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About PIP PAC safer chemsex packs

PIP PAC are safer chemsex packs, innovated by gay men in 2014.

The road has been long but, today, PIP PAC 3.0 is made up of 40 ingredients some of which need to be printed, pinched, stuck together and folded before precision packed into a Post In Proportion (PIP) pack (PAC) mailing box. Uniquely, contents are colour coded to reduce sharing and transmission of blood-borne infections including HIV and Hepatitis C.

Over 5 years, a humble folded information leaflet has evolved into a 32-page booklet with links to our gay men's health website MENRUS.CO.UK -a wealth of further guidance and support. Most recently, we included guidance on ambulance call-outs and the police, a bust card: your rights on arrest booklet, and new and expanded guidance on using GHB.

We would love to give PIP PAC away for free but they are not subsidised or receive government or grant funding. They are produced on a not for profit basis to give you the best value possible.

Discretely packaged and posted 1st class, packs fit through standard letterboxes. Purchase today by 4pm and there's a good chance you'll get yours tomorrow.

Safer Chemsex booklet (7th Edition)

Click here to complete our contact form for your free single copy of our latest Safer Chemsex booklet not forgetting to include a name and address. Please allow 5 working days for delivery.

Alcohol, recreational drug use and chemsex support

Click the link for chemsex and recreational drug use support at MENRUS.CO.UK

In early 2014, we funded (ourselves) and piloted 500 packs; since then, we make 500-1,000 packs a year. Those involved in its development are gay men with direct knowledge and experience of recreational drug use; and problematic drug use, withdrawal, and recovery. We also work with LGBT+, drugs, and sexual health services across the UK. Feedback remains very positive and we will continue to make more while the need is there.

Procurement, bulk and orders and tailored packs

Our shop sells multiples of single and twin packs only. Please, use the contact form or call for bulk orders or the chemsex booklet which can be purchased separately. Packs can be tailored with inserts (eg: details of local services), and include bespoke pack labels (eg: include the name of your organisation).

Pack updates and changes

February 2020: Chemsex booklet (A5) 7th edition, printed

January 2020: Nevershare and Needle Safe replaced with Acufine and Safe Loc

December 2019: PIP PAC box increased in size

October 2019: Electrolyte tablets replaced with DSC Nutrition (salt replacement tablets)

July 2019: Chemsex booklet (A5) 6th edition, printed

July 2019: Bust Card: Your Rights on Arrest booklet (A7) 2nd edition, printed

May 2019: Bust Card: Your Rights on Arrest booklet (A7) 2nd edition, printed

October 2018: Chemsex booklet (A5) 5th edition, printed

January 2019: Bust Card: Your Rights on Arrest booklet (A7), added

December 2018: Plastic mailer bags replaced with paper envelopes

November 2018: PIP PAC 2.0 phased out

October 2018: Chemsex booklet (A5) 4th edition, printed

May 2018: Plastics straws replaced with paper straws

October: 2017: Chemsex booklet 3rd edition, printed

August 2017: 'G' tracker, ID wristbands, and mint sweets added

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About PIP PAC safer chemsex packs PIP PAC are safer chemsex packs, innovated by gay men in 2014. The road has been long but, today, PIP PAC 3.0 is made up of 40 ingredients some of which need to be printed, pinched, stuck together and folded before precision packed into a Post In Proportion (PIP) pack (PAC) mailing box.

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Chemsex drugs awareness for gay men and who who have sex with men

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In light of the current Corona Virus public health issue, and the cessation of our face to face support, we wanted to provide some additional resources to enable you to support yourself at home. Please remember that if you would like one of the Antidote team to get in touch by phone, please contact us via email at antidote@londonfriend.org.uk and we will make contact with you.
Chemsex and CoronaVirus Advice Antidote Home Self-Support Plan Dealing with Triggers & Cravings Drug & Alcohol Harm Reduction Information Chemsex Information, Support & Advice G-Diary (Stabilisation & Reduction) Alcohol Diary
External Online Support

SMART recovery, a cognitive based solution to reducing or stopping drugs & alcohol, are currently running lots of meetings online. Please visit SMART Recovery for more information.

For those of you that also attend Fellowship meetings (or feel this may be a good option for them at this time), you may already be aware that many fellowships are either closing or moving online, with some individual meetings have decided to set up their own meetings on Skype/Zoom etc. Please visit the Soho Recovery Centre for more details.

CMA (Crystal Meth Anonymous) are also hosting Zoom meetings daily. Please visit the CMA website for further details.

Password for all CMA Zoom meeting is: unity

UKNA are holding lots of local NA meetings daily online. Please visit UKNA for more details and to find a meeting.

There is also an online resource that many are now using called "In The Rooms". This is an international platform for pretty much all recovery meetings. (AA, NA, CMA,ACA, Dharma Recovery, SMART etc,) It's free and there are meetings available every hour or so, from all over the world. Please visit in the rooms for more information.

