The short answer is because they’re fun and because we can.

DRUGS

About drugs

Why we take drugs

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

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

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

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

What is safer drug use?

Safer drug use, or harm reduction, and why it matters

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

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

The opposite can be said of primary prevention which tries to prevent people from using drugs in the first place or to stop them using once they’ve started. The focus of harm reduction is on ‘safer’ drug use rather than telling people “just say no.” You may be old enough to remember Nancy Reagan who said (now famously) in 1986 “And when it comes to drugs and alcohol just say NO.”

Harm reduction has its share of supporters and critics. On one hand: it promotes and/ or condones drug use. On the other: it’s realistic, helps keep drug users safe(r), respecting individual choices and freedoms.

Harm reduction initiatives include needle exchange schemes, drug consumption rooms, drug testing at festivals and in clubs, and providing information on safer drug use.

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

How substance use services can better support LGBTQ+ people | The Conversation | 24 Oct 2023
Myriad New Drugs Complicate Legalization, as Well as Harm Reduction | Filter | 29 Mar 2022
Hypocritical politicians prefer to let drug users die than admit policy is a failure | The Guardian | 9 Aug 2021
The Guardian view on illegal drugs: the laws don’t work | 22 Feb 2021

Harm Reduction 101 | Drug Policy Alliance | 21 Aug 2017 | 2m 24
Why the war on drugs is a huge failure | Kurzgesagt: In a Nutshell | 1 Mar 2016 | 6m 26s

The variables

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)

Borrowing from tomorrow

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.

Avoid doing any drugs during 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.

The harms

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 (one-off or sustained use), but:

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.

Reducing drug harm and risk

The basics

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

Basic harm reduction | Release

Legal

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

Drugs and the law | Release

Mixing and tolerance

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

Safer injecting

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

Safer injecting | MEN R U S

Calling 999

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

Medications

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

HIV Drug Interaction Checker | University of Liverpool

Be prepared: clubbing, partying and chillouts

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

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

Sex and drugs

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

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.

Moving Beyond ‘People-First’ Language: A glossary of contested terms in substance use | SDF Scotland | Sep 2020
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 | MEN R US | 2017 | 34s

Drugs and me

Drugs and Me provides accessible, objective and comprehensive educational material to help reduce the short and long term harms of drugs. The website was inspired by the thousands of deaths that occur in the UK due to a lack of correct drug education.

“Existing websites provide excellent information on drugs but have a falsely optimistic approach thinking that the people reading those sites will become discouraged after reading about the effects or potential health risks. This is not the reality. As Dr Carl Hart put it: “People will always use drugs. They always have used drugs. We must learn to live with this fact.” Drugs and Me aims to provide an information hub where for those who do use drugs but wish to do so in a safer way.”

Drugs and Me are a group of scientists, educators and analysts with extensive experience in drug education. They want to do something to stop the increasing number of accidents and deaths that occur in the world due to lack of drug education.

Drugs and Me
Drugs and Me Chat Bot ^NEW
Drugs and Me

The Drugs Wheel

The Drug Wheel is a classification model that groups different types of drugs based on the effect they have on the body.

Its goal is to simplify the drugs landscape, and as psychoactive drugs affect different people in different ways, some drugs fit into a number of categories. However, it’s a model and, as such, doesn’t aim to list every drug on the market, or pinpoint every compound’s effect.

Designed in collaboration with DrugWatch (UK and Ireland). Additional wheels include the Effects Wheel and Club Drugs Wheel, and wheels in French, Dutch, Italian and Polish.

The Drugs Wheel
The Drugs Wheel

DrugsWatch
Clickable Drugs Wheel | Alcohol and Drug Foundation (Australia)

Global Drug Survey

Global Drug Survey (GDS) runs the largest drug survey in the world. Over half a million people have taken part in its last 5 surveys.

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 2022
Global Drug Survey

TripSit

Aims to provide open discussion of harm reduction techniques and positive support. Promotes the use of harm reduction tools such as test kits, and offer guidance and support with regards to harm reduction when using drugs. Encourages discussion of scientific, medical, philosophical understandings, and many of us can provide advice based on life experiences, an invaluable asset for someone who may be experiencing a similar issue. TripSit is willing, and prepared to guide or ‘tripsit’ users who may be having a hard time while under the influence of drugs.

TripSit
TripSit Mobile App (Android)
TripSit Wiki: Drug Knowledge Database

PsyCare UK

Registered charity providing welfare and harm reduction services at music festivals and events throughout the UK and internationally, and has been been operating for over 10 years. Although most drug use at festivals is intended for enjoyment, some drug experiences can cause a person to be physically and mentally vulnerable; to experience feelings of fear, paranoia, delusion, discomfort and even psychosis; creating the potential for people to be a danger to themselves and others.

PsyCare UK provides a peaceful, friendly sanctuary in the midst of the sometimes hectic festival environment. Always open to provide information and support to anyone that needs it. From crisis intervention for people who may be in profoundly disturbed mental states, to support for the lonely with a hot cuppa and a chat, PsyCare UK aims to consistently support the wellbeing of all festival goers.

PsyCare UK

International Network of People who Use Drugs (INPUD)

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

International Network of People who Use Drugs (INPUD)

Talking drugs

Talking Drugs is one of the few online platforms dedicated to providing unique news and analysis on drug policy, harm reduction and related issues around the world. It delivers geographically diverse coverage of the important issues, with a level of topic expertise often lacking in the mainstream media.

Talking Drugs gives people the opportunity to become engaged in the debate and encourages those who wish to contribute to get in touch with about either volunteering or submitting a piece of work for publication. In particular, Talking Drugs is keen for people to tell their stories of how drugs and/ or policies have affected their lives or their communities.

Talking Drugs | Release

Drug Science

Drug Science Podcasts

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

Drug Science Podcast | Drug Science

Drugs and the law

The law

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
Misuse of Drugs Act 1971 | Wikipedia

Your rights on arrest

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

If you are reading this, ask yourself if you need legal help or a solicitor now?

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

Release

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

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

Release
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

Y-Stop

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.

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!

Drugs, alcohol and chemsex support

Read me first

Updated regularly, we believe these listings are both be up-to-date and accurate.

Email here if you know a service we should add, or if we’ve got something wrong.
Email here if you can’t find a service you need and we’ll try to signpost you in the right direction.

Most of the drug and alcohol services listed here are mainstream. We aim to contact drug services at least once a year to verify the services provided. However, we cannot guarantee the quality of any service.

Finding the right service for you

Some guys prefer to use gay or gay-friendly services which (as a rule) have a much better understanding of the issues affecting our lives, and the context. Others are happy to access mainstream services.

Most services aim to be welcoming, respectful, knowledgeable, and understanding. The thing is to find a service that’s right for you (as best it can) and “gets the job done.”

You may wish to phone first to check if the vibe feels right. Some of these questions may be more important than others, or you may have some of your own:

Do you have an alcohol, drugs, or chemsex service for gay/ bi men?
Do your workers have knowledge of health issues specific to gay/ bi men?
Are there service times for gay/ bi men?
Is your service LGBT+ friendly?

And why not check out the service’s website?

Your GP

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

London services restricted by area

Increasingly, 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.

London drug, alcohol and chemsex support

BARKING AND DAGENHAM

St Luke’s Service | Change Grow Live (CGL)
St Lukes, Dagenham Road, RM10 7UP | Map
020 8595 1375

Via – Subwize (under 25) | v-i-a (previously Westminster Drug Project)
The Vibe, 195-211 Becontree Avenue, Dagenham, RM8 2UT | Map
0300 303 4613

Drugs and alcohol help | Barking and Dagenham Council website

BARNET

Drug and Alcohol Service | Change Grow Live (CGL)
Barnet Recovery Centre, Dennis Scott Unit, Edgware Community Hospital, Burnt Oak Broadway, Edgware, HA8 0AD | Map
0300 303 2866

Barnet Young People’s Drug and Alcohol Service (under 24) | Change Grow Live (CGL)
Dennis Scott Unit, Edgware Community Hospital, Burnt Oak Broadway, Edgware, HA8 0AD | Map
0300 303 2866

Drug and alcohol misuse | Barnet Council website

BEXLEY

Pier Road Project aka Signpost | South London and Maudsley NHS Foundation Trust
Erith Health Centre, 50 Pier Road, Erith DA8 1RQ | Map
01322 357940

Drug and alcohol services | Bexley Council website
Could not find any services for young adults

BRENT

Via – Elev8 | v-i-a (previously Westminster Drug Project)
97 Cobbold Road, NW10 9SU | Map
Willesden Centre for Health, Harlesden Road, NW10 3RY | Map
0300 303 4611

Drug and Alcohol | Brent Council website
Website has useful information but has lumped ‘homelessness’ with ‘drug misuse’ together. They should have separate pages.

