When "Chems" Meet Sex: A Rising Phenomenon Called "ChemSex"

Raffaele Giorgetti, Adriano Tagliabracci, Fabrizio Schifano, Simona Zaami, Enrico Marinelli, Francesco Paolo Busardò, Raffaele Giorgetti, Adriano Tagliabracci, Fabrizio Schifano, Simona Zaami, Enrico Marinelli, Francesco Paolo Busardò

Abstract

Background: The term "chemsex" was coined to indicate the voluntary intake of psychoactive and non psychoactive drugs in the context of recreational settings to facilitate and/or to enhance sexual intercourses mostly among men who have sex with other men (MSM).

Objective: The authors aimed to review the mechanisms of action, the toxicity and the pattern of use and abuse of substances involved in "chemsex" practice together with the sociocultural background underlying it and the health-related consequences that they may have.

Results: Gamma-hydroxybutyrate, gamma-butyrolactone,1,4-butanediol, mephedrone, methamphetamine, sildenafil, tadalafil, vardenafil and alkyl nitrites have been described in their role of "chemsex drugs" including pharmacological action and in their implication to impair capacities to chose sexual partners and consensual sex. Moreover, it has been demonstrated that sexual activity over protracted length of time under the influence of chemsex drugs can result in rectal trauma or penile abrasions and a significant increase of the risk of transmission of sexual transmitted diseases, especially in case of condomless intercourses, which are frequent in this context, representing therefore a serious health threat.

Conclusion: One of the major problems to establish health policy priority interventions for chemsex is the lack of available epidemiological data on the issue. Finally, social actions should be taken in order to break down the barriers that currently exist among chemsex drug users in accessing services, including the shame and stigma often associated with drug use. In conclusion, more specific resources to face high risks of infections and HIV transmission are required in bisexual and homosexual individuals having SUID: sex under the influence of drugs.

Keywords: Chemsex; GHB; crystal meth; erectile dysfunction agents; mephedrone; poppers; viagra.

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Figures

Fig. (1)
Fig. (1)
Dose-related effects of GHB.

