sodium-oxybate and mephedrone

Sexualised drug use (SDU) refers to the use of drugs in a sexual context. This includes 'Chemsex'- the use of drugs (specifically crystal methamphetamine, GHB/GBL and mephedrone) before or during planned sexual activity to sustain, enhance, disinhibit or facilitate the experience. Here we aimed to synthesise available UK prevalence data for Chemsex, SDU and the use of Chemsex drugs in an undefined context (CDU) in men who have sex with men (MSM).. Papers published between January 2007 and August 2017 reporting Chemsex, SDU and/or Chemsex drug use (CDU) prevalence in MSM were identified through PubMed. Citations were searched for further eligible publications. We also conducted a review of national surveillance data, extracting prevalence data for Chemsex, SDU or CDU. Synthesized data were then assessed to determine the time at which these drugs were taken, in this case just prior to or during sexual activity (event-level).. Our search identified 136 publications, of which 28 were included in the final data synthesis. Three of the four surveillance systems assessed provided SDU or CDU data in MSM. Few publications included event-level data for Chemsex (n = 4), with prevalence estimates ranging from 17% among MSM attending sexual health clinics (SHC) to 31% in HIV-positive MSM inpatients. Prevalence estimates for SDU (n = 7 publications) also varied considerably between 4% in MSM receiving HIV care to 41% among MSM attending SHC for HIV post-exposure prophylaxis (PEP). Eighteen publications provided data for CDU.. Prevalence estimates varied considerably due to differences in the definition used and population assessed. Standardised definitions and studies with representative national samples of MSM are required to improve our understanding of the extent of Chemsex and its associated risks. Longitudinal event-level data for SDU and Chemsex are needed to monitor impact of interventions.

Topics: 4-Butyrolactone; Humans; Illicit Drugs; Methamphetamine; Sexual and Gender Minorities; Sodium Oxybate; Substance-Related Disorders; United Kingdom; Unsafe Sex

Designer drugs belong to a group of legally or illegally produced substances that are structurally and pharmacologically very similar to illicit drugs. In the past, designer drugs were often used during all-night dance parties, but they are now consumed in multiple settings from college bars to parks to private house parties. Most of these club drugs can be bought on legal websites and home-delivered for private parties. Recently, legal highs have once again become a burning media issue across the world. Our review will focus on GHB and synthetic cathinones. Literature searches were conducted for the period from 1975 to July 2010 using PubMed, EMBASE, PsycInfo, Internet underground and governmental websites using the following keywords alone or in combination: designer drugs, club drugs, party drugs, GHB, synthetic cathinones, mephedrone, methylone, flephedrone, MDAI, and MDVP. Available epidemiological, neurobiological, and clinical data for each compound are described. There is evidence that negative health and social consequences may occur in recreational and chronic users. The addictive potential of designer drugs is not weak. Non-fatal overdoses and deaths related to GHB/GBL or synthetic cathinones have been reported. Clinicians must be careful with GBL or synthetic cathinones, which are being sold and used as substitutes for GHB and MDMA, respectively. Interventions for drug prevention and harm reduction in response to the use of these drugs should be implemented on the Internet and in recreational settings. Prevention, Information, Action, and Treatment are the main goals that must be addressed for this new potentially addictive problem.

Topics: Alkaloids; Animals; Designer Drugs; Humans; Illicit Drugs; Indans; Methamphetamine; N-Methyl-3,4-methylenedioxyamphetamine; Sodium Oxybate; Substance-Related Disorders

Chemsex typically involves drugs such as GHB/GBL, crystal meth and mephedrone, and is increasingly common among MSM. The behaviour has been found to be associated with sexually transmitted infections (STIs) and mental health problems. We aimed to assess the extent of chemsex engagement and associations with different aspects of health, among MSM attending a free specialist walk-in clinic for STIs in Oslo, Norway.. Anonymous cross-sectional survey data was collected from June to October 2016. Differences in STI health (chlamydia, gonorrhoea, syphilis, HIV diagnoses), mental health (depression/anxiety) and internalised homonegativity between MSM using and not using GHB/GBL, crystal meth, mephedrone, cocaine or ketamine with sex in the last year were assessed descriptively and in a multivariate logistic regression model. The predictors were number of self-reported chlamydia, gonorrhoea or syphilis diagnoses, HIV diagnosis, depression/anxiety, and degree of internalised homonegativity. We adjusted for age, education level and having lived abroad.. Of the 518 MSM respondents, 17% reported sexualised use of either GHB/GBL, crystal meth, mephedrone, cocaine or ketamine in the last year (chemsex). We found significant positive associations between chemsex and self-reported HIV diagnoses (adjusted odds ratio [aOR] = 3.26, 95%CI = 1.37-7.76), number of reported chlamydia, gonorrhoea or syphilis diagnoses in the last year (aOR = 1.63, 95%CI = 1.18-2.12), having lived more than one year abroad (aOR = 2.10, 95%CI = 1.20-3.65), but no significant association with depression/anxiety (aOR = 1.02, 95%CI = 0.53-1.93), nor internalised homonegativity (aOR = 0.62, 95%CI = 0.33-1.19).. Chemsex engagement in Norway is relatively low compared to findings from STI clinics in other European countries, and GHB/GBL and cocaine the two most commonly used drugs with sex. Chemsex was more common among MSM having lived more than one year abroad, reporting HIV diagnoses and a higher number of either chlamydia, gonorrhoea or syphilis diagnoses in the last year. Health care providers need to be made aware of chemsex as a behavioural phenomenon among MSM, and special care should be afforded to MSM living with HIV and being diagnosed with STIs.

