Why we take drugs
The short answer is because they’re fun and because we can. 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 a 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.Alcohol and Drugs | GMFA
Recreational drugs | GMFA The Hate Crime Survey 2016 | GALOP
4 Things Johann Hari Gets Wrong About Addiction | The Fix | Jul 2015
Crime survey: Third of gay and bisexual men took illegal drugs last year | Pink News | 24 Jul 2014 Everything We Think We Know About Addiction Is Wrong | Patreon/ Johann Hari Back to top
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 often 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)
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.
Try and avoid doing any drugs in the week, particularly if you’re working. A weekend without much sleep, few meals, hours of endless dancing and drugs won’t be good for the immune system. Hardly surprising that, come Monday morning, we’re feeling a bit trashed/ completely fucked/ disco damaged (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. It’s therefore key that if and when we take drugs on the weekend we do what we can to reduce their harms and ensure the impact doesn’t carry over.Back to top
Recreational drug use has the potential to damage your mental and physical health and sense of well-being, sometimes permanently by which time you may have lost your job, credit, your home, family, friends, boyfriends, and partners.
Granted, factors include which drugs you’ve taken, in what dose, and for how long (a one-off or sustained use), but it’s quite the smörgåsbord:
- Hard-ons can be a non-starter and we become sexually incapable
- Paranoia, psychosis, depression, anxiety and/ or flashbacks
- Increased risk of developing schizophrenia
- The inability to concentrate, and memory loss
- Sleep problems and insomnia, a loss of energy and/ or weight loss
- Bringing up the rear: collapse, unconsciousness and death.
The connection between drug use and our mental health is substantial. In fact, the writing has been on the wall for some time. When we’re young and spunky and invincible these sorts of issues matter little, but those feelings of kinship are as loyal as the last G dose!
Guys lose their homes and their jobs. They no longer meet life insurance criteria and their ability to travel aboard and/ or get visas is adversely affected. Also, It may be harder to get a new job and, in some cases, a criminal record may exclude you from applying altogether.
For seasoned drug users reading this it may not be tomorrow… or next week… or next month… or next year… but a crash, an overdose, a burn, a crisis, a breakdown, a day of reckoning usually comes with all the inherent mess that comes with it.Back to top
Reducing drug harm and risk
- 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
- 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.
- Use your own injecting kit and do not share needles, syringes.
Safer injecting | MEN R U S
- 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 – maybe yours!
- 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 really 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 makes 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
Meeting guys safety check | MEN R US
Sex venues | MEN R US Guerrilla public health | Harry Shapiro | Wellcome Collection | 21 Nov 2017
Saying no doesn’t always work, and many people who use illegal drugs just want non-judgemental help and advice. From safe-use graphic guides, to safe places to exchange needles, this is a potted (and sometimes controversial) history of drug harm reduction in the UK from the 1980s on. Drug harms in the UK: a multi criteria decision analysis | David J Nutt, Leslie A King, Lawrence D Phillips/ Independent Scientific Committee on Drugs
What is harm reduction? | Harm reduction International
Addictive properties of popular drugs | DrugWarFacts.org The Dog | Three Flying Piglets for MEN R US | 2017 | 34s Back to top
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 Back to top
WHY HARM REDUCTION MATTERS
What is harm reduction and why it matters
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 using drugs in the first place, or to stop them using once they’ve started. The focus of harm reduction focuses 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.”
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.
In relation to the Gay Men’s Health Collective, examples of this include this rarther large drugs section from MEN R US, safer chemsex packs from PIP PAC, and safer injecting films from THREE FLYING PIGLETS.
What is harm reduction? | AIDS Action Europe Berlin | 22 Nov 2018 | 3m 34s
Basic harm reduction | Release
What is harm reduction? | Drugwise
Harm reduction | Wikipedia
HIV roots of harm reduction | Drug and Alcohol Findings
Harm reduction | NAM aidsmap
Why the war on drugs is a huge failure | Kurzgesagt: In a Nutshell | 1 Mar 2016 | 6m 26s
The law and drugs
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.Classes of Drugs | Release
Drugs penalties | GOV.UK
Stopped and/ or Arrested by the Police | GALOP
Misuse of Drugs Act 1971 | Wikipedia Back to top
YOUR RIGHTS ON ARREST
Your rights on arrest
Rather than re-invent the wheel, the text is based on the outstanding “Bust Card: Your Rights on Arrest” by Release—in continuous publication since the early 1970s. Text used with their kind permission. Also, the LGBT Advisory Group which was instrumental in the Metropolitan Police issuing July 2018 guidance on chemsex and what they do if they are called.
“Bust Card: Your Rights on Arrest” is also an A7 pocket-sized booklet. If you would like a free copy email us here.
If you are reading this, ask yourself if you need legal help or a solicitor now?
Bust Card: Your Rights on Arrest | Three Flying Piglets for MEN R US and PIP PAC | Jan 2019 | 1m
You have the right to be treated fairly and with respect by the police
You do not have to say anything to the police BUT if you are later charged with a crime and you have not mentioned, when questioned, something that you later rely on in court, then this may be taken into account when deciding if you are guilty. There may be good reason why you do not wish to say anything to the Police, and you should not be intimidated into answering questions. Get a solicitor down to see you in the police station as soon as possible.Remember
- There may be times when, if you give an innocent explanation for what you have done, the police may leave you alone.
- It is wise NOT to discuss the case with the police until you have consulted privately with a solicitor.
- If the police are about to arrest you or have already arrested you, there is no such thing as a ‘friendly chat’ to sort things out. Anything you say can later be used against you. Think before you talk.
When the police get it wrong
If you want to challenge anything the police have done, then get the names and addresses of any witnesses and the name or number of the police officer/s, and make a written record as soon as possible after the incident. This should be witnessed, dated and signed. If you are injured, or property is damaged, then take photographs or video recordings as soon as possible and have physical injuries medically examined. If you have been treated unfairly, then complain to the Independent Office for Police Conduct (IOPC) and contact a civil liberties group like Release or a Citizen’s Advice Bureau or a solicitor about any possible legal action.
On the street
If you are stopped by the police:
- If they are not in uniform, then ask to see their warrant card
- Ask the police if you are being detained
- Ask why you have been stopped and, at the end, ask for a record of the search
You can be stopped and searched if the police have a reasonable suspicion that you are in possession of:
- controlled drugs
- an offensive weapon or firearm
- a sharp article
- stolen goods
- or if you are in a coach or train, on your way to, or you have arrived at, a sports stadium
There are other situations where you can be stopped and searched, for example: If police fear that there might be serious violence in a particular area, they can stop and search anyone in that area for up to 48 hours (this can be extended in some circumstances). In these circumstances, the police do not need to have reasonable suspicion that you are carrying a weapon or committing a crime.Remember
If you have been stopped and searched the police should provide you with a record of the event. There is no requirement to provide a record for a stop and account (that is, where no search has taken place). You run the risk of both physical injury and serious criminal charges if you physically resist a search. However, if the initial grounds for the search are unlawful and you are then charged with resisting arrest this may be legally challenged. If it is an unlawful search, you should take action afterwards by using the law.
In the police station
You always have the right to:
- be treated humanely and with respect
- see the written Codes governing your rights and how you are to be treated
- speak to the custody officer (the officer who MUST look after your welfare)
- know why you have been arrested
- have present with you a responsible adult if you are 17 years old or below, or are vulnerable
You also have the right (but they can in rare situations be delayed) to:
- have someone notified of your arrest (not to make a phone call yourself)
- consult with a solicitor privately
- request for a medical examiner to attend to you if you feel unwell
Inform the custody officer at the earliest opportunity if you are on prescribed medication. You may in certain circumstances be permitted to ingest, or negotiate for the collection and administration of your medication.
If not, notify your solicitor and refer him to PACE 1984 Code C Part 9.
- Do not panic. The police sometimes keep you isolated and waiting in the cell. Above all else, try to keep calm. The police can only keep you for a certain period of time – normally a maximum of 24 hours (this can be extended to 36 hours by a superintendent if certain grounds are satisfied, or 48 hours for a terrorist offence). Further extensions of custody can be obtained in exceptional circumstance
- Make sure the correct time for your arrest is on your custody record
- Make sure you know why you have been arrested
- Insist on seeing a solicitor even though you might have to wait
- Always request that a solicitor be present when you are interviewed. Do not be put off seeing a solicitor by the police. It is YOUR RIGHT, and it is FREE.
- If you ask for anything and it is refused, make sure this is recorded in your custody record.
Search of your home
- The police can search premises with the consent of the occupier
- A warrant can be obtained from magistrates by the police to search premises for evidence of certain crimes
- The police can only search the section of the premises that you occupy and communal areas of the premises
- Police may enter WITHOUT a search warrant in many situations, including:
- following an arrest, the police are allowed to search premises the detained person occupies or has control over
- to capture an escaped prisoner
- to arrest a person
- to protect life or to stop serious damage to property
- other laws give police specific powers to enter premises
- You are entitled to see a copy of any search warrant
- Police can use reasonable force to gain entry
- Police should give you information about their powers to search premises
- A record of the search must be kept by the Police
- You or a friend should be allowed to be present during the search but this right can be refused if it is thought it might hinder investigations
LGBT Advisory Group
Independent Office for Police Conduct (IOPC)
Citizen’s Advice Bureau Met police guidance: Ambulance call-outs and the police | Met Police | Jul 2018 Legal Aide (App) | Release
The new Legal Aide app from Release aims to help people navigate the criminal justice system. The app has been launched to help people who have been arrested for the personal possession of controlled drugs. Y-Stop (App) | Release
Y-Stop aims to give you the tools to interact with the police safely, equipping you with all the skills and knowledge you need to handle a stop and search. Back to top
Y-Stop and search app
Instead of giving you too much information about the law and the police, it focuses on really practical information and tips to help you manage what is often a confusing and stressful encounter, ending it as quickly, confidently and smoothly as possible. We call this a harm reduction approach.
Y-Stop is a collaboration between charities, lawyers, young people, youth workers, community and media organisations and run by Release in partnership with StopWatch. It started in 2013 when we began visiting youth clubs, colleges and schools across London to better understand young people’s experiences with the police and find out what we could to do.
We found out stop and search is a disempowering, frightening and frustrating experience for young people across the UK. It has a serious impact on communities too, creating a complete lack of trust and confidence in the police, as a result of the suspicion, neglect and prejudice we often face.
Y-Stop is our solution. Through training and tools it increases your confidence and skills to deal with stop and search, and reduces the risk of conflict and harm caused by contact with the police. It also improves your relationship with the police and increases awareness amongst communities about stop and search. Most importantly it makes you more aware of how to deal with these difficult situations positively.