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In light of the current Corona Virus public health issue, and the cessation of our face to face support, we wanted to provide some additional resources to enable you to support yourself at home. Please remember that if you would like one of the Antidote team to get in touch by phone, please contact us [...]

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Recreational drugs and HIV | Terrence Higgins Trust

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Recreational drugs can interact dangerously with HIV medication.

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How you take a drug affects how quickly you start to feel its effects and how strong they are. Depending on how the drug enters you, it can damage different parts of the body.

How a drug is taken can influence how likely you are to get addicted to it. Smoking and injecting drugs cause the biggest concentration of chems in the blood in a very short amount of time. This gives the fastest, strongest hit and a greater chance you will become addicted.

Remember:

Know your dealer - always buy your drugs from someone you trust and who knows what they're selling.

Don't be alone - if you overdose or have a bad experience, you'll need help.

Bad batches happen - try a small sample of a new batch first to avoid overdosing.

Have condoms and lube with you - stimulants can make you horny.

Knowing about the specific risks with taking drugs in different ways can help you to keep these as safe as possible:

Find out about different entry methods, and how to keep these as safe as possible:
Next: Swallowing ››
Published: 07/08/2015
Next review: 07/08/2018

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How you take a drug affects how quickly you start to feel its effects and how strong they are. Depending on how the drug enters you, it can damage different parts of the body. How a drug is taken can influence how likely you are to get addicted to it.

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The videos here seek to address the uncomfortable and unglamorous public health issue, and gay community issue, of ChemSex. ChemSex is the Zeitgeist intersec...

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Our HIV and sexual health services in Brighton and Hove and West Sussex.

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ChemSex support - for Professionals - Counselling and sexual health support for gay men who use recreational drugs for sex. ChemSex.

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Clinic T (Trans Clinic) | Brighton & Hove Sexual Health and Contraception Service

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Although our core service is focused around sexual health if there is anything else that concerns you, for example psychological issues or worries about taking hormones (including concerns about self-medicating), you can discuss this with the nurse or doctor seeing you in complete confidence.

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MEN R US is an approachable and comprehensive directory to gay men's health. Help when you need it, a good read when you don't.

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Resources from Chemsex Forum: presentations, audios etc..

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Resources from Chemsex Forum: presentations, audios etc..

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What is ChemSex?

ChemSex is a term that is used when people are having sex, which involves using one or more of three specific drugs (chems) in any combination. People take part in ChemSex for a number of different reasons, some find it increases sexual stimulation, for other people it can reduce their inhibitions. ChemSex can take place in groups, and it can often last for days or over a weekend.

Engaging in ChemSex increases your risk of getting HIV and other STIs, and it can also have a negative impact on things like your work, your social life and relationships and your mental health and wellbeing.

The three drugs typically involved are Crystal Meth, M-Cat and G, for more information, you can visit http://lgbt.foundation/how-we-can-help-you/drug-and-alcohol-support/drug-types#Chemsex.

Am I having ChemSex?

It may seem like something that should be obvious, but it is easy for people to be taking part in ChemSex without necessarily knowing. Some people first get introduced to ChemSex through their partners, and eventually will begin to take part. Others may go to a party that they found through a hook-up app or social networking, and then discover it is actually a ChemSex party, which is commonly called a chill out.

However it has happened, it is important that you feel safe, and in control of what drugs you take, and the sex you have. If you ever feel as though you are pressured into doing something you don't want, contact us on 0345 3 30 30 30 and we can support you.

Can I have ChemSex safely?

Chemsex comes with a lot of risk, but this can be managed and reduced with a few simple steps:

Be Assertive

A lot of times people may ask you to bareback, and this puts you at high risk of getting HIV and STIs. It may also be something you don't feel comfortable doing when sober as you know it will make you worry, but when you are on chems, you agree to it because of the influence the drugs are having. It is important to always be assertive in what you want, and what you don't want to do, and set some ground rules before you start, so that people know what you do and do not want to do.

Get Information

Make sure you totally understand the dangers around the drugs you will take and the after effects. This will help you plan how to manage them. For more information, you can visit http://lgbt.foundation/how-we-can-help-you/drug-and-alcohol-support/drug-types#Chemsex.

Order Play Packs

We provide Play Packs in partnership with MAC AIDs Fund, and they have condoms, lube and loads of safer sex resources. To order a play pack or just for more information please visit http://lgbt.foundation/playpacks.

Have plenty of needles

Sharing needles puts you at high risk of catching HIV and other STIs that are found in the blood, like hepatitis A, B and C. Pharmacies across Greater Manchester run needle exchanges, to find one near you please visit http://lgbt.foundation/needle-directory.

Take PrEP

Many guys are using PrEP to prevent HIV protect themselves from HIV. PrEP protects from HIV, but not from other STIs, so it is important that if you are using PrEP, you get a full screening every 3 months. For more information on PrEP and how to get it, please visit http://lgbt.foundation/prep.
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Talk to Someone

Let someone know you where you are going, and what you will be up to. This way, if you feel unsafe, you can reach out to them and they will be able to help. It also means that if you have a bad time, it will be easier to talk to them about it. If you do have a bad experience but don't feel you can talk to anyone you know, you can also talk to us by emailing sexualhealth@lgbt.foundation, or by calling 0345 3 30 30 30.

