Having sex under the influence of illegal drugs – known as “chemsex” – should become a public health priority, researchers have said.
Drugs such as GHB, GBL and crystal meth are used to enhance sexual pleasure and reduce inhibitions – but may put users at risk, they warned.
Evidence suggests the drugs are used by certain groups, including gay men, for “sustained arousal” and “instant rapport” with partners.
Unprotected sex is the norm and users of the drugs report an average of five sexual partners per session, said the experts, writing in the British Medical Journal (BMJ).
The team, who are specialists working in sexual health and substance abuse in London, added: “These drugs are often used in combination to facilitate sexual sessions lasting several hours or days with multiple sexual partners.
“Mephedrone and crystal meth are physiological stimulants, increasing heart rate and blood pressure, as well as triggering euphoria and sexual arousal.
“GHB (and its precursor GBL) is a powerful psychological disinhibitor and also a mild anaesthetic.”
The experts said the growing popularity of chemsex may be putting users at risk of HIV and other sexually-transmitted diseases, as well as serious mental health problems.
They added: “Many barriers exist to chemsex drug users accessing services, including the shame and stigma often associated with drug use and ignorance of available drug services.”
They said some services are now developing specific chemsex and “party drug” clinics, with specialist mental health support and help for withdrawing from the drugs.
But they warned that users often describe “losing days” – not sleeping or eating for up to 72 hours – which “may harm their general health”.
Other researchers have said chemsex, including injecting drugs, creates a “perfect storm” for transmission of both HIV and hepatitis C.
The authors said data on drug use in a sexual context in the UK is lacking, but at one London clinic around 64% of people needing help with drug use reported using chemsex drugs in 2013/14.
The experts said: “Addressing chemsex-related morbidities should be a public health priority.
“However, in England funding for specialist sexual health and drugs services is waning and commissioning for these services is complex.”
Dr Richard Ma, from the Royal College of GPs’ sex, drugs and blood-borne virus group, said: “Chemsex is a rapidly emerging pattern of drug use, not just amongst men who have sex with men as often assumed, but heterosexual patients as well.
“Taking recreational drugs during sex can lead to a number of potentially harmful side-effects including facilitating the spread of common STIs and HIV, but also serious mental health problems, such as anxiety, psychoses and suicidal tendencies.
“As such, it is essential that both patients and healthcare professionals - including GPs and primary health care teams – are aware of these and take the issue seriously.
“The College would agree that chemsex is a public health issue and would support measures to raise awareness of its associated risks and appropriate support services in the community – as well as to help healthcare professionals to deliver the necessary care and advice to patients, without stigmatising the issue.”
He said doctors were trained to have “non-judgmental and sensitive conversations” so patients should not hesitate to discuss chemsex with their GP.
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