References

    1. McCall H., Adams N., Mason D., Willis J. What is chemsex and why does it matter? BMJ. 2015;351:h5790. [ 10.1136/bmj.h5790]. [PMID: 26537832].
    1. Bourne A., Reid D., Hickson F., Torres-Rueda S., Weatherburn P. Illicit drug use in sexual settings (chemsex) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex. Transm. Infect. 2015;91(8):564–568. []. [PMID: 26163510].
    1. Hunter L.J., Dargan P.I., Benzie A., White J.A., Wood D.M. Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM. Postgrad. Med. J. 2014;90(1061):133–138. [http://dx. ]. [PMID: 24390619].
    1. Kirby T., Thornber-Dunwell M. High-risk drug practices tighten grip on London gay scene. Lancet. 2013;381(9861):101–102. [http:// ]. [PMID: 23320280].
    1. Theodore P.S., Durán R.E., Antoni M.H. Drug use and sexual risk among gay and bisexual men who frequent party venues. AIDS Behav. 2014;18(11):2178–2186. [ s10461-014-0779-y]. [PMID: 24770947].
    1. Bracchi M., Stuart D., Castles R., Khoo S., Back D., Boffito M. Increasing use of party drugs in people living with HIV on antiretrovirals: a concern for patient safety. AIDS. 2015;29(13):1585–1592. []. [PMID: 26372268].
    1. Busardò F.P., Jones A.W. GHB pharmacology and toxicology: acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome. Curr. Neuropharmacol. 2015;13(1):47–70. [ 1570159X13666141210215423]. [PMID: 26074743].
    1. Corkery J.M., Loi B., Claridge H., Goodair C., Corazza O., Elliott S., Schifano F. Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use. Neurosci. Biobehav. Rev. 2015;53:52–78. [http://dx. ]. [PMID: 25843781].
    1. Brunt T.M., van Amsterdam J.G., van den Brink W. GHB, GBL and 1,4-BD addiction. Curr. Pharm. Des. 2014;20(25):4076–4085. []. [PMID: 24001290].
    1. Hutchins D.A., Rayevsky K.S., Sharman D.F. The effect of sodium -hydroxybutyrate on the metabolism of dopamine in the brain. Br. J. Pharmacol. 1972;46(3):409–415. [ 10.1111/j.1476-5381.1972.tb08138.x]. [PMID: 4656604].
    1. Busardo F.P., Kyriakou C. GHB in biological specimens: which cut-off levels should be taken into consideration in Forensic Toxicological Investigation? Recent Pat. Biotechnol. 2014;8(3):206–214. []. [PMID: 27099144].
    1. Pichini S., Farré M., Abanades S., Pacifici R., Zuccaro P., Langohr K., de la Torre R. Immunomodulating properties of gamma-hydroxybutyrate (GHB), flunitrazepam and ethanol in club drugs users. Addict. Biol. 2010;15(3):336–345. [. 1111/j.1369-1600.2010.00210.x]. [PMID: 20456291].
    1. Pichini S., Marchei E., Pacifici R., Marinelli E., Busardò F.P. Chemsex intoxication involving sildenafil as an adulterant of GHB. Drug Test. Anal. 2016 [ahead of print]. [ dta.2054]. [PMID: 27527498].
    1. Busardò F.P., Kyriakou C., Napoletano S., Marinelli E., Zaami S. Mephedrone related fatalities: a review. Eur. Rev. Med. Pharmacol. Sci. 2015;19(19):3777–3790. [PMID: 26502870].
    1. Weaver M.F., Hopper J.A., Gunderson E.W. Designer drugs 2015: assessment and management. Addict. Sci. Clin. Pract. 2015;10:8. []. [PMID: 25928069].
    1. Patel N.B. Mechanism of action of cathinone: the active ingredient of khat (Catha edulis). East Afr. Med. J. 2000;77(6):329–332. [PMID: 12858935].
    1. Kelly J.P. Cathinone derivatives: a review of their chemistry, pharmacology and toxicology. Drug Test. Anal. 2011;3(7-8):439–453. []. [PMID: 21755607].
    1. Dybdal-Hargreaves N.F., Holder N.D., Ottoson P.E., Sweeney M.D., Williams T. Mephedrone: Public health risk, mechanisms of action, and behavioral effects. Eur. J. Pharmacol. 2013;714(1-3):32–40. []. [PMID: 23764466].
    1. Bourne A., Reid D., Hickson F., Torres-Rueda S., Weatherburn P. Illicit drug use in sexual settings (chemsex) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex. Transm. Infect. 2015;91(8):564–568. []. [PMID: 26163510].
    1. Schifano F., Albanese A., Fergus S., Stair J.L., Deluca P., Corazza O., Davey Z., Corkery J., Siemann H., Scherbaum N., Farre M., Torrens M., Demetrovics Z., Ghodse A.H. Mephedrone (4-methylmethcathinone; meow meow): chemical, pharmacological and clinical issues. Psychopharmacology (Berl.) 2011;214(3):593–602. []. [PMID: 21072502].
