A group of community, health, and research professionals, organized under the banner of the “Cri de ralliement” committee, are calling for “chemsex”—the use of synthetic drugs in a sexual context, particularly crystal meth, GHB-GBL, and ketamine—be recognized by authorities as a public health issue before “reaching a point of no return.”
This phenomenon has grown in recent years.
The limited data available on chemsex—which is most prevalent among sexually diverse men and transgender and non-binary individuals—shows that it often stems from a combination of sexual and mental health issues. This practice also further marginalizes vulnerable communities.
According to community and research circles, support services for people who engage in chemsex are struggling to adequately meet their needs, and there is a pressing need for education about this practice.
“Current resources are not sufficient to address the issue of chemsex,” says Yannick Gaudette, a doctoral student in social work at UQAM and research assistant for the Trajectories, Diversity and Substances (TRADIS) chair. “It is largely the gay community that is currently implementing initiatives, but this remains insufficient to properly accommodate everyone with a view to changing their habits.”
As a member of the executive committee of Cri de ralliement, Gaudette emphasizes that chemsex can have social repercussions. People who engage in this practice may have difficulty maintaining their jobs, family relationships, and friendships.
“It would be appropriate to consider this a public health issue,” he says. “This would make it possible to fund specific initiatives on the issue of chemsex and allow community organizations and the health care system to really focus more on this issue so that they can provide support to those affected.”
Le Cri de ralliement’s fear of reaching “a point of no return” is motivated by the increase in consumption in Europe and the emergence of new substances, as Gaudette explains.
“This further normalizes consumption within our communities and, eventually, it becomes increasingly difficult to meet the growing need,” he says.
He also highlights how easy it is now to find synthetic drugs on dating apps. “The services that exist are run by a handful of people. It’s becoming increasingly difficult to meet needs and demand, especially since the pandemic, when we saw a slight increase in the practice of chemsex.”
Several initiatives have been put in place, but they are mainly concentrated in Montreal. The Montreal Addiction Rehabilitation Center (CRDM), for example, organizes workshops that offer weekly support groups.
People who engage in chemsex are at greater risk of psychotic episodes, anxiety, depression, overdose, and suicide attempts. This is what Luc experienced, who agreed to talk to The Canadian Press, under a different name, about his experience with chemsex.
Luc arrived in Montreal in July 2024 as an asylum seeker. The 37-year-old gay man had never used synthetic drugs in a sexual context before arriving in Quebec.
He began using drugs every time he had sex, eventually smoking crystal meth daily for several months before experiencing a psychotic episode and attempting to take his own life.
“People who take crystal meth say it opens their minds and removes inhibitions,”says Luc. “I was raped (in the past) and chemsex helped me (…) for me, it was a way of reconciling myself with sex.”
He explains that his crystal meth use allowed him to have sex for several hours, increasing his sexual performance while improving his perception of it.
“After that, I only met people who smoked (crystal meth), then had threesomes and foursomes, even though those were things I wasn’t comfortable with,” adds Luc.
The psychotic episode he experienced led him to believe that his partner was trying to poison him, which caused them to break up.
He admits that he still feels uncomfortable when it comes to talking about his chemsex experience.
“You feel judged and misunderstood,” adds Luc. He now dreads having sex because he has to abstain from drugs before he can do so. He says he is in a period of abstinence in order to reclaim his sexuality.
For physician Réjean Thomas—whose clinic, l’Actuel, which he co-founded, helped establish Le Cri de ralliement—there is “public health work to be done that is not being done,” which, in his opinion, “demonstrates the political orientation” regarding issues affecting 2SLGBTQI+ communities.
“We’ve been seeing chemsex for a long time, but not to such a significant extent (…) now it’s part of the reality of our medical practice,” he notes.
He also deplores the lack of prevention efforts by the authorities.
“We have people with major health problems for whom public health must play a more important role,” he says. “The increase in STIs, HIV, which is still around, hard drugs, and chemsex—there’s nothing more public health than that, and yet it’s the Village clinics and community organizations that talk about it and guide people to resources.”
“It’s clear that our populations, like the ones we have at L’Actuel, are of little interest to governments,” explains Thomas. “There is a lot of prejudice, a lot of stigma, where chemsex is associated with lifestyle choices, when in fact it’s a matter of vulnerability.”
When asked by The Canadian Press about recognizing chemsex as a public health issue, the Institut national de santé publique du Québec (INSPQ) responded that a state of knowledge on best public health practices related to chemsex is currently being developed.
It also indicated that training on this topic had been developed and that more than 1,000 people had voluntarily taken the course since its launch in November 2023.
The Ministry of Health and Social Services (MSSS) has also not taken a position on whether chemsex should be recognized as a public health issue.
“Preventing STIs and providing information and raising awareness about psychoactive substance use and overdose prevention are public health priorities and rely on an integrated approach rather than one focused on specific practices, substances, or behaviors,” the MSSS explained in an email to The Canadian Press.
“Chemsex, or party and play, is a practice that increases the risk of STI transmission and overdose and is therefore a concern for health and social services stakeholders and public health authorities,” it added.
–This report by La Presse Canadienne was translated by CityNews