The young people we have worked with have led the whole project, made every decision and designed all of our material as we wanted to create something you could really use. If you have an idea to make Y-Stop better, let us know!
Y-Stop | Y-Stop
Get the Y-Stop app for Android here | Y-Stop
Get the Y-Stop app for iOS here | Y-Stop Y-Stop | Release Y-Stop App Tutorial | Y-Stop | 19 Aug 2015 | 1m 55s Back to top
Legal Aide app
Legal Aide App
Thousands of people are prosecuted for simple drug possession every year in the UK – with no legal aid available. Furthermore, at MEN R US, it’s our experience that gay men’s understanding of drugs law, arrest, cautions and the criminal justice system is poor. There’s a wealth of anecdotal evidence to say that when things go wrong we don’t know who to call or what to do.
The new Legal Aide app from Release aims to help people navigate the criminal justice system. The app has been launched to help people who have been arrested for the personal possession of controlled drugs. The app was created by lawyers at Release, the UK’s centre of expertise on drugs and drug laws.Legal Aide App | Release
Get the Legal Aide app on Android | Release
Get the Legal Aide app on Apple | Release
For those without a smartphone, guidance is available in a downloadable PDF.
Arrest, legal advice, and your options in a police interview | Release | Apr 2018 | 3m 51s
Getting a caution, or being charged, for a class B or C drugs that aren’t cannabis/ khat | Apr 2018 | 2m 22s
Getting a cannabis/ khat warning, or penalty notice for disorder | Release | Apr 2018 | 2m 57s
Going to court, representing yourself, and sentencing | Release | Apr 2018 | 4m 25s
Criminal records, and their effect on jobs and travel | Release | Apr 2018 | 3m 3s
Release provide 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.Release
61 Mansell Street, London E1 8AN 020 7324 2989
11am – 1pm and 2pm – 4pm, Mon – Fri
Message service is available 24 hours and they will return your call within one business day. Email enquiry form HERE
Messages will be answered as soon as possible including weekends. Tick Tock! | Three Flying Piglets for Release and MEN R US | 2017 | 1m 0s Back to top
Global Drug Survey
Global Drug Survey
Using anonymous online research methods it runs an annual survey in many languages, which is hosted by partners in over 20 countries. Survey findings are frank, honest, and revealing. GDS explores the positives and negatives of drug use and detects new drugs trends as soon as they appear. GDS has a unique insight into personal decision-making about drug use.Global Drug Survey 2014
Global Drug Survey 2015
Global Drug Survey 2016
Global Drug Survey 2017
Global Drug Survey 2018
GDS2019 is translated into 20 languages and with partners in over 35 countries it hopes this will be its biggest yet. Committed to helping people use drugs more safely regardless of the legal status of the drug and promoting honest conversation about drug use, GDS relies on the experience and expertise from people all over the world.
GDS2019 – what it’s looking at this year:
- The acceptability of psychedelic therapies for mental illness
- Psychedelic micro-dosing – the good, the bad and who knows?
- The impact of cannabis health messages on cannabis use
- The use of cannabis edibles: the good the bad and the unexpected
- Fair trade cocaine – would you pay more?
- How much do you trust your dealer?
- Drugs, sexual assault and consent?
- Drugs the police and fair play around the world
- What drug is the best value for money
Drug and alcohol support
Read me first
Updated regularly, we believe it to be the most comprehensive listings of its kind but email us here if you know of a service we should add, or if we’ve got something wrong.
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.
Finding the right service
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 might want 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?
Coding services and lifebuoy icons
We have coded services as best we can:
A = Alcohol
D = Drugs
C = Chemsex
Services with a lifebuoy icon are:
- LGBT+ specific or LGBT+ friendly
- an established service serving the LGBT+ community
- known to/ visited by the Gay Men’s Health Collective
Email us here if you know of a service we should add, or if we’ve got something wrong.
London services restricted by area
Some services are restricted by geographical area or 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 below who will point you in the right direction. And feel free to contact MEN R US though we only signpost services.
Hours of service
Hours of service change so please click on the appropriate link for up to date information.Back to top
London drug, alcohol and chemsex support
Of all the listings we maintain the support section is the most challenging and time-consuming. New services pop-up then disappear while others don’t really advertise themselves. If you spot any errors or know of any services you think we should include please let us know here.
If you can’t find a service in your area and we will try and point you in the right direction:Phone on 07791 867885 (10am-4pm, Mon-Fri)
Email us here
We usually respond in a few hours.
Antidote @ London Friend | A D C
020 7833 1674
86 Caledonian Road, Kings Cross, London N1 9DN Thursday Drop-In @ Turning Point | Thurs, Drop-In | Antidote
020 3315 6699
32a Wardour St, London W1D 6QR
Axis Clinic | A D C
020 3299 5000
Camberwell Sexual Health Centre, 100 Denmark Hill, London SE5 9RS
Burrell Street Sexual Health Clinic | A D C
Not a walk-in service, Click here to make a referral
020 7188 6666
4-5 Burrell St, London SE1 0UN Burrell Street Clinic Slamming Packs
020 7188 6666
You will first need to speak with a health advisor.
4-5 Burrell St, London SE1 0UN
Chemclinic (Lambeth) | A D C
020 3228 1500
Lambeth residents only
Lorraine Hewitt House, 12-14 Brighton Terrace, Brixton, London SW9 8DG
Camden Community Drug Service | A D C
020 7485 2722
Camden residents only
184 Royal College Street, London, NW1 9NN
Club Drug Clinic | A D C
020 3315 6111
Hammersmith and Fulham, Kensington and Chelsea or Westminster residents only
69 Warwick Road, Earls Court, London SW 9HB
CODE Clinic | A D C
020 3315 6699
3rd Floor, 56 Dean Street, Soho, London W1D 6AQ
Dean Street | A D C
020 3315 6699
3rd Floor, 56 Dean Street, Soho, London W1D 6AQ
Antidote @ Turning Point | A D C
020 7437 3523
32A Wardour Street, Soho, London W1D 6QR
Chemsex @ Homerton | C
Homerton Row, London E9 6SR
Email Chemex @ Homerton
Lewisham New Directions | A D C
020 8314 5566
Lewisham residents only
410 Lewisham High Street, Lewisham, SE13 6LJ
SASH (Support and advice on sexual health) | A D C
For sex workers and other invididuals working within the sex industry
020 7851 2955
Residents of the City of Westminster, the London Borough of Hammersmith and Fulham, and the Royal Borough of Kensington and Chelsea only.
GRIP | A D CGRIP Club Drug Service | Tues, Drop-In | GRIP
Camden and Islington residents only
020 3317 6000
The Margarete Centre, 108 Hampstead Road, London NW1 2LS GRIP @ Bloomsbury Clinic, Mortimer Market | Tues, Drop-In | GRIP
Camden and Islington residents only
020 3317 5252
Capper Street, off Tottenham Court Road, London, WC1E 6JB
Let’s talk about gay sex and drugs | A D C
Monthly forum for talking about sex and/or drug use in the modern gay male community of London. In association with 56 Dean Street, supported by Wandsworth Oasis.
Terrence Higgins Trust (Online Support) | A D C
Wandsworth LGBTQ+ ForumThe Friday Night Club: Chemsex Peer Support Group | Wandsworth LGBTQ+ Forum
Last Friday of the month | No appointment required
229 Garrat Lane, Wandsworth London SW18 4DU
Wandsworth LGBTQ+ Forum
The Outside Theatre Company | A D (C)
020 3317 5252
61 Munster Road, SW6 5RE
This is an informal group for people who are in recovery from or have been affected by addiction. The workshop is a safe introduction to drama and to Outside Edge, suitable for those who may have little or no experience of drama and or in early stages of their recovery. Drop-In Drama aims to build confidence, have fun, and develop focus and commitment. You can just drop-in as part of your recovery process, but we do request that you have abstained that day to take part.
Narcotics Anonymous | D CNarcotics Anonymous
0300 999 1212
Find an NA meeting near you
Alcoholics Anonymous | AAlcoholics Anonymous
0800 9177 650 | 10am-10pm
Queers Without Beers | A
Queers Without Beers | Meet Up | Queers Without Beers
Queers Without Beers brings some of the most exciting alcohol-free drinks together at its exclusive pop-up bar in the heart of Bloomsbury. Craft beers, distilled botanicals, cider, wines, gin and tonic and crafts sodas all available to try on this friendly LGBTQI+ night. Syrup of Soot provides amazing food and lower sugar cakes as well as their normal offering of tea and coffee for those who need a caffeine kick. This is a sophisticated social space for LGBTI+ queers of all persuasions that doesn’t revolve around booze. Everyone is welcome – whether you have never drunk, don’t want alcohol tonight, are looking to change your drinking, or have actively quit. Free to attend, although QFB asks for a £3 donation to help with organisational costs.
One Too Many (Alcohol) Quiz | A
Other SupportFind a service near you | NHS Choices Drinkline (no website) | Public Health England
0300 123 1110 | Mon-Fri 9am-8 pm, weekends 11am-4 pm Alcohol concern Drinkaware | Industry funded
Experts attack Public Health England’s ties to drink industry | BBC | 13 Sep 2018 Back to top
Chemsex support outside London
A working progress from November 2017, this is a new section, responding to enquiries about chemsex support outside London. If you cannot find a service near you, contact your nearest LGBT, HIV organisation or sexual health service who may have local knowledge.
Birmingham LGBT Centre, 38/40 Holloway Circus, Birmingham B1 1EQ
0121 643 0821
BrightonChemsex Support | Pavilions, Brighton and Hove City Council
Richmond House, Richmond Road, Brighton BN2 3FT
01273 731900 | 0800 014 9819
23-25 Midland Road, Old Market Quarter, Bristol BS2 0JT
07971 354 498
CorbySubstance to Solution (S2S) | CGL
The Old TA Building, Elizabeth Street, Corby NN17 1PN
01604 211 304
The Hive, 63 Inkerman Street, Luton LU1 1JD
GUM Dept., Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP
Sam: 07790 560085 | Peter: 07790 560039
5 Richmond Street, Manchester M1 3HF
0345 330 3030
NorthamptonSubstance to Solution (S2S) | CGL
Spring House, 39 Billing Road, Northampton NN1 5BA
01604 211 304
WirralWirral Ways To RecoveryWirral Ways To Recovery | CGL
WWTR Birkenhead Hub, 23 Conway Street, Birkenhead, Wirral CH41 6PT
0151 556 1335
WatfordSpectrum (Hertfordshire Drug & Alcohol Services) | CGL
18 Station Road, Watford, Herts. WD17 1JU
01923 222 889 Back to top
UK Drug Service Directories
EnglandDrug and alcohol services England search | NHS Choices
Drug and alcohol services England search | Talk to Frank
ScotlandDrug services Scotland search | Scottish Drug Services Directory
Alcohol services Scotland search | Alcohol Focus
WalesDrug and alcohol services Wales search | Wales Drug and Alcohol Helpline
Republic of Ireland
Residential rehabilitation services for drugs and/ or alcohol in England and WalesResidential 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 Back to top
We’ve pulled together a selection of books which may help you better understand why sex may have become a problem, how we value and view ourselves in terms of sex, and some of the changes you can make in your life.
