They give pleasure, make us feel less inhibited, make us feel horny and more intimate sexually, and intensify feelings of friendship and togetherness when socialising.

They take us out of ourselves and away from our everyday lives, for a while at least. They take us up and down, sideways, and through the middle. If this wasn’t the case millions of people wouldn’t take them, so there’s absolutely no point saying they don’t do something when they do.

However, these are not the only reasons. Scratch the surface and there’s experimentation, unhappiness, rebellion, relaxation, escape, fitting in, loneliness, peer pressure, boredom, and the ease of availability of drugs, particularly in London.

And we’re not just talking about chemsex. Who hasn’t had a drink or two before plucking up the courage to go chat with a guy or meet him on a date for the first time? Alcohol remains the social lubricant for many, particularly on the gay scene.

If you use drugs, you’ll probably say that you know your limits and can handle them. Some people can (maybe you can) but whether you know what you’re doing or not, you can increase the risk of HIV/ STI transmission, accidents and other injuries.

If you are feeling ill, tired, worried or depressed, are on your own or have something important to do in the near future (like go to work) their effects may not be what you want or expect.

Whilst they may make you feel better in the short term they may also make you feel worse. The effects of any drug can depend on a number of factors:

• The drug itself
• How much you take
• Where you do it
• Who you do it with
• What you think the drug will do
• What you’ve mixed your drugs with
• How you’re feeling at the time
• What you’ve eaten that day
• Any other drugs you’ve taken (prescription or not)

Borrowing from tomorrow

As much as we would like to think otherwise, recreational drug use, party drugs or chemsex don’t create energy, they allow us to borrow it from tomorrow’s supply. And then, when tomorrow comes, it’s payback time. The key is to minimise the impact of the ‘weekend cocktail’ on the week.

A weekend without sleep, meals, hours of endless dancing and drugs won’t be good for the immune system. It’s hardly surprising that when Monday morning comes, we’re feeling trashed/ damaged/ fucked (delete as applicable).

After the highs of Friday night/ Monday morning, there’s nothing like a heavy dose of reality and the misery this entails, to bring on the midweek blues. When we take drugs on the weekend aim to do what we can to reduce the harms, and ensure the impact doesn’t carry over.

In so far as gay men are more likely to have heard about ‘safer sex’ and ‘safer drug use’, ‘harm reduction’ is the term most used in drugs services and the harm reduction field. For all intents and proposes, the terms are interchangeable.

Harm reduction is about practical measures and policies that reduce the harm that people do to themselves or others from their drug use. The term emerged in the 1980s in the UK in response to cases of HIV among injecting drug users and the development of needle syringe exchange schemes.

The opposite can be said of primary prevention which tries to prevent people from using drugs in the first place or to stop them using once they’ve started. The focus of harm reduction is on ‘safer’ drug use rather than telling people “just say no.” You may be old enough to remember Nancy Reagan who said (now famously) in 1986 “And when it comes to drugs and alcohol just say No!” Alternatively, Joan Rivers said “Just say no… unless you can get a really good deal”, a satirical riff on the “Just Say No” anti-drug campaign.

Harm reduction has its share of supporters and critics. On one hand: it promotes and/ or condones drug use. On the other: it’s realistic, helps keep drug users safe(r), respecting individual choices and freedoms. Harm reduction initiatives include needle exchange schemes, drug consumption rooms, drug testing at festivals and in clubs, and providing information on safer drug use.

What is harm reduction? | AIDS Action Europe Berlin | 22 Nov 2018 | 3m 34s

The basics

• Use recreational drugs consciously not casually
• Check out and learn about individual drugs at DRUGS A-Z | MEN R US
• Be aware of your vulnerability to dependency and addiction
• The more you like it the longer you should wait to do it again
• Regularly test your ability to stop using by taking a break for a week or two, or a month
• Keep an eye on developing patterns and ask for help before there’s a problem, even if it’s just a chat with friend

Basic harm reduction | Release

Legal

• Most recreational drugs are illegal and often carry heavy penalties for possession, using, and selling or buying. So, don’t share or deal openly, or get twatted in public.

Drugs and the law | Release

Mixing and tolerance

• Using drugs involves risks and taking more or mixing drugs increases the risks. Don’t take more drugs than you need – give them about an hour before taking more.
• Mixing drugs (particularly with alcohol) may make the effects of other drugs seem different or weak, which could lead to you taking too much, and some drug combinations are deadly.
• We quickly develop tolerance to party drugs and our bodies will appreciate the chance of a break to recover. You’ll get more out of your drugs if you don’t take them every week.

Safer injecting

• Use your own injecting kit and do not share needles, syringes.

Safer injecting | MEN R U S

Calling 999

• Wherever you are, if someone gets ill and you have to call an ambulance, don’t mess about. Be sure to tell the medics what’s been going on. Don’t be afraid; it could save a life – may be yours!

Medications

• If you’re taking a prescribed medicine, it’s only sensible that your drugs don’t mess that up. It’s important not to miss or change doses set by your doctor, particularly with HIV and Hepatitis C medication. You may also find it helpful to use the HIV drug interaction checker, a rather cool tool from the University of Liverpool.

HIV Drug Interaction Checker | University of Liverpool

Be prepared: clubbing, partying and chillouts

• There is no shame in taking a ‘disco-nap’ before going out
• Eat something: something high in carbohydrates for energy (eg: pasta) and vitamin-packed (such as fresh fruit and veg) will help prepare your body
• Wear lightweight (non-nylon) clothes, don’t wear hats or caps and, if you can, take warmer clothing/ change of clothes with you for when you leave
• Clubs can get very crowded and extremely hot. This can cause you problems like dehydration, serious over-heating, and heat exhaustion – all of which are dangerous. Sweating is how bodies keep cool and stop hypothermia, so drink non-alcoholic sugary drinks to replace lost fluids
• Take regular chill-out breaks to help avoid over-heating and dehydration
• Sip about a pint of water per hour (but don’t go mad)
• Try to avoid alcohol which will only dehydrate you more and NEVER mix G with alcohol
• When you’re ready for sleep, drink something sugary and eat something salty. However much you don’t feel like it, eating helps to start replacing all those lost salts and minerals

• It’s all very well going to someone’s place, particularly if you’ve not been there before, but do you know the way out?
• Be aware that drinks could be spiked
• Be prepared to take a taxi home (or back to civilisation) and that includes having a card that works or cash in your pocket. It may sound a little old-fashioned but the consensus at MEN R US is a £20 note tucked in the back of a wallet
• While we’re talking old fashioned … it can still be a good idea to tell a mate where you’re going just in case things go wrong

Sex and drugs

• Drugs and alcohol have a pain-killing effect so you may not be aware of damage being done to your body, particularly your cock and arse
• Dehydration and raised temperature make delicate skin more likely to tear and bleed. Snorting or dabbing speed or coke, and chewing gum all night, can cause ulcers and bleeding in your mouth, which may increase the risks of infection
• Drugs and alcohol can alter your perception of risk and can make you less able to get the sex you want. When you’re mashed up it can be difficult to be assertive, to say no, or to insist on condoms

Those who use drugs tend to stick to what they know. Typically, gay and straight drug scenes are different, using different drugs for different situations.

Non-LGBT and LGBT+ people use drugs in social settings, such as pubs, clubs, and festivals, usually for a few hours, night or weekend. But for gay men, especially, there are spaces and scenes where the drugs used are taken to promote and enhance sex, typically stimulants like crystal meth (‘T’), mephedrone (‘M’), and GHB/GBL (‘G’).

Historically this has not included the opioid heroin. It’s rarely used to enhance sex in the way stimulants are. Its primary physiological effect is to suppress libido and sex.

Newer drugs on the block

Heroin is becoming increasingly difficult to purchase in the UK, and this shortage is being replaced by far more more powerful synthetic versions, with growing evidence that synthetic opioids¹ such as nitazenes² and fentanyl³, are increasingly more available in the UKs recreational drug supply. Hundreds of deaths have been linked to these substances since 2023.⁴

Drug dealers

Drug dealers provide a wide range of drugs to a wide range of clients. Whatever they request, be it ‘T’, ‘G’, ‘M’, ‘K’, ‘E’, coke, speed, acid, or cannabis, they all need to be weighed, packaged and distributed, during which cross contamination can occur through the use of shared scales, bags, or surfaces on which they are prepared, so there are many situations in which cross contamination with other drugs can occur.

This is particularly problematic if drugs are contaminated with one of these synthetic opioids. A tiny, microscopic speck – invisible to the naked eye – can be enough to stop a person’s breathing within minutes. Even ‘dust’ from a previous batch can be lethal. Tiny traces of these potent synthetic opioids may end up in your ‘T’, ‘G’ or ‘M’, meaning you can take what you think is your drug of choice and still overdose.

Having a conversation

It’s understandable to assume a level of familiarity or ‘trust’ with your dealer. Perhaps you believe any problems will happen elsewhere in the supply chain, not within your own network, so why risk having an awkward conversation about contamination risks? They want repeat business so it’s unlikely they would set out to kill you intentionally! 

It may feel awkward, but it’s a practical step. A simple, direct conversation with your dealer, or whoever is supplying your chems, about how they handle, weigh, package and store drugs, can reduce the risk of cross contamination, raise awareness and keep the issue relevant. You’re not being difficult: you’re protecting yourself and the people you use with.

Practical tips

Here’s a practical list how cross-contamination actually happens (so it can be prevented):

• Using the same scoop/spoon for different powders without cleaning.
• Taring/weighing multiple drugs on the same scale platform.
• Pouring or tapping powders from one bag into another so residue falls into the next packet.
• Shaking or handling multiple bags in the same hands/gloves.
• Re-using unwashed funnels, paper, or makeshift scoops (cards, folded paper).
• Cutting or dividing blocks/tablets with the same blade/knife without wiping.
• Storing different drugs in the same container or on the same surface.
• Transferring via fingers that touch one product then another.
• Dust/aerosol spread when scraping, chopping or powdering near other stock.
• Using communal trays, chopping boards or workbenches with residue.
• Re-using packaging (old bags/foil) that still holds traces.
• Wet contamination from liquids/solvents used nearby that pick up solids.

Self-Test Strips

Self-test for fentanyl and nitazenes strips are available and are widely used harm reduction tools, but they have major limitations. A negative result on a strip is not a guarantee of safety. It only means the strip didn’t find the specific chemicals it was printed to find. Chemists are constantly creating new versions of nitazenes and test strips may not recognise the new varieties, resulting in a false negative.

¹ Man-made substances in laboratories.
² Highly potent synthetic opioids, with some variants significantly more potent than heroin.
³ A powerful synthetic opioid, 50-100 times more potent than morphine.
⁴ Of the 5,565 registered deaths in England and Wales in 2024 (up 2.1% from 2023) nearly half (47%) involved an opioid. Deaths involving nitazenes quadrupled in a year, from 52 in 2023 to 195 in 2024. However, this data does not include “cross-contamination” deaths. Half of all reported deaths involve more than one substance (e.g., cocaine mixed with alcohol or heroin mixed with benzodiazepines) so opioid-related deaths may be much higher than official records indicate.

Drugs and the law is a complicated subject and if you find yourself in trouble you should get legal advice at the earliest opportunity. If the police have reason to suspect that you’re carrying an illegal drug they have the right to search you and make you empty your pockets.

They can also take you to the police station and search you there. If drugs are found you could be charged with one of two offences: possession which means being caught with an illegal drug for your own use, and possession with intent to supply drugs which means if you had any intention to deal (sell), give away or share drugs.

You can view a copy of your “Rights on Arrest” as a PDF here. The booklet is also part of our “Safer” pack, which you can get here.

Rather than reinvent the wheel, the text is based on the “Bust Card: Your Rights on Arrest” by Release—in continuous publication since the early 1970s—text used with kind permission.

Release provides a free, confidential, non-judgemental national information and advice service in relation to drugs and drug laws. Its drugs and legal teams are highly knowledgeable lawyers and drug professionals and are on-hand to help and advise you and respond to queries. Release don’t use guides or frequently asked questions as each query will depend upon a unique set of facts and circumstances, so don’t be embarrassed to ask a question.

If you are unsure whether you have a drugs or legal inquiry don’t worry – their teams work in collaboration, so you can be assured you will receive a response to your query.

Tick Tock! | Three Flying Piglets for Release and MEN R US | 2017 | 1m

Listed in no particular order, this selection of drugs and harm reduction organisations provides accessible, evidence-informed information on drugs, their effects, risks, and safer use. Their shared aim is to reduce harm, improve decision-making, and support health and wellbeing through education, real-time alerts, and community-informed guidance for the general population and people who use drugs across varied settings.

Talking Drugs
Talking Drugs is one of the few online platforms dedicated to providing unique news and analysis on drug policy, harm reduction and related issues around the world. It delivers geographically diverse coverage of the important issues, with a level of topic expertise often lacking in the mainstream media. Talking Drugs gives people the opportunity to become engaged in the debate and encourages those who wish to contribute to get in touch with about either volunteering or submitting a piece of work for publication. In particular, Talking Drugs is keen for people to tell their stories of how drugs and/ or policies have affected their lives or their communities.
Talking Drugs | Release

International Network of People who Use Drugs (INPUD)
International Network of People who Use Drugs (INPUD) is a global peer-based organisation that seeks to promote the health and defend the rights of people who use drugs. INPUD exposes and challenges stigma, discrimination, and the criminalisation of people who use drugs and its impact on the drug-using community’s health and rights. INPUD achieves this through processes of empowerment and advocacy at the international level, while supporting empowerment and advocacy at community, national and regional levels.
International Network of People who Use Drugs (INPUD)

Drug Science
Provides an evidence base free from political or commercial influence, creating the foundation for sensible and effective drug laws. Equipping the public, media and policymakers with the knowledge and resources to enact positive change. Formed by a committee of scientists with a passionate belief that the pursuit of knowledge should remain free of all political and commercial interest.
Drug Science

These are mainstream drug and alcohol services listed by London borough. We aim to contact drug services at least once a year to verify the services provided. However, we do not guarantee the quality of service.

• A service we should add, or we’ve got something wrong, email here
• You can’t find a service (we’ll try to signpost you), email here

Services restricted by London borough
This has to do with the way they are commissioned (bought) though it’s pretty nuts for you: a guy in need of support being told a service can’t help because you don’t live in the borough. Fortunately, front-line staff tend to be helpful so if you’re in crisis contact any of the organisations listed by Borough below who will point you in the right direction. 

Finding the right service for you
Some guys prefer to use gay or gay-friendly services which (as a rule) have a much better understanding of the issues affecting our lives, and the context. Others are happy to access mainstream services. Most services aim to be welcoming, respectful, knowledgeable, and understanding. The thing is to find a service that’s right for you (as best it can) and “gets the job done.” You may wish to phone first to check if the vibe feels right. Some of these questions may be more important than others, or you may have some of your own:

• Do you have an alcohol, drugs, or chemsex service for gay/ bi men?
• Do your workers have knowledge of health issues specific to gay/ bi men?
• Are there service times for gay/ bi men?
• Is your service LGBT+ friendly?
• And why not check out the service’s website?

