Agencies in different parts of England have been dealing with issues associated with chemsex for some years.
However, the subject is rarely discussed in Wales. Is this because it has not emerged as a problem, or because we just don’t like talking about it here?
A few days ago I had a very interesting chat with Tadgh Crozier, who has worked in this field in London and elsewhere. Here’s what he’s got say.
It's 5am and the sun is just about to rise and I'm in someone else's flat that I met the night before. The chill-out started on Friday, but now it's Monday morning. I should be at work in three hours. I'm just going to have one last slam and a little sip of 'G' to get me through the next few hours.
It's 12 noon. How did that happen? The panic sets in....Where am I? Have I been out of it all this time? I need to get out of here. I'm in pain...what happened?
My mate has just text saying: ''Saw you on some cam site last night having sex with 2 blokes. U looked out of it.”
Oh no, what happened? How? Who was I with?
I need help.
But where do I turn?
This fictional scenario may sound far-fetched, however, this is the reality for many clients I have worked with around 'Chemsex'.
Chemsex is a term for the use of drugs before or during planned sexual activity to sustain, enhance, disinhibit or facilitate the experience. Chemsex commonly involves crystal methamphetamine ('crystal meth'), GHB/GBL ('G') and mephedrone, and sometimes injecting (also known as slamming).
Chemsex carries serious physical and mental health risks, including the spread of blood borne infections and viruses.
In my work with MSM (men who have sex with men) using chemsex, I commonly saw the use of 'G' - short for GHB. Clients have reported that using these drugs can make them feel like a porn star in the correct dose; if you get the measure slightly wrong then there is a big chance that they will become comatose and may even die.
Last year, the British Medical Journal warned of the rise of chemsex in the UK and now the Government has included chemsex as part of the 2017 Drug Strategy. Chemsex is a public health priority.
There are many barriers to people opening up or accessing services when using chemsex. These can include the feelings of shame and stigma often associated with drug use and also existing drug and/or sexual health services not explicitly meeting the needs of this client group.
People may engage in chemsex because of problems with intimacy and relationships, as well as wider social pressures such as intimacy, body image and the need for connection with others. If you have grown up hearing that gay people are inferior, it is more likely that you enter adulthood repressing who you are and guarding against intimacy. Relationships can, and often do, start online, but it’s also easy to organise hook-ups on gay dating apps which can also give easy access to chems.
Although London is the epicentre of the chemsex scene, it is on the rise across the UK. In 2014, Public Health Wales highlighted the link between rising HIV among gay men and chemsex.
At present, there are very limited services directly offering support to MSM in Wales around chemsex. The nearest specialist service would be Manchester, and clients are unlikely to access this readily.
Cases of HIV in Wales reached at an all time high in 2016. There were 189 positive tests in 2014, according to newly released figures which relates to data from STI clinics.
Giving out free condoms and prescribing pre-exposure prophylaxis (Prep) for those most at risk are among measures suggested to tackle the problem, along with a joint approach from both sexual health and substance misuse services to support clients who are using chemsex.