Clearly not an exhaustive list, please get in touch with us if there is a book you think we should add.
Something for the Weekend | James Wharton
“When James Wharton leaves the army, he finds himself with more opportunities than most to begin a successful civilian life – he has a husband, two dogs, two cars, a nice house in the countryside and a book deal. A year later he finds himself single, living in a room and trying to adjust to single gay life back in the capital. In his search for new friends and potential lovers, he becomes sucked into London’s gay drug culture, soon becoming addicted to partying and the phenomenon that is ‘chemsex’. Exploring his own journey through this dark but popular world, James looks at the motivating factors that led him to the culture, as well as examining the paths taken by others. He reveals the real goings-on at the weekends for thousands of people after most have gone to bed, and how modern technology allows them to arrange, congregate, furnish themselves with drugs and spend hours, often days, behind closed curtains, with strangers and in states of heightened sexual desire. Something for the Weekend looks compassionately at a growing culture that’s now moved beyond London and established itself as more than a short-term craze..”
The Chemsex Monologues | Patrick Cash
“A nameless narrator meets a sexy boy on a Vauxhall night out, who introduces him to G’s pleasures; a club night poster boy gets taken to Old Mother Meth’s place by a porn star; Fag Hag Cath is finding the chillouts have become more about the sex; Daniel is a sexual health worker who does community outreach in the saunas; and Rob’s snorting mephedrone off a framed photograph of his parents’ 25th wedding anniversary.”
5 Guys Chillin‘ | Peter Darney
“A graphic, gripping, funny and frank verbatim drama exposing the chill-out chem-sex scene. “Wanna pair of shorts? Shot of G? Line of Meth?” From surgeons to students, couples to kink; guys that love it and lost guys longing to be loved. An original look into a drug-fuelled, hedonistic, highly secret world of Grindr, and instant gratification.”5 Guys Chillin’ | Peter Darney | Oberon Books | 2016
Lust, men, and meth: a gay man’s guide to sex and recovery | David Michael Fawcett
“Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery provides the first practical resource for recovery from methamphetamine and the restoration of healthy sex and intimacy. Based on over a decade of clinical experience and research, Dr. Fawcett outlines the seductive appeal of methamphetamine and its impact on high-risk behaviors and sexual desire, resulting in the fusion ofo meth and sex in the brain. Such patterns of use quickly lead not only to a devastating addiction but in sexual dysfunction as well. Illustrated with examples from dozens of cases, this book outlines a path toward healing, describing the phases of physical, emotional, and sexual recovery and provides a broad range for supportive tools from managing triggers to mindfulness.”Lust, men, and meth: a gay man’s guide to sex and recovery | David Michael Fawcett | S FL Center for Counseling and Therapy, Inc. | 2015
Cruise control: understanding sex addiction in gay men | Robert Weiss
“Sex is always part of Ed’s day, whether he’s masturbating during his morning shower, cruising the mall during lunch, or engaging in his post-workout gym ritual. He often spends whole weekends either searching for sex partners or having sex. In his rigidly compartmentalized daily sexual activities, Ed reveals a part of himself that his friends and coworkers most likely wouldn’t recognize. About 10 percent of gay men are sex addicts. For gay men like Ed who may have a problem with anonymous online hook-ups, porn, sex clubs, and prostitutes, the first step toward personal growth is to gain as much knowledge as possible about sexual addiction. Cruise Control will help readers determine whether or not they are sex addicts and how to reclaim their sexual health. This second edition is revised and expanded to include the impact of social media and mobile apps like Grindr (which uses GPS technology for instant hookups) on the “epidemic” of sex addiction in gay males. Discover the important distinction between being a gay sex addict and a gay man exploring his sexual freedom.”Cruise control: understanding sex addiction in gay men | Robert Weiss | Gentle Path Press | 2013
Straight Jacket | Matthew Todd
“Written by Matthew Todd, editor of Attitude, the UK’s best-selling gay magazine, Straight Jacket is a revolutionary clarion call for gay men, the wider LGBT community, their friends and family. Part memoir, part ground-breaking polemic, it looks beneath the shiny facade of contemporary gay culture and asks if gay people are as happy as they could be – and if not, why not?
In an attempt to find the answers to this and many other difficult questions, Matthew Todd explores why statistics show a disproportionate number of gay people suffer from mental health problems, including anxiety, depression, addiction, suicidal thoughts and behaviour, and why significant numbers experience difficulty in sustaining meaningful relationships. Bracingly honest, and drawing on his own experience, he breaks the silence surrounding a number of painful issues, explaining:
- how growing up in the closet can overwhelm the gay child with a deep sense of shame that can leave young people with perilously low self-worth and a powerfully negative body image
- how many gay men overcompensate for childhood shame by pursuing unobtainable perfection, aspiring to have perfect bodies, boyfriends and lives
- how gay culture, so often centred around alcohol, drugs, quick sex and even quicker wit, exacerbates the problem, and what we can all do to make things better
Meticulously researched, courageous and life-affirming, Straight Jacket offers invaluable practical advice on how to overcome a range of difficult issues. It also recognizes that this is a watershed moment, a piercing wake-up-call-to-arms for the gay and wider community to acknowledge the importance of supporting all young people – and helping older people to transform their experience and finally get the lives they really want.” Penguin BooksStraight Jacket | Matthew Todd | Bantum Press | Jun 2016
The Velvet Rage | Alan Downs
“Today’s gay man enjoys unprecedented, hard-won social acceptance. Despite this victory, however, serious problems still exist. Substance abuse, depression, suicide, and sex addiction among gay men are at an all-time high, causing many to ask, “Are we really better off?” Drawing on contemporary research, psychologist Alan Downs’s own struggle with shame and anger, and stories from his patients. The Velvet Rage passionately describes the stages of a gay man’s journey out of shame and offers practical and inspired strategies to stop the cycle of avoidance and self-defeating behaviour. Updated to reflect the effects of the many recent social, cultural, and political changes, The Velvet Rage is an empowering book that has already changed the public discourse on gay culture and helped shape the identity of an entire generation of gay men.”The Velvet Rage | Alan Downs | Da Capo Press | 2012
The Epidemic of Gay Loneliness | Michael Hobbes
“Marriage equality and the changes in legal status were an improvement for some gay men,” says Christopher Stults, a researcher at New York University who studies the differences in mental health between gay and straight men. “But for a lot of other people, it was a letdown. Like, we have this legal status, and yet there’s still something unfulfilled. This feeling of emptiness, it turns out, is not just an American phenomenon. In the Netherlands, where gay marriage has been legal since 2001, gay men remain three times more likely to suffer from a mood disorder than straight men, and 10 times more likely to engage in “suicidal self-harm.” In Sweden, which has had civil unions since 1995 and full marriage since 2009, men married to men have triple the suicide rate of men married to women. All of these unbearable statistics lead to the same conclusion: It is still dangerously alienating to go through life as a man attracted to other men. The good news, though, is that epidemiologists and social scientists are closer than ever to understanding all the reasons why.”The Epidemic of Gay Loneliness | Michael Hobbes | The Huffington Post | 2 Mar 2017 Back to top
A little bit about alcohol
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 | Wikipedia
Ethanol | Wikipedia
Methanol | Wikipedia
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)
Alcohol proof | Wikipedia Back to top
What it does
Alcohol affects the body in several ways.
- It depresses and slows down the central nervous system; this is what leads to a reduction in tension, anxiety, and inhibitions.
- It provides energy… but also tons of calories that usually head for the waist. Burn it off through exercise and you’re OK but from a nutritional perspective, it’s pretty useless.
- It affects liver function. After heavy drinking, as much 50% of the liver can be ‘immobilised’ although it usually recovers within a few days.
- It makes you piss. With heavy alcohol intake the body loses more water than it takes in and you become dehydrated.
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).Liver | Wkipedia
About the liver | British Liver Trust
Love your liver | British Liver Trust
Liver disease | NHS Choices What does the liver do? | Emma Bryce/ TED-Ed | 24 Nov 2014 | 3m24s Back to top
Units and limits
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.
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 Officers’ 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.
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.
Public Health England and Drinkaware launch Drink Free Days | Public Health England | 10 Sep 2018
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
Regular excess drinking can take years off your life, study finds | BBC | 13 Apr 2018
People who drink above UK alcohol guidelines ‘lose one to two years of life’ | NHS | 13 Apr 2018 UK Chief Medical Officers’ Alcohol Guidelines Review | DoH | Jan 2016 New alcohol guidelines: How much is 14 units? | The Independent | 8 Jan 2016
View on new alcohol limits: how much advice is too much? | The Guardian [Editorial] | 8 Jan 2016
New alcohol guidelines: What you need to know | BBC | 8 Jan 2016 Alcohol units | NHS Choices
Unit of alcohol | Wikipedia
What is an alcohol unit? | Drinkaware Back to top
Government’s approach to alcohol harm is incoherent
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“In public health, prevention and treatment of alcohol misuse and its effects illustrate a huge mismatch between platitudes and practice. The 2012 Health and Social Care Act shifted public health funding and provision to local authorities, ostensibly because local government has influence over wider societal determinants of health, such as education, housing, leisure, transport, and social care. But local government budgets have been cut hard ever since, with public health hit hard. In 2012-13 the ringfence on council budgets for drug and alcohol services was lifted.”Government’s approach to alcohol harm is incoherent | BMJ | David Oliver | 11 September 2018
How behaviour changes
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 | 2m13s
What Happens When You’re Drunk? | Brit Lab | 28 May 2015 | 5m20s Back to top
The gay scene and alcohol
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
Stonewall’s Gay and Bisexual Men’s Health Survey 2013 concluded “eight in ten (78 per cent) gay and bisexual men had a drink in the last week compared to seven in ten (68 per cent) men in general. More than two in five (42 per cent) gay and bisexual men drank alcohol on three or more days in the previous week compared to 35 per cent of men in general.”