Your GP
While your GP may not have specialist knowledge about recreational drug use (or chemsex) they should be able to point you to a service that does. Furthermore, they may be able to refer you directly, and can usually connect you to other support should you need it. It’s a good place to start if you feel you can have a conversation with them.

Changing names
We’re not a fan of constant renaming, rebranding (or local authority contract churn). It can make it more difficult to know who provides what and where to go. Local authorities should have up to date details of drug and alcohol service provision in their boroughs. 

Here is a list of current drug and alcohol service providers and their previous names:

• Change Grow Live or CGL previously Crime Reduction Initiatives (CRI). Changed 2015
• Cranstoun has not changed
• Forward Trust previously Rehabilitation for Addicted Prisoners Trust (RAPt). Changed 2017
• Turning Point has not changed
• Via or v-i-a previously Westminster Drug Project (WDP). Changed 2017-18
• Waythrough previously Humankind, merged with Richmond Fellowship. Changed 2024
• We Are With You or With You previously Addaction. Changed 2020

Alcoholics Anonymous (AA), Narcotics Anonymous (NA) and Crystal Meth Anonymous (CMA) are free, volunteer‑run mutual‑aid fellowships that follow the Twelve‑Step programme:

• AA focuses on alcohol
• NA covers any drug, including prescription meds and alcohol if the member chooses
• CMA addresses crystal meth

CMA says its “meetings are open to anyone who feels they have a problem with crystal meth, and any other mind altering substances. Anyone may attend one of our meetings, regardless of age, race, sexual identity, creed, gender, religion, or lack of religion” (though its Twelve Steps mentions God six times which will suit some but not others). First names only are used and confidentiality is expected. You don’t need to call or register in advance, so please feel welcome to just come along to a meeting.” Meetings can feel raw, and you may hear harrowing life stories. That raw honesty is the point but some find it challenging or off‑putting.

We have heard stories from gay men who have not felt welcome, facing heteronormative language and assumptions, micro‑aggressions from group members and straight participants who can find it hard to relate to crystal use to enhance sex. However, we also know some groups are explicitly LGBT+ inclusive such as Soho LGBTQ+ NA, NA Queer to Stay, LGBTQ Chair and Clean & Queer in Dalston.

The important thing is to find support that’s right for you. 

The 12 steps in the UK

AA, NA, CA, and CMA in the UK remain grounded in the original 12-step framework. While they officially identify as “spiritual, not religious,” the use of terms like “God,” “Higher Power,” and “Prayer” maintains a religious overtone that some find off-putting. In the UK, the “overtones” are often softened by a more secular culture than in the US, but the literature (which has not been substantially rewritten since the 1930s) remains unchanged.

Alcoholics Anonymous (AA)
Fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. No fees or dues for membership. Self-supporting through contributions. The only requirement for membership is a desire to stop drinking.
Alcoholics Anonymous
0800 9177 650 | 10am-10pm

Narcotics Anonymous (NA)
Fellowship of men and women for whom problematic drug use has become an issue. Self-help support groups that meet regularly. Membership is open to anyone seeking help, regardless of what drug or combination of drugs has been used. No fees or dues for membership. Self-supporting through contributions. The only requirement for membership is a desire to stop using drugs.

Crystal Meth Anonymous (CMA)
Fellowship of people who share their experience, strength and hope so that they may solve their common problem, and help others to recover from, addiction to crystal meth. The only requirement for membership is a desire to stop using.
Crystal Meth Anonymous

Cocaine Anonymous
Fellowship of men and women who share their experience, strength and hope with each other. The only requirement for membership is a desire to stop using cocaine and all other mind-altering substances.
Cocaine Anonymous

Sex Addicts Anonymous
Recovery meetings offer an accepting, non-judgmental environment where common struggles can be shared and a space to learn how to apply some simple principles in everyday life.
  Sex Addicts Anonymous

Sex and Love Addicts Anonymous
Open to anyone who knows or thinks they have a problem with sex addiction, love addiction, romantic obsession, co-dependent relationships, fantasy addiction and/or sexual, social and emotional anorexia.
Sex and Love Addicts Anonymous

Co-Dependents Anonymous
Fellowship of people whose common purpose is to develop healthy relationships. Self-help groups with a common interest in working through the issues that co-dependency has caused. The only requirement for membership is a desire for healthy and loving relationships.
Co-Dependents Anonymous

Gamblers Anonymous
Fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to do the same.
Gamblers Anonymous
Gamblers Anonymous Scotland
Gamblers Anonymous Ireland

Families Anonymous 
Meetings are for Families and Friends of those with a drug or related behavioural problem. UK-wide with meetings in London.
Families Anonymous 

England
Drug and alcohol services England search | Talk to Frank

Scotland
Drug services Scotland search | Scottish Drug Services Directory

Wales
Drug and alcohol services Wales search | Wales Drug and Alcohol Helpline

Northern Ireland
Drug and alcohol services Northern Ireland search | HSC Public Health Agency

Republic of Ireland
National Directory of Drugs and Alcohol Services | National Directory of Drugs and Alcohol Services

Residential rehabilitation services for drugs and/ or alcohol in England and Wales
Residential rehabilitation services for drugs and/or alcohol in England and Wales | Rehab Online
Residential rehabilitation services for drugs and/or alcohol in England and Wales | Drink and Drugs News

While there does not appear to be a single cause of alcohol dependence, personality, environment and the addictive nature of alcohol contribute to the development of the illness. It is also thought that genetic factors probably play a part in causing dependence, and any person can become alcoholic if he drinks heavily for a prolonged period. Some symptoms can appear over a period of weeks and months, but alcohol dependency usually occurs over a period of years, sometimes decades. Symptoms fall into two categories which can include any combination of the following:

Physical symptoms

• Bad breath
• Confusion
• Hangovers and headaches
• Flushed appearance or redness in the face
• Forgetfulness and memory lapses
• Incontinence (pissing or shitting yourself)
• Nausea
• Shaking in the morning
• Stomach or tummy cramps
• Unsteadiness
• Vomiting
• Weakness, numbness or tingling in the legs and hands
• Severe shakes, hallucinations, and convulsions may occur after the sudden withdrawal of alcohol which can be life threatening.

Behavioural symptoms

• Secretive drinking, eg: at work
• Aggressive, dramatic, or grandiose behaviour
• Personality changes such as irritability, jealousy, uncontrolled anger, and/ or selfishness
• Lying to yourself and others about giving up
• Changes in drinking pattern, eg: changing from evening to early morning drinking, or changing from beers to spirits
• Neglecting food and nutrition
• Neglecting personal appearance
• Long periods of drunkenness
• Frequent changes of job

Unfortunately, most men who drink too much are either unaware that they have a problem or refuse to admit it. If you or someone close to you is drinking in excess, contact the family doctor or a helpline for advice. It is worth trying to reason with the person when he’s sober.

In severe cases it may be necessary to admit an alcoholic to hospital for a period of detoxification with medication prescribed to control the withdrawal symptoms. Even then, long-term treatment to prevent a return to previous drinking habits is invariably required and can include behavioural therapy and psychotherapy. Occasionally the drug known as is prescribed, which induces unpleasant side-effects when alcohol is taken.

The body reacts to large quantities of alcohol in several ways, although this usually takes several hours. The lining of the stomach and lower parts of the digestive system are irritated; the body is dehydrated while the level of alcohol in the blood stream exceeds the livers ability to process it; and the nervous system is shocked and needs time to recover.

Symptoms and what to do
Symptoms include headache, nausea, stomach-ache and cramps, vomiting, dizziness, and irritability. This is the twilight world of the hangover. We’ve all been there: stumbled into a cab… staggered on to a bus… rolled into bed… and fallen into a nauseous sweaty sleep.

The next day you wake up with a throbbing headache, a furry tongue, a mouth which tastes… interesting, and breath you could bottle and sell as paint stripper. The best cure is not to have got in to this sorry state in the first place. When you get a hangover you have in effect poisoned the body – albeit temporarily – and it needs time to recover. However, there are practical steps you can take to ease symptoms and aid recovery:

• Drink as much water as you reasonably can throughout the day. This rehydrates the body and helps you to piss out the toxins.
• Drinking other liquids can help the body re-hydrate, tea and coffee which contains caffeine will stimulate the nervous system but are also dehydrating. Sugar can be taken to provide energy. Fruit juices, honey and a vitamin C are also known to help and fizzy drinks may have a soothing effect upon the stomach.
• Drag your sorry arse out of bed, take a shower or bath. Take a walk to get the blood circulation going. This will help provide fresh supplies of oxygen and sugar to the brain and stimulate endorphins, the body’s natural painkillers.
• Settle down in front of the TV or a video and relax.
• The stomach can be relieved by something to eat but anything fatty or rich may make you feel nauseous.
• Aspirin or other pain relievers should only be taken after you have eaten something. Your body will be further irritated if they are taken on an empty stomach.

The hair of the dog
Another alcoholic drink, sometimes referred to as the hair of the dog, will kick start the nervous system and can make you feel better… for a while. BUT this only postpones the original hangover with a second one hot on the heels of the first.

For many years, gay pubs were the only places where we could meet other men without fear of abuse or assault. Today, while we can meet guys through a much wider range of places and activities, pubs, clubs and bars are still central to the gay scene. Also, since the main reason for going to bars is quite often to meet other guys, you’d be forgiven for not thinking about the risk of alcohol dependence. It’s not difficult just to have a few beers – three or four times a week – and you’ve reached the recommended limit before the weekend has even started.

Loneliness at the bar
A drink or two can dull the sense of loneliness as you stand by yourself in a bar trying to look confident. A drink or two will often provide the necessary confidence to go up to another guy and ask him whether… he’d like a drink. A further drink or two will also dull the sense of rejection after he tells you that he’s not interested or he’s got a boyfriend. Meeting mates for a drink can help reduce any sense of rejection, inferiority or loneliness but – on a regular persistent basis – can lead to a steady increase in the amount you drink. After all, who’s going to have ‘just the one’ or have orange juice?

Alcohol and sex
Even if you’ve found yourself a man, alcohol – even in small quantities – can reduce the enjoyment of sex. Alcohol can make it difficult to get or maintain an erection – hence the phrase ‘brewer’s droop’. It can also interfere with your judgement so you may take risks sexually that you wouldn’t find acceptable if you were sober. Guys have been assaulted, raped and murdered for less! When we are younger our bodies give us the impression that they can cope with any drink we throw down our neck. The reality, however, is that the body is storing up problems for later life.

A fine line
Of course, there is always the option not to drink alcohol or to drink low alcohol versions of beer or wines. However, the choice is usually limited and they don’t always taste particularly good. In moderation, drinking can and should be a pleasant experience, helping us to feel that little bit more relaxed, comfortable, and sociable. But despite its acceptability on the gay scene and its normalisation on TV and film, alcohol is still a drug with the potential of being highly addictive. Being selective when using it is vital if we are to enjoy the benefits but not become subject to the harm it causes. Despite protestations that ‘I know my limit’, there’s a fine line between drinking socially and becoming dependent. Anyone who drinks alcohol can become an alcoholic and the more we drink the more we increase the risk of dependency and health problems.

Gay men drink more 
In a NHS Digital 2021 report, “LGB adults were more likely to drink at levels which put them at increased or higher risk of alcohol-related harm, (that is more than 14 units in the last week): 32% of LGB adults compared with 24% of heterosexual adults. Among the white population, heterosexual and LGB adults were equally likely to report that they drank no alcohol in the last week (35% and 33% respectively). Among those from an ethnic minority, heterosexual adults were more likely to report no alcohol consumption in the last week (71%) compared to LGB adults (55%).

Even small quantities of alcohol have effects on the body which are noticeable (particularly in someone who doesn’t drink often or hasn’t done so for some time). It’s surprising how after a single drink – 20-30 minutes later – people can become more relaxed. Problems occur when people don’t take into account the effects of alcohol on behaviour when socialising, or tasks requiring co-ordination such as talking, walking, or driving.

When you are drunk
When you are drunk, you are also more susceptible to assault, non-consensual sex, theft and abuse. Prolonged heavy drinking that stops short of dependence may still cause liver and health problems. Dependence (alcoholism) can cause early death and is a major factor in absenteeism from work, accidents and relationship breakdowns. Changes in behaviour depend on the amount of alcohol reaching the brain, which are determined by several factors apart from the quantity of alcohol drunk.

• The rate at which the alcohol is drunk.
• The size of the person, eg: the larger the person the greater the diluting effect of the blood on the alcohol consumed and the more it takes to produce the same effect.
• Whether alcohol is consumed on an empty stomach or not. The effect will be much more immediate (as little as five minutes) if the stomach is empty. Food in the stomach slows down the rate at which alcohol is absorbed into the bloodstream.
• The size and condition of the liver.

Worst case scenario
Taking into account the above factors, your behaviour from a first to last ever drink might look something like this: A sense of warmth – friendliness – flushed face – talkativeness – increased social confidence – reaction time slows – further sense of mental relaxation and general well being – trip over words – tendency to be loud and talkative – inhibitions about to jump out the window – confused and disturbed thinking and co-ordination – irritability – reduced self-control – irresponsible talk and behaviour – unsteady on feet – slurred speech – unpredictable, exaggerated emotions or (aggressive) behaviour – extreme confusion and disorientation – difficulty remaining upright – drowsiness – nausea – shitting yourself – delayed or incoherent reaction to questions – coma (a state of deep unconsciousness from which you cannot be aroused) – followed by death.

Your Brain on Drugs: Alcohol | asapSCIENCE | 21 Nov 2012 | 2m 13s
What Happens When You’re Drunk? | Brit Lab | 28 May 2015 | 5m 20s

Units are measurements of alcohol consumption and can be used to help calculate the amount of alcohol contained in a drink. However, although most of us have heard of them, surprisingly few people actually know how to calculate them

• Your average pint of beer (4% strength) is 2.3 units, a stronger beer (5%) is 2.8 units, while a pint of strong cider (8%) is 4.5 units
• A standard glass of red or white wine (125ml) is 2.1 units while a large glass is 3 units
• A single shot of spirits (25ml) is 1 unit

Drinks poured at home are usually more generous and should be scored double. Also, score twice as much for extra-strength beers.

Weekly limits
As of January 2016, the first new guidance since 1995 recommends weekly intake for men is reduced from 21 to 14 units of alcohol a week. The Chief Medical Officer guidelines for both men and women who drink regularly or frequently (ie: most weeks) are as follows:

• You are safest not to drink regularly more than 14 units per week, to keep health risks from drinking alcohol to a low level
• If you do drink as much as 14 units per week, it is best to spread this evenly over 3 days or more. If you have one or two heavy drinking sessions, you increase your risks of death from long-term illnesses and from accidents and injuries
• The risk of developing a range of illnesses (including, for example, cancers of the mouth, throat and breast) increases with any amount you drink on a regular basis
• If you wish to cut down the amount you’re drinking, a good way to help achieve this is to have several drink-free days each week

14 units of alcohol roughly equate to:

• 6 pints of ordinary lager, beer or cider (at 4% strength)
• 14 single spirit drinks (at 40% strength)
• 7 glasses of wine (at 12% strength)

Spread your allowance
Spread your allowance throughout the week at this level and frequency of drinking is not likely to harm your health. However, people’s tolerance to alcohol varies enormously and even the recommended amounts may be too much.

