Chemsex Fueling Sexual Compulsivity

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By Terrence Post, LADC

An increasing number of men who have sex with men (MSM) are taking part in a combination of drug use and sexual behavior. Recently termed Chemsex, the use of chemicals to “enhance sexual pleasure” results in an insatiable sexual appetite.

This epidemic is afflicting the U.S. and made worldwide headlines in 2016 when a 35-year-old attorney in London lost his 18-year-old boyfriend to this very experience. Sexualized drug use commonly involves crystal methamphetamine and GHB, which create a phenomenal experience where the struggles and sexual inhibitions common in MSM are overrun by a rush of dopamine and other neurotransmitters creating a sexual experience that will last from hours to days at a time.

Those engaging in Chemsex often report everything about sex feeling amazing, where ejaculations are explosive, and encounters are endless. The highly addictive drugs used allow their user to stay up for days at a time engaging in sexual activity the entire time, almost immediately after use. Sex without the drugs becomes impossible, and the relief that sex brings becomes one’s most important need.

The powerful sexual arousal, commanding energy, and extreme sense of self lead the user to become powerless over their erotic temptation, sexual behavior, and drug use. Sex becomes a person’s prime means for validation, excitement, pleasure, and meaning which nothing else compares to, creating an irresistible urge to have one’s needs met.


The highly subjective reasons MSM are led to Chemsex come down to the pursuit to have pleasurable good old-fashioned sex. Loneliness, internalized homophobia, body dysphoria, attachment insecurities, and trauma create a dangerous cocktail which makes having pleasurable sex painful. The moments before, during, and after sober sex place a person in a highly vulnerable situation in which their deepest psyche is exposed and open to ridicule.

Classified as a disinhibitor, the gay party drug crystal meth or “Tina” is a way to overcome any issue which makes having pleasurable, enjoyable sex difficult. Methamphetamine literally makes its user feel insanely powerful and amazingly beautiful like the god Zeus, where there is not a thing in the world that can stand in their way.

Additionally, Chemsex allows a person to play out sexual desires and fantasies which seem so taboo and stigmatized that doing so sober creates too much stress and fear, that arousal isn’t possible. When using methamphetamine, a person can overcome intimacy issues, shame, loneliness, and fears of rejection, cope with the effects of past sexual abuse, and overcome the stigma associated with HIV. The neurobiological need for connection is accomplished, and then some, by combining drugs and sex.


With all things this insanely pleasurable come the consequences. At the very least Chemsex leads to drug addiction. People involved in Chemsex often go to great extremes in risk-taking because inhibitions are absent, lust overtakes both empathy and deliberative decision-making, causing a person to go to far greater sexual lengths than they would have without drugs. This fuels unprotected sex, disregard for partner selection, and a sexual climax the user will chase for the rest of their life without being able ever to find again.

The Catch-22 with Chemsex is that eventually the very thing MSM engaging in Chemsex sought becomes unachievable, and where staying hard even becomes a futile battle. It significantly increases risk of HIV exposure, even to different strains to those already positive, as well as unknowingly placing both drugs and sex above all other needs and life functions causing family and relationship struggles, work conflicts, and financial burdens of $90,000 annually on average. Then if these are not enough, I see many clients seeking treatment due to the inevitable psychosis which comes with Chemsex, “jumping off a three-story rooftop believing I am being chased by dogs and the FBI” may fatally destroy the very thing these men seek.


At The Pride Institute, we believe for a person to overcome their connection between chemicals and sex, it can be excruciatingly difficult but absolutely possible. Meth use in MSM has one of the highest rates of recidivism even for those who sought treatment. Most substance abuse treatment programs do not incorporate the important element of sexual behavior and MSM-specific issues when treating substance use disorders. As a result, only the drug use is treated; however, once the drug is removed, a person now has this need for sex and connection without the mindset, skills, and ability to achieve it. One can only go so long before sexual desire catches up with them and the only way they know how to get it is by using chemicals.

The connection between meth use and all elements of sexual behavior including hookup apps and the party scene, in the brain, make it impossible to have one without the other. Breaking this connection while learning how to have pleasurable sex without the use of drugs is paramount in achieving long-term sobriety. At Pride we specialize in treating Chemsex and sexual compulsivity by helping MSM learn how to balance harm with gratification, build confidence, overcome homophobia, and gain a sense of sexual adventure all while possessing a sense of pleasure, stamina, and endurance.

My experience in working with MSM at Pride puts me in a place where I can comfortably say that even the hopeless addict who has been to treatment 15+ times in their life has hope in overcoming this beast and living a happy, fulfilling life all while enjoying close, wild, pleasurable, and intimate sex. I can’t count the number of clients who have come back and said that the sex they have always wanted, felt wired for, and desired for as long as they can remember has become a purely intense more fulfilling erotic experience, whether it involves a sling, a pup mask, numerous partners, or simply passionate sex with a life partner that they finally enjoy day after day.

Hope is there, and so is our community. One thing our community can do is see those involved in Chemsex as good people going to great, but harmful, lengths to get what the majority of people have. By not doing this we push these men back into yet another closet.

Terrence Post, LADC is a substance abuse and Chemsex counselor at The Pride Institute. For more information, go to

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