A 1,000,000+ hospital admissions
More generally in England (so not gay men only) the Health and Social Care Information Centre Statistics on Alcohol in England 2016 says there were an estimated 1,008,850 hospital admissions in 2012/13 related to alcohol consumption where an alcohol related disease, injury or condition was the primary reason for hospital admission or a secondary diagnosis. The estimated cost of alcohol harm to society is £21 billion per year. Information on estimated cost to the NHS of alcohol misuse shows that it costs £3.5 billion every year, which is equal to £120 for every taxpayer.Back to top
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.Hangover | Wikipedia
Hangover cures | NHS Choices
Drinking water doesn’t prevent a hangover, study says | BBC | 25 Aug 2015 What causes a Hangover? | asapSCIENCE | 22 Jun 2012 | 2m19s
The Scientific Hangover Cure | asapSCIENCE | 27 Jun 2012 | 2m30s Back to top
Alcohol is unlikely to harm your health if you drink only small amounts and avoid drinking every day. Steps to get the best out of drinking and avoid problems include:
- Keeping to the recommended weekly intake
- Aiming for 1 or 2 (even 3) alcohol-free days a week
- Drinking slowly instead of gulping
- Alternating alcoholic drinks with non-alcoholic drinks
- Experimenting with low alcohol or alcohol-free drinks
- Not drinking on an empty stomach
- Not drinking by yourself when you are unhappy or morose
- Not having ‘one for the road’
- Not drinking to relieve anxiety, tension depression or loneliness
- Not keeping your home stocked with alcohol
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:
- Bad breath
- Hangovers and headaches
- Flushed appearance or redness in the face
- Forgetfulness and memory lapses
- Incontinence (pissing or shitting yourself)
- Shaking in the morning
- Stomach or tummy cramps
- 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.
- 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 Disulfiram is prescribed, which induces unpleasant side-effects when alcohol is taken.Back to top
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:
More doctors smoke Camels than any oher cigarette, 1949 | graficsfx | 11 Nov 2016 | 1m
Proof Chesterfield cigarettes have no adverse effects on nose, throat, sinuses, 1953 | VideoTime 2 | 29 Jun 2011 | 1m 9s
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Lucky Strike cigarette kitchen commercial, 1955 | Comasarchive | 12 Feb 2012 | 1m 4s
How nicotine works
The major active ingredient in tobacco is nicotine, a stimulant that acts on the body by causing it to increase its production of adrenalin, a chemical produced by the body in response to stress, fear or excitement, which acts by increasing the heart, pulse and breathing rates.
Every time you draw on a cigarette it delivers a burst of nicotine to the body and brain and therefore stimulates adrenaline – giving smokers a buzz or high. By working in this way on the nervous system, nicotine can reduce tiredness and improve concentration, but you should never forget it is also the reason why smokers become dependent on tobacco.
Smoking also provides rituals – lighting up, sharing a cigarette with friends – as well as providing a diversion in a stressful situation by giving smokers something to do with their hands. Nonetheless, smoking is still thought by many as sexy, cool, stress-relieving, a confidence boost, a tool with which to meet people and a tradition after a shag.
Smoking tobacco (in varying forms) has a long history but it is only in the last century, with the advent of the cigarette, that it achieved its status as a social activity (even to the extent of being promoted by doctors as a remedy to breathing problems in the 1950s). Today, however, smoking is widely accepted as being a major health hazard, with tobacco companies paying out billions in lawsuits to people who have suffered lung disease and cancer as a result of their habit.
The damaging effects of smoking are often gradual, taking many years to appear, which is why the harm it causes can often seem inconsequential to young smokers.Back to top
What’s in a cigarette
Smoke enters the lungs as gases and solid particles which condense to form a thick brown tar; this lines the passages down which the smoke travels and then collects in the lungs. Tobacco is made from several hundred chemical compounds that fall into five main categories:
- Nicotine – one cigarette can deliver between 0.5mg and 2mg depending on how it was cured and how it was smoked (up to 90% if inhaled, and 10% if not).
- Gases – carbon monoxide at 300-400 times the level considered safe in industry and hydrogen cyanide at 160 times the safe level.
- Carcinogens, or chemicals capable of causing cancer – there are anything between 10-15 in a single cigarette.
- Co-carcinogens, or chemicals which don’t cause cancers directly but which accelerate the growth of cancer.
- Irritants – substances which disturb and inflame the bronchial passages to the lungs, increase mucus secretion and damage the process of getting rid of it.
Today, the majority of cigarettes are filter-tipped which removes many of the harmful substances from cigarette smoke. Low-tar and low nicotine cigarettes will reduce the amount of nicotine and tar entering the body but some filter-tipped cigarettes allow more poisonous carbon monoxide into the lungs.
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The Origins of Tobacco: Addicted to Pleasure | BBC | 29 Aug 2015 | 4m
Does smoking damage my health?
Around 50% of smokers will die from smoking-related diseases including lung cancer, heart disease, strokes, arterial disease, chronic lung disease and cancer of the bladder, stomach, mouth and throat. Smokers’ skin ages more quickly, they get indigestion and ulcers while their partners get lung cancer through passive smoking. However, here are the details of three particularly unpleasant and threatening conditions:
Lung cancer is probably the best known harmful effect of smoking but there are other forms including mouth, lip, and throat cancer. For those of you who don’t know, cancer is abnormal cell growth and can develop for a wide variety of reasons, smoking being one of the main triggers. Normal cells have certain limits to their growth, but cancerous cells continue to grow without controls, eventually causing serious and life-threatening damage to body tissues and organs.
Coronary heart disease is the most common cause of death in middle-aged men in Western countries, and the risk to a young man who smokes over 20 cigarettes a day is about three times that of a non-smoker. Chemicals contained in cigarettes enter the bloodstream through the lungs and encourage the build-up of fatty deposits. These deposits narrow or block the arteries supplying blood to the heart, which has increasing difficulty in pumping blood.
Eventually, you feel like shite as the heart struggles to do its job. Sometimes it stops and that’s it: a heart attack. If that wasn’t enough, the deposits also damage arteries in other parts of the body including the brain (which can result in a stroke) and the legs which, in severe cases, can lead to amputation.
Inhaling cigarette smoke damages the lungs and can severely reduce their capacity to function properly. Firstly, it irritates the passageways to the lungs which narrow, produce mucous and are more susceptible to infections. Secondly, the lungs are covered with millions of little sacs (alveoli) which are responsible for passing oxygen into the bloodstream and ridding the body of carbon dioxide. Smoke inflames the alveoli causing the lungs to become less elastic and efficient.
Once carbon monoxide passes from the lungs into the bloodstream – where it competes with oxygen – it combines with the blood and interferes with oxygenation of tissues. In the short term, this leads to shortness of breath, wheezing, coughing, and recurrent chest infections. In the long term, persistently high levels of carbon monoxide in the blood lead to a hardening of the arteries which, in turn, greatly increases the risk of a heart attack.
Passive or secondary smoking
Passive or secondary smoking is breathing in air contaminated with others’ cigarette smoke. There is an increasing body of evidence that those in the vicinity of smokers (eg barmen) are at an increased risk of developing tobacco-related disorders, such as heart and circulatory diseases, bronchitis, emphysema and lung cancer. They also suffer from considerable immediate discomfort from eye irritation, sore throats, coughs, headaches, asthma and other allergic reactions, increased heart rate and breathing difficulties. Just thought we’d tell you.Back to top
Benefits of breaking the habit
If you need a cigarette when you wake up then it’s more than likely that you’re addicted and should make a serious effort to give up. If you’re a social smoker – say one or two at weekends or at parties – you should still try and give up completely. The good news is that the benefits of giving up smoking start immediately.
- After 30 minutes circulation improves, blood pressure and pulse rate return to normal.
- Eight hours later, oxygen levels in the blood return to normal, chances of heart attack start to fall.
- 24 hours later, carbon monoxide is eliminated from the body, lungs start to clear out mucus and other crap.
- 48 hours later, nicotine is no longer detectable in the body and the ability to taste and smell improves.
- 72 hours later, bronchial tubes relax and breathing becomes easier, energy levels increase.
- Two to 12 weeks later, circulation improves throughout the body, making physical activity easier.
- Three to nine months later, breathing problems such as coughing, shortness of breath and wheezing decrease, overall lung function increases by 10 to 15%.
- After five years, the risk of heart attack falls to half that of a smoker. After ten years, the risk of lung cancer falls to half that of a smoker, and the risk of heart attack falls to the same as a non-smoker.
Breaking any habit is difficult, and success depends on determination, planning, and willpower. The benefits to health far outweigh the possible discomfort of a week or two, and the additional rewards of considerable financial savings should also keep you going when things get tough.
Many smokers are physically dependent on nicotine and so when they stop smoking the craving to have a cigarette continues and will take time to die down. Withdrawal symptoms are varied and can include mood swings, depression, restlessness, anxiety, difficulty in concentrating, and sweating.
Some people find that they put on a few pounds after they give up smoking. This is partly because they are no longer taking in nicotine (which stimulates the body’s metabolism) and because their appetite has increased. However, if you only nibble on healthy snacks, you’re unlikely to put on more than a few pounds which are not as bad for your health as continuing to smoke.
There are many different ways you can give up smoking: group sessions, individual medical care (through your GP), therapy, acupuncture and hypnotism, although the act of self will is probably the most popular method used.
Nicotine replacement therapies (NRT) such as Nicotinell and Nicorette don’t stop you from smoking but provide a much-reduced level of nicotine to help control the physical withdrawal symptoms. NRT supplies controlled levels of nicotine that allow you to gradually reduce your intake. NRTs are usually supplied as chewing gum, patches, or as a nasal spray available through your chemist. A prescription medicine available only from your GP, it helps reduce the urge to smoke, lessens symptoms of withdrawal and makes quitting more bearable.
What Happens When You Stop Smoking? | AsapSCIENCE | 2 Feb 2017 | 3m 28s
- Make a date to stop smoking and stick to it. Let others know and get as much support as you can. Maybe a friend might like to give up with you.
- Bin your ashtrays, lighters and fags.
- Drink plenty of fluids (not vodka) and keep a glass of water or juice close by.
- Get more active. Increased exercise helps clear the shit from your system.
- Expect withdrawal to be irritating. It’s a sign your body is recovering from the effects of tobacco. Irritability, urges to smoke, and poor concentration is common – don’t worry, they usually disappear after a couple of weeks.
- Change your routine, eg try to avoid the shop where you usually buy cigarettes.
- Bear in mind any drama in your life might get you reaching for just one fag to get you over it. How are you going to cope with that?
- Reward yourself. Use the money you are saving to buy something special.
- Be careful what you eat: snack on fruit, raw vegetables, sugar-free gum or sugar-free sweets, not fatty foods.
- Take one day at a time. Each day without a fag is good news for your health and your pocket, remember to celebrate your success. If this doesn’t work, don’t beat yourself up, you can always try again later.