Get Tested Regularly

Get screened for Sexually Transmitted Infections, HIV and hepatitis C. Chemsex puts us at higher risk for these infections. If you're HIV negative, and concerned about any HIV risks during a ChemSex episode, you can ask your clinic or any hospital for PEP, a medicine which can help protect you from becoming infected if taken within 3 days of the possible exposure.

I want to change, how do I do it?

Here at LGBT Foundation there are a number of different services we offer, depending on the support that you need.

If you want to talk to someone about how ChemSex has affected your wellbeing and your sexual health, and on ways to make a change, then you can book an appointment in our 1-to-1, confidential service called Let's Talk About ChemSex. This is available to people who live all across Greater Manchester, and is currently funded for Gay, Bi and other men who have sex with men, whether you identify as a man some or all of the time.

If you feel as though you are addicted to chems or dependant on them, then our Drug and Alcohol Support Programme has a whole range of support around safer use, reducing, detoxing from chems, and other drugs. For more information, please visit http://lgbt.foundation/drugsandalcohol. to see about the services we have on offer.

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ChemSex is a term that is used when people are having sex, which involves using one or more of three specific drugs (chems) in any combination. People take part in ChemSex for a number of different reasons, some find it increases sexual stimulation, for other people it can reduce their inhibitions.

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An online, interactive support tool, created buy guys who get chemsex, for guys who have chemsex; or healthcare providers supporting them.

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Slamming drugs can be more dangerous in comparison to other methods of taking chems. We're here to reduce the harm injecting could potentially have. Keep yourself informed and come in and speak to us for a judgement-free consultation. We can offer you clean needles and guidance on how to take drugs safely.

Important:

Never inject below your waist

Avoid injecting into your hands or feet

Never inject deeper than 5mm or you may hit an artery or a nerve. Arteries are deeper and harder to pierce than veins, the blood is brighter and it will spurt rather than ooze

Never inject into a site that is sore, swollen or tender

Don't inject into the same spot two times in a row. Vary your injecting sites to give the vein a break and to recover

Don't bend your elbow to stop the bleeding - apply pressure and hold the bleeding site

Safer injecting practices

If you are injecting it is safer to do it yourself if you can, you then have power over of the situation. You can practice safer injecting practices like being hygiene aware and can stop if you feel something is wrong.

Never use alone. Having someone else there is important if your body reacts in a way you did not expect

Wash your hands with warm soapy water before and after injecting

Never let a used fit come into contact with a group mix. No matter how well it has been cleaned everyone must have their own fit, water, spoon and filter

Stock up on equipment so you don't run out, always get more than you think you will need

Always mix up on a clean space (wipe with a clean cloth and soapy water or use new swabs)

Clean your spoon before mixing up (wipe once with a new swab)

If you can't wash your hands use single wipes with new swabs. Remember - rubbing swabs backwards and forwards spreads the dirt and bacteria around

Stop the flow of blood after injecting with clean cotton wool, tissues or clean toilet paper

Have your own tourniquet and don't share it, wash it regularly to remove blood

Rinse your fit with clean, cold tap water straight after your hit to help remove traces of blood

If you keep your own fit, mark it and keep it somewhere safe

Always dispose of injecting equipment in a disposal container or a puncture-proof container with a child-proof lid. If possible return the container to your local needle and syringe exchange programme

Don't re-use swabs, filters or open water ampoules as they can become contaminated once opened. Dispose of them with your fits or inside two plastic bags

Be aware of blood on sleeves and clothes - if you get blood on your clothes, tourniquet or other washable items wash them immediately

If someone is helping you inject, make sure they wash their hands before and after

Injecting over a long period of time can result in:

Blocked blood vessels (caused by things mixed or cut with the drugs)

Inflamed blood vessels and abscesses

Damage to vital organs such as the liver, heart or lungs

Injecting may also increase the risk of becoming dependent on the drug thereby exposing you to serious mental health problems

Crystal meth is a strong, highly addictive amphetamine stimulant which is usually snorted, smoked, mixed with water and injected (slamming), or injected inside the anus (booty bumping). It releases the brain's stress hormone norepinephrine and 'feel good' chemicals dopamine and serotonin which makes people feel high, full of energy, confident, invincible, impulsive, less likely to feel pain and very horny with fewer inhibitions. It also increases the appetite and energy levels, so people taking Crystal can go for days without eating or sleeping. It is often used during non-stop sex sessions and on the clubbing scene.

Sex on Crystal Meth
Crystal can make people feel extremely sexually aroused for long periods. People using this drug may do things they wouldn't normally do, including risking picking up or passing on HIV. It often makes it difficult for men to get an erection or ejaculate (known as 'crystal dick'). It can become hard to think of having sex without being on meth and - like G and mephedrone - it can have a big impact on your ability to have sex sober.

