Chemsex Can Lead to Psychosis

People who have sex and consume drugs at the same time have a higher probability of developing symptoms linked to the psychotic sphere. Why? In this article we'll explain.
Chemsex Can Lead to Psychosis
Gorka Jiménez Pajares

Written and verified by the psychologist Gorka Jiménez Pajares.

Last update: 11 June, 2024

Chemsex is a concept that refers to ‘behaviors that mix sex, drugs, and pleasure’. While this mix of elements and experiences, might seem captivating, it’s attracted the attention of researchers. And they claim that “the practice of chemsex can be a springboard to psychosis.” It seems that these risky experiences are one of the great health challenges facing today’s society.

Indeed, there are multiple undesirable consequences of this practice, both in the medium and long term and on a physical and psychological scale. For example, it’s known that behaviors that gravitate around unprotected sex where drugs are also consumed, increase the risks of suffering from AIDS, hepatitis, and other sexually transmitted diseases.

As far as mental health is concerned, this practice is linked to the development of psychotic symptoms in up to four out of ten users. In fact, psychosis is one of the most frequent clinical disorders suffered by those who practice chemsex. However, it’s far from the only one. It’s also related to a high risk of suffering from depression, social phobia, and anxiety-related disorders.

“The use of stimulant drugs in the context of chemsex may increase the risk of psychosis and other mental disorders.”

-Michael Brady-

Sex, drugs, and pleasure: a dangerous cocktail

The kind of individual who practices chemsex is well-defined. They’re usually male, homosexual, and single, aged between 25 and 45, of high socioeconomic status (McCall et al., 2015). Cases of this sexual practice are also reported among the transsexual and heterosexual population, although to a lesser extent.

Among the most consumed substances are the following (McCall et al., 2018):

  • Mephedrone. A psychostimulant.
  • Methamphetamines. Substances with psychostimulant effects similar to mephedrone.
  • GHB (ecstasy). A central nervous system depressant. It produces the perception of pleasure.

Individuals who frequently practice chemsex tend to be polydrug users. This means they consume two or more substances simultaneously and repeatedly. Time is also a crucial element.

As a matter of fact, individuals might engage in chemsex for hours or even days. Therefore, it’s common for the partners with whom they have sex to change several times within the same chemsex ‘session’. If they consume the drugs intravenously, it’s known as slamsex (Drevin et al., 2021).

“The growth of this phenomenon has been closely related to the proliferation of dating on geosocial networks, such as Grindr.”

-Juan-Miguel Guerras-

Silhouette of woman lying down smoking
If the drugs used during sex are intravenous, the practice is known as slamsex.

Chemsex and psychosis: a public health problem

In 2022, Dr. Lucía Moreno-Gámez conducted an investigation. She and his colleagues analyzed the relationship between chemsex and the development of psychotic symptoms. Some of the elements they defined could potentially explain the appearance of psychotic symptoms associated with this practice (Moreno-Gámez et al., 2022). For example:

These factors constitute, in combination, a springboard to mental illness. Yet, the association between chemsex and psychotic symptoms hasn’t been studied to a great extent up until now.

“Cases of auditory, tactile, and visual hallucinations and delusions have been reported in up to 80 percent of cases.”

-Patricia Gavín-

Psychotic symptoms exhibited by those who practice chemsex

In virtually all of the studies that Moreno-Gámez analyzed, psychotic symptoms were mentioned as being prevalent among chemsex practitioners. In fact, the percentage of symptoms of this type ranged from 7.7 percent (Hibert et al., 2021) to 37.2 percent (Gavin et al., 2021).

Within the psychotic symptoms that occur most frequently among chemsex practitioners are paranoid delusions, visual hallucinations, and delusions of self-reference, as well as those of persecution. In most cases, these last less than a month. Consequently, a large percentage of subjects only fulfill the diagnostic criteria for the label of schizophreniform disorder or brief psychotic disorder.