BROMLEY

Bromley Drug and Alcohol Service (BDAS) | Change Grow Live (CGL)
Bromley Drug and Alcohol Service, 35 London Road, BR1 1DG | Map
020 8289 1999

Young people (under 18) | Change Grow Live (CGL)
Bromley Drug and Alcohol Service, 35 London Road, BR1 1DG | Map
020 8289 1999

Bromley Drug and Alcohol Service (BDAS) | Bromley Council website

CAMDEN

Integrated Drug and Alcohol Service | Change Grow Live
Kings Studios, 43-45 Kings Terrace, London NW1 0JR | Map
020 7485 2722
210 Kilburn High Rd, London NW6 4JH | Map
020 7328 3470

FWD: Drugs and alcohol support for young people (under 25) | Camden Council
No address
020 7974 3663

Help with drug or alcohol problems | Camden Council website

CITY OF LONDON

City of London and Hackney Recovery Service | Turning Point
102 Mare Street, E8 3SG | Map
0345 144 0050

Alcohol, drugs and other substances | City of London Council webside

CROYDON

Croydon Recovery Network | CGL
Lantern Hall, 190 Church Road, Croydon, CR0 1SH | Map
0300 123 9288

Croydon young people’s substance misuse service | CGL
Turnaround Centre, 51-55 South End, Croydon, CR0 1BF | Map
0300 123 9288

Drugs, alcohol and smoking | Croydon Council website

EALING

RISE | Change Grow Live (CGL)
36a Northcote Avenue, Southall, UB1 2AY | Map
0800 195 8100

Drug and alcohol dependency | Ealing Council website

ENFIELD

Enfield alcohol and drug service | Barnet, Enfield and Haringey Mental Health NHS Trust
Claverings, 12 Centre Way, Edmonton, N9 0AH | Map
020 8379 6010

Enfield Sort It for Young people (up to 18) | Compass
Hub, 29 Folkestone Road, Edmonton, N18 2ER | Map
020 8360 9102

No services listed 27/7/22 | Enfield Council website

GREENWICH

Pit Stop Plus | Metro Charity
METRO Woolwich, 1st Floor, Equitable House, General Gordon Square, London SE18 6FH | Map
020 8305 5005

Via- Greenwich | v-i-a (previously Westminster Drug Project)
821 Woolwich Road Charlton, SE7 8LJ | Map
0300 303 4552
Residents of the Royal Borough of Greenwich only

Drug or alcohol addiction | Greenwich Council website

HACKNEY

City and Hackney Recovery Service | Turning Point
102 Mare Street, E8 3SG | Map
0345 144 0050

Young Hackney Substance Misuse Service (under 25) | Hackney Council
020 8356 7377

Chemsex @ Homerton | Clifden Centre, Homerton University Hospital
Homerton Row, London E9 6SR | Map
020 7683 4103

Substance misuse support | Hackney Council website

HAMMERSMITH AND FULHAM

Drug and Alcohol Wellbeing Service (DAWS) | Turning Point
The New Coach House, 370-376 Uxbridge Road, W12 7LL | Map
020 8740 6815

The Alcohol Service | Change Grow Live (CGL)
No address
0800 0147 440
By appointment only

Club Drug Clinic | Central and North West London NHS Foundation Trust (CNWL)
69 Warwick Road, Earls Court, London SW 9HB | Map
020 3315 6111
Hammersmith and Fulham, Westminster or Kensington and Chelsea.

SASH | Turning Point
For sex workers and other individuals working within the sex industry
Various locations
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

Help with drug or alcohol addiction | Hammersmith and Fulham Council website

HARINGEY

The Grove Drug Treatment Service | Humankind
9 Bruce Grove, Tottenham, N17 6RA | Map
020 8365 9032 / 020 8702 6220

Haringey Recovery Service | Humankind
590 Seven Sisters Road, N15 6HR | Map
020 8801 3999

Alcohol and Drugs | Haringey Council website

HARROW

Via – Harrow | v-i-a (previously Westminster Drug Project)
44 Bessborough Road, Harrow, HA1 3DJ | Map
0300 303 2868

Harrow (Young People’s Substance Misuse Service) | Compass
Ground Floor, 21 Building, 21 Pinner Road, Harrow, HA1 4ES | Map
020 8861 2787

Adult substance misuse services | Harrow Council website

HAVERING

Aspire | Care Grow Live (CGL)
Ballard Chambers, 26 High Street, Romford, RM1 1HR | Map
01708 747 614

Wize Up Havering for Young People (up to 17) | CGL
Elm Park Children’s Centre, Diban Avenue, Hornchurch, RM12 4YH | Map
07909 097621 / 07730 529052

Couldn’t find specific services | Havering Council website

HILLINGDON

ARCH for Adults and Young Adults | Humankind, Central and North West London NHS Foundation Trust (CNWL) and v-i-a (previously Westminster Drug Project)
Old Bank House, 64 High Street, Uxbridge, UB8 1JP | Map
0203 838 7850

Drug and Alcohol services | Hillingdon Council website

HOUNSLOW

Addiction Recovery Community (ARC) | Central and North West London NHS Foundation Trust (CNWL)
Montague Hall, Montague Road, TW3 1LD | Map
01895 488675

HYPE: Drug and alcohol support (under 18) | Central and North West London NHS Foundation Trust (CNWL)
Montague Hall, Montague Road, TW3 1LD | Map
01895 488675

Drug and alcohol support | Hounslow Council website

ISLINGTON

Better Lives | Camden and Islington NHS Foundation Trust, Humankind and v-i-a (previously Westminster Drug Project)
99-101 Seven Sisters Road, N7 7QP | Map
020 3317 6099
309 Gray’s Inn Road, WC1X 8QS | Map
020 3317 6650
28b King Henry’s Walk, N1 4PB | Map
020 3317 7277

Better Lives Family Service: Drug service for young people under 18 | Humankind
28b King Henrys Walk, N1 4PB | Map
020 3 317 7437 / 07947 117928

Antidote | London Friend
86 Caledonian Road, Kings Cross, N1 9DN | Map
020 7833 1674

Drugs and alcohol | Islington Council website

KENSINGTON AND CHELSEA

Drug and Alcohol Well-being Service (DAWS) | Turning Point
Acorn Hall, 1 East Row, W10 5AR | Map
0330 303 8080

Young people’s services (up to 25) | Turning Point
No address
0330 303 8080

Insight (ages 12-25) | Humankind
51 Golborne Road, Ladbroke Grove, W10 5NR | Map
020 8960 5510

The Alcohol Service | Change Grow Live (CGL)
66 Lupus Street, Pimlico, London SW1V 3EQ | Map
No walk-in, by appointment only
0800 014 7440

Alcohol and substance misuse | Kensington and Chelsea Council website

KINGSTON UPON THAMES

Drugs and alcohol for adults | Kingston Wellbeing Service | Camden and Islington NHS Foundation Trust, v-i-a (previously Westminster Drug Project)
Surbiton Health Centre, Ewell Road, Surbiton, KT6 6EZ | Map
020 3317 7900

Young People’s Drug and Alcohol Service | Getting It On
Achieving for Children, Guildhall 1, High Street, KT1 1EU | Map
020 8547 6920

Drugs search (unhelpful) | Kingston upon Thames Council website

LAMBETH

Chemclinic (Lambeth) | South London and Maudsley NHS Foundation Trust

Lorraine Hewitt House, 12-14 Brighton Terrace, Brixton, SW9 8DG | Map
020 3228 1500
Lambeth residents only

Lambeth Drug and Alcohol Treatment Consortium | Lambeth Consortium
The Harbour, Community Link Team, 245 Coldharbour Lane, Brixton, SW9 8RR | Map
020 7095 1980

DASH Lambeth for drug and alcohol support for younger persons (under 21) | Brook
Click here for contact info and phone numbers

Substance misuse | Lambeth Council website

LEWISHAM

Lewisham Primary Care Recovery Service (PCRS) | Humankind
55 Dartmouth Road, Forest Hill, SE23 3HN | Map
020 8699 5263

New Direction | Change Grow Live (CGL)
410 Lewisham High Street, Lewisham, SE13 6LJ | Map
020 8314 5566

The Hub (up to 25) | Compass
38-39 Winslade Way, Catford, SE6 4JU | Map
020 8690 3020

Drugs and Alcohol | Lewisham Council website

MERTON

Via – Merton | v-i-a (previously Westminster Drug Project)
7-8 Langdale Parade, Mitcham, CR4 2YS | Map
0300 303 4610

Alcohol, drugs and substance abuse | Merton Council website

NEWHAM

Newham Rise | Change Grow Live (CGL)
327 High Street, Stratford, E15 2TF | Map
3 Beckton Road, Canning Town , E16 4DE | Map
997 Romford Road, Manor Park, E12 5JR | Map
0800 652 3879

Newham Young People’s Service (up to 18) | Care Grow Live (CGL)
Based in Canning Town
07741 196424

Drugs and Alcohol | Newham Council website

REDBRIDGE

Via – R3 – Redbridge | v-i-a (previously Westminster Drug Project)
3rd Floor, Ilford Chambers, 11 Chapel Road, IG1 2DR | Map
0300 303 4612

Via – Fusion (under 18) | v-i-a (previously Westminster Drug Project)
Station Road Centre, Station Road, Barkingside, IG6 1NB | Map
020 8708 7800

Drugs and alcohol | Redbridge Council website

RICHMOND UPON THAMES

Richmond Community Drug and Alcohol Service | RCDAS
Unit 2 Ilex House, 94 Holly Road, Twickenham, TW1 4HF | Map
020 3228 3020

Young People’s Drug and Alcohol Support Service Richmond (under 18) | Getting It On
Ground Floor, Guildhall 1, High Street, KT1 1EU | Map
020 8547 6920

Drug and alcohol support | Richmond upon Thames Council website

SOUTHWARK

CGL Southwark | Change Grow Live (CGL)
146 Camberwell Road, SE5 0EE | Map
020 3404 7699

Healthy Young People (HYP) Southwark | CGL
Click here multiple locations
No phone number

Axis @ Caldecot Centre | Antidote
15-22 Caldecot Road, Camberwell, London SE5 9RS | Map 020 3299 5000

Chemcheck @ Burrell Street clinic | Antidote
4-5 Burrell Street, SE1 0UN | Map
020 7188 6666
Not a walk-in service, Click here to make a referral

Drugs and alcohol | Southwark Council website

SUTTON

Inspire, Sutton | Cranstoun
Orion House, 19 Cedar Road, SM2 5JG | Map
020 8773 9393

