The term chemsex is derived from the words “chemical” (chemical) and “sex” (sex). Substances commonly associated with chemsex are used for the purpose of disinhibiting and enhancing sexual intercourse and include GHB (gamma hydroxybutyrate), methamphetamines (such as mephedrone, also known as "meph" or "M-Cat"), cocaine and stimulants sex acts known as "poppers". There is currently no consensus definition of the term chemsex in the literature (1).
Substances legalized in Brazil, such as alcohol, can also be used for this purpose. Although there are no studies that report the isolated use of alcohol in this context, there are reports in the media that associating alcohol with sex has become frequent, especially among young people, who seek the substance as a way to disinhibit and relax during sex. However, it is important to emphasize that this practice can bring some important risks to the physical and mental health of its practitioners.
A systematic review analyzed 12 articles related to chemsex indicated that the highest prevalence of the practice occurs among the population of men who have sex with men (MSM), but not limited to this group (2). In 2020, a Brazilian study carried out in Rio de Janeiro also showed that the use of illicit drugs and alcohol was common among MSM, and the score of the ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test), a screening questionnaire used to assess the involvement and problems related to the use of alcohol, tobacco and other substances, was higher in individuals who reported practicing chemsex (3).
Chemsex is associated with a number of health risks, as described in several studies and systematic reviews (4,5,6,7), specially an increased likelihood of contracting sexually transmitted infections (such as HIV). In addition, it is related to risky sexual behaviors, such as not using condoms and involvement with multiple partners. There is also a higher incidence of problems related to mental health, such as depression, anxiety and episodes of paranoia. Some substances, such as GHB, have a high overdose potential and can be fatal when mixed with alcohol (4,5,6,7).
Regarding the management of acute chemsex intoxication, a distinction must be made if there is an association with other substances such as alcohol or the presence of psychiatric disorders. The treatment should be comprehensive, with an inquiry of the patient's goals, in addition to providing information and education on the problems associated with the use of illicit substances. Psychoeducation is also crucial for reducing the risk of transmitting infectious diseases.
In short, it is suggested to investigate the use of substances related to sexual activity in order to receive adequate treatment, encompassing the prevention and screening of sexually transmitted infections, psychic symptoms and risk behaviors (1) More studies are needed to improve knowledge about the practice of chemsex, the associated risks and the best forms of intervention and care to promote the health of people involved in this practice (8).
