The link between the use of substances and sexual behaviour is close and complex and extends back long into human history. The term chemsex was first used to describe very particular circumstances – the use of drugs, sometimes specifically methamphetamine and or mephedrone, and sometimes specifically injecting these drugs, by men who have sex with men and specifically in contexts where sex involves multiple partners.

From these origins, the term came to be used to describe the use of stimulant or other drugs more generally in this context or in the context of men having sex with a single partner especially using ‘hook up’ apps like Grindr.

The term is useful in describing the close association between sexual behaviours substance use and associated risk and the close relationship between these for some people. In working with people involved, the term ‘sober sex’ emerged as a way to describe sex that did not involve the use of substances.

The term is not generally contested. However there is awareness that the term could be applied to any situation where a person is involved in sexual activity while using any substance. Such a broadening of the definition may be unhelpful and it may be necessary to define what experience and behaviour is being referred to when using this term.

There is also awareness that it may appear that people other than men who have sex with men are not engaged in sex, possibly involving multiple partners and substance use – which is, of course, untrue and in moralising discourses may stigmatise men who have sex with men. There are therefore potential ambiguities in its use.

Where people report dependency it seems to be on chemsex rather than the substances they are using. Thus, if it is regarded as a problem chemsex is regarded as a sexual and relationship problem rather than a substance problem. In terms of treatment and support, in practice, focus seems to have settled on relationships and sex rather than on substances. There is an obvious and significant role for harm reduction also. It is possible that, in developing drug treatment services which were more generally lgtbt+ ‘friendly’ or focussed, the perception of chemsex and how people might be supported may change.

The term is most effectively used when the intended meaning is made clear and then the term chemsex becomes a shorthand for this particular definition in the context.