Quit smoking supportStop smoking | NHS Choices
Stop Smoking London | Stop Smoking London
0300 123 1044 | Mon-Fri, 9am – 8pm; Sat-Sun, 11am -4pm
NHS Smokefree | NHS Smoke Free
0300 123 1044 | Mon-Fri, 9am – 8pm; Sat-Sun, 11am -4pm Stoptober | Public Health England (PHE)
Quit smoking campaign Stoptober backs e-cigs for first time | BBC | 21 Sep 2017 Stopping smoking cuts the risk of some cancers quickly in people with HIV | nam aidsmap | 17 Feb 2017
Smoking and HIV Factsheet | nam aidsmap | Nov 2016
HIV, smoking and lung cancer | nam aidsmap | 11 Mar 2015 Smoking and cancer | Cancer Research UK
Tobacco statistics | Cancer Research UK Smoking and quitting | British Heart Foundation
Smoking and heart disease in young people | British Heart Foundation Smoking | Diabetes UK
Help with giving up smoking | Diabetes UK Smoking | Wikipedia The Special, Toxic Relationship Between Gays and Smoking | Advocate | 7 Jan 2017
A New Gay Epidemic — And What You Can Do to End It | Huff Post | 2 Feb 2016
Smoking hits an all-time low… but not for gay people Pink News | 20 Nov 2015 Back to top
About E Cigarettes
E cigarettes and vaping
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 in 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 back of our collective throats]. The e-liquid is heated to make a vapour which looks like the smoke from real cigarettes carrying the nicotine to the lungs where it is absorbed.
Widely 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 unequivocal that vaping is much 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 harms they may cause.
E-cigarettes ‘much better for quitting smoking’ | BBC | 30 Jan 2019
Public Health England maintains vaping is 95% less harmful than smoking | The Guardian | 28 Dec 2018
Smoking vs Vaping | AsapSCIENCE | 16 Aug 2015 | 4m 19s
US surgeon general urges crackdown on e-cigarettes ‘epidemic’ among teenagers | The Telegraph | 18 Dec 2018
Vaping: how safe is it? | The Conversation | 8 Aug 2018
Vaping: All you need to know about the smoking alternative | BBC Newsround | 17 Aug 2018
Clearing up some myths around e-cigarettes | Public Health England | 20 Feb 2018 Articles on vaping | The Conversation | 2014-2018 Is vaping safe? | British Heart Foundation
Are e-cigarettes harmful? | Cancer Research UK
E cigarettes | NHS Electronic cigarette | Wikipedia
Construction of electronic cigarettes | Wikipedia
Positions of medical organisations on electronic cigarettes | Wikipedia Back to top
Chemsex is shorthand for gay men taking drugs during sex, first appearing on apps like Grindr, Bareback Real Time (BBRT), Gaydar, and Scruff (and yes, there are lots of others). However, it’s not the same as recreational drug use (eg: popping a pill or smoking a joint), rather it is a specific form of recreational drug use:
“Chemsex is the term used to describe sexual activity between gay and bisexual men under the influence of specific drugs, usually methamphetamine, mephedrone and GHB/GBL, to enhance and stimulate the experience. Sometimes the drugs are injected, which is known as ‘slamming’. It often takes place with multiple sexual partners and sessions of long duration, sometimes over several days. Those that engage in chemsex often report unprotected sex and other risky behaviours.”
Chemsex: More than just sex and drugs | Adfam | London Friend
The Chemsex Study | Sigma Research | Mar 2014
The chemsex narrative
Gay men have been taking drugs for years and it wasn’t so long ago we were dropping ‘E’s. Today it’s ‘chemsex’ and professionals are over it like a rash with opinions, forebodings perspectives, predictions, and reports. What is new, however, is that if and when guys eventually crash and burn the consequences are more damaging, more lasting, and require more complex and comprehensive intervention recovery and support. However,
“The needs of men engaged in chemsex are not best served by suggesting chemsex is universal. In fact, suggesting that it is universal runs the risk of giving the impression that it is both inevitable and impossible to escape. Most gay men in Britain, even in its gay centres, are not having chemsex.”
Ford Hickson, The Conversation, 21 Jun 2016
The truth is the ‘chemsex’ narrative is still unfolding, and we have a way to go before we have a more rounded understanding its its true extent and (long term) implications for gay men and our community.
Terms you may have heard
- Slamming – another word for injecting and the practice of dissolving crystal meth or mephedrone in water before injecting it into yourself or someone else
- PnP – shorthand for ‘Party and Play’ used to arrange ‘sex and drugs’ hook-ups online where there will be drugs, or you may be expected to bring some
- parTy – using drugs with an emphasis on Tina aka crystal meth (smoked or injected)
- HnH – high and horny
- Chem friendly – any combination of Methamphetamine (crystal/ crystal meth/ Tina/ meth), Mephedrone (meph/ drone) or GHB/ GBL (G, Gina) … though others drugs may be used.
Unfortunately these and other terms are often lumped together which is not necessarily helpful in understanding what is happening and why.
MoreSlamming | GMFA
Getting slammed | GMFA
Slamming | Friday/Monday | THT
Chemsex exposed | GMFA FS #147
Party and play | Wikipedia Back to top
Further reading on chemsex
Published articles, reports, studies and news
We’ve pulled together a selection of published articles, reports, studies and news. It’s not perfect or complete so please let us know if there’s something you think we should include.
2019The drug GHB is killing gay men | BuzzFeed | 22 Jan 2019
2018Chemsex and PrEP reliance are fuelling a rise in syphilis among men who have sex with men | The Conversation | 28 Nov 2018
Overtones singer Timmy Matley died from balcony fall while on crystal meth | Gay Star News | 4 Oct 2018
Brian Paddick was one of Britain’s most senior police officers. Now he’s speaking out about his ex-boyfriend dying from a chemsex drug | Buzz Feed | 29 Sep 2018
The chemsex problem is now so bad that families of those involved can get help | BuzzFeed | 15 Aug 2018
Gay men having chemsex are five times more likely to have a new HIV diagnosis than other gay men | aidsmap.com | 23 May 2018
Far more harms associated with crystal meth than other chemsex drugs | aidsmap.com | 24 Apr 2018
Sharing solutions for a reasoned and evidence-based response: chemsex/party and play among gay and bisexual men | A Bourne, J Ong, M Pakianathan | 9 Apr 2018
Chemsex exemplifies much wider issues with drugs and sexual consent | The Conversation | 3 Apr 2018
Loneliness and community are key to chemsex | 2 Apr 2018
The dark side of chemsex: A high cost to pay for temporary relief | Gay Times | 1 Apr 2018
Dramatic shift in drug use trends caused by growth of formerly legal highs | Drs. Rob Ralphs, Paul Gray | 27 Feb 2018
Sex, drugs and research—review probes the world of ‘chemsex’ | Jason Ong | 6 Jul 2018
Why high rents and loneliness are driving chemsex in London | Gay Star News | 22 Feb 2018
Chemsex is an issue among gay men living with HIV in the UK, study reveals | Avert | 30 Jan 2018
2017Chemsex drugs and former legal highs targeted by Home Office | The Guardian | 14 Jul 2017
The Inside Story of London’s Chemsex Scene | Vice | 12 Jun 2017
An observed rise in g-hydroxybutyrate-associated deaths in London | Forensic Science International 270 (2017) 93-97 | Imperial College London | Jan 2017
2016Chemsex: why is gay sex causing straight panic? | João Florêncio | The Conversation | 12 Apr 2016
Gay sex survey: why preventing HIV means calling an end to finger pointing | Ford Hickson | The Conversation | 21 Jun 2016
Sex, drugs and self-control: why chemsex is fast becoming a public health concern | Alastair Macfarlane | FSRH Margaret Jackson Prize Essay | 30 Jun 2016
2015Chemsex and gay men: Has the issue been overblown? | Pink News | 7 Apr 2015
Examining consent to sex while high on drugs: ChemSex | Design Redefined | Mar 2015
Acute HCV infections observed among HIV-negative gay men in London | NAM Aidsmap | 10 Jun 2015
Sexual transmission of HCV is increasing among gay and bisexual men with HIV | NAM Aidsmap | 18 Sep 2015
Chemsex and care-planning: one year in practice | David Stuart and Johannes Weymann/ 56 Dean Street | HIV Nursing, 2015; 15
The rise of chemsex on London’s gay scene | BBC News/ Radio 4 | 5 Jul 2015 | 10m33s
2014Experts warn of rise in gay ‘slamming’ | The Independent | 19 Jan 2014
Slings, slamming and Chemsex | Huff Post Lifestyle | 10 Feb 2014
Gay men warned on risks of ‘chemsex’ | The Guardian | 8 Apr 2014
Chemsex risks are not restricted just to gay men | The Guardian | 10 Apr 2014 The chemsex study | Lambeth, Southwark and Lewisham | Sigma Research | Mar 2014
Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study | Marina Daskalopoulou et al | Lancet HV, Vol 1 | Oct 2014
2013High-risk drug practices tighten grip on London gay scene | Kirby, T, Thornber-Dunwell, M | Lancet, Vol 381 | Jan 2013
High-risk drug practices in men who have sex with men | Victoria L Gilbart et al | Lancet, Correspondence, Vol 381 | Apr 2013
Sexualised drug use by MSM: background, current status and response | David Stuart/ Antidote | HIV Nursing | Spring 2013
New HIV diagnoses in London’s gay men continue to soar | Kirby, T, Thornber-Dunwell, M | Lancet, Vol 382 | Jul 2013
HIV, HCV, and drug use in men who have sex with men | Sean R Hosein, David P Wilson | The Lancet, Correspodence, Vol 382 | Sep 2013
2010Crystal methamphetamine: an intractable problem | Thorley, F | HIV Nursing | Sep 2010
Books and plays
Something for the Weekend | James Wharton | Biteback Publishing | 2017
“When James Wharton leaves the army, he finds himself with more opportunities than most to begin a successful civilian life – he has a husband, two dogs, two cars, a nice house in the countryside and a book deal. A year later he finds himself single, living in a room and trying to adjust to single gay life back in the capital. In his search for new friends and potential lovers, he becomes sucked into London’s gay drug culture, soon becoming addicted to partying and the phenomenon that is ‘chemsex’. Exploring his own journey through this dark but popular world, James looks at the motivating factors that led him to the culture, as well as examining the paths taken by others. He reveals the real goings-on at the weekends for thousands of people after most have gone to bed, and how modern technology allows them to arrange, congregate, furnish themselves with drugs and spend hours, often days, behind closed curtains, with strangers and in states of heightened sexual desire. Something for the Weekend looks compassionately at a growing culture that’s now moved beyond London and established itself as more than a short-term craze..” Biteback Publishing
“A nameless narrator meets a sexy boy on a Vauxhall night out, who introduces him to G’s pleasures; a club night poster boy gets taken to Old Mother Meth’s place by a porn star; Fag Hag Cath is finding the chillouts have become more about the sex; Daniel is a sexual health worker who does community outreach in the saunas; and Rob’s snorting mephedrone off a framed photograph of his parents’ 25th wedding anniversary.” Oberon Books 5 Guys Chillin’ | Peter Darney | Oberon Books | 2016
“A graphic, gripping, funny and frank verbatim drama exposing the chill-out chem-sex scene. “Wanna pair of shorts? Shot of G? Line of Meth?” From surgeons to students, couples to kink; guys that love it and lost guys longing to be loved. An original look into a drug-fuelled, hedonistic, highly secret world of Grindr, and instant gratification.” Oberon Books Back to top
Research shows club drug GHB associated with brain and cognitive changes
Scientists have discovered that regular use of the party drug GHB, and especially unconsciousness following GHB use, is associated with brain changes including negative effects on long-term memory, working memory, IQ, and higher levels of stress and anxiety.