Alcohol-free days
You should aim for at least 2 or 3 alcohol-free days a week. Don’t save up your allowance to blow it over one night at the weekend because it puts excessive strain on the body and liver especially.

The more you drink
The risk to your health and safety increases, the more you drink. If you drink 30+ units a week you are running the risk of liver damage, accidents and alcohol dependency. It’s not only your physical health that’s affected: your drinking could lead to social and legal difficulties, eg: drink/driving offences, problems with your friendships and relationships or the loss of your job. It’s when we’re tanked like this that we may behave badly at parties, become aggressive and argumentative and take risky decisions when it comes to sex.

No alcohol safe to drink, global study confirms

The Global Burden of Disease, a large new global study published in the Lancet has confirmed previous research which has shown that there is no safe level of alcohol consumption. The researchers admit moderate drinking may protect against heart disease but found that the risk of cancer and other diseases outweighs these protections. A study author said its findings were the most significant to date because of the range of factors considered.

No alcohol safe to drink, global study confirms | BBC | 24 Aug 2018

The digestive system absorbs around 30% of any alcohol drunk. This is carried around the body by the bloodstream and reaches the liver, one of the largest and most important body organs.

The liver makes and regulates many of the body’s chemicals and helps break down and eliminate toxins and other poisonous substances from the blood. It is here that alcohol is broken down, at a rate of 1 pint of beer or 30cc (1oz) of whisky per hour.

This process breaks down around 90% of the alcohol into carbon dioxide and water, the remaining 10% being processed through the lungs and as sweat (which is why you may smell rotten the morning after).

Alcohol (chemical name ethyl alcohol or ethanol) is a colourless liquid in its pure form, usually found as a beverage, and is both powerful and addictive.

Ethanol is produced by fermentation – the chemical reaction between bacteria and starch such as maize, barley, rice, potatoes, hops and grapes. Malt and barley make beer, and grapes make wine, but only a 10-15% level of alcohol is possible by this method. Spirits such as gin, brandy, vodka, whisky and liqueurs which have a higher alcoholic level require distillation as well as fermentation.This means that the water is evaporated, leaving the alcohol in greater concentration. Distilled alcohol is also added to fermented drinks to strengthen them, eg: sherry, port and other fortified wines.

Alcohol by volume (ABV)
The strength of alcohol is denoted by the term ABV (alcohol by volume) and this describes what percentage of total liquid is alcohol. Alcoholic drinks can be divided by strength into three categories:

• Beers: up to 7-8% ABV (alcohol by volume)
• Wines: up to 20% ABV
• Spirits: up to 40% ABV (in the UK)

Electronic cigarettes, known as e-cigarettes or vaporisers, are battery-powered devices, a cigarette substitute that provides small amounts of nicotine without the tobacco or other chemicals from real cigarettes.

E-cigarettes are made up of 3 parts:

• a tank to hold the e-liquid (contains the nicotine and flavouring)
• an atomiser to heat e-liquid (roughly 100 – 250 °C within a chamber)
• a battery to power the atomiser (1000 – 5000mAh approx)

The main substances making up the liquid in the e-cigarettes are nicotine (which comes in varying strengths), propylene glycol, glycerin, and some flavours/ smells/ aromas … from fruit favours to bubblegum to coke. [Yes, we’ve just thrown up a bit in the back of our collective throats]. The e-liquid is heated to make a vapour that looks like the smoke from real cigarettes carrying the nicotine to the lungs where it is absorbed.

Acknowledged that vaping is less harmful than smoking there is a focus on determining what issues and harms e-cigarettes and vaping may cause. Although not harmless, the evidence is that vaping is safer than smoking.

However, it’s worth bearing in mind that the history of modern-day cigarettes has been going on for decades while the e-cigarette was only invented in 2003. So, the e-cigarette narrative has yet to run its course, and we have a lot still to learn, particularly concerning what damage and harm they may cause.

The recent spate of news about the harms and deaths vaping causes does not appear to bode well for either users or the industry. Watch this space!

News and articles

While cigarettes account for the bulk of tobacco consumption there are also cigars, pipe tobacco, snuff and chewing tobacco. According to The Tobacco Atlas, the tobacco leaf is grown in at least 124 of the world’s countries.

In 2012, nearly 7.5 million tonnes of tobacco leaf was grown on almost 4.3 million hectares of agricultural land, an area larger than Switzerland. China is the world’s leader in tobacco production, with 3.2 million tonnes of tobacco leaf grown in 2012.

How times have changed
Wrong on so many levels, advertisements like this today are unconscionable, and are illegal in many countries, but here are typical TV commercials for cigarettes from the 1940-50s:

With some overlap, GHB and GBL content on this website is split between three locations:

What it is and how it comes

• Closely related, GHB and GBL are depressants/ sedatives with anaesthetic effects – downers (slowing down the body’s reactions and functions)
• Other names include ‘G’ and ‘Gina’
• Usually comes as a colourless (sometimes slightly oily) liquid; and a white crystalline powder. Also comes as a paste or in capsules but this is less common.
• When consumed (ingested) GBL is converted into GHB in the body.
• Under UK law the drug is classified as Class B (Misuse of Drugs Act 1971).
• GHB has a medical use to treat narcolepsy, while GBL is sold as a rust/ stain/ alloy wheel remover cleaner.

The difference between GHB and GBL
GHB and GBL are two closely related drugs often referred to simply as “G”.

GHB (gamma-hydroxybutyrate)

• Produced as a white-ish salt powder and as a clear liquid with almost no smell and a soapy, salty taste
• For recreational use on the chemsex scene, it is most usually found in clear liquid form (the salt powder dissolved in water)
• It can also be found as a paste or in capsules though this is less common. These can be hand-filled with a syringe which makes accurate dosing very difficult.

GBL (gamma-butyrolactone)

• An industrial-strength solvent used as an alloy cleaner paint stripper and for removing graffiti
• Produced as a clear liquid and has a sharp, bitter chemical taste and smell
• Turns into GHB once in the bloodstream
• Can be 2-3 times stronger than GHB. The effects can come on quicker and be more unpredictable

Why knowing the difference between GBL and GHB matters

• GBL is more likely to be the same purity as it is manufactured and sold as an industrial-strength cleaner. In fact, some of the websites and bottle labels state the purity as a percentage (eg: 99.7%). On the other hand, GHB is produced as a salt powder and dissolved into water which is why dose strength is more likely to vary.
• If you are taking ‘G’ you should know beforehand whether it is GHB or GBL. This is because GBL may be two to three times stronger than GHB.
• For example: if your 1ml dose of GHB is actually GBL, the strength may be the equivalent of taking 2-3ml. This level is more likely to lead to over-dosing (unconsciousness and coma), particularly if you have not tried it before or have a lower tolerance. The reverse is also true: if your 1ml dose of GBL is actually GHB, the actual strength may be 2-3 times less.

How it’s taken
The time it takes to reach a desired high will often depend on your size, weight and metabolism; what you have already taken; the purity of the drug and the dose amount.
Reducing drug harm and risks | MEN R US

• Orally and swallowing
  A measured dose is mixed with juice (eg: orange, cranberry) or other soft drink.
  Do not mix G with alcohol
• Booty bumps
  Mixed with lubricant, drawn up into a syringe without the needle, and injected up the arse hole.
• Injecting
  This is NOT advised 
• Snorting
  This is NOT advised

Safer use
GBL/ GHB | THT
GHB and GBL | Drug Science
G (GHB/GBL) | Antidote

Interactions

• Check with your sexual health or HIV clinic.
• Check out HIV Drug Interaction Checker: comprehensive, user-friendly drug interaction charts providing clinically useful, reliable, up-to-date, evidence-based information.

Desired highs

• Feeling relaxed, more sociable, reducing inhibitions, horny, wanting more intense and extreme sex, euphoric, and drowsy.
• Some say the effects are similar to alcohol.

Sex on G

• Reduces ability and/ or makes it impossible to consent (agree) to anything. You may not be aware of what is happening, leaving you at risk of sexual assault, rape and murder. Conversely, you may commit a crime against someone else who hasn’t freely given their consent.
• It May result in more extreme sex you might not otherwise consider. Less likely to feel pain.
• Longer and rougher sex can increase the likelihood of condom failure and tears/ sores/ bleeding (cock/ arse/ dick/ mouth), which may not be noticed at the time. 
• It May result in compulsive/ repetitive wanking (masturbation) because you are so horny.
• It May be difficult and/ or impossible to shoot your load (cum/ come)

Using G and the comedown

• Sweating, nausea, headaches, vomiting; disorientation, delirium, amnesia, psychosis, severe agitation, paranoia; muscle numbness, seizures, convulsions; tachycardia; audio and visual hallucinations; loss of consciousness, coma, and death
• Their combined effect can slow down your breathing. You may fall into a deep sleep (from which you cannot be woken up), fall into a coma and/ or die.
• Do NOT use G if you have heart or breathing problems, high or low blood pressure, or epilepsy.

Addiction, dependency and other issues

• You can become dependent on G with regular use.
• Rules of thumb (guidance) include that you should not take another dose of G within two hours to reduce overdosing and do not take G for more than 2 days in a row to avoid developing tolerance and dependence.
• Do not try withdrawal from G on your own as this can be very dangerous, sometimes fatal. If dependent, ALWAYS seek professional medical/ drug service support.
• High risks associated with mixing G with other depressant drugs (downers), including alcohol, tranquilisers, ketamine and/ or medications, can make you drowsy.

For guidance on the following, click the link below:

• Measuring and dosing
• Drinking G with soft drinks
• Timings and keeping a record of dose amounts and when they are taken
• Overdosing
• Mixing with alcohol and other drugs
• Spiking drinks and lubricant

Further information
GHB | Wikipedia
GBL | Wikipedia
GHB | Erowid
GHB | KFX
GHB (and GBL) | Release
This icon means there appears to be no noticeable activity in 6 months or more.

As far back as 1999, New York Magazine ran the article “Nightlife ’99: Clear and Present Danger”, which noted that “GHB first became a fixture at raves and gay ‘circuit parties’ in the early nineties.” 

Before the word chemsex was coined, terms such as slamming, PnP, parTy, HnH, and chem-friendly were (and still are) shorthand for gay men using this iteration of drugs. The slang appeared on hook-up apps including Grindr, Recon, Bareback Real Time (BBRT), Gaydar, and Scruff.

Chemsex, as it would eventually be called, was (and is) not the same as popping a pill, snorting a line, or smoking a joint. It’s a specific form of drug use. Definitions vary, but chemsex is commonly described as the use of three drugs …

• Crystal meth (‘T’)
• Mephedrone (‘M’)
• GHB or GBL (‘G’)

… to enhance the sex you’re having, and make it last longer. Conversely, drugs like cocaine, speed, ‘E’, alcohol, and cannabis are taken more often for the experience.

• Chemsex is primarily associated with gay men (gay, bisexual, and other men who have sex with men/ GBMSM)
• Chemsex sessions, parties or hook-ups are typically arranged on apps, and take place in homes (not scene venues)
• Chemsex typically involves long(er) sex sessions with one or more partners
• Crystal meth and mephedrone are uppers speeding up the body’s reactions, while GHB and GBL are downers slowing down the body’s reactions
• Crystal is usually smoked in a glass pipe or injected. GHB and GBL is added to soft drinks in small millilitre (ml) dose amounts. Mephedrone is usually snorted, or injected

Other drugs are sometimes used, eg: ketamine; and some argue that just because they use ‘G’ or smoke ‘T’ once in a while (so not regularly) doesn’t mean they’re into chemsex. It just means they use ‘G’ or smoke ‘T’ once in a while. 

When defining chemsex, it is worth asking why, and for whom: While the chemsex label helps services talk about overlapping issues such as sex, drugs, consent, and health, not everyone agrees with the term or feels it reflects their experiences.

Phrases like “using any combination of these drugs to help facilitate, enable, or enhance sex” may be useful for professionals, but they resonate less with gay men.

What it is and how it comes

• Methamphetamine (crystal) is a powerful amphetamine – an upper/ stimulant (speeding up the body’s reactions and functions).
• Other names include ‘Tina’, ‘meth’, ‘ice’, ‘crystal’, ‘crank’, ‘yaabaa’.
• Usually comes as colourless crystals; also a whitish powder/ pills (which may include a colourant).
• Under UK law the drug is classified as Class A (Misuse of Drugs Act 1971).
  
• Crystal releases the brain’s stress hormone norepinephrine and ‘feel-good’ chemicals dopamine and serotonin.

How it’s taken
The time it takes to reach a desired high will often depend on your size, weight and metabolism; what you have already taken; and purity of the drug and the dose amount.
Reducing drug harm and risks | MEN R US

• Slamming injecting
• The powder is dissolved in a liquid (eg: water) and injected into a vein.
• Smoking
  The crystals are heated in a glass pipe and smoked.
• Snorting ‘sniffed’, ‘keyed’ or ‘bumped’
  Snorted up the nose in powder form through a straw or a rolled-up banknote.
• Booty bumps
  Powder form dissolved in a liquid (eg: water), drawn up into a syringe without the needle, and injected up the arse hole. Alternatively, a finger is dabbed in the powder and then put up the arse hole.
  Orally and swallowing ‘bombing’
  A finger is dabbed in the powder and rubbed it onto the gums inside your mouth. Alternatively, the powder is wrapped a toilet or cigarette paper and swallowed.

Safer use
Crystal and our bodies | Tweaker | US
Crystal meth | Antidote

Interactions

• Check with your sexual health or HIV clinic.
• Check out HIV Drug Interaction Checker: comprehensive, user-friendly drug interaction charts providing clinically useful, reliable, up-to-date, evidence-based information.

Desired highs

• Feeling alert, awake, confident, empathic, euphoric, full of energy, happy, disinhibited, (very) horny, an intense and focused sex drive, impulsive, sociable and talkative.

Sex on crystal

• Suppresses the need for sleep or eating, sometimes for days.
• May result in more extreme sex; eg: fisting and/ or involve ‘riskier’ sex you might not otherwise consider making
  
• Erections can be difficult/ impossible (also known as ‘crystal dick’). Some take erectile dysfunction medication to counteract this 
• May result in compulsive/ repetitive wanking (masturbation) because you are so horny
• May be difficult and/ or impossible to shoot your load (orgasm)
• Longer and rougher sex can increase the likelihood of condom failure, and tears/ sores/ bleeding (cock/ arse/ dick/ mouth) which may not be noticed at the time. 
• Less likely to feel pain

Using T and the comedown

• The comedown can feel overwhelming: exhaustion, tiredness, depression, difficulty sleeping/ chronic insomnia, difficulty focusing and/ or concentrating. Also, the strength of the comedown will be worse the more you use it.
• Aggressive behaviour, paranoia, and  (in some cases) suicide.
• Not eating or lack of food can result in acid reflux and gastritis
• Crystal messes with your body temperature, increasing your heartbeat/ blood pressure, risking stroke, heart attack, coma and death
• Long(er) term use can result in obsessive/ repetitive behaviour, psychosis, paranoia, and long term mental health issues
• A high risk of psychological dependence, tolerance builds up quickly, and users need more to get the same high.