Health risks of Crystal Meth

Long or rougher crystal-fuelled sex sessions can cause the genitals, mouth or anus to become irritated, sore or bleed. This may not be noticed at the time, but it can increase the risk of HIV, Hepatitis C and other sexually transmitted infections being passed on.

Due to increasing the body temperature, heart beat and blood pressure, it can increase the risk of heart attack, stroke, coma or death

Comedowns can leave a person exhausted, aggressive and paranoid, in some cases even suicidal.

People can develop stomach problems such as acid reflux or gastritis due to not eating for a long period of time.

With long-term use, crystal meth can damage the lungs, nose and mouth and lead to lasting mental health problems, even after quitting the drug. It can also interact dangerously with other recreational and prescription drugs

People may find quitting crystal very difficult and its effects on the brain can last long after giving the drug up.

Useful to know

Injecting is best avoided. It's the quickest way to getting addicted and runs the risk of serious health problems (skin abscesses, collapsed veins, blood poisoning and heart infections).

Sharing injecting equipment puts you at high risk of getting or passing on HIV, Hepatitis C and other infections.

Using hot pipes might injure your mouth and if you share them it risks passing on infections like hepatitis C and HIV.

Condoms are more likely to break after about half an hour of use. So during long sex sessions it makes sense to check condoms regularly and put a fresh one on after 30 minutes.

Although Mephedrone (Meph) is now illegal, it developed popularity in 2009 along with other so called "Legal Highs". It is a stimulant that causes speediness and euphoric effects.

Psychological dependance is common with Mephedrone. If you're worried this applies to you come and see us.

Mephedrone is most often a powder and can be snorted, mixed with a drink, "bombed" (wrapped in paper or put in a capsule and swallowed), booty-bumped (syringed up the anus) or injected.

Meph is very irritant and commonly causes inflammation.

Snorting the drugs can cause nose bleeds. Swallowing it mixed with a drink can cause a sore throat.. It is particularly damaging to your veins. The best harm reduction advice (besides not doing it at all) would be to "bomb" it in a paper wrap or capsule, to avoid the aggravation to nostrils, veins and throat.

Side effects include heart palpitations, anxiety, sleeplessness, temperature fluctuations and in some cases hallucinations and fainting.

GHB/GBL causes a feeling of euphoria and reduced inhibitions, but when used carelessly it can also be very dangerous.

There are many common dangers with GHB/GBL including accidental overdose, "going under" on a dance-floor, date-rapes in saunas, or visits to A&E. People using the drug frequently can physically dependent (addicted) to the drug. They may find themselves forced to dose hourly to avoid difficult and dangerous withdrawal symptoms.

Dependent use means that stopping GHB/GBL without medical supervision poses dangerous health risks, to clear your system you will require an in-patient detox.

If you are using GHB or GBL dependently (multiple times daily, for more than 2 weeks), then it is advisable that you are assessed for a medically supervised detox. A GHB/GBL detox is not a service that 56 Dean Street can provide; you would need to contact your local borough drug & alcohol service. Below is a list of the London services that provide GHB/GBL detoxes; if your own borough is not there, or if you have no formal connections to a London borough (eg, residence, GP, hostel) then come to see us at 56 Dean Street Chemsex support and we will explore options for you.
TRI BOROUGH (WESTMINSTER - KENSINGTON&CHELSEA - HAMMERSMITH & FULHAM)
CLUB DRUG CLINIC
http://clubdrugclinic.cnwl.nhs.uk/ BARKING & DAGENHAM
RED LION SERVICE
https://www.changegrowlive.org/content/red-lion-service-barking-dagenham BARNET
WPD - BARNET RECOVERY CENTRE
http://www.wdp.org.uk/find-us/london/barnet-0 BEXLEY
THE PIER ROAD PROJECT
https://www.bexley.gov.uk/services/public-health/drug-and-alcohol-services BRENT
WPD - BRENT RECOVERY & WELLBEING SERVICE
http://www.wdp.org.uk/find-us/brent BROMLEY
BDAS - BROMLEY DRUG AND ALCOHOL SERVICE
https://www.changegrowlive.org/content/bromley-drug-alcohol-service-bdas CAMDEN AND ISLINGTON
GRIP CLUB DRUGS SERVICE
https://www.candi.nhs.uk/services/grip-club-drugs-service CITY OF LONDON
WDP
http://www.wdp.org.uk/get-help/club-drugs CROYDON
CROYDON RECOVERY NETWORK
http://www.turning-point.co.uk/croydon-recovery-network.aspx EALING
CGL - EALING RISE
http://www.ealingrise.org.uk/ ENFIELD
ENABLE - ENFIELD DRUG AND ALCOHOL SERVICE
http://www.beh-mht.nhs.uk/mental-health-service/mh-services/enable-enfield-alcohol-and-drug-service.htm GREENWICH
CGL - ASPIRE GREENWICH
https://www.changegrowlive.org/content/greenwich-aspire HACKNEY
HACKNEY RECOVERY SERVICE
http://hackneyrecoveryservices.org.uk/ HARINGEY
THE GROVE
http://www.beh-mht.nhs.uk/mental-health-service/mh-services/the_grove_drug_treatment_service_haringey.htm HARROW
WPD - HARROW RECOVERY SERVICE
http://www.wdp.org.uk/find-us/london/harrow-0 HAVERING
WPD - HAVERING
http://www.wdp.org.uk/find-us/london/havering HILLINGDON
WPD - ARCH
http://www.wdp.org.uk/find-us/london/hillingdon HONSLOW
iHEAR PARTNERSHIP
http://www.ihearpartnership.org/ KINGSTON
KINGSTON WELLBEING SERVICE
https://www.kingstonwellbeingservice.org/ LAMBETH
CHEMCLINIC
http://www.slam.nhs.uk/our-services/service-finder-details?CODE=SU0995 LEWISHAM
CGL - LEWISHAM
https://www.changegrowlive.org/content/new-direction-lewisham MERTON
WDP - MERTON
http://www.wdp.org.uk/find-us/london/merton NEWHAM
CGL - NEWHAM RISE
https://www.changegrowlive.org/content/cgl-newham-rise REDBRIDGE
WDP - REDBRIDGE
http://www.wdp.org.uk/find-us/london/redbridge RICHMOND
RICHMOND INTEGRATED RECOVERY SERVICE
https://www.changegrowlive.org/content/richmond-integrated-recovery-service SOUTHWARK
CGL
https://www.changegrowlive.org/content/cgl-southwark TOWER HAMLETS
RESET
https://www.elft.nhs.uk/service/362/Reset-Tower-Hamlets-Drug-and-Alcohol-Service WALTHAM FOREST
CGL - WALTHAM FOREST