Research shows club drug GHB associated with brain and cognitive changes | Medical Xpress | 8 Oct 2018
Adverse effects of GHB-induced coma on long-term memory and related brain function | Filipa Raposo Pereira, Minni T.B. McMaster, Nikki Polderman, Yvon D.A.T. de Vries, Wim van den Brink, Guido A. van Wingen | 1 Sep 2018
One person dies from “G” in London every 12 days
Deaths related to GHB/ GBL (“G”) rose by 119% in London between 2014 and 2015 according to an Imperial College London study which analysed data from 2011 to 2015 (collected from coroners across London). Deaths from “G” has more than doubled in just 12 months to 29 and so (on average) one person has been dying from “G” every 12 days.
Observed rise in “G” associated deaths in London | Toxicology Unit, Imperial College London | 25 Nov 2016
Wikipedia (GHB) | Wikipedia (GBL)
Global Drugs Survey Guide to Safer GHB Use
Back to top
There’s More to G Than Cock | Global Drug Survey
About this guide
With some minor edits, this 5th edition guide (August 2018) is a transcript of a 26 page booklet produced by PIP PAC, one of our other projects. As MEN R US and PIP PAC collaborated on the text you may find some content duplicated elsewhere on the website.Contact us if you would like us to send you a copy of this A5 booklet.
Chemsex Booklet | Three Flying Piglets | 1 Jan 2019 | 60s
We are not doctors or substance misuse professionals, but a group of rather gorgeous informed gay men, passionate about sex and their health, with direct experience of drug use, addiction, withdrawal, and recovery. Some of us are living with HIV and/ or Hepatitis C so—in some ways—this is our narrative and our story.
We are not alone and this edition has been updated, tweaked, and proofed by friends, shags, allies and organisations supporting the work we do, and who continue to give their time generously at every turn. Huge thanks to Injecting Advice, Global Drug Survey, Survivors UK, Release, 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.Back to top
Good to know
Mixing drugs is not a good idea as you may not know what you are getting and how the strength and/ or combination will affect you. Mixing increases the chances of interactions, overdose, passing out and/ or a trip to the accident and emergency department (A&E).
Know your chems
Whenever you can, test your drugs and/ or use an accurate scale to measure the proper dose. When using an unknown substance, build up your dose in small increments.
Make sure you eat enough. Even if you’re not hungry, try to eat small amounts regularly. Soft food is easier to swallow. Fruit, smoothies, protein shakes, porridge, yoghurt and soups are nutritious and provide new energy.
Take your medication
Are you on medication such as HIV antiretroviral medication? Set an alarm on your mobile so that you take your meds on time. Carry a spare dose with you just in case.
To prevent dehydration, it’s important to drink water, herbal tea or sport drinks regularly. Coffee and alcohol are not good options.
Recreational drugs often delay tiredness and exhaustion. Take regular breaks outside the sex setting and chill out. And if you can’t sleep, find a quiet dark space to help you relax better.
Take a shower at least once every 24 hours. It’s relaxing and energizing. Wash your hands regularly. If you are going to brush your teeth do so gently or use a mouthwash instead. Sugar free chewing gum helps protect teeth and gums.
You may be physically and mentally exhausted, feel empty, moody and grumpy. Watching movies and listening to music is a good way to chill. Good food speeds up recovery and consider taking multivitamins. If you feel up to it, engage in some light activity by going for a walk or playing some sports.
Help should you need it
If things are bad make sure you can call a mate and know where to get help, should you need it.
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 and chemsex can have serious consequences, and can cause lasting harm. Sexual consent is about having the ability and freedom to agree to sexual activity. This is something that must be clearly established between two people before any kind of sexual act or behaviour, and you can change your mind at any time.
Words we may not fully understand
Words like ‘consent’, ‘sexual assault’ and ‘rape’ may be new in that it has only been recently that they are being talked about more openly particularly in relation to gay men. Holding a mirror up to our sex lives can be difficult for many reasons; and for many gay men, it’s hard to believe that we may be a victim of sexual assault or rape.
Sex without consent
Sex without consent is a crime. Talking about this stuff is not easy, particularly when we’re high and horny. If something has happened to you, you may not even have found the words yet. Whether it’s a feeling … sense … or hazy memory: talk to a friend, go to a sexual health clinic, or phone a helpline.
Sex and consent | MEN R US Back to top
Sexual health check-ups
- Screen, detect and treat sexually transmitted infections (STIs) including HIV—with results often within hours
- Offer PEP – a course of HIV medication if you have been at risk of HIV infection, effective for up to 72 hours after exposure
- Provide information, support and advice on maintaining a healthy sex life
- May be able to offer PrEP
- Provide a point of contact in the event of future problems
Pre-Exposure Prophylaxis (PrEP)
The evidence supporting this comes from the PROUD study which reported in February 2015 that PrEP reduced the risk of HIV infection by 86% for gay men and other men who have sex with men. This was one of the most robust studies ever taken into drug-based HIV prevention.
Where and how to get PrEP
Accessing PrEP on the NHS is different in England, Scotland, and Wales; with a pilot in Northern Ireland. Alternatively, you can buy PrEP privately or on-line for £20-40/ month but you are advised to connect with your sexual health service for monitoring.
Post Exposure Prophylaxis (PEP)
PEP is a course of medication after a potential exposure to HIV, designed to reduce the risk of HIV infection. It is the same meds that are used to treat HIV. The course lasts 28 days and may be able to prevent you becoming infected with HIV if you start taking it within 72 hours from the time of exposure; eg: a condom break or bareback sex.
If you think you may need PEP don’t spend the next 72 hours wondering, or searching the Internet for the right advice as the right advice is go to a sexual health clinic now. The sooner you start treatment the more likely its success.
You can also obtain PEP at accident and emergency departments (A&E) at some hospitals—especially important at weekends because most sexual health clinics are closed.Post Exposure Prophylaxis (PEP) | MEN R US Back to top
Avoid ever re-using or sharing equipment
If this booklet is included in a PIP PAC pack you should notice colour-coded syringes, spoons and straws to reduce the risks of sharing (yellow/ green or red/ blue).
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 (scratch a letter/ number on the side) to ensure you know which is yours. You should also flush it through with clean fresh water after use so that it doesn’t clog with congealed blood.
To reduce possible damage to the veins use short thin needles. Short needles meant for injecting insulin are the most suitable.
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, 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. Whether you are using ampoules or boiled water, throw away leftovers after use as bacteria build up quickly.
Washing your hands and cleaning 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 and clutter-free place to slam, ensuring surfaces are clean.
Alcohol pads/ swabs
Alcohol pads are sterile-packed and 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 hit 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 else (neck, cock or groin) is potentially very dangerous. If you have done this we advise to seek advice from a drugs service.
The inside of the elbow is by far and away the safest place to inject. Injecting anywhere else (eg: the neck, cock or groin) is potentially very dangerous and we advice you to seek advice from a drugs service. Aim to slam at least 1cm away from your last slam location and rest injecting sites by not injecting in the same place. If possible, learn to swap arms.
Tourniquet (pronounced turn-e-kay)
Used properly, tourniquets raise veins and can be helpful for some when injecting. However, a badly used tourniquet introduces many new risks and it would be safer not to use one at all rather than to use a tourniquet badly.
For example, some guys don’t like a needle and syringe ‘flapping around’ while they release the tourniquet which is why they release it after injecting. This is not advisable as it puts pressure on the veins (which can burst) and can cause serious circulation problems if you pass out with the tourniquet tight around your arm. The ideal tourniquet should be:
- Wide enough to not cut into the skin
- Long enough to tie in a way that
- You can loosen with your mouth
- Have some give in it
- Medical tourniquets
You need to be able to release the tourniquet without removing a hand from the needle once it’s sited. Medical tourniquets are designed to be used by another person and not the person being injected.
Tourniquets and the law
Here we have a problem (at least in the UK) as Section 9a of the Misuse of Drugs act specifically stops being able to legally supply tourniquets of any kind to injecting drug users. It should be noted however that in the history of the act there hasn’t been a single prosecution of a drug service giving out ANY form of harm reduction equipment.
Cotton wool swabs/ kitchen roll/ tissue
Immediately after slamming, press on the injection site with a cotton wool swab, folded kitchen roll or tissue to help the site close quickly. This also helps reduce bruising and helps the veins heal faster. Don’t use alcohol pads for this as it slows down the healing of the wound.
Needle (sharps) disposal
Use a sharps bin or sharps disposal unit whenever possible. These come in a variety of shapes and sizes and don’t have to be bulky. Only recap a needle if it’s your own. Some guys improvise by sealing used equipment in plastic drinks bottles with screw caps then throw them away as domestic waste. Be aware this could present a risk to refuse collectors so it’s important to dispose of equipment as safely as possible.
So, at the risk of repeating ourselves: use a sharps bin or disposal unit whenever possible and take it to a needle exchange for safe disposal.
More about safer slammingMore here about safer slamming | MEN R US Back to top
Back-loading (barrel-mixing chems)
Some guys dissolve their chems in warm water inside the syringe barrel, giving it a vigorous shake before slamming. However, tiny particles that don’t dissolve can cause problems. We strongly recommend you dissolve chems in sterile water, or freshly boiled water, in a sterile cup and draw the solution through a filter.
Crystal meth dissolves easily in water, while mephedrone and other drugs can be more difficult to dissolve. Bottom line: whatever you inject into your vein needs to be fully dissolved, as pure as possible, and not contain any unnecessary crap.Back to top
Booty bumps (chems up the arse)
Booty bumps (chems up the arse)chems taken up the arse using a syringe without the needle (mixed in the barrel and squirted up) or put up there using a finger. The chems are absorbed through the lining of the anal canal and rectum.