    1. Angoa-Pérez M., Kane M.J., Francescutti D.M., Sykes K.E., Shah M.M., Mohammed A.M., Thomas D.M., Kuhn D.M. Mephedrone, an abused psychoactive component of bath salts and methamphetamine congener, does not cause neurotoxicity to dopamine nerve endings of the striatum. J. Neurochem. 2012;120(6):1097–1107. [PMID: 22191803].
    1. Vardakou I., Pistos C., Spiliopoulou Ch. Drugs for youth via Internet and the example of mephedrone. Toxicol. Lett. 2011;201(3):191–195. []. [PMID: 21187132].
    1. Vaiano F., Busardò F.P., Palumbo D., Kyriakou C., Fioravanti A., Catalani V., Mari F., Bertol E. A novel screening method for 64 new psychoactive substances and 5 amphetamines in blood by LC-MS/MS and application to real cases. J. Pharm. Biomed. Anal. 2016;129:441–449. []. [PMID: 27490334].
    1. Kouvelas D., Goulas A., Papazisis G., Sardeli C., Pourzitaki C. PDE5 inhibitors: in vitro and in vivo pharmacological profile. Curr. Pharm. Des. 2009;15(30):3464–3475. [. 2174/138161209789206971]. [PMID: 19860692].
    1. Ashour A.E., Rahman A.F., Kassem M.G. Vardenafil dihydro-chloride. Profiles Drug Subst. Excip. Relat. Methodol. 2014;39:515–544. []. [PMID: 24794912].
    1. Yuan J., Zhang R., Yang Z., Lee J., Liu Y., Tian J., Qin X., Ren Z., Ding H., Chen Q., Mao C., Tang J. Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis. Eur. Urol. 2013;63(5):902–912. [ 10.1016/j.eururo.2013.01.012]. [PMID: 23395275].
    1. Romanelli F., Smith K.M. Recreational use of sildenafil by HIV-positive and -negative homosexual/bisexual males. Ann. Pharmacother. 2004;38(6):1024–1030. [ aph.1D571]. [PMID: 15113986].
    1. Fisher D.G., Malow R., Rosenberg R., Reynolds G.L., Farrell N., Jaffe A. Recreational viagra use and sexual risk among drug abusing men. Am. J. Infect. Dis. 2006;2(2):107–114. [http://dx. ]. [PMID: 17191089].
    1. Chu P.L., McFarland W., Gibson S., Weide D., Henne J., Miller P., Partridge T., Schwarcz S. Viagra use in a community-recruited sample of men who have sex with men, San Francisco. J. Acquir. Immune Defic. Syndr. 2003;33(2):191–193. [http://dx.doi. org/10.1097/00126334-200306010-00012]. [PMID: 12794553].
    1. Fisher D.G., Reynolds G.L., Napper L.E. Use of crystal methamphetamine, Viagra, and sexual behavior. Curr. Opin. Infect. Dis. 2010;23(1):53–56. [. 0b013e328334de0b]. [PMID: 19918176].
    1. Harte C.B., Meston C.M. Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors. Arch. Sex. Behav. 2011;40(3):597–606. []. [PMID: 20358273].
    1. Solomon H., Man J., Gill J., Jackson G. Viagra on the internet: unsafe sexual practice. Int. J. Clin. Pract. 2002;56(5):403–404. [PMID: 12137453].
    1. Hanson G.R., Rau K.S., Fleckenstein A.E. The methamphetamine experience: a NIDA partnership. Neuropharmacology. 2004;47(Suppl. 1):92–100. [. 06.004]. [PMID: 15464128].
    1. Yu S., Zhu L., Shen Q., Bai X., Di X. Recent advances in methamphetamine neurotoxicity mechanisms and its molecular pathophysiology. . Behav. Neurol., . 2015;2015(103969) [http://dx. ] [PMID: 25861156]
    1. Kurtz S.P. Post-circuit blues: motivations and consequences of crystal meth use among gay men in Miami. AIDS Behav. 2005;9(1):63–72. []. [PMID: 15812614].
    1. Bolding G., Hart G., Sherr L., Elford J. Use of crystal methamphetamine among gay men in London. Addiction. 2006;101(11):1622–1630. [. 01571.x]. [PMID: 17034442].
    1. Melendez-Torres G.J., Bonell C., Hickson F., Bourne A., Reid D., Weatherburn P. Predictors of crystal methamphetamine use in a community-based sample of UK men who have sex with men. Int. J. Drug Policy. 2016;36:43–46. [ j.drugpo.2016.06.010]. [PMID: 27474800].
    1. Urbina A., Jones K. Crystal methamphetamine, its analogues, and HIV infection: medical and psychiatric aspects of a new epidemic. Clin. Infect. Dis. 2004;38(6):890–894. [ 381975]. [PMID: 14999636].
    1. Romanelli F., Smith K.M., Thornton A.C., Pomeroy C. Poppers: epidemiology and clinical management of inhaled nitrite abuse. Pharmacotherapy. 2004;24(1):69–78. [ phco.24.1.69.34801]. [PMID: 14740789].