Topics: Cocaine; Cross-Sectional Studies; Gonorrhea; HIV Infections; Homosexuality, Male; Humans; Ketamine; Male; Methamphetamine; Sexual and Gender Minorities; Sexual Behavior; Sexually Transmitted Diseases; Sodium Oxybate; Substance-Related Disorders; Syphilis

Chemsex (drug use to enhance sex) has emerged among men who have sex with men (MSM). Non-consensual sex (NCS) is hypothesised to occur frequently under the influence of chemsex, however data are scarce. In this cross-sectional study, it was aimed to assess whether NCS is associated with chemsex.. We offered a survey about chemsex in the past 6 months (crystal methamphetamine, mephedrone and/or gamma-hydroxybutyrate/gamma-butyrolacton use) and NCS (sexual experiences beyond one's limits or unpleasant sexual experiences) in the past 5 years to Amsterdam-located gay dating platform users. Associations were assessed using χ² test, Fisher's exact test and multivariable logistic regression.. Of 891 participants, 30.6% (273 of 891) engaged in chemsex; 21.2% engaging and 16.7% not engaging in chemsex reported any NCS experiences (p=0.109).Among MSM who reported any NCS experiences, chemsex engagers reported being touched against one's will less often compared with non-engagers (22.4% vs 39.8%; p=0.036). Yet, chemsex engagers reported passing out and not remembering what happened during drug use more often (41.4% vs 8.7%; p<0.001). The level of suffering from NCS experiences did not differ between chemsex engagers and non-engagers (p=0.539); and was rated by most participants with no suffering at all or low suffering (77.1%). In the multivariable regression analyses, chemsex engagement in the past 6 months was associated with NCS (adjusted OR 1.46; 95% CI 1.01 to 2.11).. A substantial proportion of MSM (regardless of chemsex engagement) reported NCS in the past 5 years. In multivariate logistic regression analysis, chemsex engagement was associated with an NCS experience. Among participants who reported NCS, suffering related to NCS however, did not differ between chemsex engagers and non-engagers. Sexual healthcare professionals need to address chemsex and NCS during consultations involving MSM and refer men for specialised help if deemed necessary.

Topics: 4-Butyrolactone; Adult; Aged; Cross-Sectional Studies; Homosexuality, Male; Humans; Male; Methamphetamine; Middle Aged; Netherlands; Recreational Drug Use; Sexual and Gender Minorities; Sexual Behavior; Sodium Oxybate; Surveys and Questionnaires

Outbreaks of shigellosis among men who have sex with men (MSM) have been reported since the late 1990s. HIV infection is an important risk factor. Since 2014, the global shigellosis epidemic has intensified. Whether chemsex (the use of crystal methamphetamine, γ-hydroxybutyrate or mephedrone to enhance sex) is a new risk factor has not been previously examined.. Seventy-five shigellosis cases were compared with 225 controls. High pVL (>100 000 copies/mL; adjusted OR (aOR): 4.9, 95% CI 1.4 to 16.9), gonorrhoea (aOR: 29.4, 95% CI 2.3 to 340.2) and syphilis (aOR: 4.3, 95% CI 1.6 to 11.6) were independent risk factors of shigellosis. Twenty shigellosis cases and 59 controls completed the questionnaire. Oral-to-anal sex (aOR: 15.5, 95% CI 3.6 to 66.7), chemsex (aOR: 5.6, 95% CI 1.4 to 22.7) and poppers use (aOR: 10.9, 95% CI 1.9 to 64.2) within 12 months were independent behavioural risk factors of shigellosis.. Chemsex is a new risk factor for shigellosis among MSM living with HIV, as identified in the 2015-2016 outbreak. Additional risk factors include poppers use, sexual risk behaviours and high pVL. Further studies on chemsex among MSM, which is a rising public health concern, are urgently required.