Addiction, dependency and other issues

• It’s easy to keep using more… and become dependent
• High risk of psychological dependence,  tolerance builds up quickly, and users need more to get the same high
• Slamming gives a faster rush but the high is usually shorter than say booty bumps or snorting
• Like other amphetamines, using crystal can result in memory loss, paranoia, and fits
• You can lose track of time, also forgetting to take your HIV medication on time, as prescribed
• Rubbing meph into your gums and can cause damage both to your gums and teeth
• Snorting meph can damage to your nasal passages and cause nose bleeds
• Nose, mouth and lung damage depending on how much you take
• Taking meph up the arse (booty bumping) can damage the lining of your anal canal increasing the risk of HIV, STI and HCV transmission
• Injecting can cause vein damage, vein collapse, sepsis (blood poisoning), and other infection (eg: ulcers, gangrene) 
• Crystal can screw with your body’s ability to regulate temperature leading in over-heating
• There are reports that a cocktail of crystal and other drugs can result in overdosing and death

Further information
Crystal meth | Tweaker
Crystal meth | Wikipedia
Crystal meth | Erowid
Crystal meth | Release
This icon means there appears to be no noticeable activity in 6 months or more.

What is and how it comes

• Mephedrone is a powerful amphetamine – an upper/ stimulant (speeding up the body’s reactions and functions)
• Other names include ‘drone’, ‘meph’, ‘meow’, ‘meow-meow’, ‘miaow, miaow’, ‘bubbles’, ‘bounce’, ‘plant food/ feeder’, ‘bath salts’
• Usually comes as a fine white/ off-white/ yellowish/ mustard coloured powder. Also comes as small but coarser crystals which are crushed into a powder to make it easier to use. Less common it can come in capsules.
• Under UK law the drug is classified as Class B (Misuse of Drugs Act 1971).
• Before classification as a Class B drug in 2010, it was legally sold as plant food or bath salts. Often cut with other substances the quality can vary greatly.

How it’s taken
The time it takes to reach a desired high will often depend on your size, weight and metabolism; what you have already taken; and purity of the drug and the dose amount.
Reducing drug harm and risks | MEN R US

• Slamming injecting
  The powder is dissolved in a liquid (eg: water) and injected into a vein.
• Snorting ‘sniffed’, ‘keyed’ or ‘bumps’
  Sometimes divided into lines for sharing, it is snorted up the nose in powder form from a smooth (glass) surface, through a straw or a rolled-up banknote. The effects are usually quite rapid. Doing it this way can be painful and can lead to damage to the inside of the nose (nasal passage).
• Booty bumps
  The powder is dissolved in a liquid (eg: water), drawn up into a syringe without the needle, and injected up the arse hole. Alternatively, a finger is dabbed in the powder and then put up the arse hole.
• Orally; and swallowing ‘bombing’
  A finger is dabbed in the powder and rubbed it onto the gums inside your mouth. Alternatively, the powder is wrapped a toilet or cigarette paper and swallowed. 

Safer use
Mephedrone | THT
Mephedrone | Drug Science
Mephedrone | Antidote

Interactions

• Check with your sexual health or HIV clinic.
• Check out HIV Drug Interaction Checker: comprehensive, user-friendly drug interaction charts providing clinically useful, reliable, up-to-date, evidence-based information.

Desired highs

• Feeling alert, awake, confident, empathic, euphoric, full of energy, happy, disinhibited, (very) horny, an intense and focused sex drive, sociable and talkative.
• Described as a combination of cocaine and ecstasy (MDMA).

Sex on meph

• Suppresses the need for sleep or eating, sometimes for days.
• May result in more extreme sex; eg: fisting and/ or involve ‘riskier’ sex you might not otherwise consider
• Erections can be difficult/ impossible. Some take erectile dysfunction medication to counteract this 
• May result in compulsive/ repetitive wanking (masturbation) because you are so horny
• May be difficult and/ or impossible to shoot your load (orgasm)
• Longer and rougher sex can increase the likelihood of condom failure, and tears/ sores/ bleeding (cock/ arse/ dick/ mouth) which may not be noticed at the time. 
• Less likely to feel pain

Using M and the comedown

• Anxiety, on edge, agitated, dizzy, hot and sweaty, racing heart like it’s going to burst through your chest (palpitations)
• Feeling overwhelmed, profound tiredness, depression, difficulty sleeping (insomnia), difficulty focusing and/ or concentrating.
• The strength of the comedown will be worse the more you use.
• Teeth grinding (gurning), and tongue biting, inside cheek chewing (but you may not notice), and mouth ulcers
• A ‘stench’ during the days following which can be picked up by those around you
• A need to shit a lot… and quickly

Addiction, dependency and other issues

• It’s easy to keep using more… and become dependent
• High risk of psychological dependence,  tolerance builds up quickly, and users need more to get the same high
• Like other amphetamines, using meph can result in memory loss, paranoia, and fits
• You can lose track of time, also forgetting to take your HIV medication on time, as prescribed
• Slamming gives a faster rush but the high is usually shorter than say booty bumps or snorting
• Rubbing meph into your gums and can damage both to your gums and teeth
• Snorting meph can damage to your nasal passages and cause nose bleeds
• Taking meph up the arse (booty bumping) can damage the lining of your anal canal increasing the risk of HIV, STI and HCV transmission
• Injecting can cause vein damage, vein collapse, sepsis (blood poisoning), and other infection (eg: ulcers, gangrene) 
• Meph can screw with your body’s ability to regulate temperature leading to over-heating
• There are reports that a cocktail of mephedrone and other drugs can result in overdoses and death

Further information

For 10+ years, we have been gathering published articles, reports, studies, and news by year from the late 1990s. These lists are neither definitive nor complete, but they provide a common thread spanning two decades and a springboard to explore further. MEN R US volunteers are committed to sharing accurate, respectful, and reflective content about our communities and articles selected are reviewed for factual reliability. While mainstream media remains an important source of information, fact-checking standards have declined in recent years, especially around sensitive or fast-moving topics.

GMHC aims not to share content from tabloid publications to uphold integrity and avoid harm. Tabloid journalism, including some reputable documentary makers, often prioritises sensationalism over substance, perpetuating ‘end-of-days’ type narratives rather than solution-focused content. Such reporting tends to reinforce harmful stereotypes about gay and queer men, ignoring the structural issues, such as marginalisation, trauma, and limited access to healthcare, that contribute to drug use in sexual contexts. This media type fosters stigma, fear, and silence by focusing on shock value rather than lived experience. GMHC rejects these narratives and instead promotes journalism that is thoughtful, inclusive, and rooted in empathy. We aim to support a more informed and compassionate understanding of chemsex and the wider health and social issues affecting our communities.

Please contact us if there’s something you think we should include.

2026

2025

2024

News/ articles 2023 – 1998

A selection of books and playa about chemsex:

• Tweakerworld | Jason Yama | 2023
• The Truth About Chemsex | Justin David Duwe | 2018
• Something for the Weekend  | James Wharton | 2017
• The G Club | Paul Madden | 2017
• Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery | David M Fawcett | 2016
• 5 guys chillin’ | Peter Darney | 2016
• The Chemsex Monologues | Patrick Cash | 2016
  

GMHC was shocked and saddened to learn that David Stuart died suddenly on 10 January 2022 aged 54.

David was known to many for his pioneering work in chemsex and for raising awareness of this challenging field and credited with coining the term ‘chemsex’. An activist, advocate, worker, lecturer, researcher and campaigner, David undertook the work with passion, empathy, and kindness while also acknowledging his own struggles.

He joined London Friend as a volunteer in 2007, later becoming its training and outreach manager. In 2014, he joined 56 Dean Street as its substance misuse lead specialising in chemsex. David was also an advocate speaking at conferences, collaborating on research papers, his work key in raising chemsex as a health issue. He has left a rich and complex legacy for his peers, community, allies and friends.

In 2016, ReShape and David Stuart and GMFA collaborated on the first European Chemsex Forum in London. 

David advised on several short chemsex harm reduction films for the Gay Men’s Health Collective including “Triptych” and “Alchemy”. He also collaborated on two safer slamming (injecting) shorts on crystal meth and mephedrone. Viewed thousands of times, they are believed to be the first safer injecting films for gay men. He was always a joy to have on set. GMHC also made “Chemsex: An Intervention” for his own body of work, embedded below.

Chemsex: A Brief Intervention | David Stuart | 2013

A Loud Exhaust by David Stuart

Mental health check-in
Before anything, ask yourself: Am I in the right frame of mind to play or go out? Be honest.

Prep the Session

• Estimate how long the hook-up might last and plan accordingly.
• Video call new guys to verify profiles — catfish risk is real.
• Agree an end time with your host and aim to stick to it.
• Bring some cash to chip in for supplies.
• Have an exit strategy in case you need to leave fast.
• Tell someone you trust where you’re going. Carry a ‘next of kin’ card.
• Add an emergency contact to your phone’s lock screen.
• Take a photo of the street when you arrive. Try what3words.

Pack Smart

• Fully charge your phone. Bring a charger, cable, and power bank.
• Pack backup cash/card and keep it separate from your supply money.
• Avoid impulse cashpoint withdrawals — risky and traceable.
• Meds? Take them, bring extra just in case.
• Mini toiletry bag: tissues, wipes.
• Condoms, lube, gloves (fisting), douche kit, clean slamming kit.
• Bottled water, energy bar, mints/gum.
• Feed your pets.
• Got a partner? Think up a solid cover story.
• Poncho — just in case.

Stay Safe

• Don’t cruise or hunt for new meets when high — you’re more vulnerable.
• Keep your stuff zipped up and on you.

Plan the Comedown

• Fresh sheets on the bed before you go.
• Prep snacks, fruit, hydration tablets or electrolyte drinks.
• Clean T-shirt, underwear, eye drops, skin moisturiser ready.
• Replace contact lenses.
• Pack sunglasses for the daylight walk home.
• Sexual health check-ups and self-test kits

PIP PAC are safer chemsex packs made up of 40 ingredients, some of which need to be printed, pinched, stuck together and folded before being precision packed into a Post In Proportion (PIP) pack (PAC) mailing box. Uniquely, contents are colour coded to reduce sharing and transmission of blood-borne infections, including HIV and Hepatitis C. 

PIP PAC was innovated by gay men in 2014—some of whom are living with HIV and/ or Hepatitis C—with direct knowledge and experience of recreational drug use; and problematic drug use, withdrawal, and recovery.

We would love to give PIP PAC away for free, but they are not subsidised or receive government or grant funding. They are produced on a not-for-profit basis to give you the best value possible. Discretely packaged and posted 1st class, packs fit through standard letterboxes. Purchase online today, and there’s a good chance you’ll get yours tomorrow.

• Wash your hands and clean the injection site
• Choose a quiet, safe place to inject
• Ensure the surfaces you prepare on are clean
• Whenever possible, use a sterile spoon and dry, clean filter available from needle exchange services and PIP PAC
• Avoid torn filters or exposed fibres as they can end up being injected and cause problems
• Never share your injecting equipment
• If you have to re-use equipment make sure it’s yours
• Use a sharps bin whenever possible. If not available improvise; eg: use a plastic drinks bottle with cap
• Only recap needles if a sharps bin or alternative is not available
• It’s always best to only recap your own needle to avoid risk of infection
• Take your sharps bin to a needle exchange for safe disposal

Safer injecting crystal meth

Safer injecting crystal meth | Three Flying Piglets for MEN R US | 2014 | 3m 24s
 Precautions D’injection: Crystal Meth | Français | Three Flying Piglets for MEN R US | 2014 | 3m 24s

Safer injecting mephedrone
Safer injecting mephedrone | Three Flying Piglets for MEN R US | 2014 | 3m 25s
 Precautions D’injection: Mephedrone | Français | Three Flying Piglets for MEN R US | 2014 | 3m 25s

Needle and syringe supplies
You may find the simplest option is to buy supplies online. We mention Exchange Supplies because they have collaborated with us on PIP PAC (our safer chemsex packs) for several years. While gay men have usually given mainstream drug services a wide berth you can drop by your local service who should provide you with FREE needles, syringes, swabs and condoms etc without a load of hassle or questions.

More
Further safer injecting tips and advice can be found here but bear in mind these are mainstream resources and don’t address safer clamming and/ or chemsex specifically:

Organisations and services

Gay men needing chemsex support require specialist help and advice. Unfortunately, these services are not universally available, and things can be worse outside the big cities.

When guys experience a ‘crash’ after chemsex or find themselves in crisis they often need support from a range of services (eg: recovery, mental health, legal, housing, debt) and mainstream services are not always geared up to work together—though some are making efforts to improve ths.

The truth is that issues like this are affecting many LGBT+ people trying to access health services at a time when there is less funding available and more cuts than ever before. Services are trying to work better together to provide tailored and integrated support—but finding the right help can still be complicated and frustrating. In larger towns and cities some sexual health, drug, LGBT+, mental health, and local authority services are working together. However, some services lack “subject matter expertise” (SME) which refers to knowledge, skills, and/ or experience in a specific field or topic, such as chems, sex, and the lives of LGBT+ people.

Too often services are “heteronormative” in that they assume heterosexuality as the default experience, often excluding or overlooking LGBT+ identities, relationships, and needs. Drug services are waking up to the fact they’ve ‘neglected’ the LGBT+ community for decades, with many only seeming to have a passing understanding of gay men’s health and wider LGBT+ issues. However, some are starting to respond positively, becoming LGBT+ friendlier, developing expertise—something long overdue.

Gay, gay friendly, or mainstream
We understand gay men often prefer gay or gay-friendly services that reflect their lived experience and have a better understanding the issues affecting their lives, understanding the unique challenges of chemsex. Ohile others are comfortable accessing mainstream services.

Most health and support providers aim to be welcoming, respectful, and knowledgeable—but the key is to find a service that feels right for you, one that listens and truly ‘gets the job done.’

Your doctor (GP)
It’s understandable why you might feel your GP won’t have the knowledge and expertise they need when dealing with issues surrounding chemsex, but they should be able to be supportive and signpost you to someone who can help you. This might include a drugs or counselling service though these are unlikely to be gay-specific.  GPs are the ‘gateway’ to primary care so developing a relationship is potentially very important.

If you don’t know where to start
Perhaps a first step may be talking to someone you trust, a friend, a sex bud, even the ex. Some of the best support can still be found within our own community. If you don’t know where to start, contacting a local HIV or LGBT+ organisation can be a good place to start. While they may not be able to help you directly, they usually know what’s going on in the area and can signpost accordingly.

Ask questions and check
Before engaging with a service, don’t hesitate to check whether it feels like a good fit. A quick call or visit by you or a friend can give you a sense of their vibe. Here are some questions you might ask.

• “Do you have a drug, alcohol and/ or chemsex service specifically for gay/ bi men?”
• “Have your frontline staff had training on chemsex, gay men’s health, and wider LGBT+ issues?”
• “How do existing clients respond to LGBT+ people?”
• “Would you say your service is LGBT+ friendly?”

