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

DNA Magazine - - CONTENT #227 -

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.

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