Switch Sutton (up to 18) | Cranstoun
Orion House, 19 Cedar Road, SM2 5JG | Map
020 8773 9393

Sutton Drug and Alcohol Recovery Team | South West London and St George’s Mental Health NHS Trust
Jubilee Health Centre East, 6 Stanley Park Road, Wallington, SM6 0EX | Map
020 3513 3950

Drink and drugs | Sutton Council website

TOWER HAMLETS

Reset | CGL
183 Whitechapel Rd, London E1 1DN | Map
020 3889 9510

Safe East (up to 19, and 25) | Compass
Safe East Clinical Hub, 59 Mile End Road, Mile End, E1 4TT Map
020 3954 0091

Where to get help | Tower Hamlets website

WALTHAM FOREST

CGL Waltham Forest | Change Grow Live (CGL)
1 Beulah Road, Walthamstow, E17 9LG | Map
0203 826 9600

| Waltham Forest Young People’s Service | Change Grow Live (CGL)
313 Billet Road, Higham Hill, Waltham Forest E17 5PX | Map
020 3404 1098

Alcohol and drug misuse | Waltham Forest Council website

WANDSWORTH

Wandsworth Community Drug and Alcohol Service | We Are With You
St. John’s Therapy Centre, 162 St Johns Hill, Wandsworth SW11 1SW | Map
020 3228 1777

Catch 22: Wandsworth Young People’s Health Agency | Getting It On
201-203 Lavender Hill, SW11 5TB | Map
07770 573 131

Substance misuse | Wandsworth Council website

WESTMINSTER

Drug and Alcohol Well-being Service (DAWS) | Turning Point
32a Wardour Street, Soho, London, W1D 6QR | Map
0330 303 8080

The Alcohol Service | Change Grow Live (CGL)
0800 0147 440
By appointment only

Dean Street Chemsex Support | Chelsea and Westminster Hospital NHS Foundation Trust
3rd Floor, 56 Dean Street, Soho, W1D 6AQ | Map
020 3315 5656

Club Drug Clinic | Central and North West London NHS Foundation Trust (CNWL)
69 Warwick Road, Earls Court, London SW 9HB | Map
020 3317 3000
Hammersmith and Fulham, Westminster or Kensington and Chelsea.

CODE Clinic @ 56 Dean Street | Chelsea and Westminster Hospital NHS Foundation Trust
Link takes you to information supplied by London Friend.
56 Dean Street, Soho, W1D 6AQ | Map

Substance Misuse | Westminster Council website

More drugs support

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

Narcotics Anonymous
Fellowship of men and women for whom problematic drug use has become an issue. Self-help support groups that meet regularly. Membership is open to anyone seeking help, regardless of what drug or combination of drugs has been used. No fees or dues for membership. Self-supporting through contributions. The only requirement for membership is a desire to stop using drugs.
Narcotics Anonymous
0300 999 1212
10am-midnight
Find an NA meeting near you

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

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

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

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

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

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

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

Central London Action on Sexual Health (CLASH) and Sexual Health on Call (SHOC)
CLASH provides free and confidential sexual health outreach services for sex workers, homeless people, drug users, Black Asian and Minority Ethnic people (BAME) and men who have sex with men (MSM) living or working in Camden and Islington. SHOC provides free and confidential sexual health outreach services for sex workers in Haringey. Services are located at the Mortimer Market Centre and Archway Centre.
CLASH/ SHOC
CLASH: Camden and Islington only | SHOC: Haringey only

UK Smart Recovery
Promotes choice in recovery through a national network of mutual aid meetings and online training programs with comprehensive teaching materials and manuals.
UK Smart Recovery

Spitalfields Crypt Trust (London)
Motivated by its inclusive Christian ethos, provides an effective and compassionate recovery programme, addressing peoples’ needs holistically – from housing, homelessness, employability, and health to social connections.
Spitalfields Crypt Trust (London)

The British Association of Dramatherapists
Dramatherapy has as its main focus the intentional use of healing aspects of drama and theatre as the therapeutic process. It is a method of working and playing that uses action methods to facilitate creativity, imagination, learning, insight and growth.
The British Association of Dramatherapists

Queers without Beers
Queers Without Beers | Queers Without Beers
Queers Without Beers | Meet Up | Queers Without Beers

One Too Many (Alcohol) Quiz
20 quick questions | Global Drugs Survey (GDS)

The Outside Theatre Company
Drop-In Drama | The Outside Edge Theatre Company | Thurs, 6-8pm
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.

Chemsex support outside London

Bit of a nightmare to keep up-to-date, further organisations will be added as we find them. If you cannot find a service near you, contact your nearest LGBT, HIV organisation or sexual health service who may have local knowledge.

Birmingham
Chemfidential | Birmingham LGBT/ CGL
Birmingham LGBT Centre, 38/40 Holloway Circus, Birmingham B1 1EQ
0121 643 0821

Brighton
Brighton and Hove Recovery Service | CGL
Richmond House, Richmond Road, Brighton BN2 3RL
01273 731900

Bristol
Prism: LGBT+ Alcohol & Drug Support | Bristol Drugs Project
23-25 Midland Road, Old Market Quarter, Bristol BS2 0JT
07971 354 498

Corby
Substance to Solution (S2S) | CGL
The Old TA Building, Elizabeth Street, Corby NN17 1PN
01604 211 304

Liverpool
Coast | Addaction
GUM Dept., Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP
Sam: 07790 560085 | Peter: 07790 560039

Manchester
Chemsex Support | LGBT Foundation
5 Richmond Street, Manchester M1 3HF
0345 330 3030

Northampton
Substance to Solution (S2S) | CGL
Spring House, 39 Billing Road, Northampton NN1 5BA
01604 211 304

Wirral
Wirral Ways To RecoveryWirral Ways To Recovery | CGL
WWTR Birkenhead Hub, 23 Conway Street, Birkenhead, Wirral CH41 6PT
0151 556 1335

Watford
Spectrum (Hertfordshire Drug & Alcohol Services) | CGL
18 Station Road, Watford, Herts. WD17 1JU
01923 222 889

UK Drug Service Directories

England
Drug and alcohol services England search | NHS
Drug and alcohol services England search | Talk to Frank

Scotland
Drug services Scotland search | Scottish Drug Services Directory
Alcohol services Scotland search | Alcohol Focus

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

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

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

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

About alcohol

A little bit about alcohol

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

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

Alcohol | 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 by volume | Wikipedia
Alcohol proof | Wikipedia

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

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

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

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

Liver | Wkipedia
About the liver | British Liver Trust
Love your liver | British Liver Trust
Liver disease | NHS

What does the liver do? | Emma Bryce/ TED-Ed | 24 Nov 2014 | 3m 24s

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.

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

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

14 units of alcohol roughly equate to:

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

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

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

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

No alcohol safe to drink, global study confirms

The Global Burden of Disease, a large new global study published in the Lancet has confirmed previous research which has shown that there is no safe level of alcohol consumption. The researchers admit moderate drinking may protect against heart disease but found that the risk of cancer and other diseases outweighs these protections. A study author said its findings were the most significant to date because of the range of factors considered.
No alcohol safe to drink, global study confirms | BBC | 24 Aug 2018

UK’s soaring liver cancer death rate blamed on alcohol and obesity | The Guardian | 9 Jul 2023
Government not taking “appalling” harms from alcohol seriously enough | UK Parliament | 24 May 2023
Alcohol deaths in the UK rose to record level in 2021 | The Conversation | 9 Dec 2022
Alcohol deaths up almost 19% during the pandemic – the greatest increase since 2001 | The Conversation | 8 Dec 2021
‘Soaring alcohol misuse’ could overwhelm service BBC | 15 Sep 2020
Alcohol and your brain: study finds even moderate drinking is damaging | The Conversation | 11 Sep 2020
Two standard alcoholic drinks a day no longer safe, National Health and Medical Research Council, Australia | The Guardian | 16 Dec 2019
Public Health England and Drinkaware launch Drink Free Days | Public Health England | 10 Sep 2018
Regular excess drinking can take years off your life, study finds | BBC | 13 Apr 2018

UK Chief Medical Officers’ Alcohol Guidelines Review | DoH | Jan 2016

Alcohol units | NHS
Unit of alcohol | Wikipedia
What is an alcohol unit? | Drinkaware

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 | 2m 13s
What Happens When You’re Drunk? | Brit Lab | 28 May 2015 | 5m 20s

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

National representative data on the health of lesbian, gay and bisexual adults in England published for the first time | NHS Digital | 6 Jul 2021

The hangover

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
How to cure a hangover | BBC Good Food

What causes a Hangover? | asapSCIENCE | 22 Jun 2012 | 2m 19s
The Scientific Hangover Cure | asapSCIENCE | 27 Jun 2012 | 2m 30s

Safer drinking

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

Five ways to make a success of not drinking, even if you’re sober-curious

Be clear about why you’re abstaining
Embrace sober firsts
Plan your alcohol substitutions
Don’t apologise for not drinking
Share your experience with friends

Five ways to be sober-curious (and make a success of not drinking) | The Guardian | 1 Sep 2019

Alcohol dependence

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

Physical symptoms

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

Behavioural symptoms

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

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

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

Alcohol addiction: could the brain’s immune system be the key to understanding and treating alcoholism? | The Conversation | 11 Aug 2020

What Happens When You Quit Alcohol? | 28 Dec 2021 | AsapSCIENCE | 9m 43s

About smoking

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:

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.

Nicotine Dependence: How Does it Happen? | Swedish

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.

Cigarette | Wikipedia

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.

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.

Benefits (quit smoking) | NHS

Quitting smoking

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

Ten-point plan

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.

