A collaborative response to Chemsex & GHB usage

Chemsex refers to the use of substances to facilitate or enhance sexual experience. The 3 most commonly used drugs in a sexual context include Gamma Hydroxybutyrate (GHB) & Gamma Butyrolactone (GBL), Methamphetamines, and Mephedrone. There are a number of complications that have arisen from chemsex, and the use/dependence on GHB. This included an increase in the incidence of HIV, and sexually transmitted diseases, and presentations to Emergency Departments with GHB/GBL overdoses or withdrawals. A 2016 survey of men who have sex with men, by the Gay Men’s Health Service revealed that 1 in 4 participants engaged in chemsex in the previous 12 months, and this population was more likely to have had more sexual partners and have had condomless anal sex.

The Chemsex Working Group, Ireland is a multidisciplinary, and multi-sectoral organisation established to address the harms associated with chemsex and drug use as well as facilitate sexual health and drug addiction staff training. The Chemsex Working Group is an integration of a number of services within Sexual Health and within Addictions. These services include the HSE-National Drug Treatment Centre, Gay Men’s Health Service, Rialto Community Drug Team, HIV Ireland, National Public Health, Social Inclusion and Vulnerable Groups, and the Sexual Health Department in St. James’ Hospital. Some of the successful harm reduction campaigns included posters, videos and "G Cards" as well as emergency management information packs.

Intervention settings that were highlighted within the Chemsex Working Group regarding addressing the target population included primary (where harm reduction advice and information on chemsex and GHB/GBL was given), secondary (in settings where the harmful use of GHB/GBL could be detected), and tertiary (which included managing the harmful effects, detoxification, and rehabilitation).

The GHB Detoxification Clinic was developed to manage withdrawals from GHB, and the scope of this clinic has recently included the treatment of withdrawals from Methamphetamines. Since its inception, there have been 104 detoxification episodes, with approximately 80% being completed on an outpatient basis. 23% of the clinic's service users are heterosexual male, 23% are heterosexual female, and 54% are homosexual male. The relapse rate of GHB/GBL usage is similar to international figures of approximately 70%. Management also includes streamlined referrals to relevant services and being involved in campaigns focused more on harm reduction advice with an emphasis on personal safety.

Competently addressing chemsex is challenging. It is evident that that harm reduction measures and treatment interventions must tackle drug use together with sexual health and mental health.