https://wwWER HAMLETS w.changegrowlive.org/content/cgl-waltham-forest-chingford
WANDSWORTH
WANDSWORTH COMMUNITY DRUG AND ALCOHOL SERVICE
https://www.addaction.org.uk/services/wandsworth-community-drug-and-alcohol-service

Recreational Use

Always be responsible for your own dosing. Always.

Avoid mixing GHB/GBL with alcohol and ketamine as this increases your chance of 'going under' or having fits and coma

Take appropriate doses at appropriate time intervals. A commonly used dose would be between 0.5ml and 1ml. Never dose again within the same 3 hour period

Stick to your own doses and times. Don't accept GHB/GBL from friends just because it's being offered

Use a measured dropper bottle or syringe to measure your doses. Never just pour it casually into a cup and never drink from the bottle or from someone else's drink

Dependence

If you use GHB/GBL regularly for a long weekend you might find yourself feeling anxious, sweaty and shaky the week after or unable to sleep. These are the first signs of dependence (addiction). Even though a shot of GHB/GBL would alleviate these symptoms, resist the urge to take GHB/GBL and try to ride out these early signs with rest and stress free activities.

If you have become dependent on GHB/GBL, your withdrawals will be shakes, sweats, sleeplessness and extreme anxiety. In this case, you should continue taking your GHB/GBL in regular amounts at regular time intervals. Then you can seek medical advice from a drugs advisor at 56 Dean Street, Antidote, your local borough drug service, or GP

Keep a record of your doses and times, to stabilise your use and reduce chaotic ups and downs.

If you're experiencing withdrawals and have no GHB/GBL you should go to A&E and be honest about your situation. This is the safest course of action as withdrawals can be dangerous.

Try not to panic, help is available

NOTE:

GHB and GBL are not the same thing; GHB is the chemical produced in the body when we drink GBL. (The liver converts the GBL to GHB after ingestion.) And sometimes, though less commonly, GHB is a different form of the drug that can come as a powder or liquid, different from GBL. In regard to the effects on the body, they are essentially the same; but when it comes to dosing, it is important to understand the difference.

GBL is the most commonly used form of the drug, and the one you are most likely to find available on the internet, often sold as a liquid cleaning solvent. Concentrations of GBL when bought on the internet rarely vary enough to cause concern in regard to dosing. Take appropriate doses at appropriate time intervals. A commonly used dose of GBL might be between 0.5ml and 1ml. Never dose again within the same 3 hour period. If unsure or inexperienced, always start with the lowest dose, and if it doesn't work after 45 minutes, you might increment up; in this case, make sure your second dose is never more than half of your first dose.

is less commonly available than G BL; sometimes sold as a powder to be mixed with water (never sniffed, never injected), and sometimes already mixed and in liquid form (liquid GHB). This would be more likely to have been sold to you by a dealer or on the dark web, than via traditional internet shopping. G HB in liquid form (not G BL) is perhaps the most dangerous way to ingest the drug, as the concentration can vary enormously. Some samples of liquid GHB in Holland measured between 350 and 550 mg/ml; but without testing your sample, there is really no way of knowing the concentration of your liquid GHB, so be extremely careful. Don't assume anything. Carefully check the concentration with your source before calculating your dosage. 2.5ml of liquid GHB might be a safe dose to start with - but again, there are no guarantees, and be sure that it is GHB and not GBL you are using, as a 2.5ml dose of GBL could be fatal.