Some chems taken this way can act faster than if swallowed or snorted and feel much stronger, but this can cause irritation, bleeding and/ or inflammation, increasing the risk of infection, and cause lasting damage to the arsehole and rectum.
Remember to wash your hands and use a new syringe each time, and lube the arsehole and the syringe barrel before inserting gently.Back to top
Injecting people and the law
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.Injecting other people | MEN R US Back to top
Hepatitis C and douching
There has been a marked increase in Hepatitis C (Hep C) among gay men, which raises additional issues if you are already living with HIV. Fucking, fisting, and sharing douche kits, dildos and snorting straws can all put you at risk of catching Hep C, HIV and other STIs. You reduce risks by:
- Using condoms for fucking or getting fucked
- Using sterile syringes and needles when slamming
- Using sterile syringes for booty bumps
- Using latex or non latex gloves when fisting or getting fisted
- Using your own supply of lube and not sharing
- Using a new condom on dildos every time they are used
- Using your own straw when snorting drugs
Disinfecting douche heads
Keeping douche heads and douche kit clean is an important part of reducing risks, especially at sex parties where 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 well before each arse.
Hepatitis C | STIs MEN R US Back to top
About and using G
GHB and GBL are two closely related drugs often referred to simply as “G”. This section concentrates on GHB as a liquid.
- GHB has been used as a general anaesthetic, a treatment for narcolepsy and alcoholism, and used by bodybuilders to promote hormone growth. It has almost no smell and a soapy salty taste. GHB is also found in minute quantities in the human body, some beers and wines, beef and small citrus fruits.
- GBL is an industrial strength solvent used an alloy cleaner, paint stripper, and for removing graffiti. It’s taken in liquid form and has a sharp bitter chemical taste and smell.
- GBL turns into GHB once in the bloodstream and the effects are identical to GHB. However, you should note that GBL is 2-3 times stronger dose for dose, the effects can come on quicker, and it can be more unpredictable. GHB and GBL are commonly sold and taken orally in liquid form but can also be found as a powder, paste or in capsules, though this rarer.
GHB | Wikipedia
GBL | Wikipedia
GHB/ GBL | Drugwise
- GHB can make you feel relaxed, more sociable, horny, reducing inhibitions (wanting more intense and extreme sex), euphoric and drowsy.
- 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.
- Overdosing on GHB can lead to unconsciousness and coma and/ or result in death. Side effects include dizziness, nausea, vomiting, loss of coordination, and muscle spasms.
- It’s easy to overdose on GHB because there’s a small difference between a dose that causes the effect you want and a dose which leads to an overdose.
- Even careful dosing can turn into an overdose leading to loss of consciousness and increased vulnerability.
- Be aware that different concentrations of the drug exist and you should only increase your dose incrementally allowing time for the full effects to kick in before taking more.
- GHB is a Class C 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 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.
Your rights on arrest | MEN R US
Ambulance call-outs and the police | MEN R US
- Measure and check your own doses ideally using a 1ml or 2ml plastic syringe
- GHB is a solvent so 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 GHB 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
- The effects of G come on quickly within 10-15 minutes
- Batches of G may differ slightly in strength. Check a new batch by taking a smaller dose than usual, waiting at least 60 minutes before taking the next dose
- G is extremely dose sensitive. Even a slightly higher dose than normal can cause you to pass out, lose consciousness, and/ or fall into a coma
- 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
Dosing amounts (ml)
- .5ml – 1 ml is a common starting dose
- 1 – 1.5 ml has been described as a ‘sweet’ or ‘happy’ spot
- 1.5 – 2 ml can be a ‘sweet’ or ‘happy’ spot for those with higher tolerances
- 2.5 – 3 ml might be a dose for those with higher tolerances but you are more likely to pass out and fall into unconsciousness, coma, and die
- 3 ml and above might be OK for those with high tolerances, but you are much more likely to pass out and fall into unconsciousness, coma, and die
Drinking G with soft drinks
- A dose of G is usually taken with a soft drink like coke 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 quantity 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
Tracker Sheet | A4 Landscape | PDF | English | Deutsche | Français | PIP PAC and Aids-Hilfe Switzerland
Mixing with alcohol and other drugs
- Never use G if you are by yourself as you are putting yourself at extreme risk
- GHB is a depressant and mixed with other depressants and sedatives increase the chances of things going wrong and overdosing even if they are taken several hours apart
- Never mix G with alcohol, opioids (heroin, codeine), tramadol, benzodiazepines (Xanax, diazepam) and ketamine
- Some HIV medications interact with G (and other drugs), so you should have a conversation with a health professional you trust first. See below.
- If you pass out, your breathing passage can become blocked, and you could suffocate and die
- Do not be afraid to call emergency services. Click here for more
Drink spiking is when alcohol or drugs are added to someone’s drink without them knowing – so without their consent. In many cases, drinks are spiked with the intent of sexually assaulting or raping a person. There are also increasing instances of burglary and murder.
- G is added to soft drinks
- G is mixed with water-based/ silicone lubricants before/ during sex
- G is mixed in syringe lubricant applicators (or syringes without needles) and inserted up the bum
Some guys fantasise about consensual rough sex and rape scenarios when taking any recreational drug increases the risk of harm and is potentially life-threatening
- Measure, check and drink your own doses and don’t leave your drink unattended
- If you come to a drink later throw it away and wait an hour before dosing again, starting slowly
- Take a supply of your own lubricant if playing with a partner for the first time, unless you know and trust them
- Ensure consent is given freely and safe words are agreed, as required
The Sexual Offences Act 2003 states that it is an offence to administer a substance, like GHB and GBL, to a person with intent to overpower that person to enable sexual activity with them. This can mean up to 10 years’ imprisonment.Sexual Offences Act 2003 | Wikipedia
Words like ‘consent’, ‘sexual assault’ and ‘rape’ may be new in that it has only been recently that they are being talked about more openly, particularly in relation to gay men. Holding up a mirror to our sex lives can be difficult for many reasons; and for many gay men, it’s hard to believe that we may be the victim of sexual assault or rape. Or that we may be committing a crime ourselves.
Sex without consent is a crime. Talking about this stuff is not easy, particularly when we’re high and horny. If something has happened to you, you may not even have found the words yet. Whether it’s a feeling … sense … or hazy memory: talk to a friend, go to a sexual health clinic, or phone a helpline. The link below includes details of support organisations.Sex and consent | MEN R US
HIV medication and drug interactionsHIV Drug Interactions | University of Liverpool
Interactions between HIV treatment and recreational drugs | NAM aidsmap
Recreational drugs and HIV meds | i-base
Recreational drugs and HIV | Terrence Higgins Trust
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
- 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
Addiction (or dependence) and withdrawal
- 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 2 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
Check out our drugs and chemsex support section here.GHB/ GBL | Antidote @ London Friend (London)
GHB: The High-way code | Global Drug Survey
GHB: going over and getting hooked | Global Drug Survey
Storing and decanting
- Shake the bottle before measuring a dose as G can settle causing later doses to be stronger than earlier ones
- G is usually sold in 500ml and 1 litre quantities which is why it’s decanted into smaller containers to a syringe or pipette can be inserted
- Put G out of the way, so people don’t pick it up thinking it’s a glass of 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
Many thanks to the volunteers who gave time freely to write this section including A, H, N, C, V, L, G, K, D, 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 to improve this section.Back to top
Finding the right chemsex support
When guys ‘crash’ or are in crisis, they often require multiple services (eg: recovery, mental health, legal, housing, debt) and mainstream services are not always geared up to work together—though some are trying to improve.
Issues like this affect many LGBT+ people accessing health services generally at a time when there is less funding and more cuts than ever before.
The response to chemsex by mainstream drug services is understandably slower than we would like. Many only Seem to have a cursory understanding of gay men’s health and wider LGBT+ issues. However, some are starting to respond positively, becoming LGBT+ friendlier, something long overdue.
But, the first step in getting help may be talking to someone you trust, a friend, a sex bud … even the ex. Some of the best support is to be found within our own community.Chemsex support services | MEN R US Back to top
Ambulance call-outs and the police
Ambulance call-outs and the police
In July 2018, the Metropolitan police issued the following guidance on chemsex and what they do if they are called. The guidance (in blue) has been produced working with LGBT advisors to the police (including the Gay Men’s Health Collective and Release) and third party agencies with experience of supporting victims of sexual violence under the influence of drugs.
If you’re under the influence of drugs
All allegations of crime are taken seriously and sexual assaults are dealt with sensitively by specially trained officers, known as SOIT (Sexual Offence Investigation Techniques) officers. They’re trained to understand the difficulties faced by someone reporting sexual violence and can direct you to the most appropriate support services. If you report a sexual assault to us your SOIT officer will be the point of contact with us.
You’ll be asked if you’ve taken or used drugs or alcohol, this is mainly to make sure you are feeling well enough to give a proper account of what happened, and legally agree (consent) to a medical examination. If you aren’t able to they can take some basic information and take a statement and tests at a later date.
It’s also important that we know from the start if there were any drugs and/or alcohol involved, because if it comes out later it might affect how well you are believed. Not because you’ve taken drugs, but because you didn’t give the full information from the beginning which might look like you’re trying to hide something.
You won’t be arrested for using or telling us you’ve used drugs; that isn’t illegal. You can report to us online, by calling 101 if it isn’t an emergency, and on 999 if you or someone else is in immediate danger. If you want to report to us anonymously, you can do that. Some recommended ways to report anonymously:
– The Havens (organisation who help people whohave been raped or sexually assaulted)
– National Ugly Mugs (if you’re a sex worker)
– Through one of our partners such as GALOPor Survivors UK
If you’re in possession of drugs
If you tell us you’re in possession of drugs, or that you supplied (shared or sold) drugs in the past, we can’t ignore this, as physical possession, supply, or possession with intent to supply (PWITS) are criminal offences.
If you’re the victim of a crime when you were taking drugs, and you don’t tell us but it comes out later, it might affect any future court case. You might be seen as a less reliable witness or victim because you kept information back. But you will have a chance to explain why you did this. The law that deals with drug offences is the Misuse of Drugs Act 1971.
If you’re arrested
You won’t be arrested for using drugs while having sex; if you admit to criminal offences (e.g. supply of drugs, committing rape or other sexual offences) you’ll be arrested. If you work with children or vulnerable adults (as an employee or volunteer) we might tell them you have been arrested, but this depends on the offence and other things. This is called a disclosure.
There’s no set list of jobs or types of jobs that will trigger us telling your employer, or an organisation where you volunteer, if you’re arrested. Instead, the police have the power to decide what information to disclose, and to who – this is under the Common Law Police Disclosure (CLPD) scheme.
