HEALTHCARE PROFESSIONALS

Supporting Chemsex Clients

It can be difficult to know what to do or how to respond to a patient who discloses chemsex usage, however, here are some tips on how to deal with patients or service users in this position safely, non-judgementally and in a harm-reducing way.

How to Talk About Chemsex

In general, there are a few recommended ways to talk about chemsex with users, even if you don't have much prior knowledge. However, we do advise having some basics down, such as knowing what chemsex is, terminology specific to chemsex use and how parties are organised. Most of this information can be found in our resource hub.

It is also worth noting that, whilst the main substances used in chemsex are crystal emth, GHB/GBL and mephedrone, chemsex addiction is not just limited to these three drugs. Chemsex can incude many other kinds of substances, and if an individual has problematic use with any substance combined with sex, generally we can define this as chemsex and offer support.

Health Concerns

In engaging with chemsex, apart from the risks associated with drug use and riskier sexual practices, several health concerns may be present for people dealing with chemsex. Physical health concerns include exposure to HIV and STIs, addiction to substances, risk of overdosing, fatigue and drugs interacting with other substances, legal or illegal.

Mental health and social concerns for people engaged in chemsex include social isolation, potetial sexual assault, abusive power dynamics, debt, failing to meet responsibilities (work, family, parters, etc.), mental distress and psychosis.

It's important to note that these concerns and health problems are not exhaustive, and it's important to listen to people engaged in chemsex to take a personal and holistic approach to their care.

Harm Reduction

Service providers can make a big difference by offering harm reduction support in a non-judgmental way. Many people who engage in chemsex may be nervous about stigma, so being open, respectful, and practical is key.

You can support safer sex by providing condoms, water-based lube, and gloves (including for fingering and fisting). Referring people to PrEP services and encouraging regular sexual health check-ups is also important.

If someone injects, offer a needle and syringe exchange. This should include sterile needles, syringes, filters, spoons, water, and vitamin C or citric acid. Supplying full kits helps prevent infections and injuries.

Talk about safer injecting practices in simple terms. For example, explain the difference between veins and arteries, show how to rotate injection sites, and stress the importance of using clean equipment every time. More advice around injecting substances (called 'slamming') can be found here.

Service providers can also share harm reduction information about different chems, safer dosing, and the risks of mixing drugs. Signpost people to mental health services, chemsex-specific support groups, or LGBTQ+ community organisations.

Above all, offering a safe space without judgment helps people feel supported and more able to make healthier choices.

How to Talk About Chemsex

When talking about chemsex, it’s important to use neutral, respectful, and non-judgemental language. Avoid phrases that might make someone feel ashamed or stereotyped, such as “I know this is a weird question, but…”, “I’m sure you’re not doing this, but…”, “You don’t look like the type, but…”, or “Are you a drug addict?”.

Instead, use open-ended questions that encourage discussion. Try asking, “Do you use party drugs, and which ones?”, “Are you having a good time when doing this?”, or “The drugs you describe using are often used in chemsex parties, is that something you engage in?” These questions show curiosity and support rather than judgment.

Key principles for professionals include being curious rather than judgmental, avoiding labels, and keeping conversations practical and focused on safety. Support people in making informed choices about their use, reassure them that their information is confidential, and create a space where they feel comfortable sharing.

Responding to Disclosures

It can be difficult to give advice, as every person’s situation is individual. However, a harm reduction approach is the safest way to support someone engaging in chemsex. Encourage people to use drug testing kits, such as those available from LGBT Foundation, to check drug purity. Advise avoiding mixing drugs with other substances or alcohol. A “low and slow” approach is safer, meaning taking small doses and spacing them out; using a timer can help and be used easily on a person's pho.

Teach people the recovery position in case of an overdose, and always call an ambulance if someone becomes unresponsive. Encourage planning a safe route home and setting a clear time for leaving a session. Refer people to support groups or services such as LGBT Foundation Recovery or The REACH, all accessible via our website.

Advise never to share needles or any injecting equipment, including douching supplies. Promote regular sexual health testing every three months, and the use of condoms, lube, PEP, and PrEP when needed. Finally, encourage doing as much as possible sober and with people they trust.

Why People Engage in Chemsex

There are many reasons why someone may engage in chemsex. People may want to feel more sexually free, reduce inhibitions, or pursue desires that feel difficult without substances.

Some use drugs to feel more connected to others or to enhance sexual experiences, such as having longer-lasting sex or reducing performance pressure. Certain types of sex, like fisting, can feel easier or more pleasurable with chem use. Peer influence can also play a role.

Beyond sexual reasons, people may use chemsex to cope with stress, anxiety, loneliness, or past trauma. It can provide a sense of escape, belonging, or emotional release. For many, pleasure and enjoyment remain key motivators.

Understanding these diverse reasons helps professionals provide non-judgmental, tailored support.

Barriers to Support

People who engage in chemsex may face several barriers when seeking support. Lower self-esteem, reduced sexual confidence, and higher anxiety can make it harder to ask for help. Relationship difficulties or experiences of abuse can also contribute to feelings of isolation.

Many individuals come from families or communities that are queer-phobic, which can increase fear of stigma or rejection. Men living with HIV may use chemsex to cope with HIV-related stigma. Additionally, people often anticipate judgment from others, including health professionals, which can prevent them from reaching out for the support they need.

To reduce these barriers, it’s essential to respond without judgment, even if someone’s disclosure is surprising or unexpected. Ask questions carefully and in an open way that does not carry prejudice. Using direct, supportive questions—such as “What do you know about chemsex?”—helps create a safe space where people feel comfortable sharing and accessing support.

Referrals for Support

If someone you are supporting is engaged in chemsex, several UK-based services provide confidential support, harm reduction advice, and peer guidance. Here are some key resources you can access:

LGBT Foundation – Peer support and guidance for LGBTQ+ people. https://www.lgbt.foundation
London Friend – Antidote Service – Support for LGBTQ+ people navigating chemsex and mental health. https://londonfriend.org.uk/chemsex-support/
The REACH – Harm reduction advice and support for chemsex users. https://www.thereach.london
Chemsafe.Space – UK-wide chemsex harm reduction resources and service finder. https://chemsafe.space
Club Drug Clinic (London) – Specialist support for GHB, meth, and mephedrone use. https://clubdrugclinic.com
SMART Recovery UK – Peer support for reducing or stopping substance use. https://www.smartrecovery.org.uk
NHS Sexual Health Services – Find your nearest clinic by postcode. https://www.nhs.uk/service-search/sexual-health/find-a-sexual-health-clinic