It’s also worth checking out the service’s website. Look for signs that they acknowledge and support your needs. Are terms like chemsex, LGBT, gay, MSM, or GBMSM mentioned anywhere?

As much as we would like to think otherwise, using chems (recreational drugs) doesn’t create energy, they allow us to ‘borrow’ from tomorrow’s supply. And then, when tomorrow comes, it’s ‘payback’ time. Coming down happens because the feel-good chemicals produced by the brain have been released and used up. You will likely feel down until your brain has had the time it needs to replace them. While some seem to take comedowns in their stride, others find them very challenging. It may take a few days to fully recover from a comedown. If you’re already tired, anxious, on your own, or have something important to do the next day, the effects of the comedown may be worse. The key is to minimise the impact and assist recovery.

Plan ahead
Stock-up beforehand, e.g.: snacks, some creature comforts and fresh sheets. Let others know that you’re coming down and try to ensure there’s a reliable person you can call.

Cravings
Taking more drugs to reduce cravings will delay the comedown and make it worse. The more drugs you take or mix, combined with a lack of food and sleep, will slow down your recovery.

Eat, sleep, hydrate, repeat
You will likely be dehydrated. Water will help flush the toxins out of your system. Eat and drink little and often, even if your appetite is poor. It’s important to get back into a routine, so aim for your usual bedtime.

Rest but do stuff
Try to relax. Avoid stressful situations and environments. Naps are good. Find something that will keep you occupied even if its little things strung together, e.g.: a shower, a chat with friends, a puzzle, TV or film, a book, a short walk in fresh air, or do some housework.

Medication
Ensure you continue to take prescribed medication at the correct time.

Put your phone down
Phones are a distraction from reality and a gateway to hook-up apps, porn and temptation. You will get back into a routine, and sleep better, if your body and brain are calm and relaxed. So, leave it alone.

Cocks, arses and mouths
Watch out for ulcers, sores, and cuts – particularly if they are not healing and/ or getting painful. Know where your sexual health service and local Emergency Department (A&E) are located should you need them. There’s always NHS 111 and your GP.

Relaxation techniques
Meditation, massage therapy, acupuncture, yoga and mindfulness can all help clear the mind, calm and regulate thinking, and relieve stress.

With some minor edits, this is a copy of our Safer Chemsex booklet (May 2025, 11th edition) included in our PIP PAC safer chemsex packs and Safer 2 packs (2025). The successor to Safer 1*, the Safer 2 pack has been produced to help you stay safer and signpost to the support you may need, when you need it.

The pack has been updated and ‘Using G’, ‘Support Pathways’, ‘Self Care’, and ‘Health and Wellbeing’ are new, following feedback and suggestions. While there’s a focus on chems, many health issues addressed here affect us all.

We’re not health professionals, rather gay men passionate about our health and wellbeing—some with direct experience of chems, problematic drug use, and recovery. This pack has been edited, tweaked and proofed by peers, shags, allies, organisations and services, who have given their time generously at every turn.**

There is no escaping it, we continue to live in tough times and the health support we need may be difficult to find and access. However, we hope the information here will point you in the right direction.

Safer 2 is our take on being gay and queer today, joining up the dots of our health and well-being. It’s not perfect, it’s sometimes messy, but it’s ours.

Hope
We continue to see unhelpful reporting on chemsex in the media and bleak narratives by some organisations. Yes, navigating support can be challenging [shit] but over the past year, harm reduction and support has been revitalised in London with services and commissioning bodies working better together—with many LGBT+ staff and volunteers (some in recovery) at the forefront of this change. Safer 2 is part of this.

Though our LGBT+ paths and life experiences vary, many of us face shared challenges: from phobias and heteronormativity to discrimination; stigma; hate crimes; a lack of dedicated support; and long waits for treatment. While this pack was produced by gay men, we hope there is something useful for everyone.

Words of caution
Not all gay men use drugs, or do so for sex, or in problematic ways. The needs of gay men are not best served by suggesting chemsex is universal. In fact, suggesting it’s universal runs the risk of giving the impression that it is both inevitable and impossible to escape.***

Letters and words
LGBT+ stands for Lesbian, Gay, Bisexual, and Transgender, with the plus sign (‘+’) acknowledging Queer, Intersex, Asexual, and other identities not captured by these letters. It’s an umbrella term for the community, with several variations. Safer 2 has chosen to use LGBT+

When we say ‘gay men’, we include queer, bisexual, men who have sex with men, and those who don’t like labels. We see you. We hear you. We love you.

The small print
Safer 2 pack information is provided for educational and harm reduction purposes only. It is not medical advice and does not encourage or condone drug use. Any reliance you place on the information supplied here is at your own risk.

Thank you
Special thanks to Release, Injecting Advice, Global Drug Survey and Exchange Supplies. Rather than re-invent the wheel, extracts from “Slamming Dos and Don’ts” by Mainline (Netherlands), and content from Injecting Advice, and Exchange Supplies have been adapted, with their kind permissions. Stunning illustrations by Walter Walrus.

Great sex, connection and consent
Great sex should be about connection, intimacy, affirmation, and fun, as much as it is about being safer. However, some of the choices we make during sex on chems can have serious consequences and can cause lasting harm.

Words like ‘consent’, ‘sexual assault’ and ‘rape’ may be new for some, but they are being talked about more openly—not just among gay men, and the wider LGBT+ community but across society more generally.

Holding a mirror up to our sex lives can be difficult and for many (often) complex reasons it can be hard to believe that we may be a victim of sexual assault or rape, or that we may be committing a crime ourselves.

What is consent?
Consent is the freely given, enthusiastic, and informed agreement to participate in a sexual act. A person must:

• Have the capacity to consent—not impaired (affected) by substances, age, or mental incapacity.
• Provide consent voluntarily—without pressure, threats, or manipulation.
• Be able to withdraw consent at any time.

Legal age of consent
16 years old in the UK which applies all genders and sexual orientations. It is illegal to engage in sexual activity with someone under 16, even if they agree.

If something has happened
Sex without consent is a crime. Talking about this stuff is not easy but, if something has happened to you, you may not even have found the words yet. Whether it’s a feeling … sense … or a hazy memory: try talk to a friend, go to a sexual health clinic, or phone a helpline.

Consent must be clear
Consent cannot be assumed based on previous sexual activity, a relationship, or lack of resistance. Silence or the absence of a “no” does not equal consent.

Withdrawal of consent
Consent can be withdrawn at any point during sexual activity. Continuing after consent is withdrawn is a crime.

Capacity (ability) to consent
A person cannot consent if:

• They are unconscious or asleep.
• They are under the influence of drugs or alcohol to the point where judgment is impaired.
• They are under the age of 16 or in certain power dynamics, such as with a teacher or care provider.

Coercion and force
Consent given under threat, pressure, or manipulation is not valid. Any sexual activity without valid consent is considered sexual assault or rape under UK law.

How to ensure consent

• Ask openly: Clear communication about boundaries and willingness. Use questions like: “Are you comfortable with this?” or “Do you want to continue?”
• Respect boundaries: Pay attention to verbal and non-verbal cues. Stop immediately if there is uncertainty about consent.
• Educate yourself: Learn about the nuances of consent, especially in situations involving power dynamics or intoxication.

Regular sexual health check-ups are essential for a responsible and enjoyable sex life. Sexual health services screen, detect and treat sexually transmitted infections (STIs) with some results in minutes, including HIV.

These services are a useful contact point in the event of future problems, and many provide information and advice on maintaining a healthy sex life. They may also offer PrEP and or PEP. 

STI self-test kits (London)
Sexual Health London (SHL) is London’s online sexual health e-service* that provides free sexual health testing. Simply register with SHL and complete an online consultation to order your free test kit.

The service provides testing for a range of sexually transmitted infections including chlamydia, gonorrhoea, HIV, syphilis, hepatitis B and hepatitis C via samples you collect at home. The service is designed for individuals who have or present no symptoms. If you do have symptoms attend a local sexual health clinic.

* Hillingdon, Croydon and Greenwich do not participate in SHL but have their own arrangements for home testing kits Checked 31-03-25

While the Safer Chems booklet (part of Safer 2 pack) includes information about PrEP, PEP, and DoxyPEP, more can be found under STI on this website.

Avoid re-using or sharing equipment
If you find yourself in a situation where you have to re-use, make sure you only use your own and no one else’s.Get into the habit of marking your own syringes so you know which is yours, e.g.: scratch on a letter/ number. You should also flush it through with clean fresh water after use so that it doesn’t clog with congealed blood. If this booklet is included in a PIP PAC safer chemsex pack, you will notice colour-coded syringes, spoons and straws to reduce the risks of sharing and the transmission of blood-borne infections (BBV), inc. HIV and Hep C.

Needles for injecting
The gauge (G) of a needle refers to the thickness of the needle. Lower numbers, e.g.: 18G) mean thicker needles. Higher numbers, 30G) mean thinner needles. Higher gauges are often used to reduce vein damage and discomfort. For example, PIP PAC safer chemsex packs include 29G fixed needle syringes.

Sterile cups, spoons and filters
Sterile packaged cups or spoons with filters are the best choice for dissolving chems in water but avoid torn filters or exposed fibres as they can end up being injected and can cause problems. Dissolving chems in a regular teaspoon is the best alternative but, before use, disinfect the spoon in boiling water or soak in 1-part thin bleach to 10-parts water, remembering to rinse off thoroughly.

Sterile water
Sterile water, available in small ampoules is best for dissolving and injecting. The best alternative is freshly boiled tap water, letting the water cool down before use. Use sufficient water to completely dissolve the drugs. If you are re-using syringes do not share water. Throw away any leftover water after use as bacteria can build up quickly.

Wash your hands and clean the site
Wash your hands before you inject and clean the injection site with an alcohol pad. Alternatively, clean the site with a cotton ball and alcohol, or by washing it with soap and water, drying with a clean paper towel or tissue.

Choose a quiet place
Choose a quiet, safe clutter-free place to slam, ensuring surfaces are clean.

Alcohol pads/ swabs
Alcohol pads are sterile-packed suitable for single use only. By wiping the slam site firmly once with a pad, you disinfect the needle’s point of entry. You can also disinfect the site by washing it thoroughly with soap and water or use a cotton ball and alcohol.

Where to inject
The inside of the elbow and lower arms. Try not to inject below a recent site on the same vein: go above it (towards the heart) so the previous site is not irritated twice. Aim to slam at least 1cm away from your last slam location and rest injecting sites to allow them to heal and reduce scarring. If possible, learn to swap arms.

Injecting elsewhere
Injecting elsewhere else (neck, cock or groin) is potentially very dangerous. If you have done this, we advise to seek advice from a drugs service.

Cotton wool swabs/ kitchen roll/ tissue
Immediately after slamming, press on the injection site with a cotton wool swab/ folded kitchen roll/ tissue to help the site close quickly. This also helps reduce bruising and helps the veins heal faster. Don’t use alcohol pads as they slow down the healing of the wound.

There are possible serious outcomes for someone who injects another person with drugs. There is a risk of prosecution for administering a drug to someone if it can be proved that there was an intention to cause injury or endanger life.

Anyone prosecuted for one of these offences could argue that the intention didn’t exist because they were giving the drug to help someone and increase safety, rather than harm them. But this probably won’t protect them from at least being arrested initially and potentially having to go through a court case where that argument can be made.

If someone dies after being injected by you, you could be charged with manslaughter. Intent does not need to be proved instead the prosecution would have to show that you had been reckless or negligent. This would be on the grounds that someone injecting another person takes on a duty of care to that person, so where that duty is breached (either by doing something or failing to do something), and this causes or significantly contributes to the person’s death, that is gross negligence and so a crime.

This is a very serious offence and can carry a long prison sentence.

More
We’ve had several queries about injecting other people and the law so we asked Release, who said this:

There are possible serious outcomes for someone who injects another person with drugs.

There is a risk of prosecution for administering a drug to someone if it can be proved that there was an intention to cause injury ¹ or endanger life ². Depending on the offence charged, the maximum sentence is 5 or 10 years in prison.

Anyone prosecuted for one of these offences could argue that the intention didn’t exist because they were giving the drug to help someone and increase safety, rather than harm them. But this probably won’t protect them from at least being arrested initially and potentially having to go through a court case where that argument can be made.

Also, if someone dies as a result of one of the offences above, then the person doing the injecting might be charged with manslaughter.

A charge for manslaughter might also happen if the police and prosecution say the death happened because the person doing the injecting was negligent. This would be on the grounds that someone injecting another person takes on a duty of care to that person, so where that duty is breached (either by doing something or failing to do something), and this causes or significantly contributes to the person’s death, that is gross negligence and so a crime.

The maximum sentence for manslaughter is life in prison.
Anyone advising someone to inject other people also risks being prosecuted for encouraging or assisting an offence ³. These offences can be committed even where the main offence isn’t committed – so even if no one follows the advice that is published (or at least the police aren’t aware/have no evidence of this) you could still be guilty of an offence.

The maximum sentence is whatever the maximum prison sentence is for the offence which is encouraged/assisted, or a fine.

¹ Section 24 Offences Against the Person Act 1861
² Section 23 Offences Against the Person Act 1861
³ Serious Crime Act 2007

Hepatitis C (HCV)
There has been a marked increase in HCV among gay men, which raises additional issues if you are already living with HIV. Fucking, fisting, and sharing douche kits, dildoes and snorting straws can all put you at risk of getting HCV, HIV and other STIs.

Test and treat
Treatment for Hepatitis C has improved dramatically in recent years. If you test positive, it’s usually a course of tablets over 8 to 12 weeks.

Reducing risks
You can reduce risks by using:

• Condoms for fucking or getting fucked.
• Sterile syringes and needles when slamming.
• Sterile syringes for booty bumps.
• Gloves when fisting or getting fisted.
• Your own supply of lube and not sharing.
• A new condom on a dildo every time it is used.
• Your own straw when snorting drugs.

Cleaning douche kit and douche heads
Keeping douche heads and douche kit clean, especially when they may be shared. Use a commercially available sex toy cleaner, or you can make up your own solution of 1-part thin bleach to 10-parts water. Make sure you clean and rinse the douche head thoroughly between each arse.

With some overlap, GHB and GBL content on this website is split between three locations:

The difference between GHB and GBL
GHB and GBL are two closely related drugs often referred to simply as “G”.

GHB (gamma-hydroxybutyrate)

• Produced as a white-ish salt powder and as a clear liquid with almost no smell and a soapy salty taste
• For recreational use on the chemsex scene, it is most usually found in clear liquid form (the salt powder dissolved in water)
• It can also be found as a paste or in capsules though this is less common

GBL (gamma-butyrolactone)

• An industrial-strength solvent used an alloy cleaner, paint stripper, and for removing graffiti
• Produced as a clear liquid and has a sharp bitter chemical taste and smell
• Turns into GHB once in the bloodstream
• Can be 2-3 times stronger than GHB, the effects can come on quicker, and be more unpredictable

30:30:30 | Three Flying Piglets film for MEN R US | 2024 | 45s

Why knowing the difference between GBL and GHB matters
GBL is more likely to be the same purity as it is manufactured and sold as an industrial-strength cleaner. In fact, some of the websites and bottle labels state the purity as a percentage (eg: 99.7%). On the other hand, GHB is produced as a salt-powder and dissolved into water which is why dose strength is more likely to vary.