Adult smoking habits in the UK: 2019 Office for National Statistics

Quit smoking support

Stoptober | Public Health England (PHE)
Quit smoking campaign Stoptober backs e-cigs for first time | BBC | 21 Sep 2017

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

Smoking is back and it’s still cool (and deadly) | The Guardian | 2 Jul 2023
Minister Neil O’Brien speech on achieving a smokefree 2030: cutting smoking and stopping kids vaping | GOV.UK | 11 Apr 2023
Smokers in England to be offered vaping kits to help them quit cigarettes | The Guardian | 11 Apr 2023
Thérèse Coffey to drop smoking action plan, insiders say | The Guardian | 11 Oct 2022
Number of smokers has reached all-time high of 1.1 billion, study finds | The Guardian | 27 May 2021
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

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

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

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

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

Smoking vs Vaping | AsapSCIENCE | 16 Aug 2015 | 4m 19s

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

News and articles

Disposable vapes to be banned for children’s health, government says | BBC | 29 Jan 2024
Ministers set to ban single-use vapes in UK over child addiction fears | The Guardian | 11 Sep 2023
Is vaping nicotine the answer to quitting smoking? Positive Living | AUS | 29 Jun 2023
How much nicotine is in a cigarette compared to a vape? | The Guardian | 23 Jun 2023
Lobbyists with links to Big Tobacco fund pro-vaping Facebook campaigns | The Guardian | 18 Jun 2023
Vaping: High lead and nickel found in illegal vapes | BBC News | 23 May 2023
Can vaping help people quit smoking? It’s unlikely | The Conversation | 3 May 2023
No, vapes aren’t 95% less harmful than cigarettes. Here’s how this decade-old myth took off | The Conversation | 27 Apr 2023
UK plan to encourage smokers to take up vaping means swapping one health risk with another | The Conversation | 25 Apr 2023
No, vapes aren’t 95% less harmful than cigarettes. Here’s how this decade-old myth took off | The Conversation | 17 Apr 2023
How bad is vaping and should it be banned? | THe Conversation | 20 Mar 2023
Wellness vapes: what you need to know about vaping vitamins and other supplements | The conversation | 16 Aug 2022
Advice for Retailers and Producers | 23 Mar 2022 | GOV.UK
Is it better to vape than smoke? Definitely, but it’s still worse than quitting entirely | The Guardian | 17 Apr 2022
A damning review of e-cigarettes shows vaping leads to smoking, the opposite of what supporters claim | The Conversation | 6 Apr 2022

2021 - 2014

About chemsex

Chemsex

As far back as 1999, New York Magazine’s article ‘Nightlife ‘99: Clear And Present Danger’ said “GHB first became a fixture at raves and gay “circuit parties” in the early nineties. The FDA declared the drug unsafe and illegal to market in 1990, and several states have banned it because of its use as a date-rape drug.”

Before the word chemsex was coined, ‘slamming’, PnP, ‘parTy’, ‘HnH’, and ‘chem friendly’ were/ are shorthand for gay men using this new generation of drugs, the slang appearing on hook-up apps Inc. Grindr, Recon, Bareback Real Time (BBRT), Gaydar, and Scruff. Chemsex, as it would eventually be called, is not the same as popping a pill, snorting a line, or smoking a joint. Instead, it’s a specific form of recreational drug use.

What is chemsex

Chemsex is using any combination of the following drugs to help facilitate, enable or enhance sex:

Methamphetamine (crystal/ crystal meth/ Tina/ meth)
Mephedrone (meph/ drone)
GHB/GBL (G/ Gina)

For context:

Yes, other drugs may be used
There are variables but, usually, crystal meth is smoked in a glass pipe or injected, GHB/ GBL is added to soft drinks in small millilitre (ml) dose amounts, and mephedrone is injected
Crystal and meph are uppers speeding up the body’s reactions while GHB/ GBL is a downer slowing down the body’s reactions
Using these drugs, it’s said that there’s heightened sexual energy and focus, a greater connection between partners, enabling sex for longer and, in some cases, heavier sex sessions
Arranging chemsex through hook-up apps is the norm for gay men, Grindr and Scruff, for example
Chats will often say whether someone uses these drugs for sex, actively looking for someone who does, and include a range of so-called ‘secret’ emojis for easy reference

Like people in society generally, gay men have been using drugs recreationally for years, and it wasn’t so long ago it was dropping ‘E’s. Today it’s ‘chemsex’ and professionals are over it like a rash with opinions, forebodings, perspectives, predictions, and research. Some argue the word chemsex does what it says on the tin (sex on chemicals) while others say it’s yet another unhelpful label ascribed to gay men. It wasn’t so long ago gay men were under a similar microscope during the HIV and AIDS epidemic. However, if and when this form of drug use becomes problematic (which can include addiction and psychosis) the consequences are more damaging, more lasting, and require more complex and comprehensive intervention, recovery, and support.

If you engage in chemsex and would like to know how to be safer, check out our Be Safer Campaign.

More

Words and phrases you may have heard

Unfortunately, these and other terms are often lumped together which is not necessarily helpful in understanding what is happening and why.

Slamming – another word for injecting and the practice of dissolving crystal meth or mephedrone in water before injecting it into yourself or someone else
Chems – drugs, typically crystal meth, mephedrone and GHB/ GBL (also known as “G”)
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 other drugs may be used.
Tweaker – ‘tweaking’ means making minute adjustments to something, like using a small screwdriver to repair a radio. Doing this can include a turn to the left, the right, back again, left again … so it’s not a stretch that it’s also slang for someone exhibiting repetitive, sometimes compulsive, behaviour. And so not a stretch again that it’s used to describe a highly-strung easily distracted individual into chemsex which can also relate to making minute adjustments to a drug dose to get the desired high. Anyway, that’s our explanation. Let us know if you have a better one?

Click me

Methamphetamine (crystal meth/ Tina)

What it is and how it comes

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

How it’s taken

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

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

Safer use

Reducing drug harm and risks | MEN R US
Safer injecting | MEN R US
Safer slamming (film) | MEN R US
Click here if you would like a copy of our Safer Chemsex Pack.

Safer drug use, or harm reduction, and why it matters | MEN R US
Drug harms | MEN R US
Reducing drug harm and risk | MEN R US

Interactions

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

Interactions between HIV treatment and recreational drugs | NAM aidsmap
Recreational drugs and HIV meds | i-base
Recreational drugs and HIV | Terrence Higgins Trust

Desired highs

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

Sex on crystal

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

Using T and the comedown

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

Addiction, dependency and other issues

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

Further information

Crystal meth | Tweaker
Crystal meth | Wikipedia
Crystal meth | Erowid
Crystal meth | Release

This icon means there appears to be no noticeable activity in 6 months or more.

GHB and GBL

Please note that GHB/ GBL content is split between two locations: the basics (here) and about and using G, which is geared more towards safer G use.

What it is and how it comes

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

The difference between GHB and GBL

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

GHB (gamma-hydroxybutyrate)

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

GBL (gamma-butyrolactone)

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

Why knowing the difference between GBL and GHB matters

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

How it’s taken

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

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

Safer use

About and using G | MEN R US
Click here if you would like a copy of our safer chemsex booklet.

Safer drug use, or harm reduction, and why it matters | MEN R US
Drug harms | MEN R US
Reducing drug harm and risk | MEN R US

Interactions

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

Interactions between HIV treatment and recreational drugs | NAM aidsmap
Recreational drugs and HIV meds | i-base
Recreational drugs and HIV | Terrence Higgins Trust

Desired highs

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

Sex on G

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

Using G and the comedown

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

Addiction, dependency and other issues

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

For guidance on the following, click the link below:

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

About and using G | MEN R US

Further information

This icon means there appears to be no noticeable activity in 6 months or more.

There’s More to G Than Cock | Global Drug Survey | 5m 25s

Mephedrone (meow meow/ m-cat)

What is and how it comes

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

How it’s taken

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

Safer use

Mephedrone | Friday/ Monday
Mephedrone | SX Scot
Mephedrone | Drug Science
Mephedrone | Antidote

Safer drug use, or harm reduction, and why it matters | MEN R US
Drug harms | MEN R US
Reducing drug harm and risk | MEN R US

Interactions

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

Interactions between HIV treatment and recreational drugs | NAM aidsmap
Recreational drugs and HIV meds | i-base
Recreational drugs and HIV | Terrence Higgins Trust

Desired highs

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

Sex on meph

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

Using M and the comedown

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

Addiction, dependency and other issues

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

Further information

Mephedrone | Wikipedia
Mephedrone | Erowid
Mephedrone | KFX
Mephedrone | Release

This icon means there appears to be no noticeable activity in 6 months or more.

News articles, and research

We have pulled together a selection of published articles, reports, studies and news by year from the late 1990s.

These lists are neither definitive nor complete but they do provide a common thread spanning two decades. and a springboard for you to explore further.

