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
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.