If you are taking ‘G’ you should know beforehand whether it is GHB or GBL. This is because GBL maybe two to three times stronger than GHB.

For example: if your 1ml dose of GHB is actually GBL, the strength may be the equivalent of taking 2-3ml. This level is more likely to lead to over-dosing (unconsciousness and coma) particularly if you have not tried it before or have a lower tolerance. The reverse is also true: if your 1ml dose of GBL is actually GHB the actual strength maybe 2-3 times less.

Effects

• On the upside: G can make you feel relaxed, more sociable, horny, reducing inhibitions (wanting more intense and extreme sex), euphoric and drowsy.
• On the downside: the effects of G can include: sweating, nausea, headaches, vomiting; disorientation, delirium, amnesia, psychosis, severe agitation, paranoia; muscle numbness, seizures, convulsions; tachycardia; audio and visual hallucinations; loss of consciousness, coma, death
• GHB and GBL are central nervous system (CNS) depressant drugs which mean they have a sedative effect on the body, slowing reaction times down, similar to being drunk on alcohol (including loss of body control).

The law

• GHB is a Class B drug, which means it’s illegal to have for yourself, to give away, or sell.
• Possessing GHB can get you up to two years in prison, an unlimited fine, or both.
• Supplying someone else with GHB, friends or sexual partners, for example, can get you up to 14 years in prison, an unlimited fine, or both. Supplying need not be for money or profit. The legal definition is very wide and can be simply knowingly passing on to another.
• If the police catch you supplying illegal drugs in a home, club, bar or sauna, for example, they can prosecute the landlord, club owner or any other person concerned in the management of the premises.
• GBL is available for legitimate use in industry, but if someone supplies or possesses it knowing or believing that it will be swallowed and ingested, they are committing an offence.
• If you’re caught driving under the influence, you may receive a heavy fine, driving ban, or prison sentence. Due to the similarities with alcohol such as possible slurred speech and loss of coordination the risk to you and others both in terms of detection and inflicting harm on others is likely to be increased. Do not drive if you have used G.
• The Sexual Offences Act 2003 states that it is an offence to administer a substance, like GHB and GBL, to a person with the intent to overpower that person to enable sexual activity with them. This can mean up to 10 years’ imprisonment. This is why it is sometimes called a ‘date rape’ drug.

Measuring

• Measure and check your own doses ideally using a 1ml or 2ml plastic syringe
• G will strip (melt) off syringe markings though putting a piece of clear tape over the markings can slow this down. Ideally, have spare syringes to hand
• Asking someone else to watch you prepare a dose is always a good idea
• It’s easy to overdose on G because there’s a small difference between a dose that causes the effect you want and a dose which leads to an overdose
• It’s easier to make mistakes measuring doses when you are high or trying to measure a dose in low light
• It can be especially tricky measuring doses accurately using pipettes or soy sauce fish-shaped bottles. Though they look similar, they can hold different amounts, even by a small amount

Dosing and effects
The effects of ‘G’ will likely differ depending on your weight, size, metabolism, what you’ve eaten, and any other drugs you have taken.

• Start low go slow. Wait at least 2–3 hours before taking more.
• The effects of ‘G’ usually come on within 10-20 minutes.
• GHB can cause dehydration—drink plenty of water.
• Reducing the amount you take and increasing the time between doses can help reduce the likelihood of overdosing or passing out.
• You reduce the likelihood of drug harms by taking less ‘G’ than more, though any dose can cause serious problems.
• It’s not uncommon to feel nauseous or be sick the first time you take ‘G’.

Dose amounts (ml)
The effects of G are likely to differ depending on your weight, size, metabolism, what you’ve eaten, and any other drugs you have taken.

The Difference | Three Flying Piglets film for MEN R US | 2020 | 30s

Drinking G with soft drinks

• A dose of G is usually taken with a soft drink like cranberry or orange juice to mask the taste. Some flavours work better than others
• Used glasses should be rinsed out properly first
• Only drink from a glass you prepared or given to you by someone you know and trust
• Drinking G straight from the bottle (neat/ unmixed) is highly dangerous and can cause damage to your teeth, mouth, throat and stomach

Timings and keeping a record of dose amounts and when they are taken

• Accurately timed doses reduce the likelihood of passing out and overdosing
• Never dose again in less than 60 minutes, but some recommend waiting 2-3 hours
• If you are uncertain, slow down or STOP
• It’s also a good idea to keep a ‘tracking sheet’ with names, dosing times and the number of doses to help everyone keep track of what you and others have taken. This can be as simple as a sheet of paper with names down the side and times/ does along the top. Alternatively, keep track by using your phone’s notepad function and stopwatch

Storing and decanting

• Shake the bottle before measuring a dose, as ‘G’ can settle, causing later doses to be stronger than earlier ones
• GBL is usually sold in larger bottle quantities (eg: 1 litre) which is why it’s decanted into smaller containers so a syringe or pipette can be inserted
• Put bottles/ storage containers out of the way so people don’t pick it up thinking it’s water
• Some people dye their G with blue food colouring to distinguish it from water and help prevent accidental dosing
• Pre-measured doses are sometimes contained in soy fish bottles; heat-sealed straws or refillable pill capsules

Overdosing

• Using ‘G’ on your own places you at additional risks if you experience problems (eg: dizziness, nausea, vomiting, loss of coordination, and muscle spasms) or overdose and become unconscious. If you pass out, your breathing passage can become blocked, and you could suffocate.
• There’s a small difference between a dose that causes the effect you want and a dose which leads to a person going under. Even careful measuring can result in unconsciousness and increased vulnerability, leading to coma, and even death.

‘G’ doesn’t mix

• Ideally, do not use ‘G’ if you are by yourself, as you are putting yourself at extreme risk
• ‘G’ is a depressant, and, when mixed with other depressants and sedatives, the chances of things going wrong increases. Overdosing can occur even if they are taken several
  hours apart.
• Mixing ‘G’ with alcohol, opioids (heroin, codeine), tramadol, benzodiazepines (Xanax, diazepam) and ketamine greatly increases the likelihood of unwelcome interactions and overdose.
• If you pass out, your breathing passage can become blocked, and you could suffocate and die. Some HIV medications interact with ‘G’ (and other drugs), so have a conversation with a health professional you trust first.
• Do not be afraid to call emergency services. Click here for more.

Rite of passage

• Over time, using ‘G’ until you pass out has become normalised and is not seen as a concern. In fact, ‘going under’ or ‘G-ing out’ is thought of as a ‘rite of passage’, and actively sought out by some.
• While you may be looked after by others when this happens, it can be frightening and disorientating coming to in an ED, ICU, a police cell, or on the streets.
• Guys say they remember playing in one place, only to wake up some time later in a different part of London, surrounded by ‘strangers’. This ‘shift in time’ can feel weird, even traumatising, resulting in aggressive and violent behaviour.
• This is a red flag to seek support.

Spiking drinks and lubricant  Drink spiking is when alcohol or drugs are added to drinks without an individual knowing, so without their consent. There are a small but increasing number of reported instances of drinks and lubricants being spiked with G with the intent of sexual assault, rape, and murder, including burglary and theft.

• G is added to soft drinks.
• G is mixed with lubricant for sex, before and during.
• G is mixed in syringe lubricant applicators (syringe-type devices without needles) and inserted up the bum.

What to do:

• Measure, check and drink your own doses and don’t leave drinks unattended
• If you come back to a drink later throw it away, wait an hour before dosing again, starting slowly
• Take a supply of your own lubricant if playing with a partner(s) for the first time
• Ensure consent is given freely and safe words are agreed

Watching out for others, overdose situations and the emergency services

• Hopefully, you will keep an eye out for mates and sex buds, and they’ll do the same for you
• If you spot someone who may be in trouble, ask, and check they’re OK
  If you are trained or qualified, place them in the recovery position. But remember: even with the best of intentions, you can do more harm than good if you are not trained or qualified, with possible legal implications if something goes wrong. Click here for more.
• Call 999 and ask for an ambulance and stay with them until the emergency services arrive
• Calling an ambulance in an overdose situation can save lives. Ensuring friends get the right medical help if they need it is the top priority. However, there have been occasions when an ambulance has not been called because guys are fearful the police will turn up as well, and that if there are drugs or there has been a fatality, this could lead to arrest and investigation. Click here for more.

Sex on ‘G’

• Reduces ability and/ or makes it impossible to consent (agree) to anything. You may not be aware of what is happening, leaving you at risk of sexual assault, rape and murder. Conversely, you may commit a crime against someone else who hasn’t freely given their consent.
• Using G may result in more extreme sex you might not otherwise consider, eg: less likely to feel pain.
• Longer and rougher sex can increase the likelihood of condom failure and tears/ sores/ bleeding (dick/ arse/ mouth), which may not be noticed at the time.
• May result in compulsive/ repetitive wanking (masturbation) because you are so horny
• It may be difficult and/ or impossible to shoot your load (cum)

The comedown
Comedowns can feel physically and emotionally draining, especially after extended use. Common ‘G’ symptoms include:

• Extreme tiredness or drowsiness
• Low mood or anxiety
• Brain fog, confusion, or difficulty focusing
• Irritability or emotional sensitivity
• Muscle weakness or fatigue
• Memory lapses (especially if ‘G’ was re-dosed or mixed with other substances)
• If you’ve used ‘G’ heavily or alongside other drugs, the comedown can be more intense and longer-lasting.

Seek medical advice immediately if symptoms include tight pressure headaches, vomiting, disorientation, delirium, amnesia, psychosis, severe agitation, paranoia, muscle numbness, seizures, convulsions, tachycardia, and auditory and visual hallucinations.

Tolerance, addiction, dependence, withdrawal, and problematic drug use

• Regular use of GBL builds tolerance, meaning users need to take more to feel the same effects
• G has the potential of being highly addictive and daily/ regular use can lead to severe, physical withdrawal symptoms which require medical help. If you have been taking G regularly for long periods, you can become dependent
• Don’t use for more than two days in a row to reduce the likelihood of developing a physical dependency to G and the risk of dangerous withdrawal
• For users physically dependent on G, one of the biggest risks is the rapid onset of ‘withdrawal syndrome’, which can be potentially fatal. Within a few hours of their last dose, they start to develop cravings for more G and can become anxious, sweaty, agitated, and confused
• In a matter of hours, withdrawal can rapidly escalate, progressing to hallucinations, delirium and life-threatening seizures
• Users experiencing these symptoms are likely to require admission to an accident and emergency department (A&E)
• It can be very dangerous to suddenly stop so seek support talk from a drug service, GP or A&E before attempting to stop

Thank you
Huge thanks to the volunteers who give their time freely to research and write this complex section. Contributors include A, H, N, C, V, L, G, K, D, B, F, T and P. We are not doctors or substance misuse professionals, rather a group of gorgeous informed gay men, passionate about sex and our health, with direct experience of drug use, addiction, withdrawal, and recovery. Let us know if you have a suggestion.

Withdrawal is what happens when your body and brain react to the absence of a drug that it has become dependent on. It’s your system trying to re-align after sustained drug use.

When you use a drug often, your body adapts and starts relying on it to function normally. If you suddenly stop or reduce the drug, your body experiences a ‘shock’ or ‘crash’. It’s like taking away a crutch before your body is ready to stand on its own.

Types of withdrawal physical symptoms
Shaking, sweating, nausea, vomiting, headaches, fatigue, muscle pain, chills; seizures (in severe cases, like with ’G’, alcohol, or benzos)

Types of withdrawal psychological symptoms
Anxiety, irritability, depression or mood swings, cravings, trouble sleeping, confusion or paranoia.

How long does withdrawal last?
It depends on the drug, how long you used it for, dose amounts and your body. Some symptoms can last for a few days, while others (like cravings or mood changes) can last weeks, or longer.

Support when withdrawing is essential
For example, withdrawal from ‘G’ can begin hours after the last dose and may be dangerous, needing medical supervision.
Some drug withdrawals—especially from ’G’, alcohol, benzodiazepines, or opioids—can be life-threatening without professional support.

Problematic drug use refers to any pattern of drug taking—legal or illegal—that causes harm to health, relationships, work, safety, or daily life. It’s not just about what you use, but how it affects you and those around you.

Problematic drug use is a sign that support or change may be needed. People can and do reduce or stop problematic use, especially with non-judgmental, harm reduction, or therapeutic support. The focus is on reducing harm, not shaming behaviour.

The term emerged in the late 20th century, especially in public health, harm reduction, and social work fields, as a non-judgmental alternative to words like “addict”, “drug abuse”, and “substance misuse”. It is a helpful term when engaging gay men who use chems, many of whom feel alienated by stigmatising language.

Signs of problematic drug use

• Using drugs even when it causes physical or mental harm.
• Feeling like you can’t cut back or stop, even if you want to.
• Neglecting work, relationships, or other responsibilities.
• Taking risks while high, eg: driving.
• Using chems to cope with stress, trauma, or other strong emotions.
• Getting through comedowns or withdrawals regularly.
• Spending more money or time than you planned to on drugs.

While people often use the words addiction and dependence interchangeably, they aren’t the same thing (especially in drugs services, medical and psychological settings). There is an overlap: many people with addiction are also dependent, but not everyone who is dependent has an addiction.

Dependence

Dependence is a strong word for extreme need. It means your body has adapted to a substance, ‘G’ for example, and now needs it to function normally.

Signs of dependence:

• Withdrawal symptoms if you stop, eg: shaking, sweating, anxiety, insomnia.
• You may tolerate more over time, needing higher doses to get the same effect.

Addiction

Addiction involves compulsive (repetitive) behaviours and a psychological drive (head stuff) to keep using, despite harms.

Signs of addiction:

• Craving or obsessing about the substance or behaviour
• Continued use despite negative consequences, eg: health, relationships, work)
• Feeling unable to stop, even if you want to
• Can involve both psychological and physical dependence

Habit, dependence, and addiction

Another word you may have heard, habit is a regular behaviour that you do automatically or routinely. It can be harmless, helpful, or harmful. They are behaviours that you are in control of and that you can modify as needed to suit your needs and goals. In relation to drug use, habit, dependence, and addiction are closely linked but they aren’t the same thing. Think of habits as a seed, and dependence or addiction as what can grow out of it under certain conditions and circumstances.

Tolerance is when your body gets used to a drug over time, so you need more of it to feel the same effect. It’s a common part of how the body and brain respond to repeated use of a substance.

When you first take a drug, your body responds strongly. With repeated use, your brain adapts—it becomes less sensitive to the drug. So, over time, the same amount has less effect.

For example, someone starting on a 1ml dose of ‘G’, might need higher and higher doses the longer they use it, to achieve the same high.

Why it matters

Higher doses equals higher risk, especially with depressants like ‘G’, opioids, or benzos. People may take more thinking it’s safe, but their body can’t keep up. Tolerance can hide overdose risk: you may feel fine, but your respiratory system (breathing) may not.

Types of tolerance

• Physical tolerance: your body processes or resists the drug more efficiently.
• Psychological tolerance: You don’t feel the same mental effects anymore, even if your body reacts.