The police should only disclose information if they identify a ‘significant risk’ and an ‘urgent pressing’ social need to address. The National Police Chiefs’ Council (NPCC) says that ‘pressing social need might be the safeguarding, or protection from harm, of an individual, a group of individuals, or society at large.’ The police have a duty to balance public interest against your rights, including how a disclosure might affect your private life.
If you’re in a job or voluntary role that involves being in a position of trust or responsibility with the public, then the police will definitely think about making a disclosure. The decision will be based on:
– your job/type of work
– the offe nce being investigated
– any specific circumstances
– an assessment of risk to an individual
– or group of people
Any disclosure has to be authorised by an experienced officer. For example, in London, the decision is taken by an officer who is at least an Inspector. The police can’t make a decision about what happens with your job – they just give the information to your employer so they can decide what, if anything, to do. Your employer should have policies in place on how to deal with this situation.
Will police attend if an ambulance is called?
We work with the Ambulance Service to work out when we need to attend if they are called. We’ll likely attend if:
– there’s suspicion that a crime has been committed
– entry (to the premises) may need to be forced to let the ambulance crew in
– the patient may be a danger to themselves
– the patient may be a danger to the ambulance crew
There are lots of specific reasons why police can enter (and search) a property without a warrant. The police also have a general power to enter to arrest someone or ‘to save life or limb’. So if, for example, an ambulance crew arrive and are refused entry by the occupier they’ll call us for help.
The police can then use their power if they feel that they need to gain entry to save or protect someone’s life. But if the Ambulance Service are already inside dealing with the situation the power to save life or limb wouldn’t apply, as it wouldn’t be necessary to enter.
It’s possible that refusing entry will look suspicious, but you have the right to say no. The law that deals with drug offences is the Police and Criminal Evidence Act 1984.
Our thoughts on this 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.Chemsex advice and information | Metropolitan Police | July 2018 Back to top
Safer slamming (injecting)
Safer slamming (injecting)
- 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 mephedrone
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.PIP PAC 3.0 safer chemsex pack for gay men | PIP PAC
Injecting Supplies | Exchange Supplies
Drug and Alcohol Services: Search by Post Code | NHS Choices
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:Injecting Advice | Injecting Advice
Safer injecting | drugs.ie
The Safer Injecting Handbook | Exchange Supplies Back to top
Used properly, tourniquets raise veins and can be helpful for some when injecting. However, “a badly used tourniquet introduces many new risks and it would be safer not to use one at all rather than to use a bad tourniquet badly.” For example, some guys don’t like a needle and syringe ‘flapping around’ while they release the tourniquet which is why they release it after injecting. While this is a practice, it’s not advisable.
If you use one correctly a tourniquet will increase the size of a vein considerably, this of course makes it easier to hit and so reduces the risk missed hits (that lead to abscess). But that’s only if you use a tourniquet in the right way. Used incorrectly you can increase the risks of damage to the vein, totally fail to get a vein at all or even put the entire arm at risk. That’s why it’s important to let injectors know how to use tourniquets.How to use a tourniquet | Injecting advice Tourniquet | Wikipedia
A history of the tourniquet | David R Welling et al
Drug paraphernalia and UK law | Exchange Supplies
Safer injecting resource pack (pg 42) | KFX
Back to top
Section 9A of the Misuse of Drugs Act
Under Section 9A of the Misuse of Drugs Act 1971, it is a criminal offence to supply or offer to supply articles for administering or preparing controlled drugs. The Act says an offence will be committed if the following circumstances exist:
- An article is supplied or offered to be supplied.
- The article may be used or adapted to be used (whether by itself or in combination with another article or articles) in the administration of a controlled drug.
- The person supplying or offering to supply the article did so in the belief that the article would be so used by any person, whether to administer the drug to themselves or another, in circumstances where that administration would be unlawful.
Articles such as crack pipes, grinders, spoons, bongs and tourniquets could fall within this prohibition. However, prosecutions under section 9A – even of headshops clearly promoting drug use – are now virtually unheard of, and there has never been an employee of a drug service tried for this offence.
Injecting other people
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  or endanger life . 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 . 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.
 Section 24 Offences Against the Person Act 1861
 Section 23 Offences Against the Person Act 1861
 Serious Crime Act 2007
CHEMSEX FIRST AID
Chemsex first aid
Chemsex First Aid is a 20 page PDF booklet that “…covers general First Aid practices for some specific chemsex-related emergencies. It includes some information on how to make judgement calls, and when not to, when to call an ambulance, as well as some tips to help avoid some of the most common emergencies that can happen in chemsex environments. The guide is not a comprehensive harm reduction resource. The booklet focuses on emergencies and First Aid that might be applied in them. Harm reduction information regarding chems is much more extensive.”
The booklet is divided into 4 sections:
- GHB, GBL related emergencies
- Crystal methamphetamine and mephedrone/ 3MMC/ 4MMC/ cathenone related emergencies
- Other emergencies that can happen in chemsex environments
- A summary of First Aid Situations
This is an excellent resource though greater attention to the layout and formatting would make it an easier read.A word of caution: 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. Chemsex first aid | David Stuart and Ignacio Labayen De Inza | Sep 2018 Back to top
Hepatitis C and chemsex
Chemsex and slamming (injecting) are largely understood to be responsible for a marked increase in Hepatitis C among gay men. This raises additional issues if you are already living with HIV.
Fucking, fisting, sharing douche kit, sharing lube, and sharing dildos and snorting straws can all put you at risk of catching Hepatitis C, HIV and other STIs. You can reduce your risk by:
- Using condoms for fucking or getting fucked
- Using sterile syringe and needles when injecting
- Using latex or non latex gloves when fisting or getting fisted
- Using your own supply of lube and not sharing
- Using a new condom on dildos every time
- Using your own straw when snorting drugs
Gay Men’s Hepatitis C Support Group | GMFA
Hepatitis C [HCV] and HIV/ HCV co-infection | NAM Aidsmap
Hepatitis C | NHS Choices
Hepatitis C | Wikipedia
Hepatitis C | British Liver Trust
Hepatitis C | The Hepatitis C Trust
Disinfecting douche heads
Keeping douche heads and kit clean is an important part of reducing risks, especially at sex parties where 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 well before each use.
MoreEnglish clinic survey finds that 40% of gay men with new hepatitis C infections are HIV negative | NAM aidsmap | 7 Apr 2019
Epidemic of sexually transmitted hepatitis C in gay men now involves both HIV-positive and HIV-negative men | NAM aidsmap | 29 Mar 2019
Hepatitis C drops among HIV-positive London gay men after direct-acting antiviral scale-up | World Hepatitis Alliance | 7 Mar 2019
Hepatitis C is detectable in rectal and nasal fluid | NAM aidsmap | 13 Nov 2018
New HCV infections in HIV positive gay men | i-base | 17 Aug 2017
Hepatitis C infection and reinfection among men who have sex with men | World Hepatitis Alliance | 29 Sep 2016
Sexual transmission of HCV is increasing among gay and bisexual men with HIV | NAM Aidsmap | 18 Sep 2015
Acute HCV infections observed among HIV-negative gay men in London | NAM Aidsmap | 10 Jun 2015
The chemsex study | London Boroughs of Lambeth, Southwark and Lewisham | Sigma Research | March 2014 Back to top
Hepatitis C treatment
Use the links below to find out about treatments:Hepatitis C [HCV] and HIV/ HCV co-infection | NAM Aidsmap
Hepatitis C | British Liver Trust
Hepatitis C | The Hepatitis C Trust
Hepatitis C | GMFA
Hepatitis C | NHS Choices Sofosbuvir for treating chronic hepatitis C | NICE
Ledipasvir–sofosbuvir for treating chronic hepatitis C | NICE
Elbasvir–grazoprevir for treating chronic hepatitis C | NICE Hepatitis C treatment is not straight forward | NAM Aidsmap
Buying hepatitis C drugs online | Hepatitis C Trust
NHS ‘abandoning’ thousands by rationing hepatitis C drugs | The Guardian | 28 Jul 2016
New Hepatitis C cures are affordable | FixHepC | 29 Nov 2016 Back to top
London accident and emergency departments
London accident and emergency departmentsLewisham Hospital | Lewisham High Street, Lewisham, London SE13 6LH | MAP
020 8333 3000 (Switchboard) The Royal London Hospital | Whitechapel Road, Whitechapel, London E1 1BB | MAP
020 7377 7000 (Switchboard) St Thomas’ Hospital | Lambeth Palace Road, London SE1 7EH | MAP
020 7188 7188 (Switchboard) St Mary’s Hospital | Praed Street, London W2 1NY | MAP
020 3312 6666 (Switchboard) Hammersmith Hospital | Du Cane Road, London W12 0HS | MAP
020 3313 1000 (Switchboard) Charing Cross Hospital | Fulham Palace Road, London, W6 8RF | MAP
020 3311 1234 (Switchboard) Chelsea & Westminster Hospital | 369 Fulham Road, London SW10 9NH | MAP
020 3315 8000 (Switchboard) Royal Free Hospital | Pond Street, Hampstead, London NW3 2GQ | MAP
020 7794 0500 (Switchboard) University College London Hospital | 235 Euston Road, Euston, London NW1 2BU | MAP
020 3456 7890 (Switchboard) Whittington Hospital | Magdala Avenue, Highgate Hill, Archway, London N19 5NF | MAP
020 7272 3070 (Switchboard) Homerton University Hospital | Homerton Row, Homerton, London E9 6SR MAP
020 8510 5555 (Switchboard) Back to top
Better known drugsRelease
Global Drugs Survey
Wikipedia Trippy Facts about LSD | BetUDidntKnow | 25 Oct 2014 | 3m00s
Alkyl nitrites (also listed under Poppers)Release
Wikipedia 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
Global Drugs Survey Guide to Safer Alcohol Use
Amphetamines (also listed under Speed)
Global Drugs Survey | Guide to Safer Cannabis Use
Crystal meth (also listed under Methamphetamine)
Global Drugs Survey Guide to Safer GHB Use
Global Drugs Survey | Safer Guide to Ecstasy
Global Drugs Survey | Guide to Safer Ketamine Use
Methamphetamine (also listed under Crystal Meth)Antidote
Poppers (also listed under Alkyl Nitrites)Release
Speed (also listed under Amphetamines)
Wikipedia What Happens When You Stop Smoking? | AsapSCIENCE | 2 Feb 2017 Back to top
Betel and arecaKFX
FentanylFentanyl | Wikipedia
Fentanyl | Erowid
Fentanyl | The Guardian | 29 Aug 2017
NRG-1, NRG-3, naphyroneRelease
Synthetic cannabinoids (cannabis)Release
Valium (see Diazepam
Zopiclone, Zaleplon and ZolpidemRelease
4MTAWikipedia Back to top