Chem-Sex: A Substance Use Therapist Explains this Epidemic among Gay Men

What is Chem-Sex?

With chem-sex, we see a unique presentation of symptoms, behaviors and triggers that clinicians must understand in order to provide proper treatment. Chem-sex is particularly pervasive in the LGBTQIA+ community. Over the past couple of decades, there is a growing problem of chem-sex with gay cis men who use crystal meth in particular. While many therapists are well-versed in addiction, very few providers are educated on the nuances of this specific presentation. Clients who engage in chem-sex have often developed a bind, where sex and substances rarely exist separately. Therefore, teaching clients to develop  a new relationship with their sexuality—one that is absent from any exogenous substance—is a complex task. Clients will need help identifying their sexual ideals, and differentiating healthy from unhealthy sexual behaviors. They will need to address underlying shame that drives the need to engage in chem-sex in the first place. And finally they will need community support to remain accountable and committed to their recovery.

Here are my top tips for treating chem-sex:

1. Avoid triggers, such as hook-up apps.

2. Find a therapist who specializes in chem-sex.

3. Identify healthy & unhealthy sexual behaviors.

4. Create a safety plan, with bottom-line behaviors.

5. De-catastrophize cravings (they will happen).

6. Stay accountable with your support system.