Life after chemsex

Taken from the new print issue of THE FACE. Get your copy here.

“I was in the worst place. 2020 was a dark year for me,” says Tommy Macnally. ​“I didn’t know where to go or who to turn to.” Video-calling from his home in Windsor, Tommy is a chipper, conventionally handsome man. He’s a recovery worker at Antidote, a bespoke LGTBQ+ drug and alcohol service in London. But until going sober six years ago, he was living a double life: holding down his job as a personal trainer while also attending ​“chillouts” – a specific form of sex party in which drugs are taken to enhance the experience – with alarming regularity. He would turn up on Monday to lead a 9am spin class, having not slept for four days, paranoid and afraid that his clients could tell.

This is a reality for many involved in chemsex, a still-growing scene of sexualised drug use primarily – although not exclusively – among gay and/​or bisexual men, and men who have sex with men (GBMSM). This can be enjoyed and managed, though, increasingly, many participants are unable to maintain control over it. Sexual encounters become chaotic or dangerous, users stop showing up for work, relationships with close ones fall apart, comedowns become debilitating and drug splurges eat into personal finances.

At the start of this year, the Office for National Statistics released data confirming that the risk of death by drug poisoning was 2.8 times higher for those identifying as lesbian, gay, bisexual or ​“other” versus those identifying as heterosexual. It also stated that males had a higher rate of death than females. A ​“Call For Evidence” surrounding chemsex was issued by the government at the end of last year. The community waits with baited breath.

Certainly the chemsex issue has been covered in the national press (“A ​‘silent crisis’” /​“How chemsex destroyed the life of a celebrity lawyer”), sensationalised (“Tracey Cox reveals why more straight women are trying out chemsex”) and has even appeared in primetime comedy (Alan Partridge does an exposé in This Time). PhDs have been dedicated to the matter, and even scene outsiders know the main drugs (“chems”) involved: crystal meth (“Tina”), liquid GBL and GHB (“G”),and mephedrone. But to get into the chemical detail: Tina and mephedrone are both stimulants. The former increases impulsiveness, confidence and sex drive; the latter increases alertness and affection. G, a sedative, is a logical complement to these, inducing euphoric effects and sexual arousal, and lowering inhibitions. Together, they combine the necessary stamina and relaxation for prolonged sex.

Now, we know you may well know all this. But for all the column inches dedicated to chemsex, little has been said of the life-saving work taking place behind the scenes – nor the success stories, such as Tommy’s. Before chems, his life was ​“lovely”. In his early twenties, he could go out, drink with his friends and have meaningful sex with someone he liked. ​“I’m glad I had that experience of the gay community. It feels like such a simpler time,” says the 37-year-old from Surrey. ​“There’d be a group of 15 of us and we’d all go out to G‑A-Y [at Heaven],” he says of the fabled London queer night. ​“I don’t have anything like that anymore.” At the time, drugs weren’t in his purview. Then, when he was into chems, his friendship group, understandably, was entirely made up of drug users. Now, he has drastically reshaped his life and has a much smaller circle. So what happened in between?

Before he himself was part of the chemsex scene, ​“I was in a relationship with someone who was lost in it when I met him, ​”Tommy says, noting that this partner never used with him. ​“I was naive and didn’t know anything about it. I saw this broken man, and I wanted to rescue him.” When their ​“quite toxic” relationship ended, Tommy fled to Sydney for afresh start. There, in search of new guys in a strange city, he looked to Grindr.

Soon enough, he was introduced to what Australians call ​“ice”, not knowing it was crystal meth. ​“All these seemingly happy, beautiful Australian men were taking it and having a great time. It just seemed to be what was done.” This was the perfect storm: as well as providing Tommy with the illusion of falling in love with every guy he met, ice was socially lubricating his new life, allowing him to form intense relationships fast. ​“Suddenly I was able to experiment sexually in ways that I was perhaps previously hesitant or shy to approach,” he remembers. ​“It was almost as if all judgement was off the table.” It also prolonged these sexual experiences. ​“What would normally be an anxiety-ridden half hour [of sober sex], where you’re wondering if they like you or are they enjoying it – all of that is removed. I became quite self-centred, doing what I felt was good, as was everyone else in that situation.