Always start with a low dose to determine if it works for you, and if there is no effect after 45 minutes, increment up gently with a second dose; this second dose should never be more than half of your first dose.

Whether it is GHB or GBL you are using, appropriate dosing vary person to person, depending on body weight, how much sleep you've had, when you ate last, other drugs you might have taken, and other factors. Alcohol and Ketamine are especially dangerous in this regard, and should never be used with GHB/GBL.

Both GHB and GBL are drugs that can develop into a physical dependence, and if this kind of addiction develops, you should not consider stopping "cold turkey" without advice from a doctor or drugs worker, as these withdrawal symptoms can be dangerous, and sometimes fatal. Sexual assaults, poor choices around safer sex, and overdsoses (sometimes fatal) are commonly reported consequences of GHB and GBL.

More GHB/GBL harm reduction tips from our friends at Drugs.ie can be found here.

If a new pair of gloves is used with each sexual partner you can cut the risk of most infections, you can pick up gloves as well as lube and condoms from 56 Dean Street.

There is a risk of HIV transmission from fisting if the fister (the guy doing the fisting) has cuts or sores on his hand or wrist

It is easy to damage the lining of the rectum when fisting, so if fisting is followed by condomless anal sex the risk of transmission of HIV and Hepatitis C to either partner is much higher.

Using oil-based lube (such as Crisco) for fisting can cause problems if you have anal sex afterwards. This is because the oil damages the rubber that's used in most condoms. Either use a water-based lubricant or switch to non-latex condoms which are not affected.

If more than one person is being fisted, HIV or Hepatitis C could be passed from one fistee to another via anal mucus or blood carried on the fist

It's best to have your own pot of lube. Sharing lube can also lead to the transmission of HIV and other STIs, as the pot can become contaminated with others blood or anal mucus

Hepatitis A and gut infections like salmonella and shigella (causing fever, diarrhoea with blood and mucus) can get passed on if anything gets passed to the mouth

Urine carries no risk of HIV transmission. There is little risk of passing on any infections.

Shared dildos and butt plugs can pass on infections. Wash sex toys thoroughly after use, using warm soapy water or a sterilising fluid designed for baby bottles.

Alternatively use a condom on it and change it between partners.

Using sex toys may cause microscopic damage inside. You may not notice anything but it may increase the chance of HIV transmission if followed by condomless sex.

Shared penile toys such as Fleshlights can also pass on infections As with dildos, you should wash them thoroughly after use, using warm soapy water or a sterilising fluid designed for baby bottles.

Using other household objects can be very dangerous. If you do, avoid anything with sharp edges or anything that may break inside you. If it doesn't have a base, be careful not to let it go too deep inside you. If you lose anything inside go to A&E.

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Slamming drugs can be more dangerous in comparison to other methods of taking chems. We're here to reduce the harm injecting could potentially have. Keep yourself informed and come in and speak to us for a judgement-free consultation. We can offer you clean needles and guidance on how to take drugs safely.

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Ice: Training for Frontline Workers: Log in to the site

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The focus of the forum was on chemsex that has become problematic. There are many gay men who use drugs without having difficulties, but the meeting was not about these 'happy users', Knoops said.

The forum opened with a minute of silence for those men who have died of drug overdoses and drug-related suicides. Many of the activists present had got involved in this work because of these cases. "In the eighties and nineties I saw too many gay men dying of AIDS and I don't want to see this happen again," said Arnd Bächler of the counselling organisation Schwulenberatung Berlin.

Leon Knoops said that Mainline's peer support meetings on chemsex are often attended by men who seem to have lost control. "They often participate in sex marathons which go on for days. They experience physical issues like sleeping problems, losing weight, dental problems and dehydration.

"Mental issues such as depression, psychotic episodes and suicidal tendencies are also frequently occurring problems," he said. "Men have shared stories about losing jobs, houses and partners due to their drug use."

The response to problematic chemsex should come from within the gay scene itself, but will require gay men to acknowledge the issue. Jan Großer of Schwulenberatung Berlin said that gay men had a long history of defending their sexual culture and shared sexual spaces. As gay sex tends to be seen as an "uninhibited, horny, fun party where everyone looks hot", it can be difficult to accept that people are coming to harm in these sexual spaces, he said.

We need to create new narratives of gay sexuality which encourage men to accept and express their emotions as they arise, he suggested. Many men use drugs to overcome their inhibitions, but many of these inhibitions relate to very 'normal' concerns such as having a less than perfect body. "At the moment it feels like a lot of gay men feel obliged to censor and suppress some of their emotions in order to have sex," he said.

Gay men should change their sexual culture so as to have better sex, with richer emotional experiences and deeper personal connections. "Sleazy pigs can be emotionally aware too," he said.