    1. Lowry T.P. Psychosexual aspects of the volatile nitrites. J. Psychoactive Drugs. 1982;14(1-2):77–79. [. 1080/02791072.1982.10471914]. [PMID: 6126533].
    1. Wood R.W. The acute toxicity of nitrite inhalants. NIDA Res. Monogr. 1988;83:28–38. [].
    1. Vignal-Clermont C., Audo I., Sahel J.A., Paques M. Poppers-associated retinal toxicity. N. Engl. J. Med. 2010;363(16):1583–1585. []. [PMID: 20942681].
    1. Savary P., Biotti D., Abouaf L., Bernard M., Chaise F., Guerrier O., Tilikete C., Vighetto A. Poppers toxic maculopathy misdiagnosed as atypical optic neuritis. Eur. J. Neurol. 2013;20(7):e90–e91. []. [PMID: 23750837].
    1. Schulze-Döbold C., Ben Denoun M., Dupas B., Paques M., Massin P. Retinal toxicity in users of poppers. Ann. Intern. Med. 2012;156(9):670–672. []. [PMID: 22547484].
    1. Davies A.J., Kelly S.P., Bhatt P.R. Poppers maculopathyan emerging ophthalmic reaction to recreational substance abuse. Eye (Lond.) 2012;26(6):888. []. [PMID: 22402700].
    1. Jeon S.Y., Kim Y.J., Kim Y.H., Shin J., Yun J., Han K., Park H.K., Kim H.S., Cha H.J. Abuse potential and dopaminergic effect of alkyl nitrites. Neurosci. Lett. 2016;629:68–72. []. [PMID: 27369324].
    1. McGowan J.A., Sherr L., Rodger A.J., Fisher M., Miners A., Anderson J., Johnson M.A., Elford J., Collins S., Hart G., Phillips A.N., Speakman A., Lampe F.C. Antiretrovirals, sexual transmission risk and attitudes (ASTRA) study group. Age, time living with diagnosed HIV infection, and self-rated health. HIV Med. 2016 [Epub ahead of print].
    1. Lampe F.C. Sexual behaviour among people with HIV according to self-reported antiretroviral treatment and viral load status. AIDS. 2016;30(11):1745–1759. [. 0000000000001104]. [PMID: 27045375].
    1. Speakman A., Rodger A., Phillips A.N., Gilson R., Johnson M., Fisher M., Anderson J., OConnell R., Lascar M., Aderogba K., Edwards S., McDonnell J., Perry N., Sherr L., Collins S., Hart G., Johnson A.M., Miners A., Elford J., Geretti A.M., Burman W.J., Lampe F.C. The antiretrovirals, sexual transmission risk and attitudes (ASTRA) study. Design, methods and participant characteristics. PLoS One. 2013;8(10):e77230. []. [PMID: 24143214].
    1. Kirby T., Thornber-Dunwell M. High-risk drug practices tighten grip on London gay scene. Lancet. 2013;381(9861):101–102. [http:// ]. [PMID: 23320280].
    1. Colfax G., Guzman R. Club drugs and HIV infection: a review. Clin. Infect. Dis. 2006;42(10):1463–1469. [. 1086/503259]. [PMID: 16619161].
    1. Colfax G.N., Mansergh G., Guzman R., Vittinghoff E., Marks G., Rader M., Buchbinder S. Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: a venue-based comparison. J. Acquir. Immune Defic. Syndr. 2001;28(4):373–379. []. [PMID: 11707675].
    1. Rawstorne P., Digiusto E., Worth H., Zablotska I. Associations between crystal methamphetamine use and potentially unsafe sexual activity among gay men in Australia. Arch. Sex. Behav. 2007;36(5):646–654. []. [PMID: 17690971].
    1. Bourne A., Reid D., Hickson F., Torres-Rueda S., Steinberg P., Weatherburn P. Chemsex and harm reduction need among gay men in South London. Int. J. Drug Policy. 2015;26(12):1171–1176. []. [PMID: 26298332].
    1. Bourne A., Reid D., Hickson F., Torres-Rueda S., Weatherburn P. Illicit drug use in sexual settings (chemsex) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex. Transm. Infect. 2015;91(8):564–568. []. [PMID: 26163510].
    1. Bains M., Crook P., Field N., Hughes G. Safer chemsex: consideration of Shigella. Br. J. Gen. Pract. 2016;66(644):124. []. [PMID: 26917637].
    1. Gilbart V.L., Simms I., Jenkins C., Furegato M., Gobin M., Oliver I., Hart G., Gill O.N., Hughes G. Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales. Sex. Transm. Infect. 2015;91(8):598–602. []. [PMID: 25921020].
    1. Romanelli F., Smith K.M., Pomeroy C. Use of club drugs by HIV-seropositive and HIV-seronegative gay and bisexual men. Top. HIV Med. 2003;11(1):25–32. [PMID: 12717048].

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