Can tolerance go down?

If you stop or reduce use, tolerance often decreases over time. But because your body can no longer handle the old dose (you were used to before to stopped) there’s risk of overdose if you start using again.

For some, in recovery, a happy ending (wanking/ masturbating) while watching porn can be a powerful emotional and sensory trigger. As cravings grow, there may be temptation to seek chems or some of your old patterns of behaviour which can make a relapse more likely, if you’re not prepared.

However to be very clear: wanking itself isn’t ‘bad’ or wrong, in fact it’s awesome—but in recovery, being aware of your personal triggers around it can keep you safer and stronger.

Why it happens

• Porn often recreates the sights, sounds, and fantasies associated with past chemsex experiences.
• Your brain may start linking horniness with the old chemical highs, stirring up cravings.
• Feeling horny activates body memories of using drugs during sex. Even if you’re sober, your body might react
  as if it’s expecting chems.
• Wanking and porn already release dopamine, the brain’s reward chemical. If your brain learned that dopamine + chems = intense pleasure, it can crave the full experience, not just the sexual release (shooting your load).
• After wanking, especially alone, you can feel lonely, empty, or craving intimacy. This emotional dip can trigger a desire to reconnect through old patterns—often leading to contacting risky networks or thinking “just once won’t hurt.”

Ways to break the cycle

• Pause before porn: Ask yourself if you’re feeling lonely, bored, stressed, or seeking connection.
• Set limits: Time your porn viewing, or take porn breaks if it feels risky.
• Use different types of porn: content not linked to past chem use, eg: soft porn rather than hardcore.
• Self-soothe without porn: Practice mindful touch, or engage in physical activity that isn’t tied to past habits.
• Reach out, if cravings spike.

Cravings are temporary. Your recovery is stronger than any craving. You are not alone. You are building something better with every wave you ride out.

For those moments when cravings hit during recovery.

Delay

• Tell yourself: “I’ll wait 15 minutes.”
• Cravings rise and fall like waves—they won’t last forever.

Distract

Do something totally different for 15–20 minutes

• Watch a funny video
• Text a sober friend
• Go for a walk or stretch
• Cook a quick meal

Ground Yourself: 5-4-3-2-1 Technique

• 5 things you can see
• 4 things you can feel
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

Focus on your senses to pull your mind back into the present.

Connect

Call or message someone in your support network. Say out loud: “I’m having a craving. I want to ride it out.” You don’t have to do this alone.

Keep a list remind yourself why you’re recovering

• Health
• Freedom
• Opportunity
• Self-respect
• Real connection
• Growth

Safer alternatives: if you need to soothe yourself

• Take a cold shower
• Wrap up in a blanket
• Practice slow breathing
• Cuddle something soft

Plan ahead

• Delete ‘risky’ apps when feeling strong.
• Set up emergency contacts you can call or message.
• Have a ‘distraction toolkit’ ready, eg: music playlists, games, cake mix, knitting, art supplies.

Grieving over past drug use can be a complex and emotional process. It involves coming to terms with the impact that chems use had on many areas of a person’s life, relationships, and well-being. This grief is part of the healing process.

This grief can be for the person you were before you starting using chems, but it can also be for the person you were whilst using chems.

• Loss of time: Grieving the time spent using chems, especially if it resulted in harms, missed opportunities, damaged relationships, and ‘lost years’.
• Regret and guilt: actions taken while using chems, including mistakes, poor decisions, or hurting yourself and others. These feelings can be hard to resolve and accept.
• Grief for a “different self”: people might grieve who they were when they were using, especially if that person felt more confident, carefree, or disconnected from reality.
  Missed connections: people can use chems as a way to cope with emotional pain or to connect with others. They might grieve the loss of those coping mechanisms or the false sense of intimacy that drug use has provided.
• Identity and culture: drug use can become a part of a person’s identity, and some gay men view recreational drugs as part of their identity and culture. Losing or changing this part of themselves may cause confusion, a sense of identity loss, a loss of belonging, and can be felt keenly.
• Physical and mental healing: recovery can bring up physical or psychological pain from past chems use, and the process of healing can feel like mourning the body or mind you once had.

Saying goodbye to the ‘high’

Saying goodbye to the high can be as devastating and as complicated as losing a loved. All the stages of grief apply to this journey you are undertaking and the process will involve many mixed emotions. Let them in lovingly and allow them to happen.

You will need come to terms with the idea of never ‘seeing’ the high again, bargaining to find ways to make it possible, and anger that you can’t just enjoy a ‘little play’ without it turning into addiction again.

Getting rid of ‘stuff’

Disposing of supplies, gear and other paraphernalia can be incredibly difficult and cause many strong feelings. Our emotional attachment to these items can often be complex and confusing. But think of this event as day one of your grieving journey. It’s important to be gentle with yourself, seek support from peers or professionals, and remember that recovery is a journey of self-compassion and growth.

Sober sex refers to sex (or sexual activity) without the influence of chems, drugs or alcohol. It means being fully present and aware during sex, often leading to more intentional, authentic, and consensual interactions. Those who practice sober sex do so for better health, communication, friendships and relationships, and a lot of life stuff.

Challenges

• Old habits: chems lower inhibitions and intensify sexual experiences. People can associate sex with chems, making it hard to separate the two.
• Cravings: sex may trigger the desire to use substances again because of previous reliance on them to feel more confident, relaxed, or energised during sex.
• Anxiety: without chems to numb feelings, individuals may experience heightened anxiety, performance pressure, or self-consciousness.
  Lack of coping mechanisms: chems can serve as a coping mechanism for underlying emotional or psychological issues. Sober sex can bring up feelings or emotions that were previously hidden by substance use.
• Building new sexual intimacy: individuals may need to rediscover or redefine sexual intimacy without chems. Learning to connect without drugs means building trust and communication from scratch can feel daunting.

Sober sex can be challenging because it often involves confronting emotions and experiences that were previously numbed or altered by chems. Without the influence of chems or alcohol, people may feel more vulnerable, anxious, or self-conscious. This can make it harder to relax, communicate openly, and feel comfortable in intimate situations. Additionally, if someone has used chems as a way to enhance sexual experiences or lower inhibitions, navigating sex without them can feel unfamiliar or intimidating.

Reality check

It can be hard to ignore when our brain tells us how “good” chemsex was. But try to focus on the reality, not just the initial short term high. Think about how you will feel the next day, the day after that, and the day after that…

Never, ever, have sex or spend time with those who disrespect you. They do not have your best interests at heart and they will likely use you for their own pleasure, and walk away. They will not be there for you on day five.

This may have been OK with you in the past, but it’s not OK now. It’s not how you deserve to be treated. Don’t give them that. Remember who you are and your worth.

Grounding is a set of techniques that help you stay present in the here and now—especially when you’re feeling overwhelmed, triggered, anxious, or craving during recovery. It’s about reconnecting to your body, your senses, and your immediate environment so you don’t get swept away by difficult thoughts, urges, or emotions. Grounding:

• Helps you manage cravings without acting on them
• Calms anxiety, panic, or emotional flashbacks
• Breaks the cycle of automatic reactions
• Strengthens self-awareness and self-control

Examples of grounding techniques include:

Sensory Grounding (5-4-3-2-1 method)

• 5 things you can see
• 4 things you can touch
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

Physical grounding

• Take slow, deep breaths
• Stamp your feet on the ground
• Hold a cold object (like an ice cube)

Mental grounding

• Count backwards from 100 in threes
• Name all the colours you can see
• Recite a poem, mantra, or song you know by heart

Grounding is not

• Pretending bad feelings don’t exist
• Forcing yourself to be happy”
• A magic fix. It’s a tool for managing tough moments safely

Triggers and cravings are connected but not the same. A trigger doesn’t always lead to a craving if you have strong coping strategies. A craving can also happen on its own, especially early in recovery.

 Trigger = The Spark

• A trigger is something external or internal that sets off a reaction, like a reminder or cue that makes you think about using. It can be:
• A person, place, situation, or emotion
• Seeing a drug, smelling something familiar, feeling lonely, stressed, or excited
• A memory linked to past use

Example: seeing an previous hook-up and feeling stirred up or thinking about chems.

Craving = The Fire

A craving is the intense desire, pull, or urge to actually use a drug after being triggered (or even without a trigger). It feels:

• Physical, eg: tight chest, restlessness
• Emotional, eg: yearning, obsessing
• Urgent, like you “have to” get the substance

Example: after seeing a previous hook-up (trigger), you start strongly craving using again.

Cravings are intense urges to use drugs (like ‘G’, ‘T’, ‘M’) linked to sex on chems. They can be strong, sudden, and emotional, and are natural, but can be challenging.  Cravings don’t mean you’re failing; they’re a part of change and recovery. Acting on cravings is different from having cravings. Every time you ride one out, you build strength and new wiring in your brain.

Why do they happen?

• Brain rewiring: Chems link pleasure, sex, and drug use together deeply in the brain’s reward system.
• Triggers: Seeing certain apps, photos, people, locations—or even feeling lonely or stressed—can ignite cravings.
• Emotional needs: Cravings often aren’t just about drugs; they can also be about wanting connection, validation and escape from painful feelings
• Body memory: Feeling horny can trigger memories of using and craving.

What cravings feel like

• Intense need: to use apps, find drugs, and hook-ups
• Restlessness: eg: racing heart, shallow breathing
• Tunnel vision: eg: focusing on getting high or hooking up
• Feeling guilty: desperate, or trapped in obsessive thinking

Ways to manage cravings

• Delay: tell yourself to wait 15 minutes. Cravings often pass.
• Distract: do something totally different (go for a walk, make a sandwich, take a shower).
• Ground yourself: use grounding techniques to bring your mind back to the present.
• Talk it out: contact a support person or recovery buddy.
• ‘Ride the wave’: know that cravings are temporary, they rise, peak, and fall like waves.

More on delay: 15 minutes

• During these 15 minutes breath. Smile. Breathe and smile some more.
• Playing the tape forward (all the way to the end) Reflect on this decision; whether to use or not.
• Reflect on the next 6 hours, the next 24 hours of your life, and what they’ll be like, if you choose to use.
• Reflect on the money you’ll spend, the good and bad things that might happen (based on past experiences).
• Reflect on the commitment you made to not use…
• And the reasons you made that commitment.

And after 15 mins… after this reflection…

Make your decision

IF you decide to use… cool. At least it is a calm, considered, reflective decision. That’s great progress.

Anxiety and co-factors

Never forget the anxiety you felt whenever you used: the poor sleep, the constant worry about leaving the house, and the dread that clung to everything. Keep that memory close. Find a picture or an object that captures that feeling. Let it be your daily motivation to stay on the path of recovery.

The “Craving Emergency Plan”

If you can, plan ahead and have a “craving emergency plan”, such as keeping this booklet to hand, ready for these vulnerable moments.

Triggers are people, places, emotions, or situations that can stir cravings or make you more likely to use. Triggers don’t mean you’re failing, they’re a part of change and recovery. The important thing is to notice them early, respond with healthy coping tools, and reach out if needed.

Emotional

• Loneliness, stress, anxiety or feeling low
• Feeling rejected or disconnected
• Boredom or desire for escapism
• Shame, or unresolved trauma

Digital

• Dating or hook-up apps, late night hunting
• Profile pics, invites, scrolling (re-living) past messages
• Words like “PnP”, “Tina”, “G”, “HnH”,  or “slamming”
• Porn, and/ or sexualised images

People

• Ex-hook-ups, partners, old chemsex contacts, and dealers
• Friends and friends-of–friends with links to chems
• Family members

Environmental

• Visiting places linked to chems (eg: saunas, hotels, flats)
• Being alone in new or unfamiliar places
• Party or club environments where drugs may be available

Drugs

• Using drugs not directly related to chems (eg: ketamine, alcohol or poppers)
• Visuals, smells and sounds that remind you of past sessions (eg: porn, syringes, dark rooms, music)

Kit and gear

 Keeping kit or gear (paraphernalia) and/ or drugs at home can be triggering. You might think that the drugs are out of sight, out of mind. But, all it takes is for you to stumble on what you have stashed away for a trigger to occur.

Feeling horny

Feeling horny can be triggering, especially if you are remembering past chemsex experiences. While you may find sober sex hard, frustrating or boring, whatever it is, ‘sex’ in all senses of the word must be addressed.

Ways to cope with triggers

• Create a relapse prevention plan (eg: with a professional)
• Use apps or blocks to manage online exposure
• Develop positive habits to combat triggers
• Practice grounding or mindfulness when cravings hit
• Have a support contact system, though this can be difficult

Recovery or change from chems can be incredibly challenging, but it also offers a chance for a more positive and fulfilling future. The struggle often stems from the deep physical and psychological hold chems can have, and gay men can find themselves caught in cycles of dependence, leading to feelings of shame, isolation, and despair.

Breaking free or making change can involve overcoming intense cravings, facing underlying mental health issues, and dealing with trauma or emotional wounds. For some, it’s also about coming to terms with cultural legacies about who we are as gay men, how we identify, and our sense of community. This is tough life stuff.

Above all, recovery brings opportunities for growth and change  whether through safer chems use, in person support, de-tox, therapy, and/ or groups. It’s a journey that takes time and effort, but we can rebuild relationships, rediscover their sense of purpose, and feel more connected to ourselves and others.

Welcome to the Safer 2 pack, a no-nonsense guide to safer chems produced by gay men with lived experience. Inside, you will find the following booklets and leaflets. Click the links for a PDF:

• 0. WELCOME TO SAFER 2 (A5, 12 pages)
  Welcomes readers to the resources, explains background, themes and, for the first time, includes an index for all eight resources.
• 1. SAFER CHEMS (A5, 36 pages)
  In the 11th edition, a guide to safer chems use, harm reduction including ‘T’, ‘G’ and ‘M’, slamming, come downs, and overdoses (calling 999).
• 2. HOOK-UP SAFER (A5, 23 pages)
  Sixteen no-nonsense tips to help you remain safer, and providing a spring board to get the best out hooking up.
• 3. HEALTH AND WELLBEING (A5, 16 pages)
  An overview of health and wellbeing with a focus on the need for connection, ways to boost motivation, and getting out and active.
• 4. NAVIGATING SUPPORT (A5 28, pages)
  A guide to better understand how NHS, statutory and local authority services work and navigating the support you may need.
• 5. HIV/ STI/ HCV ‘RISK-O-METER’ (A5, 4 pages)
  An innovative, if irreverent, tool to gauge risks and harms associated with 16 practices relating to sex, chems and sexually transmitted infections (STIs).
• 6. USING ‘G’ (A5, 12 pages)
  A response to rising ‘G’ related emergency service (A&E) admissions and the most requested harm reduction information topic.
• 7. OVERDOSES AND CALLING 999 (A5, 4 pages)
  A flow diagram indicating potential outcomes for calling, or not calling for an ambulance, and if the police turn up first.
• 8. YOUR RIGHTS AND THE LAW (A5, 12 pages)
  Your essential guide to your rights when stopped, questioned, searched, and/ or arrested by the police.
• 9. SELF CARE (A5, 16 pages)
  A guide to understanding triggers and cravings (knowing the difference), sober sex, loss and grief, grounding and survival kit tools.