Psychotic symptoms can  be directly linked to drug use over a long period of time (Schreck et al., 2020). In the context of the practice of slamsex, it’s suggested that the risk of developing psychotic symptoms such as those described above is multiplied up to three times (Dolengevich et al., 2019).

“Chemsex is a self-destructive spiral that can lead to death.”

-Dr Miguel Ángel López-Ruz-

Young people consume alcohol and drugs
The consumption of alcohol and drugs during the practice of chemsex increases the risk of developing psychosis.

A look to the future

As we’ve already mentioned, there’s a risk of developing symptoms of psychosis as a consequence of this pernicious sexual practice. And, it’s a high risk. If we make a comparison between the percentage of psychotic symptoms in the general population and relate it to the percentage of psychotic symptoms in chemsex practitioners, it’s easier to understand (van Os et al., 2009).

  • Five out of 100 people experience psychotic symptoms in the general population.
  • In the population that practices chemsex, more than 37 out of 100 experience psychotic symptoms.

At the beginning of the practice, a multitude of factors can increase the possibility of individuals carrying out chemsex. For example, trauma, adverse events, and avoidant attachment styles.

In conclusion, this habit includes the use of drugs together with unprotected sex. These are two aspects that, in combination, increase the probability of developing psychotic symptoms.

“There is an association between the practice of chemsex and the risk of developing psychosis, and our findings suggest that this symptomatology may be more frequent than previously thought.”

-Lucía Moreno-Gámez-

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Drevin, G., Rossi, L. H., Férec, S., Briet, M., & Abbara, C. (2021). Chemsex/slamsex-related intoxications: A case report involving gamma-hydroxybutyrate (GHB) and 3-methylmethcathinone (3-MMC) and a review of the literature. Forensic science international321, 110743.
  • Dolengevich-Segal, H., Gonzalez-Baeza, A., Valencia, J., Valencia-Ortega, E., Cabello, A., Tellez-Molina, M. J., Perez-Elias, M. J., Serrano, R., Perez-Latorre, L., Martin-Carbonero, L., Arponen, S., Sanz-Moreno, J., De la Fuente, S., Bisbal, O., Santos, I., Casado, J. L., Troya, J., Cervero-Jimenez, M., Nistal, S., Cuevas, G., … U-SEX GESIDA 9416 Study (2019). Drug-related and psychopathological symptoms in HIV-positive men who have sex with men who inject drugs during sex (slamsex): Data from the U-SEX GESIDA 9416 Study. PloS one14(12), e0220272.
  • Guerras, J. M., Hoyos, J., Donat, M., De La Fuente, L., Palma, D., Ayerdi, O., & Garcia Perez, J. N. (2022). Sexualized drug use among men who have sex with men in Madrid and Barcelona: The gateway to new drug use? Front. Public Health, 10.
  • Hibbert, M. P., Germain, J. S., Brett, C. E., Van Hout, M. C., Hope, V. D., & Porcellato, L. A. (2021). Service provision and barriers to care for men who have sex with men engaging in chemsex and sexualised drug use in England. International Journal of Drug Policy, 92, 103090.
  • McCall, H., Adams, N., Mason, D., & Willis, J. (2015). What is chemsex and why does it matter? BMJ (Clinical research ed.)351, h5790.
  • Moreno-Gámez, L., Hernández-Huerta, D., & Lahera, G. (2022). Chemsex and Psychosis: A Systematic Review. Behavioral Sciences, 12(12), 516.
  • Strasser, M., Halms, T., Rüther, T., Hasan, A., & Gertzen, M. (2023). Lethal Lust: Suicidal Behavior and Chemsex—A Narrative Review of the Literature. Brain Sciences, 13(2), 174.
  • Schreck, B., Guerlais, M., Laforgue, E., Bichon, C., Grall-Bronnec, M., & Victorri-Vigneau, C. (2020). Cathinone use disorder in the context of slam practice: new pharmacological and clinical challenges. Frontiers in Psychiatry, 11, 705.
  • Van Os, J., Linscott, R. J., Myin-Germeys, I., Delespaul, P., & Krabbendam, L. (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological medicine39(2), 179–195.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.