HomeScienceAn ongoing public health problem

    An ongoing public health problem

    Chemsex emerged first in the late 2010s, and only grew during the Covid-19 pandemic and the subsequent multiple lockdowns. A contraction of chemicals and sex, this practice consists in consuming psychoactive substances before having sex. “This ritualized use, observed exclusively in men who have sex with other men [MSM]has nothing to do with the recreational use of products like alcohol or cannabis that are linked to sexuality,” explained Jean-Victor Blanc, an addiction psychiatrist at the Saint-Antoine public hospital, which five years ago opened a specialized chemsex consultation service. According to him, between 3% and 5% of the population consumes “recreational” psychotropic drugs before sex.

    Chemsex was long considered an epiphenomenon, but the emergence of geolocalized dating apps like Grindr, and very cheap new synthetic drugs called cathinone that can be home-delivered, accelerated its development. 3-MMC, 3-CMC, GHB, MDMA, methamphetamine… they can be consumed orally, intranasally, or intravenously (known as “slam”). Their users say they increase their libido and performance while having disinhibiting and entactogenic effects, increasing their empathy towards their sexual partners.

    While the phenomenon has been growing in France, its prevalence remains difficult to quantify. In 2019, the APACHES sociological survey conducted by the Observatoire Français des Drogues et des Toxicomanies (French Monitoring Center for Drugs and Drug Addiction, OFDT) for the French Directorate General of Health found that between 13% to 14% of MSM had taken part in chemsex in the last 12 months. This number reaches 25% to 30% for dating app users and between 30% and 50% for patients with infectious diseases. The high percentages have turned it into a real public health problem.

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    The Chemsex 2022 report, sent on March 17, 2022, to then Minister of Health Olivier Véran, reported on a meta-analysis of 38 studies estimating the practice’s prevalence to be between 3% and 29% among MSM in the United States and Western Europe. “Grindr, one of the main gay dating apps, claimed in 2020 to have over 500,000 users in France, which could mean a very rough estimate of 100,000 to 200,000 people potentially affected,” its authors wrote.

    The practice of chemsex can be intermittent and festive. In the Apaches report, Maitena Milhet, a sociologist and researcher at the OFDT, said some users could be “happy” participating in chemsex. “You can discover drugs at the same time as chemsex, whether you’re 18 or 62 years old, become addicted to them in a few weeks, or use them in a controlled way,” she wrote. “At first, they only use them on weekends, but then some will start on Thursday, sometimes as early as Wednesday, until they eventually use [them] continually throughout the day,” noted White.

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