Topics: Adult; Case-Control Studies; Coinfection; Disease Outbreaks; Dysentery, Bacillary; Gonorrhea; HIV Infections; Humans; Logistic Models; Male; Methamphetamine; Multivariate Analysis; Odds Ratio; Risk Factors; Sexual and Gender Minorities; Sexual Behavior; Sodium Oxybate; Substance-Related Disorders; Syphilis; Taiwan; Viral Load

Recent evidence has suggested that chemsex (the use of mephedrone, crystal methamphetamine and γ -hydroxybutyrate/ γ -butryolactone (GHB/GBL) to enable, enhance and prolong sexual interactions) has increased among men having sex with men (MSM) attending sexual health clinics in large UK cities. To date there has been no data from the UK or Europe that describes changes in chemsex over time within a cohort of MSM.. The prospective cohort study, Attitudes to and Understanding Risk of Acquisition of HIV over Time (AURAH2), collected online questionnaire data from HIV negative or undiagnosed MSM (at enrolment) from 2015 to 2018, recruited from sexual health clinics. We aim to investigate changes in chemsex, three individual drugs associated with chemsex, frequency of chemsex sessions and measures of sexual behaviour, among the cohort of MSM over the study's 3 year follow-up period.. In total 622 MSM completed at least one online questionnaire for the AURAH2 study, of which 400 (64.3%) were still engaged with the study within the last six months of follow-up. Prevalence of chemsex significantly declined during the follow-up from 31.8% (198/622) at the first online questionnaire, to 11.1% (8/72; p < 0.001) at the 9th. This decline was reflected in the proportion of MSM reporting use of two of the three individual chemsex drugs: mephedrone use had significantly declined from 25.2% at the first online questionnaire to 9.7% (p < 0.001) at the 9th, GHB/GBL use had also declined from 19.9% to 8.3% (p = 0.001). While crystal methamphetamine use declined, but not significantly (11.1%-6.9% [p = 0.289]). Most measures of sexual behaviour (any anal sex, group sex, recent HIV test and bacterial STI) also tended to decline over the follow-up period, with the exception of CLAI with more than one and more than two partners.. Chemsex and use of two individual chemsex drugs (mephedrone and GHB/GBL) significantly declined over time among individuals in the study, alongside most measures of sexual behaviour with the exception of those related to CLAI. Focusing health promotion and HIV prevention, such as awareness of post-exposure prophylaxis (PEP) and access to pre-exposure prophylaxis (PrEP), on MSM that report chemsex, and in particular problematic chemsex, would be highly beneficial, potentially only necessary for a relatively short period of time for individuals, and could have long term benefits for HIV and STI prevention.

Topics: Adult; England; Health Knowledge, Attitudes, Practice; Homosexuality, Male; Humans; Male; Methamphetamine; Middle Aged; Prospective Studies; Sexual Behavior; Sodium Oxybate; Unsafe Sex; Young Adult

Reports of sexualised drug taking (chemsex) have increased significantly in recent years. There is currently limited intelligence on chemsex outside of London. An anonymous survey was promoted via several sources including voluntary services and a sexual health clinic in order to establish the risks associated with chemsex, and how support services can best be tailored to meet the needs of those in Greater Manchester, UK. Quantitative and qualitative data were collected on demographics, drug use, sexual practices and barriers and facilitators to accessing support. Fifty-two men who have sex with men completed the online survey. Thirty-nine (75%) were HIV-positive and 11 (21%) were hepatitis C virus (HCV) positive, all of whom were HIV/HCV co-infected. The most commonly used drugs were mephedrone (81%) and gamma hydroxybutyrate/gamma butyrolactone (79%). Nineteen (37%) reported ever injecting drugs. High-risk sexual practices were reported by respondents. Barriers to accessing support included a fear of being recognised. Findings demonstrate those engaging in chemsex are participating in a number of high-risk sexual practices, taking substances with significant risks and administering these substances in potentially high-risk ways. Results demonstrate the need for promotion of existing services, with key areas to target where chemsex sessions are most commonly arranged. Results may be useful in other metropolitan cities, both for commissioning and tailoring of chemsex support services.

Topics: 4-Butyrolactone; Adult; Coinfection; Harm Reduction; Hepatitis C; HIV Infections; Homosexuality, Male; Humans; Internet; London; Male; Methamphetamine; Middle Aged; Risk-Taking; Sexual Behavior; Sexual Partners; Sodium Oxybate; Substance-Related Disorders; Surveys and Questionnaires; Unsafe Sex; Young Adult