Adam Schultz, an activist from London, said that when he withdrew from chemsex, he had to reconstruct his entire social network and social life. An important part of his recovery was to find 'safe spaces' where he could reconnect with gay men on a social, rather than sexual level. He joined running clubs, pole dancing classes and social groups. He particularly appreciated the frank discussions he could have at the open mic night 'Let's Talk About Gay Sex and Drugs'. He needed a safe space to think about and talk about his experience: "I finally gave meaning to what happened to me."

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Loneliness and community are key to chemsex

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The second European Chemsex Forum, recently held in Berlin, highlighted how the perspectives of activists and health professionals working on the issue have changed. When the first forum took place two years ago in London, most of the discussion was about the drugs that gay men were taking, the impact of potent drug combinations on the body and the brain, and whether a harm reduction approach is even possible when the drug is crystal meth.

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Gay and bisexual men who reported engaging in chemsex (the use of specific drugs to enhance or facilitate sex) were five times more likely to be newly diagnosed with HIV, nine times more likely to be diagnosed with hepatitis C and four times more likely to be diagnosed with a sexually transmitted infection (STI) during a 13-month follow-up period, according to London data published this week in HIV Medicine.

"This is the first published study to demonstrate a significant association between chemsex disclosure and new HIV diagnosis," said Dr Mark Pakianathan and colleagues at St George's University Hospital, London. Clinicians and public health officials should use the findings to identify a population particularly vulnerable to HIV acquisition who could be targeted for pre-exposure prophylaxis (PrEP) and other prevention interventions, they say.

During routine appointments for sexual health care at St George's between June 2014 and July 2015, 1840 gay and bisexual men were asked questions about mental health, substance use and chemsex. (A previous aidsmap.com article reported on harms associated with chemsex.) Their ages ranged from 14 to 82 years, but the median was 34. Just under a third were born outside the UK and the cohort was ethnically diverse.

Currently engaging in chemsex was reported by 286 men (16.5% of all men).

Drugs most commonly used for chemsex were mephedrone (198 men), GHB/GBL (152 men), crystal methamphetamine (126 men), cocaine (54 men), other amphetamines (36 men) and ketamine (22 men). Of note, the St George's researchers used a wider definition of chemsex than some other groups, who define it as only the use of the first three drugs in a sexual context.

Men often used more than one drug at the same time. Injecting drug use was reported by 74 men.

Whereas 1.8% of men who did not report chemsex had a new HIV diagnosis during 2014 or 2015, this was the case for 8.6% of men who were involved in chemsex. In multivariate analysis (which took into account a range of other factors which influence HIV infection), chemsex was associated with a fivefold increase in the risk of HIV infection (adjusted odds ratio 5.1, 95% confidence interval 2.6-10.1).

The researchers comment that chemsex sessions may last several days and involve mucosally traumatic sex with multiple partners. Given the high incidence of HIV in this population, sexual partners who met at chemsex parties may be men who have very recently acquired HIV, have not been diagnosed and have an extremely high viral load.

A new diagnosis of hepatitis C occurred in 0.2% of men who did not report chemsex and 2.8% of men who did (eleven men in total). In multivariate analysis, this amounts to a ninefold increase in risk (adjusted odds ratio 9.2, 95% confidence interval 2.3-36.3).

Similarly, diagnoses of STIs were elevated in men involved in chemsex. This was true for all STIs (adjusted odds ratio 3.5), rectal STIs (4.5) and acute bacterial STIs (3.9).

Gay and bisexual men attending sexual health services should be assessed for chemsex participation, the researchers say. "Disclosure should prompt health promotion, harm minimization and wellbeing interventions."

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Gay men having chemsex are five times more likely to have a new HIV diagnosis than other gay men

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Gay and bisexual men who reported engaging in chemsex (the use of specific drugs to enhance or facilitate sex) were five times more likely to be newly diagnosed with HIV, nine times more likely to be diagnosed with hepatitis C and four times more likely to be diagnosed with a sexually transmitted infection (STI) during a 13-month follow-up period, according to London data published this week in HIV Medicine.

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The second European Chemsex Forum, recently held in Berlin, highlighted a number of difficulties and harms experienced by chemsex users, including non-consensual sex. "We have heard many stories of men who, during sexual marathons that last for days, pass out on GHB or GBL, while the sex continues to take place," said Leon Knoops of the Dutch harm reduction organisation Mainline. "When they come around, they often have no recollection of what happened.

"Men have spoken from two sides of the coin, and many wonder if this could be considered rape or if it's just a part of the game. This often triggers immense shame and guilt."

Dr Chris Ward of the Manchester Royal Infirmary and the city's chemsex support clinic (Reach at the Hathersage Centre) said that it is already known that male victims of sexual assault or rape often do not report the incident to police or to healthcare professionals. Under-reporting may be linked to concerns about masculinity, the stigma of being a victim of sexual assault, a fear of being not believed, or not being aware that what has happened was a crime.

In the context of chemsex, many men feel that their drug use or being in a highly sexualised environment blurs the line around consent. Overdosing means that men might drift in and out of consciousness or may cycle between pleasure and distress while having sex.