It might be easy to assume that chemsex is thrillseekers’ territory and that everyday people don’t fall into it. The experience of Tommy – a sober, thoughtful, far-from-reckless man – proves otherwise. And you can see the appeal: a lowering of inhibitions, reports of amazing sex and the ability to bypass self-esteem issues, especially if being queer is frowned upon in your immediate circle. For older men, the spectre of Section 28 – only abolished in the UK in 2003 – still lingers. According to the Sex Education Forum’s latest poll, from 2024, 60 per cent of LGBTQ+ students said that they don’t learn enough about sex. Queer hook-up culture bears little resemblance to heterosexual courtship models. It’s unique, and that’s special, but it also means the community is sometimes less equipped when things go awry.

And so, for Tommy, sex became dependent on drugs. Conscious that things had gotten out of hand, after 11 months in Australia he decided to come home. ​“I naively thought I could just get on a plane and leave this whole issue behind. No one would ever need to know about it.” The reality, as he discovered when he landed back in the UK in 2014, was very different. Chemsex culture? ​“I could see it everywhere.” Almost immediately, he fell into the London chem scene. Subtle codewords and hints he had barely noticed on Grindr – ​“H’n’H” (high and horny), ​“P’n’P” (party and play) – were now obvious and ubiquitous.

Over eight years of sexualised drug taking, Tommy’s life progressively unravelled. Eventually, during the pandemic lockdowns, Tommy – enmeshed in a life of lies and secrets and hedonism – found himself unemployed, back living with his parents and in thousands of pounds’ worth of debt. ​“I was using drugs on my own in the family house,” he admits. ​“I remember looking at myself in the mirror, in my parents’ spare bedroom, with the drugs, unable to believe I was here.”

Tommy’s wake-up call came when his sister’s partner committed suicide. When he asked if there was anything he could do to help, she simply made him promise he would never do the same. ​“It made me look at my life,” Tommy recalls contemplatively. ​“I wasn’t suicidal, but I certainly was struggling to find anything to get out of bed for other than drugs.”

His pathway to recovery began, although it wasn’t linear. ​“I literally just Googled ​‘gay drug support’.” The name of a Soho clinic, 56 Dean Street, came up. There, he met the late David Stuart, a chemsex and HIV advocate. The two figured out an arrangement: every day for six weeks, Tommy would email Stuart, sharing his motivation to remain in recovery. Stuart would respond, acknowledging that he was there to support him. Once those six weeks came to a close, Tommy attempted sober sex for the first time in close to a decade. Having not dealt with his triggers, he relapsed and carnage resumed. Then, he found out that Stuart had passed away. He continued to use, bereft and down- trodden. Eventually, Tommy’s despairing sister put him into therapy and he joined a 12-step programme. Finally, after being surrounded by death and despair, things really started to change for Tommy. After six months of sobriety, he applied to volunteer with Antidote. After 18 months, a full-time role came up; Tommy applied and got the job. Now, he provides one-to-one ​“listening” for queer people facing substance and alcohol problems (often stemming from chemsex), dispensing guidance and care.

Dr Naomi Fitzgerald is a sexual health consultant working at London’s King’s College Hospital, providing clinical support for people facing similar issues to Tommy. ​“I had a patient in his thirties who sadly died as a consequence of injecting crystal meth,” she says. ​“He developed endocarditis, which is a very severe infection of the heart. It’s where bacteria enters the bloodstream and infections develop on the valves of the heart.” We’re sitting inside a pub off Borough Market, a 10-minute Uber from Fitzgerald’s workplace. Slight and blonde, the 43-year-old speaks with a kind tone that jars against the clinical, often harrowing subject matter at hand.