Formålet med undersøkelsen var å kartlegge forekomsten av rusmiddelbruk under sex (chemsex) blant et utvalg av mannlige pasienter ved Olafiaklinikken i Oslo, en poliklinikk for seksuelt overførbare infeksjoner. Vi ønsket også å se hvilke variabler innen psykisk helse, seksuelt overførbare infeksjoner og seksualatferd som var assosiert med chemsex for menn som har sex med menn og menn som har sex med kvinner.. Studien var anonym og spørreskjemabasert blant mannlige pasienter ved poliklinikken i perioden 1.7.2016-20.10.2016.. Svarprosenten var 96 (1 050 fikk utdelt skjema, 1 013 ble inkludert). Av disse rapporterte 144 (14 %) bruk av chemsex i løpet av det siste året - 87 (17 %) menn som har sex med menn og 57 (12 %) menn som har sex med kvinner. Av de som hadde hatt chemsex, oppga flere menn som har sex med menn hivinfeksjon, at de hadde hatt syfilis, over ti sexpartnere og hadde deltatt på sexfest det siste året. Flere menn som har sex med kvinner oppga psykiske plager.. Det bør utredes nærmere hvordan helsevesenet best kan møte chemsexbrukernes behov. Spesielt er det viktig med informasjon om skadereduksjonstiltak og støtte til de som ønsker å slutte eller redusere bruken av chemsex.

Topics: Adolescent; Adult; Bisexuality; Cocaine; Designer Drugs; Hepatitis C; Heterosexuality; HIV Infections; Homosexuality, Male; Humans; Illicit Drugs; Ketamine; Male; Mental Health; Methamphetamine; Middle Aged; Norway; Refugees; Sexual and Gender Minorities; Sexual Behavior; Sexual Partners; Sexually Transmitted Diseases, Bacterial; Socioeconomic Factors; Sodium Oxybate; Surveys and Questionnaires; Unsafe Sex; Young Adult

Chemsex is a colloquial term used by gay men in some parts of the UK to describe the use of psychoactive substances (typically mephedrone, GHB/GBL or crystal methamphetamine) during sex. Use of these drugs by gay men in London appears to have risen sharply from relatively low levels and, as yet, there is little data to inform appropriate harm reduction services. This study sought to understand the personal and social context of chemsex and the nature of harm reduction need.. In-depth interviews were conducted with 30 self-identifying gay men (age range 21-53) who lived in three South London boroughs, and who had used either crystal methamphetamine, mephedrone or GHB/GBL either immediately before or during sex with another man during the previous 12 months. Data were subjected to a thematic analysis.. While around half of participants had utilised a range of drugs over many years, others had only recently been introduced to drugs, often by sexual partners who wished to enhance the sexual session. As relatively new drugs on the gay scene, understanding of appropriate dosing was lacking and a majority described overdoses, particularly in relation to GHB/GBL. Negotiation of sex, especially in group sex environments, was complicated by the effects of the drugs and a small number of men reported concerns relating to sexual consent. While a significant proportion of men had experienced a range of physical and mental health harms, few had accessed professional support for fear of judgement or concern about chemsex expertise.. Findings from this study indicate a substantial degree of harm in the usage of relatively new psychoactive substances in highly sexual circumstances. Generic drug services, typically designed to address the needs of opiate users, may not be sufficiently resourced to address the specific and acute needs of gay men engaging in chemsex.

Topics: 4-Butyrolactone; Adult; Drug Overdose; Harm Reduction; Homosexuality, Male; Humans; London; Male; Methamphetamine; Middle Aged; Needs Assessment; Self Medication; Sexual Behavior; Sodium Oxybate; Young Adult

This communication reports the blood concentrations of alcohol and drugs from 376 cases of alleged driving under the influence of drugs analysed at the Forensic Science Service Chorley and London laboratories between February 2010 and March 2011. The samples were analysed for alcohol, amphetamine, benzodiazepines, cocaine, MDMA, opiates, γ-hydroxybutyrate (GHB), ketamine, methadone and methylmethcathinone (the 4-isomer of which is known as mephedrone). The results were interpreted with respect to the number and type of drugs of abuse detected and the concentrations measured. Alcohol was quantified in 113 cases (30%), and of these a level in excess of the prescribed UK limit for driving of 80 mg% was present in 90 cases. In 80 cases, only the concentration of alcohol was measured, the concentrations of both drugs and alcohol were measured in 33 cases. In the remaining 263 cases, only the concentrations of relevant drugs of abuse were measured. The most common drug of abuse quantified was cocaine which was detected in 92 cases, either as the active drug or as its major metabolite benzoylecgonine, followed by diazepam which was quantified in 76 cases. Concentrations of some new drugs, and drugs rarely reported in driving under the influence cases are also presented.

Topics: Adolescent; Adult; Amphetamine; Automobile Driving; Central Nervous System Depressants; Chromatography, Liquid; Cocaine; Diazepam; England; Ethanol; Female; Forensic Toxicology; Gas Chromatography-Mass Spectrometry; Humans; Ketamine; Male; Methadone; Methamphetamine; N-Methyl-3,4-methylenedioxyamphetamine; Narcotics; Nordazepam; Sodium Oxybate; Substance Abuse Detection; Substance-Related Disorders; Wales; Young Adult