Why Are More Gay Men Injecting Methamphetamine: the Rush, Pleasure or Kinship?
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Chemsex or party and playing (PnP) has steadily been on the rise among gay men for at least the last decade. Anecdotal information suggests that it saw a huge surge during the Covid-19 pandemic, in particur the practice of slamming or injecting methamphetamine.
Slamming is the intravenous injection of crystal methamphetamine (also known as crystal meth, tina and ice). Similar to chemsex involving different substances (including GHB/GBL, mephedrone, MDMA and, to a lesser extent, cocaine and ketamine), slamming can take place before or during sexual activity to facilitate, prolong or enhance the sexual experience.
In 2016 a study noted that gay couples who slammed (or injected drugs) often did it together, according to research. Contrastingly, single gay men who practiced chemsex were usually introduced to it following a breakup or at the beginning of an aggressive relationship with a drug-using partner. For those who had suffered from a serious breakup prior to their drug use, many claimed drugs were a way to “free” themselves sexually from their monogamous relationship.
Following that study a recent look took these findings and increased concern around chemsex into consideration. AIDSmap: the EU’s Drug Strategy 2021-2025 included LGBTI+ people for the first time. It emphasises the importance of recognizing the diversity of people who uses drugs but it only refers to the LGBTI+ community once in general and still does not address chemsex in particular.
For Thijs Albers’s study, 25 men who have sex with men and had previously engaged in chemsex participated in semi-structured interviews to share their experiences with and opinions on personal and social dynamics around slamming. The interviews took place in 2020 and due to COVID-19, most were conducted online. The majority (22) of the men identified as gay, two as bisexual, and one as straight. The ages of the men ranged from 22 to 75, with an average age of 46. Most participants (21) were born and raised in the Netherlands, 9 lived in a big city, 15 were single, 10 were in a committed relationship, and 6 were married (2 with women).
The research aimed to identify the men’s psychosocial reasons for slamming; the interviews covered various topics including the advantages and disadvantages of sexualised crystal methamphetamine use, settings where slamming takes place and partners are found, and sexual, physical and mental health. The findings of the study were analysed in two categories: individual and social factors motivating slamming.
At sex parties I became increasingly curious to the intense effect of the rush I saw developing in others. If I asked about the added value, people always answered: ‘there are no words to describe the rush’. They were right. After a slam Tina all boundaries dissipate. The effect is intense and euphoric.” – 29 years
Participants used words such as “intense”, “horny”, “overwhelming” and “perfection” to describe the feelings following slamming. In addition, some mentioned the erotic nature of the preparation of the materials, the injection, and watching others anticipate and experience the rush.
“A lot of slammers become addicted to the ritual. The strong rush you crave or that you see develop in the other person. After a slam, a person’s voice drops a few octaves and he adopts a different body posture. That has something animalistic, I find that erotic. Also when I watch slam videos, I get a kick from the effect of the rush, the moment the drug is coursing through the bloodstream. Others enjoy the rush directly after the slam.” – 44 years
Another reason mentioned by many participants was feeling less sexually inhibited, which can facilitate different sexual practices. Some mentioned how slamming can change their perception of an act.
Some participants highlighted the role of online spaces in finding other men who slam. According to them, the internet enabled men to find others with similar interests. The code words used (such as Party and Play, PnP, Tina, T, High and Horny, HnH) and emojis (such as candy, clouds and ice cubes) helped them find chemsex and slamming partners faster and easier.
“Through a dating app I had contact with a guy living around the corner. We met up and had sex and used for the whole weekend. When I was evicted from my room the next week I moved in with him. We became roommates and fuckbuddies, going to sex parties together.” – 25 years
They concluded:
Although men who engage in chemsex use harm reduction techniques to a greater or lesser extent, Albers emphasises “the need for the increased adoption of harm reduction techniques in the population of MSM who have chemsex, focusing on mitigating harm and prevention of risk of ‘problematic’ use”.
The strategies and programmes aiming to reduce the harm associated with substance use need to be informed by users’ experiences if they are to address their needs. Therefore, understanding the lived experience of pleasure, drugs and sex is a core component of developing effective harm reduction programmes for chemsex.
The timing of this study dovetails with another report from Australia that found: a third of gay and bisexual men who engage in chemsex in Australia said they would feel comfortable discussing chemsex with their family doctor/general practitioner, according to a study by Dr Daniel Demant and colleagues recently published in Addictive Behaviours Reports. Most men agreed they knew where to access relevant information on harm reduction and chemsex, but many participants were worried about being judged by health professionals.
More participants would feel comfortable talking to a sexual health doctor (59%), sexual health counsellor (53%), sexual health nurse (46%) or community health worker (44%) than general practitioners (34%) and general counsellors (36%). In addition, a significant portion of the participants have felt that they would be judged by health professionals. This concern was a barrier to accessing health services as those who feared judgement knew less about where to access professional help or harm reduction information. Furthermore, only a small part of the participants have discussed chemsex with any health care professional at all.
Researchers emphasise the role of trustworthiness and relevancy of the information received on information-seeking behaviours and conclude there is room for improvement for community organisations and sexual health services.
They recommend community organisations “establish stronger relationships with this community to understand their information needs and information-seeking behaviour. Engaging in co-design processes has the potential to lead to resources and offerings of higher relevance for this population, particularly low-threshold interventions and offerings that may allow to reach a substantial proportion of people engaged in chemsex.”
They add that “sexual health services should consider targeted education of medical and nursing staff on chemsex and to communicate the availability of such expertise to the community.”