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

2024

Developing a coordinated response to chemsex across health, justice and social care settings: expert consensus statement | Cambridge University Press | 25 Jun 2024
New Zealand charity unknowingly gives out sweets with lethal levels of meth | The Guardian | 14 Aug 2024
Attempts to criminalise chemsex users are making the queer scene less safe than ever | PDF | Gay Times | Apr 2024
‘There is no information out there’: Hundreds treated by ambulance crews for chemsex-related incidents in Croydon | South London Press | 8 Apr 2024
Anaesthetist jailed for stealing NHS drugs for chemsex | BBC News | 6 Apr 2024
So you’re thinking about trying G? | Dazed | 21 Mar 2024
Detoxing from G is ‘100 times worse than alcohol withdrawal’, expert warns | Journal.ie | 15 Jan 2024

2023

Understandings, attitudes, practices and responses to GHB overdose among GHB consumers | BMC | 2 Sep 2023
Hundreds of bottles of party drug GBL found in Big Yellow Self Storage and Safestore lockers | The Standard | 1 Aug 2023
So you’re thinking about trying chemsex? | Dazed | 30 Jun 2023
Synthetic stimulants – the current situation in Europe (European Drug Report 2023) | 16 Jun 2023
Judge jails barrister who tried to buy drugs from two men he represented | The Guardian | 13 Jun 2023
London paramedics to help reduce risks of chemsex | London Ambulance Service (joint project with GMHC) | 11 May 2023
Inside London’s chemsex crisis: paramedics to hand out advice cards as ambulance is called every day | i (pay wall) 10 May 2023
The Met was ill-prepared when Stephen Port began killing gay men – and it still is | The Guardian | 28 Apr 2023
Abused gay men don’t see they are victims – study | BBC News | 14 Apr 2023
Who Invented Mephedrone? A Brief History of Research Chemicals | Vice | 6 Mar 2023
We need to talk about chemsex | UnHerd | 13 Feb 2023
Olympic champion Matthew Mitcham on chemsex and overcoming addiction: ‘There was a lot of fear’ | Pink News | 3 Feb 2023
The rise of chemsex ‘cuckooing’ as drug gangs take over vulnerable men’s homes | inews | sign-in required | 12 Jan 2023

News/ articles 2022 – 1998

2022

Letter from the Minister of State for Crime, Policing and Probation to the Chair of the Advisory Council on the Misuse of Drugs | GOV.UK | 27 April 2022
The letter relates to the 2020 Advisory Council on the Misuse of Drugs (ACMD) report An assessment of the harms of gamma-hydroxybutyric acid (GHB), gamma-butyrolactone (GBL), and closely related compounds
David Stuart Obituary | The Lancet; Vol 399, Issue 10328, P904 | 5 Mar 2022
Increasing emergency department admissions for chemsex-related intoxications in Barcelona, Spain, among people living with HIV: an observational study from 2018 to 2020 | BMC Public Health | 18 Feb 2022
Remembering David Stuart | Scottish Drug Forum (SDF) | 20 Jan 2022
David Stuart: An Inspirational Leader in Chemsex Harm Reduction | Filter | 19 Jan 2022
David Stuart, chemsex and LGBTQ sexual health ecpert, has died | Attitude | 12 Jan 2022
Pioneering chemsex activist and support worker dies suddenly: ‘We owe him a huge debt’ | Pink News | 12 Jan 2022
Four Lives: Stephen Port is not the only killer to have used chemsex to find victims but society is in denial | inews | sign in required | 5 Jan 2022

2021

2020

Call for tougher penalties in UK for possession of chemsex drugs | The Guardian | 20 Nov 2020
Killer drug GHB ‘should be reclassified’, says official report | BBC | 20 Nov 2020

Assessment of the harms of gamma-hydroxybutyric acid, gamma-butyrolactone, and closely related compounds
In January 2020 the Home Secretary commissioned the Advisory Council on the Misuse of Drugs (ACMD) to review the evidence for the classification of gamma-hydroxybutyric acid (GHB), gamma-butyrolactone (GBL) and related compounds under the Misuse of Drugs Act 1971 (MDA), and the scheduling of these compounds under the Misuse of Drugs Regulations 2001 (MDR). In response the ACMD provided this report which reviews the evidence of harms, use in crime and prevalence of GHB and related compounds that have emerged since the ACMD’s last significant assessment of the risks in 2008.
Assessment of the harms of gamma-hydroxybutyric acid, gamma-butyrolactone, and closely related compounds | Advisory Council on the Misuse of Drugs

Hanging, blowing, slamming and playing: erotic control and overflow in a digital chemsex scene | Kristian Møller | 13 Oct 2020
An old, dangerous drug [GHB] has made a comeback with a new generation of users | NBC News | US | 13 Aug 2020
People are still going to chemsex parties, just in a different way | VICE | 19 May 2020
Crystal meth: Europe could now see a surge in supply and use | The Conversation | 15 May 2020
People are still meeting for chemsex under lockdown and police warn the risks are greater than ever | BuzzFeed News | 4 May 2020

Sex addicts talk about how they’re dealing with lockdown | Vice | 20 Apr 2020

What Zoom can mean for quarantined chemsex participants | Talking Drugs | 1 Apr 2020

The UK is ramping up its efforts to tackle a wave of chemsex crimes | BuzzFeed | 12 March 2020
Police officer under criminal investigation after collapse of two chemsex trials | Brighton & Hove News | 3 Mar 2020
There have been 60 deaths linked to Chemsex in London alone | Gay Star News | 1 Mar 2020
Man who dumped body after chemsex death jailed | BBC News | 28 Feb 2020
Reynhard Sinaga: court to decide on whole-life sentence for rapist | The Guardian | 16 Jan 2020
Reynhard Sinaga: ‘Evil sexual predator’ jailed for life for 136 rapes | BBC News | 6 Jan 2020
Priti Patel urges review of date-rape drugs after Reynhard Sinaga case | The Guardian | 6 Jan 2020

Reynhard Sinaga: How the Manchester rapist found his victims | BBC | 6 Jan 2020
GHB: The drug used as a ‘rapist’s weapon of choice’ | BBC News | 6 Jan 2020

2019

High sex, low risk: how gay and bisexual men who use drugs are protecting themselves from HIV | The Kirby Institute | 10 Dec 2019
Why do gay men do chemsex? | nam aidsmap | 29 Nov 2019
Inside the rising chemsex response in Europe | Filter | 16 Nov 2019
HIV-positive gay men in England report highest chemsex rates in four-country survey | nam aidsmap | 13 Nov 2019
Thousands of gay men asked this chemsex adviser for help on grindr with their drug problems. the app blocked him | BuzzFeed | 12 Oct 2019
Gay ‘chemsex’ is fuelling urban HIV epidemics, AIDS experts warn | Reuters | 12 Sep 2019
Sex, drugs and Murder | Channel 4 Dispatches | 6 Sep 2020
The sex drug that kills, part 1: The hidden epidemic of abuse, overdose, and death caused by the sex drug G | BuzzFeed | 5 Sep 2019
The sex drug that kills, part 2: The lethal sex drug GBL is being sold through Facebook | BuzzFeed | 6 Sep 2019
The sex drug that kills, part 3: He found his husband dead from a GHB overdose but is now fighting to uncover the truth about what happened | 7 Sep 2019
The sex drug that kills, part 4: A warning has been issued that rapists are mixing the drug GHB with lubricant | Buzzfeed | 8 Sep 2019
This is what it’s like when your son dies from the chemsex drug GHB | BuzzFeed News | 4 Aug 2019
Gay and bisexual men with problematic chemsex are a diverse group with significant sexual and psycho-social risks | nam aidsmap | 15 July 2019
Four modes of chemsex: study participants describe their experiences | Filter | 18 Jun 2019
Decline in chemsex over time in three English clinics | nam aidsmap | 9 May 2019
Chemsex survival kits come with color-coded syringes and a booklet on what to do if you’re arrested | Queerty | 15 Apr 2019
English clinic survey finds that 40% of gay men with new hepatitis C infections are HIV negative | nam aidsmap | 7 Apr 2019
Chemsex: Brits more likely to combine drugs with sex, survey finds | BBC | 2 Apr 2019
10 years of Grindr: A rocky relationship | BBC | 25 Mar 2019
Chemsex comedown: What’s behind the rise in people seeking therapy for ‘sober sex’ | HuffPost | 14 Mar 2019

2018

Chemsex and PrEP reliance are fuelling a rise in syphilis among men who have sex with men | The Conversation | 28 Nov 2018
This is how the justice system is trying to stop the chemsex crimewave | BuzzFeed | 31 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
Research shows club drug GHB associated with brain and cognitive changes | Medical Xpress | 8 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 connection of chemsex: Does it offer a real sense of community? | Gay Times | 23 Jan 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
Chemsex is an issue among gay men living with HIV in the UK, study reveals | Avert | 30 Jan 2018

2017

2016

2015

2014

wp-svg-icons icon=”globe” wrap=”i” size=”12px” color=”#000000″] 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 | M Daskalopoulou et al | Lancet HV, Vol 1 | Oct 2014
Chemsex risks are not restricted just to gay men | The Guardian | 10 Apr 2014
Gay men warned on risks of ‘chemsex’ | The Guardian | 8 Apr 2014
Slings, slamming and Chemsex | Huff Post Lifestyle | 10 Feb 2014
Experts warn of rise in gay ‘slamming’ | The Independent | 19 Jan 2014

2013

2012

A qualitative descriptive study of perceived sexual effects of club drug use in gay and bisexual men | J J Palamar, M V Kiang, E D Storholm, P N Halkitis | 16 May 2012
The haunting spectacle of crystal meth: A media-created mythology? | T C Ayres, Y Jewkes | 24 Jul 2012

2011

1998-2010

“In our experience, many gay men do not want to access generic mental health or drug services as they do not see themselves as having generalised mental health problems or experiencing the same issues as other problem substance users. This is even though the detrimental effects on their lives can be similar. Traditional harm-minimisation and risk-reduction strategies for recreational drug use also appear to have poor success in supporting people taking crystal meth.”
Crystal methamphetamine: an intractable problem | Thorley, F | HIV Nursing | Sep 2010

“In the global north, however, the phenomenon that has caused the most alarm is the epidemic of crystal meth use that started amongst gay men in the western USA in the early 1990s, spread to the east coast around 2000, and shows signs of becoming a problem in London’s gay scene now.”
The lonely drug: crystal meth in the UK | Gus Cairns | nam aidsmap | 1 Mar 2010

