways in which gay men continue to “push the envelope” as they seek more intense chemsex experiences.
“Some engage in typically taboo behaviour such as injecting other people’s blood and purposefully trying to catch HIV or hepatitis C,” he says. “Or having more extreme sex and pushing their bodies to the limit – whether that be through pain, multiple partners, or partying for days without food or water or sleep.”
Other people may move on from ingesting or smoking their drugs to injecting them and taking meth anally. Combining certain drugs and taking risks with GHB and alcohol is also common. The consequences have been reported in the media and, while chemsex is often sensationalised, Fenton has seen gay men die or severely injure themselves as a result of drug psychosis triggered by chemsex addiction. Because relationships, families and friendships can be shattered, and people can end up in trouble with the police or in jail, “it is a problem for the whole community,” he says.
At the Second International Conference on Chemsex in Berlin this year, attendees discussed the relationship between chemsex addiction and mental health issues like trauma and loneliness, bullying and abuse, low self-esteem and internalised pain from homophobia.
The conference released the following statement: “We need to treat chemsex as a condition of loneliness, low self-esteem, disempowerment, fear and lack of community cohesion.”
If this perspective doesn’t resonate with you, don’t worry. Simon Ruth stresses that “there’s no one path for everybody” and ultimately treatment comes down to the individual. However, he notes that all treatment programs should examine why people turn to certain substances and behaviours, and to prompt the person to question what role they are playing. “You just have to find a program that meets your needs.”
If you have concerns for yourself, your partner or a friend, the online resources listed below are a good starting point.
Process addiction is the constant scrolling through apps to the point that it’s detrimental to work, social life and home life – the more a person seeks out the experience, the less pleasure they derive from the action.