For the past 10 years, Dr Fitzgerald has watched the chemsex problem in London grow. At first, in the 2010s, it was largely associated with pockets of Southwest London, taking root in Vauxhall before spreading across Oval and Stockwell – last year, The Fence dubbed this smattering of ​“chill- outs” The Tina Triangle.

“At King’s, from a year’s worth of data that we collected [from 2023 to 2024], roughly a third of admissions as a result of drugs were related to chems, which is a high proportion,” she says. Currently, Dr Fitzgerald is carrying out a study tracking deaths and incidents tied to chemsex. King’s runs a chemsex clinic in partnership with Antidote, and an HIV liaison psychiatry service, covering it and other hospitals in Southeast London, which offers special expertise on psychosis and addiction. King’s is also working with third-party organisations to expand its services.

According to a report published by ITV last year, police figures showed that in London, 2023, there were around three chemsex-related fatalities each month. Police feared that 2024 would see a record high. The same article also reported that, according to the London Ambulance service, at least one ambulance a day is believed to be called for chemsex-related drug use. Similarly, Greater Manchester Combined Authority published a report in 2023 signalling growth in sexualised drug use amongst GBMSM.

I ask Dr Fitzgerald how patients using chems present. ​“It depends where they’re at. Maybe some of my patients who are living with HIV start to miss appointments, or maybe we already know that they’ve developed an addiction to chems-related drugs.” There are also cases where patients tell her they’re considering chems, at which point her role becomes focused on educating them ​“without judgement”. In the more acute cases, people can end up homeless, losing their jobs, estranged from family and – as is increasingly the case – using chems in isolation, as well as in the context of sex. Tommy, certainly, can relate to that. ​“I was on my own, using on the hour, every hour, physically and psychologically dependent – just a complete prisoner to the substances.”

Consent and physical safety during sex on chems is a big concern. With G, it takes a misdose of one millilitre to make a potentially fatal error. ​“I have patients that come in and tell me that something has happened but they don’t know [what],” Dr Fitzgerald says. ​“If you’re inhibited cognitively, your brain is not functioning as it normally would. You can’t decide whether you’re wanting to do something or not. So, my argument is that, if someone thinks they’ve been sexually assaulted, it shouldn’t be treated any differently.” Nonetheless, many people are, understandably, put off reporting incidents to the police.

It’s a lot to manage as a physician, and no doubt well outside the remit of her job description. But Dr Fitzgerald shares Tommy’s passion for helping. ​“We as HIV and sexual health physicians have historically always been advocates for our patients,” she says. ​“That is [especially] par for the course if you’re looking after people of minority groups – trying to smooth out health inequalities and trying to raise awareness is really a part of the job. It is what we need to do.”

Combining charity and activism is a longstanding part of LGBTQ+ sexual health organising. This is made clear when I speak with Antidote’s founder, Monty Moncrieff. Video-calling from his home in London, the bearded 55-year-old – barbell piercing in his right ear, stretcher in the left – speaks with urgency and the kind of practised eloquence of someone who has had to fight to see change. His career in the queer wellbeing sector began in 1996, when he started volunteering at the legendary helpline Switchboard. He took calls, pre-Google, as people sought information on things like finding a gay plumber or a gay flatshare, HIV prevention and safer sex. Then, in 2002, while working at drug and alcohol charity Turning Point, he set up Antidote. Its focus has shifted slightly over the years, but the essence remains the same: psychosocial support and talking therapy.

When Antidote began, Moncrieff recalls, alcohol was the biggest issue among the queer community, although powder cocaine, ecstasy and ketamine were becoming problematic. But soon after that, around 2003, a fear emerged that crystal meth was going to become the next crack cocaine among the broader drug-using UK populace. This, though, wasn’t necessarily the case when it came to Antidote users – that is, until 2007, when clients started to report crystal meth usage. These reports often came from people who had moved here from Australia or the US, where it was already an established issue. People like Tommy.