“An opposite trend has been observed in the use of GHB, which, according to data from high and medium quality studies, more than doubled between 1999 and the mid-2000s.”
The impact of drugs on different minority groups: a review of the UK literature | D Beddoes, S Sheikh, M Khanna, R Francis | Jul 2010

“Crystal meth is a highly addictive synthetic stimulant. Although reported use among school students has declined, it has devastating effects on those who become dependent. Use appears to be increasing in the difficult-to-study high-risk groups such as street youth
and gay men.”
The burden and management of crystal meth use | J A Buxton, N A Dove | 3 June 2008

“Because of its ability to reduce inhibitions and increase sexual drive, an emerging body of research has repeatedly identified crystal methamphetamine as a key variable in explaining new HIV transmissions among men who have sex with men (MSM).”
In the shadows of a prevention campaign: Sexual risk behavior in the absence of crystal methamphetamine | C Grov, J T Parsons, D S Bimbi | 2008

“About 40 men sit on fold-up chairs arranged in a circle in the upstairs room of Metropolitan Community Church. They’re all crystal methamphetamine addicts in recovery. Some have been sober for two weeks, some two years.”
Time out for a guest writer on crystal meth | Pink News | 12 Sep 2007

“It is possible that the overwhelming majority of our participants were initiated to methamphetamine in a purely social, non-sexual setting simply because they were all recruited at club settings. The young gay and bisexual methamphetamine users who use the drug primarily for sexual purposes may not frequent club venues.”
Initiation into methamphetamine use for young gay and bisexual men | J T Parsons, B C Kelly, J D Weisera | 29 Mar 2007

“The Advisory Council on the Misuse of Drugs has recommended to Home Secretary John Reid that the currently Class B drug should be moved to Class A, giving police the right to crackdown on it. Crystal meth is a popular clubbing drug with the gay community, also known as ‘tina’, ‘krank’ or ‘ice’, the ease of production and euphoric effects have ensured dramatic escalation of the drug’s distribution worldwide.”
Government advisors push to reclassify gay clubbing drug | Pink News | 12 Jun 2006

“The government is considering the reclassification of a drug believed to be taking hold in the gay club scene after police warnings that it is dangerous and is now being made within the UK for the first time.”
Creeping menace of crystal meth, the drug more dangerous than crack | The Guardian | 15 Nov 2005

Association for Gay, Lesbian and Bisexual Issues in Counselling | Volume XXXI, Issue 3; Fall/ Winter 2006
Crystal’s Sexual Persuasion | Michael Shernoff. This article was first published in The Gay & Lesbian Review Worldwide V. XII, No. 4 (pp. 24-27) July- August 2005 | pages 7, 8 ,10

“Crystal meth is impacting the health and wellness of gay and bisexual men in King County and it shows no signs of going away. New ideas, new strategies, and new commitments are clearly needed to reverse the damaging course of crystal use in our community.”
Deconstructing Tina | Gay Men, Drug Use, and HIV Workgroup et al | PDF | US | 2004

“Step into the world of crystal meth – also known as Tina, hydro, crank or ice – and enjoy boundless energy, increased sensation, horniness, killer confidence and zero sexual inhibitions. The problem is that outside crystal meth land, reality can end up seeming so inhospitable you just want to retreat back into Tina’s version, where it’s okay not to eat or otherwise take care of yourself. Crystal meth is the perfect party and play (P ‘n’ P) drug – except that the meth men I talked to have a tough time maintaining a use that’s purely recreational.”
Crystal palace: Doing Tina is so much fun, everything else is a pain | Shaun Proulx | Xtra | PDF | CA | 24 Nov 2004

“In recent years, methamphetamine has become a drug more commonly used among gay and bisexual men in New York City. Findings indicate that among self-identified club-drug–using men, methamphetamine is widely used by men across age groups, educational level, race/ethnicity, and HIV status.”
Longitudinal investigation of methamphetamine use among gay and bisexual men in New York | City: Findings from Project BUMPS | P N Halkitis, K A Green, P Mourgues | PDF | US | 28 Feb 2005

“The use of recreational drugs in the UK is on the increase, as is the range of available substances. One relative newcomer to the drugs of misuse that is achieving popularity in the UK among ‘raver’ and bodybuilders is gamma-hydroxybutyrate (GHb), also known as ‘liquid ecstasy’.”
Liquid ecstasy – a new kid on the dance floor | J Rodgers, C H Ashton, E Gilvarry, A H Young | Feb 2004

“Methamphetamine is well documented for its association with sexual activity. Users report that it significantly enhances the sexual experience. Tina, as it is known by many of its gay users, enjoys the reputation that it makes sex so good that it is difficult to think about anything else. In South Florida, the use and abuse of this drug appears to be increasing.”
Methamphetamine and other potentially risky sex-enhancing drugs | D M Fawcett, A E Taule | Florida, US | PDF | US | Dec 2004

“The viral loads of HIV-positive people who use the recreational drug methamphetamine are significantly higher than those of individuals who do not take the drug, according to research conducted in San Diego and published in the December 15th edition of the Journal of Infectious Diseases.”
Does methamphetamine affect HIV viral load? | Michael Carter | nam aidsmap | UK | 17 Dec 2003

“Some know it as crystal. Others refer to it as Tina, a campy abbreviation of its other name, Christina. But among the habitués of New York’s frenetic gay club scene, the extraordinarily powerful stimulant commonly known as crystal meth is earning a new nickname: the Evil One.”
Friend of tina | Google answers (string) | 13 May 2003

“Also, many of these drugs have central and neurotoxic effects (GHB, methamphetamine), which may have effects on neurotransmitters, involved in the central initiation of the erectile pathway. More worrisome is the increase in high-risk sexual behaviour and sexual assault. Young adults need to be informed of the risks that these drugs pose to their sexual health.”
‘Club drugs’ and erectile function: Far from sexual ‘ecstasy’ | J C Lee | 2001

“Australian doctors have reported what they believe to be a fatal interaction between ritonavir and methamphetamine, commonly known as crystal or crystal meth. Crystal is a popular recreational drug amongst gay men, especially in North America and Australia, but this is the first report of a potentially harmful interaction since the introduction of protease inhibitors more than four years ago.”
Potential fatal interaction between protease inhibitors and crystal meth | Gus Cairns | nam aidsmap | UK | 5 Mar 2001

“GHB – Gamma-Hydroxybutyrate – first became a fixture at raves and gay “circuit parties” in the early nineties. The FDA declared the drug unsafe and illegal to market in 1990, and several states have banned it because of its use as a date-rape drug.”
Nightlife ‘99: Clear And Present Danger | New York Magazine | 22 Nov 1999

“Products containing gamma-butyrolactone (GBL) * are marketed for many claimed purposes, including to induce sleep, release growth hormone, enhance sexual activity and athletic performance, relieve depression, and prolong life.”
Adverse events associated with ingestion of gamma-butyrolactone Minnesota, New Mexico, and Texas, 1998-1999 | CDC | US | 25 Feb 1999

2022-1998

Books and plays

A selection of books and playa about chemsex:

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

Tweakerworld | Jason Yama
“Meet Jason: a college-educated documentary film producer, cat parent of two and one of San Francisco’s top drug dealers. After Jason’s world falls apart in LA, he moves to Berkeley for a fresh start with his kid brother. Just one problem: his long-closeted Adderall addiction has exploded into an out-of-control crystal meth binge. Within weeks, Jason plunges into the sprawling ParTy n’ ’Play (PnP) subculture of the Bay Area’s gay community. With painful honesty, Jason Yamas has crafted a landmark narrative that is not just a personal account of addiction, but a portrait of a vulnerable, largely undocumented community of people who, for many reasons, have been marginalized to the point of invisibility.”
Tweakerworld | Jason Yama | Unnamed Press | 2023

The Truth About Chemsex | Justin David Duwe
“This book is the first of its kind and is about Chemsex Addiction. Chemsex Addiction is the combination of dangerous sex acts and lethal drugs that are highly addictive. This addiction is now at epidemic levels in most major cities in Western Europe, North America and Australia. Not since the HIV/AIDS epidemic has the gay/bisexual community been faced with such a massive health issue when considering its prevalence and health implications. This book addresses its’ causes, prognosis, and solutions for individuals, family members, therapists and medical professionals whose paths cross with individuals suffering from Chemsex Addiction.”
The Truth About Chemsex | Justin David Duwe | Book Baby | 2018

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..” Biteback Publishing
Something for the Weekend | James Wharton | Biteback Publishing | 2017

The G Club | Paul Madden
“It’s the living that have to resurrect themselves, not the dead…”The G Club is the story of two strangers struggling with grief who are trying very different ways to cope with their pain. On his first day back to work, Jamie meets an older lady who is at a different stage of the grieving process. By night, Jamie stumbles into the world of the illegal drug ‘G’ (GHB) as a way for him to block out his pain. By day, he attempts to help this stranger with her own grief, while also trying to hold down his job as a counsellor. Unknowingly, they require one another to begin the healing process and start dealing with their loss.
The G Club | Paul Madden | Independently published | 2017

Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery | David M Fawcett
“A 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 M Fawcett | 2016

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.” Oberon Books
5 Guys Chillin’ | Peter Darney | Oberon Books | 2016

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.” Oberon Books
The Chemsex Monologues | Patrick Cash | Oberon Books | 2016

Click for details

David Stuart

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

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

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

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

Chemsex: A Brief Intervention | David Stuart | 2013

Chemsex; origins of the word, a history of the phenomenon, and a respect to the culture | PDF | David Stuart | 2019

A Loud Exhaust by David Stuart

Safer chemsex

Safer chemsex guide introduction

With some minor edits, this is a copy of our Safer Chemsex booklet (May 2023, 10th edition) included in our PIP PAC safer chemsex packs and “Safer” campaign pack (2023).

