Chemsex, the use of methamphetamine, GHB/GBL and other drugs in combination with sexual behaviors, is a significant global problem, especially among men who have sex with men (MSM). It is one of the most significant factors affecting new HIV infections and poor antiretroviral medication adherence. Chemsex instills confidence and a sense of interpersonal connection, along with heightened sexual desire. It also is an effective way of numbing uncomfortable emotions such as shame, internalized homophobia or loneliness. The combined intensity of stimulants, sex, and porn hijack the brain’s reward circuitry, effectively resetting the baseline level needed for both sexual arousal and performance. When used to enhance sexual behavior, these drugs create a lasting fusion between the intoxicated state and sexual behaviors. Once fused, tolerance quickly develops resulting in escalating drug use, the need for more intense sexual encounters, and sexual dysfunction. If such fusion has occurred, abstinence from the drugs often results in a loss of sexual desire. This presentation illuminates the biological, cultural, and psychological impact of chemsex and provides interventions and approaches that help clinicians support the client in reclaiming healthy, drug-free sex and intimacy.

1. Attendees will describe meth’s impact on the body and brain, including the fusion of substance intoxication and sexual behavior.
2. Attendees will demonstrate knowledge of best practices for chemsex treatment and the clinician’s role in promoting a sex positive approach, including reducing shame and stigma, to treat fused sex and drug use.
3. Attendees will compile practical steps to help recovering chemsex users untangle drug use, sex and intimacy, thereby reclaiming healthy sexual behaviors and relationships.