A year later came a tipping point of sorts: people were now reporting to Antidote for crystal meth, G and mephedrone use. In the early 2010s, mephedrone – while also being used widely outside the queer community – was the most predominant drug issue at the charity, but it became increasingly clear that G and meth were also being used in a sexual context. Then came the gay hook-up and dating app boom: Grindr in 2009, Scruff in 2010. Fetish-focused Recon, then initially available as a website only, came to smartphones in 2010. All of this, coupled with a global ecstasy supply slump and the ready availability of mephedrone – then legal – helped to sow the seeds of chemsex.

Understanding chemsex now, as a fully fledged epidemic, means being wary of reinforcing an age- old stereotypes: that gay men take more drugs. Rather, there are grains of truth in that, plus more context to consider. GBMSM have sex differently due to historic and continued oppression – in many ways, setting the bar for new forms of sex and relationships.

Yes, statistically, queer people are more predisposed towards taking drugs. Per the British CrimeSurvey for the years 2007 to 2009, gay and bisexual men were three times more likely than heterosexual men to do so, a figure that also rang true in 2013 to 2014. The arrival of hook-up apps meant a sex scene that was already alive and well in darkrooms and cruising sites was ready to shift up a gear. If these minimal courtship methods were already efficient IRL, here was an even easier, quicker way to operate.

These days, the situation around queer drug use has become increasingly complex. Previously, goals with Antidote clients might have been set around maintaining drug abstinence. Today, objectives also need to cover sexual health and behaviour to ensure a client’s sex life doesn’t overstep the boundaries of what they would be comfortable with if not high. ​“Some people might be using because it helps them be more experimental with sex,” says Moncrieff. ​“But what we do find is that, sometimes, people are expressing a bit of regret. People are in terrible states when they [visit].” To this point, for Tommy, chemsex meant that ​“even with someone you’re not that physically attracted to, there’s a connection that feels like everything you’ve looked for.”

Going sober obviously brings its own challenges, too. After experiencing psychosis and paranoia while on the drugs, people often have to reckon with anxiety, depression and stress when they’re coming off them. ​“I often say in training [sessions] that chemsex and the drugs associated with it have changed the game for us as a treatment and support provider,” says Moncrieff. ​“I really don’t think that’s overemphasising it.”

Several times in our conversation, Moncrieff notes that trans and non-binary people are encouraged to use the Antidote service, too. They are also vulnerable groups, although drug use patterns differ slightly. Leo Pavam, head of development and outreach at The LoveTank, an organisation supporting marginalised communities – queer, POC and migrant in particular – confirms this when we meet at The Love Tank’s office in East London. Pavam avoids the term ​“chemsex” in his work here because of its association with GBMSM. ​“We try to use ​‘sexualised drug use’ because it feels more inclusive – a bigger term for similar behaviour,” he says. ​“For instance, in trans communities, there’s a bigger use of ketamine, so we should be looking to actually produce [training, research and re-sources] related to ketamine and harm reduction.” This term, harm reduction, is core to Sex, Drugs and Care 4 All, combined Love Tank and Antitdote program that trains chill-out and party community members to guide other users on safer drug-taking.

It’s hardly a scoop, but sexualised drug use is here to stay. It’s human nature to want to enhance our sex lives, and it’s an unfortunate reality that minority groups face complicated psychosocial issues with drugs and sex alike. But having sex on drugs with less harm goes a longway. For as long as the frontline workers continue to get up, head to work and research, the queer community can survive. In a country where gay bars and queer venues are declining and online apps promise anonymous sex on tap, often with the promise of a heady enhancement, it’s easy to sensationalise chemsex as a crisis. It’s a problem, yes, but one that’s being boldly tackled by organisations such as Antidote and The Love Tank, and by dedicated health professionals like Dr Fitzgerald. Tommy turned a corner. He wasn’t the first, and he won’t – can’t, shouldn’t – be the last.

“I’ve had to rebuild and face the fact that I didn’t have any friends left because of my own decisions,” says Tommy. ​“But it’s a process: I’m now making connections that are meaningful. It’s the quality, not the quantity.”