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 8th 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. Thanks to Da, Ed, Fr, Ga, Ha, Ma, Ni, Sw, Nw, Bh, Pa, Be, Ki and To. Special thanks to Release, Injecting Advice, Global Drug Survey and Exchange Supplies.

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

Good to know

Mixing drugs
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.

Eat
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.

HIV Drug Interaction Checker | University of Liverpool

Drink water
To prevent dehydration, it’s important to drink water, herbal tea or sport drinks regularly. Coffee and alcohol are not good options.

Get rest
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.

Freshen-up
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.

Coming down
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.

Sexual health check-ups

Regular sexual health check-ups every 3-6 months are essential for a responsible and enjoyable sex life. Sexual health clinics and services:

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

STI self-test kits (London)

Sexual Health London (SHL) is London’s sexual health e-service* that provides free sexual health testing via the internet and local venues. Simply register for SHL and complete an online consultation to order your free STI test kit. The service provides testing for a range of sexually transmitted infections including chlamydia, gonorrhoea, HIV, syphilis, hepatitis B and hepatitis C via samples you can collect at home. The service is designed for individuals who have no symptoms. If you have symptoms please attend your local sexual health clinic.

Sexual health checks-ups and clinics | MEN R US
Sexual health checks-ups and clinic map | MEN R US ^NEW
SHL STI self-test kit | MEN R US

Pre-Exposure Prophylaxis (PrEP)

PrEP is the use of HIV medication, taken regularly, to keep HIV negative people from becoming infected. PrEP is now FREE from most NHS sexual health services across the UK. Alternatively, you can buy PrEP privately and/ or online but you are strongly advised to connect with your sexual health service for monitoring.

Condoms and antibiotics

PrEP is one of a combination of strategies that can reduce the risk of getting HIV, though condoms are still the most effective method of preventing HIV and other sexually transmitted infections (STI). Even if PrEP is the game-changer many believe it is, it offers zero protection against other STIs which are on the rise at a time when some antibiotics are failing.

Pre-Exposure Prophylaxis (PrEP) | MEN R US

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 from 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 to 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

Safer slamming

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.

Needles
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
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.

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

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

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:

Non-absorbent
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 slamming

More here about safer slamming | MEN R US

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 more 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.

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.

Spiking drinks and lubricant

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

What to do:

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.

Booty bumps | Friday/ Monday
Booty bumping | Tweaker
How to Booty Bump Better | San Francisco AIDS Foundation
Sexual Offences Act 2003 | Wikipedia

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 | MEN R US

Get a free Hep C home testing kit | NHS

About and using G

The difference between GHB and GBL

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

GHB (gamma-hydroxybutyrate)

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

GBL (gamma-butyrolactone)

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

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

Why knowing the difference between GBL and GHB matters

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

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

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

Effects

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

Sweets from strangers | Three Flying Piglets film for MEN R US | 2020 | 27s

The law

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

The Law and GHB (and GBL) | Release
Your rights on arrest | MEN R US
Ambulance call-outs and the police | MEN R US

Measuring

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

Dosing

The effects of G come on quickly within 10-20 minutes
Batches of G may differ slightly in strength. Check a new batch by taking a smaller dose than usual, waiting at least 60-90 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
The effects of G are likely to differ depending on your weight, size, metabolism, what you’ve eaten, and any other drugs you have taken
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)

0.5ml – 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
The effects of G are likely to differ depending on your weight, size, metabolism, what you’ve eaten, and any other drugs you have taken

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

Drinking G with soft drinks

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

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

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

Overdosing

Overdosing on G 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 G 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.

Mixing with alcohol and other drugs

Never use G if you are by yourself as you are putting yourself at extreme risk
G 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. For example, ketamine’s anesthetic effects combined with GHB’s depressant properties, greatly increases the likelihood of overdose
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

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

G is added to soft drinks

G is mixed with lubricant for sex, before and during

G is mixed in syringe lubricant applicators (syringe-type devices without needles) and inserted up the bum

What to do:

Measure, check and drink your own doses and don’t leave drinks unattended

If you come back to a drink later throw it away, wait an hour before dosing again, starting slowly

Take a supply of your own lubricant if playing with a partner(s) for the first time

Ensure consent is given freely and safe words are agreed

Serial killers and rapists | MEN R US

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

Consent

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 interactions

HIV 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

Out of this world | Three Flying Piglets film for MEN R US | 2020 | 32s

Watching out for others, overdose situations and the emergency services

Hopefully, you will keep an eye out for mates and sex buds, and they’ll do the same for you
If you spot someone who may be in trouble, ask, and check they’re OK
If you are trained or qualified, place them in the recovery position. But remember: even with the best of intentions, you can do more harm than good if you are not trained or qualified, with possible legal implications if something goes wrong, Click here for me
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 two days in a row to reduce the likelihood of developing a physical dependency to G and the risk of dangerous withdrawal
For users physically dependent on G, one of the biggest risks is the rapid onset of ‘withdrawal syndrome’, which can be potentially fatal. Within a few hours of their last dose, they start to develop cravings for more G and can become anxious, sweaty, agitated, and confused
In a matter of hours, withdrawal can rapidly escalate, progressing to hallucinations, delirium and life-threatening seizures
Users experiencing these symptoms are likely to require admission to an accident and emergency department (A&E)
It can be very dangerous to suddenly stop so seek support talk from a drug service, GP or A&E before attempting to stop

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

Thank you

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

Providing first aid in overdose situations

Before we start, we should clarify this has not been written by legal experts, This content is only for guidance. Furthermore, even with the best intentions, you can do more harm than good if you are not trained or qualified in first aid, with possible legal implications if something goes wrong.

See if you can wake them by calling their name and/ or shaking them firmly but gently.
If there’s no response, with your cheek over their nose and mouth, look down the body to see their chest moving and feel for breath on your cheek. (Do this for 10 seconds).
If they are not breathing, call 999 for an ambulance, following the operator’s instructions.
If they are breathing but not responsive, place them in the recovery position if you feel able, and call 999, following the operator’s instructions.
Stay with them until help arrives.

What to do in an emergency | FRANK
After an incident | NHS

How to put an adult in the recovery position | St John Ambulance
Recovery position | Wikipedia

Why queer people are stocking up on this life-saving nasal spray for drug overdoses | Queerty* | 1 Oct 2021

Global Drug Survey | 2017 | 4m 34s

Good Samaritan law
In researching this content, there are very few cases on which to base any judgement; various scenarios are discussed and the words ‘probably’ and ‘maybe’ are used a lot when referring to the outcome of an imagined scenario in court.
Good Samaritan law | Wikipedia

Come downs

Much as we would like to think otherwise, using chems (recreational drugs) doesn’t create energy; they allow us to ‘borrow’ from tomorrow’s supply. And then, when tomorrow comes, it’s ‘payback’ time. Coming down happens because the feel-good chemicals produced by the brain have been released and used up. You will likely feel down until your brain has had the time it needs to replace them.

While some seem to take comedowns in their stride, others find them very challenging. It may take a few days to fully recover from a comedown. If you’re already tired, anxious, on your own, or have something important to do the next day, the effects of the comedown may be worse. The key is to minimise the impact and assist recovery:

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

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

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

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

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

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

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

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

Cuckooing

Cuckooing is a crime where drug dealers or gangs take over a home to store, sell and/ or make drugs. The tenant or owner is often vulnerable and/ or living alone; this includes people who use drugs, older people, people with learning difficulties, physical or mental health issues, and people living in poverty.

Drug dealers target their victims carefully- sometimes over many weeks, even months – offering ‘friendship’ and ‘free’ drugs as incentives to gain trust. Once in control, the dealers or gangs move in and take over the property and lives of the victim, often with threats and coercion, sexual exploitation, and violence. Victims are frightened of going to the police, fearful of being involved with drugs, and/ or being identified as a dealer.

While cuckooing has been well-recorded within the general population for over a decade, it would appear to be a relatively new phenomenon in relation to gay men and chemsex. However, we are all human, and it’s not a stretch to see how some gay men may find the offer of ‘friendship’, ‘free’ drugs, and sex hard to resist. Unfortunately, the combination of gay men, hook-up apps, and the privacy of home sex parties can afford is fertile ground for drug dealers seeking and exploiting victims.

Knowing when and how to include new issues can be challenging without sounding alarmist or gratuitous. Reliable data relating to gay men, chemsex and cuckooing is conspicuous by its absence, so we are cautious about adding this content.

Data

Sifting through questions asked by London Assembly Members, there have been 328 offences flagged with Cuckooing Activity by the Met police recorded between 01/01/2019 and 28/02/2022 (broken down by London Borough). We understand these to be cuckooing offences within the general population only; ie: data does not include the sexuality of victims and/ or if the offences are chemsex related.

Over recent years, London Assembly Members have been asking The Mayor about cuckooing. Two recent examples: *

Question: Cuckooing offences by borough. Please advise a breakdown by borough of the offences marked with a cuckooing flag on the Metropolitan Police database.
Answer: A Count of 328 Offences flagged with Cuckooing Activity by the MPS recorded between 01/01/2019 and 28/02/2022. See the attached PDF converted from an MPS Excel file.
Question: How many cuckooing cases did the MPS flag in 2021?
Answer: As of March 2022, 129 offences recorded in 2021 calendar year have been flagged as Cuckooing Activity. Please note that the ‘Cuckooing’ flag was first introduced on the crime recording system in April 2019. Furthermore, the MPS Crime Recording System is a live recording system and flags can be added or removed at any time during current or past investigation.

