Safer Sex and the implications of drugs & alcohol

“Everything in the world is about sex — except sex” – Oscar Wilde

Why do people come for therapy?

Drugs, Alcohol and Safe Sex – the implications:

There are many reasons why people have, or seek, sex. Sex seems to be at one and the same time the most simple and most complex of human interactions. In that space, the use of mind altering substances like drugs and alcohol adds another layer of complexity. At its best, risk aware consensual sex affords escapism, pleasure, affirmation and relational bonding. If that’s the kind of sex people are having, then the informed use of mind altering substances like drugs and alcohol can be an enhancement. However, if the substances are being used to suppress or evade the emotional complexity of the sexual encounter there is a potential for problems. Different substances have different psychological and physiological impacts. We are typically culturally aware of the effects of alcohol (a legal mind altering substance) which can reduce inhibition and adversely affect ‘performance’. The use of other drugs can involve breaking the law and connecting with the illegal supply community, who’s motivations are unlikely to include consideration for the well-being of their clients or scrupulous attention to the purity of their offering.

Understanding the risks:

Apart from the risks of an illegal supply chain and unverifiable product purity leading to unquantifiable dosage, the use of drugs can affect the quality of decision making. If you are under the influence of alcohol or drugs, you might engage in sex acts and select partners you wouldn’t entertain when sober. Depending how under the influence you or your partner(s) are, it may be difficult to establish if consent has been given. There is a risk that you may be taken advantage of, or worse. It’s illegal to ply someone with drugs or alcohol with the intention of having sex with them once they have lost the capacity to consent. Some drugs can affect your sexual function, making it harder to get or maintain an erection, make sex less pleasurable or maybe affect your ability to achieve an orgasm. This can
lead to mixing drugs (for example, taking Viagra) which can have unforseen health consequences. Sensible safe sex procedures and contraception may be forgotten leading to the risk of disease transmission and unwanted pregnancy.


Chemsex is a particular manifestation of the use of drugs with sex that has evolved within the community of men who have sex with men (MSM). Drugs like crystal meth, mephedrone GBL and GHB are chosen for the purposes of enhancing sex because they have a powerful disinhibitory effect. Typically a Chemsex party can last several days with participants engaging with multiple sexual partners and having sex lasting several hours. The drugs of choice create a feeling of euphoria and sustained sexual arousal. They can allow deeper rapport with sexual partners facilitating increased sexual pleasure with lowered inhibitions. However, we once again encounter issues of consent and safety if the psychological motivations of the participants are not clear.

Current thinking suggests that Chemsex has evolved as a toxic combination of the availability of ‘hook-up’ apps like Grindr, a preference for private home parties rather than more exposed public meeting places and the effect of shame and internalised homophobia suffered by the gay community. In a society still hostile to non-heterosexual practices, the simple freedom to seek love, connection and pleasure from your chosen source of desire can be inhibited, leading to alienation from the self from a young age. This self alienation can play out as potentially self harming activities such as the inherently risky Chemsex parties. The after-effects of Chemsex can fuel any latent shame which can lead to a downward spiral of behaviours. Anecdotal reports suggest high rates of transmission of
STIs including HIV and hepatitis C (from needle sharing). Worse still, there reports of deaths from overdoses.

The Typical Drugs Involved:

Crystal Meth (methamphetamine hydrochloride), Mephedrone (4-methyl methcathinone), GBL (gamma-Butyrolactone) and Ecstacy (3,4-Methyl?enedioxy?methamphetamine – MDMA). These drugs tend to generate a state of empathy, depersonalisation, disinhibition, euphoria, and relaxation. They can also act as a stimulant and aphrodisiac, but can also have a dissociative effect which may interfere with memory of the event. GHB (gamma-Hydroxybutyric acid) is a sedative and has been linked with ‘date rape’. Poppers (alkyl nitrites) relax the sphincter muscles.


Awareness, informed decision making, and appropriate precautions can keep you safe.

A complete understanding of the concept of Consent is vital.

And by the way, you don't need to wait for a crisis.

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