These resources are included in all PIP PAC safer chemsex packs.

NEPTUNE has been developed to improve clinical practice in the management of harms resulting from the use of club drugs and novel psychoactive substances. It is aimed at clinicians working in a range of frontline settings, including drug treatment and recovery services, emergency departments, sexual health services, primary care and mental health services.

Mainline | Dutch | English
Pioneers in Harm Reduction | Drugs, safer drug use, including chemsex. Mainline provides harm reduction services, training, consultancy and a lifestyle magazine. We work with partner organisations domestically and abroad through various projects. We have been dedicated to the principle of harm reduction, for 28 years.
Mainlne

Just Say Know | Dutch | French | Italian
Drugs, safer drug use, including chemsex. DRUGS – JUST SAY KNOW informiert über psychoaktive Substanzen, ihre Wirkungen, Nebenwirkungen und Risiken und weist auf die Möglichkeiten zum Safer Use hin. Die Website umfasst Allgemeine Informationen rund ums Thema Drogenkonsum und Substanz-Informationen zu 30 bewusstseinsverändernden Drogen sowie zum verbreiteten Mischkonsum.
Just Say Know

NOMOREC: No More (Hepatitis) C | French | English
Hepatitis C is seen as a serious infection. Quite a few gay men have had it in recent years. The possibility of getting it (again) is a concern to many men. That’s why we started NoMoreC. Our long-term goal: no new hepatitis C infections among gay men in Amsterdam.
NOMOREC

Chemfriendly | Norwegian
Chemfriendly er en organisasjon som arbeider for å spre rusvett om tryggest mulig og overdose- forebyggende rusbruk blant skeive i Norge. Aktivistene våre har bakgrunn fra HivNorge, Sexarbeidernes interesseorganisasjon PION, Helseutvalget, Foreningen Tryggere Ruspolitikk og Hepatitt C-klinikken. Målet til Chemfriendly er å forebygge overdoser og infeksjoner hos skeive rusbrukere. Metoden vi arbeider etter er skadereduksjon, og Chemfriendlys aktivister inkluderer helsepersonell og likepersoner. Skadereduksjon betyr at vi møter rusbrukerne der de er på deres premisser. Ingen pekefingre – bare kjærlighet, kunnskap og brukerutstyr.
Chemfriendly
Chemfriendly

How to put someone in the recovery position
How to put someone into the recovery position | NHS | 1m 6s
The Recovery Position | St John Ambulance | 2m 31s
Helping someone who is unresponsive and not breathing | Red Cross | 1m 48
Don’t Walk By | Global Drug Survey | 4m 33s

Social Action, Responsibility and Heroism Act 2015
In the common law of England and Wales, there is no criminal liability for failing to act in the event of another person being in danger; however, there are exceptions to this rule. In instances where there has been an assumption of responsibility by the bystander, a dangerous situation was created by them, or there is a contractual or statutory duty to act, criminal liability would be imposed on the bystander for their failure to take action. According to Wikipedia, the courts are reluctant to penalise people attempting rescue. The Act helps protect ‘good Samaritans’ when considering a claim of negligence or a breach of duty.
Social Action, Responsibility and Heroism Act 2015 | Wikipedia

Good Samaritan Law
Elsewhere in the world, there is also Good Samaritan law that offers legal protection to people who give reasonable assistance to those who are or whom they believe to be injured, ill, in peril, or otherwise incapacitated. The protection is intended to reduce bystanders’ hesitation to assist for fear of being sued or prosecuted for unintentional injury or wrongful death.
Good Samaritan Law | Wikipedia

This toolkit is designed to give harm reduction organizations and syringe services programs an overview of chemsex We have received questions about booty-bumping and supplies for a kit, how to reach communities of men who have sex with men who are engaged in chemsex, and what supplies and resources to have available for sex workers using stimulants. As providers of harm reduction services, we have an obligation to ensure adequate resources for all clients.

Resources on chemsex have mostly come from our friends in Europe. While valuable, their experiences are specific to their communities and the laws of their countries. Additionally, these resources often limit their scope to men who have sex with men, ignoring the fact that other communities also engage in chemsex.

Bluelight is an international, online, harm-reduction community committed to reducing the harms associated with drug use. It neither condemns nor condones the use of drugs. Rather, it accepts that drug use will always exist irrespective of legal status or societal norms. While there is no truly safe way to use drugs, it understands that prohibition and abstinence are not realistic or desirable solutions for everyone, nor have they been adequate in addressing the serious public health concerns associated with drug use. While there is no universal definition of drug-related harm reduction, Bluelight believes that through frank and open discussion it is able to deliver accurate information, eliminate misinformation and empower individuals to make wiser, more responsible choices.

What began as a campaign exploring STI transmission, Tweaker is now an international resource for drug-use safety, packed with information, tips, and harm reduction information.

When it was clear that crystal meth was a large community driver for HIV infections among gay men, Tweaker.org was created as part of a social marketing campaign to help gay men understand crystal meth and how it affects their sexual risk-taking and overall health.

The website was first launched in 1997 by STOP AIDS Project and was revitalized by the Stonewall Project in 2002. Updated and redesigned in 2019, Tweaker.org is viewed by more than 980,000 unique visitors across the globe annually.

• Crystal meth
• Alcohol and drugs drugs
• True stories
• Sexual health resources
• Substance use resources
• Harm reduction resources
• Apps to support you

In July 2018, the Metropolitan Police Service (MPS) issued guidance on chemsex and what they do if they are called.

Asking why, GMHC was informed “It has been removed as it was outdated and contained a number of inaccuracies. Developing new copy is taking time. The ask is that there needs to be accurate advice and guidance for the public on this outward facing national platform. This isn’t straight forward due to the complexity of what is present, the fact that drugs are involved and because Chemsex cuts across multiple areas within policing and vulnerability.”

We believe the (old) guidance should have remained online (with appropriate caveats) until the new guidance is active. For over six months, MPS guidance on chemsex remains conspicuous by its absence which disadvantages LGBTQ+ Londoners and professionals working in the chemsex field.

Our thoughts on the (old) guidance

This guidance is based on the position of the Metropolitan Police Service (MPS), which covers the Greater London area. Whilst police forces in other parts of the country can look to the MPS for working practices, they might actually do things differently. Whilst this guidance does not provide clear protection against investigation of a drug-related offence, it is absolutely right that drug use is not an offence in the UK.

However, possession and/ or possession with intent to supply a control drug is, and if you are questioned about these specific activities you should say nothing until you have a solicitor to represent you, or have at least spoken to one. But, the possibility of being questioned by the police should not be a reason to not call an ambulance if there has been an overdose or some other incident that needs medical help.

Calling an ambulance in an overdose situation can save lives. Ensuring friends get the right medical help if they need it is the top priority. However, there have been occasions when an ambulance has not been called because guys are fearful the police will turn up as well, and that if there has been a fatality this could lead to arrest and investigation.

Unfortunately, we cannot advise you to air rooms, tidy up, shower and put on some clothes and send your house guests away because (if a crime has been committed under the law, and evidence is removed or destroyed as a result) we could be arrested and prosecuted for actively encouraging you to do this.

The best advice we can give you is to always call an ambulance if you think someone’s life is at risk.

In August 2020, we tried to get a clearer picture of chemsex overdose situations and emergency service call-outs to improve our safer chemsex messaging and campaigning. This is a summary of the findings*. We have left the survey open, and the data was updated in March 2024.

Click here if you would like to take the short 2-minute anonymous survey.

• Gay men are less likely to call for an ambulance in overdose situations because they are fearful the police will turn up as well.
  36.81% Strongly agree; 36.8% Agree; 13.2% Uncertain; 13.2% Disagree
• How do you know gay men are less likely to call for an ambulance in overdose situations because they are fearful the police will turn up as well?
  31.4% personal experience; 45.7% heard stories/ word of mouth; 8.6% Just something I know; 14.3% other explanations
• In overdose situations, when an ambulance AND the police have turned up …
  38.9% had direct experience; 50% had heard stories/ word of mouth; 11.16% other
• If someone overdoses on ‘G’ and is unconscious, what are you more likely to do if you cannot wake them?
  54.1% said to call 999; 43.2% said they would let them sleep it off; 37.8% said they would try first aid**
• If you were to call 999 for an ambulance, how likely do you think it is the police would turn up as well?
  40.5% very likely; 24.3% likely, 29.7% uncertain; 5.5% unlikely
• Where was your last chemsex experience?
  73.2% London; 17.1% England; 9.7% Other
• Which chemsex drugs have you used?
  85.4% Crystal meth; 92.7% GHB or GBL; 43.9% Mephedrone; **

* Based on a total of 45 respondents, 97.6% of whom identified as gay / 2.4% identified as straight. Respondents were aged 20s: 7.1% | 30s; 42.9% | 40s: 28.6% | 50s: 19% | 60s 2.4%. ** Respondents were able to tick more than one option.

Calling an ambulance in an overdose situation can save lives. Ensuring friends get the right medical help if they need it is the top priority. However, there are times when an ambulance is not called because guys are fearful the police will turn up as well which could lead to arrest and investigation.

Below we have listed what we understand may happen when 999 is called for an ambulance:

• When someone overdoses on ‘G’ others around them may let them sleep it off, stay nearby, and/ or administer first aid; eg: place them in the recovery position. (If someone dies as a result of an overdose and this is regarded suspicious then the police will investigate and may make arrests).
• When a 999 is called for an ambulance in an overdose situation, an ambulance will arrive, usually taking the patient to the hospital (A&E).
• The police may also attend and investigate. This may result in arrest and charges¹ if the police believe a crime has been committed (eg: possession, intent to supply, sexual assault and rape). This may result in a court appearance and, if convicted, a sentence, with potentially life-changing implications for those concerned.
• There have also been instances where an ambulance has been called, but the party (scene) has been tidied up, and guests have left, before the ambulance and/ or the police have attended. This becomes problematic if the police suspect/ learn a potential crime scene has been contaminated and/ or evidence removed. This could result in arrest and charges, court, and a sentence.

¹ If you are charged (eg: with Possession) then you may avoid a conviction (eg: get a Caution), or a prison sentence (get a community sentence, even for Intent to Supply, in some circumstances).

Flow diagram

Click here to view a flow diagram. The diagram is a simplification of a range of scenarios which can be complex with life-changing implications. It is for guidance only. If you or someone else is in trouble, get professional advice at the earliest opportunity. Know your rights when questioned and/ or arrested. Anything you say may be used as evidence against you and others.

Listings for Accident and Emergency (A&E) Departments in Greater London is located under BODY:

Similarly, this website has mapped the following services:

2C-B
Drugs and me
Wikipedia
Frank

AMT
Release
Wikipedia
Frank

Alprazolam
Release
Wikipedia

Betel and areca
KFX
Wikipedia

BZP
Release
Wikipedia

Codeine
Release
Wikipedia

Diazepam (Valium)
Release
Wikipedia

Fentanyl
Fentanyl | Wikipedia
Fentanyl | Erowid

Khat
Release
KFX
Wikipedia

Kratom (Mitragyna speciosa)
Drugs and me
Erowid
Wikipedia

Lorazepam
Release
Wikipedia

MCPP
Release
Wikipedia

MDAI
Release
 Wikipedia

Methedone
Release
KFX
Wikipedia

Methoxetamine
Release
Wikipedia

Methylone
Release
Wikipedia

Modafinil
Drugs and me
Wikipedia

Morphine
Release
Wikipedia

Naloxone
Release
Wikipedia

Naltrexone
Release
Wikipedia

NRG-1, NRG-3, naphyrone
Release
 Wikipedia

Opium
Release
Wikipedia

Phenazepam
Release
Wikipedia

Piperazines
Release
Wikipedia

PMMA/ PMA
Release
Wikipedia

Rohypnol (flunitrazepam)
Release
Wikipedia

Salvia
Release
Wikipedia

Solvents
Release
KFX

Subutex/ Suboxone
Release
Wikipedia

Synthetic cannabinoids (cannabis)
Release
KFX
Wikipedia

Temazepam
Release
Wikipedia

TFMPP
Release
Wikipedia

Valium (see Diazepam

Xanax
Release
Wikipedia

Ya Ba
Wikipedia

Zopiclone, Zaleplon and Zolpidem
Release
Wikipedia

4MTA
Wikipedia

Acid (LSD)
Drugs and me
Release
KFX 
Erowid
Global Drugs Survey
Wikipedia
 Your Brain on LSD and Acid | AsapSCIENCE | 4 May 2017 | 3m 31

Alcohol
Drugs and me
Release
KFX
Erowid
Wikipedia

Alkyl nitrites (also listed under Poppers)
Release
KFX
Wikipedia
Poppers in the UK: a brief guide to the battle over legality | Dazed | 13 Aug 2020
Priti Patel ‘minded’ to decriminalise sales of ‘poppers’ drug | BBC News | 12 Aug 2020
ACMD does not see a need for an exemption under the Psychoactive Substances Act 2016 | ACMD | 16 Mar 2016
Crispin Blunt MP ‘outs himself’ as popper user | BBC | 20 Jan 2016
GMHC talks poppers ban after Psychoactive Substances Bill passes | BBC Radio Surrey | 21 Jan 2016
Poppers users beware… | The Guardian | 21 Jan 2016
UK ban on poppers could have disastrous health consequences for MSM | Release | 20 Jan 2016
Legal highs: psychoactive drugs policy ‘rushed’, say MPs | BBC | 25 Oct 2015

Alcohol
Drugs and me
Release
KFX
Wikipedia
 Global Drugs Survey Guide to Safer Alcohol Use

Amphetamines (also listed under Speed)
Release
KFX
Erowid
Wikipedia

BDO | 1,4-Butanediol

Benzodiazepines
Drugs and me
Release
KFX
Erowid
Wikipedia

Cannabis
Drugs and me
Release
KFX
Erowid
Wikipedia
Global Drugs Survey | Guide to Safer Cannabis Use

Cocaine
Drugs and me
Release
KFX
Erowid
Wikipedia

Crack cocaine
Release
KFX
Wikipedia

Crystal meth (also listed under Methamphetamine)
Antidote
Release
Erowid
Wikipedia

DMT
Drugs and me
Release
Wikipedia

GHB/ GBL
Drugs and me
Release
KFX
Erowid
Wikipedia (GHB)
Wikipedia (GBL)
Global Drugs Survey Guide to Safer GHB Use

Heroin
Release
KFX
Erowid
Wikipedia

Legal highs (also listed under New psychoactive substances)
Wikipedia
Drugwise
 Release

Ecstasy (MDMA)
Drugs and me
Release
KFX
Erowid
Wikipedia
Global Drugs Survey | Safer Guide to Ecstasy
Your Brain on MDMA | AsapSCIENCE | 16 Oct 2014 | 3m 31

Ketamine
Drugs and me
Release
KFX
Erowid
Wikipedia
Global Drugs Survey | Guide to Safer Ketamine Use 

Mephedrone
Antidote
Release
 KFX
Erowid
Wikipedia

Methamphetamine (also listed under Crystal Meth)
Antidote
Release
Erowid
Wikipedia

Magic mushrooms
Release
KFX
Erowid
Wikipedia