London Boroughs

Not scientific, but MEN R US volunteers visited all local authority websites in mid-January 2023. 15 referenced cuckooing in documents or in news . 17 had no mention.

News media

MEN R US volunteers searched for news articles with the words ‘cuckooing’ and ‘chemsex’ (2021 and 2022) and could find nothing of any substance. More recently, there has been a single article on 12/01/23 in the Independent or “I” News (paywall) picked up by other outlets.

Other references

Within the context of chemsex, cuckooing has started to appear in documents such as:

South Gloucestershire Drugs Needs Assessment (2020)
Tower Hamlets Partnership Substance Misuse Strategy (2020-2025)

Cuckooing | Wikipedia

The common cuckoo and cuckooing
The only British bird not to rear its young is the common cuckoo. Instead, females find nests built by other birds, lay eggs, and then fly away. The nest owner (eg: willow warblers, robins or meadow pipits) incubates the egg as its own and feeds the chick when it hatches. The cuckoo chick wants all the food for itself, so pushes the other eggs out of the nest, sending them to their deaths. The chick braces its feet on the sides of the nest and rolls each egg over the edge.

Common Cuckoo chick ejects eggs of Reed Warbler out of the nest | Artur Homan | 4 Jun 2013 | 3m 57s

With reference to criminal activity, the term cuckooing is believed to have been first coined in 1992 by Michael E. Buerger. Defensive Strategies of the Street-Level Drug Trade; Journal of Crime and Justice Vol. XV, No. 2 1992. Its use fell by the wayside but regained wider use from around 2010 when cuckooing was becoming an increasingly common problem in the Southern Counties.

Cuckooing crimes on rise across London | BBC | 18 May 2023
Jess Phillips and Iain Duncan Smith lead calls to criminalise ‘cuckooing’ | The Guardian | 26 Feb 2023

Finding the right chemsex support

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

When guys ‘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.

Truth is, 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. In larger towns and cities, some sexual health services, drug and LGBT+ mental health, local authority services are working together to provide tailored and integrated support.

Drug services, particularly, are waking up to the fact they’ve ‘neglected’ the LGBT+ community for decades and many only seem to have a passing understanding of gay men’s health and wider LGBT+ issues. However, some are starting to respond positively, becoming LGBT+ friendlier, developing expertise—something long overdue.

Some of us prefer gay or gay-friendly services which, as a rule, are much better understanding the issues affecting our lives, and the context. Others are happy to access mainstream services.

Most health services aim to be welcoming, respectful, knowledgeable, and understanding. The thing is to find a service that’s right for you and that “gets the job done.”

Ask questions
Consider you or a friend phoning a service first to check if the ‘vibe’ feels right. Some of these questions may seem a little direct (kind-of the point) and you may have some of your own:

“Do you have a drug, alcohol and/ or chemsex service specifically for gay/ bi men?”
“Have your frontline staff had training on chemsex, gay men’s health, and wider LGBT+ issues?”
“How do existing clients respond to LGBT+ people?”
“Would you say your service is LGBT+ friendly?”
Check out the service’s website; are ‘chemsex’, ‘LGBT’, ‘gay’, ‘MSM’ and/ or GBMSM included anywhere?
MSM: men who have sex with men. GBMSM: gay and bisexual men and other men who have sex with men.

Your GP
It’s understandable why you might feel your GP won’t have the knowledge and expertise they need, but they should be able to be supportive and/ or signpost you to someone who can. This might include a drugs or counselling service though these are unlikely to be gay-specific. GPs are also the ‘gateway’ to local health services you so developing a relationship with your GP is potentially very helpful.

HIV and LGBT+ organisations
If you don’t know where to start, contacting a local HIV or LGBT+ organisation can be a good place to start. While they may not be able to help you directly, they usually know what’s going on in the area and can signpost accordingly.

Can you talk with a friend you trust?
Perhaps 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 can still be found within our own community.

Drugs, alcohol and chemsex support services | MEN R US

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 injury¹ or endanger life². 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 offence³. 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.

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

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.

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.

Drug paraphernalia and UK law | Exchange Supplies
What are the UK drug laws? | DrugWise
People who inject drugs: infection risks, guidance and data | Public Health England
Injecting drug use and needle exchange | Release

Injecting other people | MEN R US

Support and further information

MEN R US
Gay men’s health website with a large section on chemsex including further support and services in/ outside London.

HIV Drug Interaction Checker
Comprehensive, user-friendly, drug interaction charts providing clinically useful, reliable, up-to-date, evidence-based information.

Injecting Advice
Offers support and advice to injecting drug users and people working in harm reduction services (especially needle programmes).

Exchange Supplies
Supplies products, information, and services to improve and prolong the lives of people who inject drugs.

Drugs Meter
Drugs Meter allows users to see how their drug use compares to others, offering objective, personalised feedback.

The Havens
Sees anyone in London who has been raped/ sexually assaulted in the past 12 months. Offers treatment, advice and support 24/ 7. You can self-refer.

GALOP
Supports lesbian, gay, bi, trans and queer people who have problems with the police/ questions about the criminal justice system.

Survivors
Help/ support for sexually abused men as well as their friends and family, no matter when the abuse happened.

NAM aidsmap
Information about HIV and AIDS with independent, clear and accurate information is vital in the fight against HIV and AIDS.

SXT
Online service that helps find the right type of sexual health service near you in under a minute including screening.

Mental health | MEN R US
Including helplines, support, groups and networks with content on loneliness, depression, and stress and anxiety.

LGBT+ helplines and organisations | MEN R US
Helplines, forums, groups and networks; and organisations for the trans; and Black, Asian and Minority Ethnic communities.

Reporting LGBT+ Hate Crime | MEN R US
Reporting hate crime, hate crime support and hate incidents and hate crime statistics.

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

Needle and syringe supplies

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

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

More

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

Injecting Advice | Injecting Advice
Safer injecting | drugs.ie
The Safer Injecting Handbook | Exchange Supplies

Tourniquets

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

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.

Safer chemsex in a box

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

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

Order here: PIP PAC | Gay Men’s Health Collective

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

SAFER PACK (FREE)

Booklets and leaflets (free)

A range of booklets and leaflets are contained in our “Safer” pack – home-grown by GMHC volunteers with expertise from friends and allies.

These resources are included in all PIP PAC safer chemsex packs

PIP PAC | GMHC
“Safer” Campaign 2023

More chemsex support

Tweaker (US)

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

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

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

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

Tweaker
Relaunched Tweaker site tightens ties to substance-use support group | San Francisco AIDS Foundation | 2019
San Francisco AIDS Foundation

Bluelight (US)

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

Bluelight

Chemsex Toolkit 101

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

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

Chemsex Toolkit 101 | Chicago Recovery Alliance | USA

Chemsex first aid

WARNING!
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. Our best advice is to call 999 for an ambulance.

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

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

EU Mainland and EAA

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

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

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

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

NEPTUNE

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

Neptune | Novel Psychoactive Treatment UK Network

Guidance on the clinical management of acute and chronic harms of club drugs and novel psychoactive substances | Neptune | 2015
Club drug use among lesbian, gay, bisexual and trans (LGBT) people | Neptune | 2016

Calling 999: ambulance call-outs, and the police

Calling 999: what may happen

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

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

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

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

Flow diagram

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

Snapshot survey: calling 999 for ambulance and police call-outs

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

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

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

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

Met Police (London) guidance on chemsex (2018)

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

The guidance was removed from the MPS website in 2023, but there is a PDF here or click below.

Chemsex

Chemsex is a term used to describe sex (often long sessions with multiple partners) under the influence of psychoactive drugs (particularly mephedrone, GHB, GBL and crystal meth).

If you’re engaging in chemsex and something happens that you’ve not consented to or you’re assaulted, we understand you could be nervous about reporting it to us, but we hope this advice will address those concerns.

This information has been produced by working with LGBT advisers to the police 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. They’re trained to understand the difficulties faced by someone reporting sexual violence and can direct you to the most appropriate support services.

You’ll be asked if you’ve taken or used drugs or alcohol, this is mainly to make sure you’re feeling well enough to give a proper account of what happened, and legally agree (consent) to a medical examination, if that’s required. 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:

Crimestoppers
through The Havens (an organisation that helps people who have been raped or sexually assaulted)
if you’re a sex worker you can go through National Ugly Mugs
through one of our partners such as Galop or 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 were 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’ll be able 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 (for example, 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’ve 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, we have the power to decide what information to disclose, and who to – this is under the Common Law Police Disclosure (CLPD) scheme.

We’ll only disclose information if we 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.’ We 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, we’ll definitely think about making a disclosure. The decision will be based on:

your job/type of work
the offence 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.

We can’t make a decision about what happens with your job – we 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 may 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 we can enter (and search) a property without a warrant. We 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.

We can then use our power if we feel we 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.

Click here

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

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

Our thoughts on the (old) guidance

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

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

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

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

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

London accident and emergency departments

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

Accident and Emergency (A&E) Departments

Similarly, this website has mapped the following services:

Sexual Health
Drugs and Alcohol
Police Stations (Walk-In)

Greater London Services Map

Accident and Emergency Departments (A&E)
Not all London boroughs have an A&E but this has more to do with how they have evolved and been planned over time.
Drugs and Alcohol, and Chemsex Services
These are commissioned (provided) by local authorities so you will have to access these services* located in your borough.
Sexual Health Services and Clinics
Even though there is a drive to use self-test kits, we’ve mapped 30 clinics across Greater London.
Metropolitan Police Service Stations (Walk-In)
The Metropolitan Police Service website doesn’t provide a list of walk-in stations, so we have.
Metropolitan Police Service Custody Suites
If you arrested in one Borough, your custody suite may be located in another. We list them because the Metropolitan Police Service doesn’t.