Nonetheless, under UK law, a person who is incapacitated through drink or drugs, or is unconscious, cannot give their consent to a sexual act.

Chris Ward said that the way chemsex users are asked about the issue is important. When his clinic asked about being raped or being forced into sex (the same language used with women), it was under-reported. Men involved in chemsex tend to describe their experiences in different terms.

"The presentation is much more subtle," he said. "When we learnt how to ask the question properly, over a third of people in our chemsex clinic reported being a victim of a sexual offence."

He and his colleagues now have a conversation about unwanted sexual attention, negotiation and coercion, with questions such as:
"Have you ever received any unwanted sexual attention at parties?" "Have you ever been made to feel like you have to have sex?" "Have you ever had sex you weren't aware of at the time?" "Do you feel like you can say 'no' to sex at parties?"
Previously, when men were asked about rape or being forced into sex, 5 of 30 men disclosed non-consensual sex. Since the new questions have been used, 23 of 60 men attending the chemsex clinic have disclosed non-consensual sex. Most of these cases involved men being penetrated while they were unconscious; only eight of the men were previously aware that it was a crime.

In addition, nine men said that they had had sex that they didn't want to have but didn't feel able to refuse because they were at a chemsex party. Three men had been assaulted more than once, two men believed that they had been the victim of a planned assault (for example, being deliberately overdosed) and one man reported being filmed and injected while he was unconscious.

Only two of these men decided to take the incident to the police.

Two men attending the clinic came to realise that they had been the perpetrator of non-consensual sex. Ward said that these were particularly challenging situations for clinical staff to work with.

Rebecca Evans, a nurse at the clinic, said that one reason why asking about non-consensual sex could be difficult for staff was because it might not be clear what they would do with the information. As sexual health clinicians, they would not be providing ongoing therapy or support. However, they could help men identify a way to move forward - having a robust referral network to organisations such as SurvivorsUK and the LGBT Foundation was important.

Fred Bladou of AIDES in Paris commented that it was important to draw attention to power relations within this environment. He was particularly concerned about young people, migrants and sex workers who are often particularly vulnerable, for example attending a party on the understanding that their drugs would be provided and paid for. "The chemsex community is not always very friendly and we have to think about the most vulnerable people in the community," he said.

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Non-consensual sex is a recurrent problem in the chemsex environment

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The second European Chemsex Forum, recently held in Berlin, highlighted a number of difficulties and harms experienced by chemsex users, including non-consensual sex. "We have heard many stories of men who, during sexual marathons that last for days, pass out on GHB or GBL, while the sex continues to take place," said Leon Knoops of the Dutch harm reduction organisation Mainline.

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Dean Street is a friendly, convenient and free NHS sexual health clinic in the heart of London. The service - based in Soho - also offers full outpatient HIV clinic services.

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A dangerous interaction is possible between ritonavir or cobicistat and several recreational drugs:

Crystal methamphetamine (crystal, tina, meth)

MDMA (ecstasy, X, mandy)

Mephedrone (miaw miaw, plant food, bath salts)

Ketamine (K, vitamin K, special K)

Erectile dysfunction drugs (Viagra, Cialis, Levitra)

Benzodiazepines (benzos, Valium, Xanax)

The interaction may increase the intensity of the effect of the recreational drug, sometimes to unpleasant or dangerous levels.

Experts judge the potential for interactions with the first three drugs listed to be 'moderate' and with the last three to be 'high'. There have been a handful of documented cases of deaths and serious side-effects in people taking ritonavir alongside crystal meth, MDMA or ketamine.

Heavy use of ketamine can lead to damage to the liver and bile ducts. Overdoses of erectile dysfunction drugs are dangerous for the heart. An overdose of benzodiazepines could result in the person passing out.

Poppers may also interact with erectile dysfunction drugs, causing a potentially dangerous drop in blood pressure. This may be more likely if you are also taking ritonavir or cobicistat.

For GHB (gamma-hydroxybutyrate) and GBL (gamma-butyrolactone), the risk of interactions is unknown.

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Factsheet Interactions between HIV treatment and recreational drugs

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A dangerous interaction is possible between ritonavir or cobicistat and several recreational drugs: Crystal methamphetamine (crystal, tina, meth) MDMA (ecstasy, X, mandy) Mephedrone (miaw miaw, plant food, bath salts) Ketamine (K, vitamin K, special K) Erectile dysfunction drugs (Viagra, Cialis, Levitra) Benzodiazepines (benzos, Valium, Xanax) The interaction may increase the intensity of the effect of the recreational drug, sometimes to unpleasant or dangerous levels.

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by Tuukka Tammi

Too often, the materials that projects produce are eventually hidden somewhere, forgotten and unused as the project ends. That is a pity, not to mention a waste of resources. To avoid this, we have tried to preserve our materials in places which stay alive and kicking after our project has ended, and the people who worked on it have moved on to new. An article by Tuukka Tammi.
The three-year EU Joint Action on HIV and Co-infection Prevention and Harm Reduction, HA-REACT, produced a bunch of materials that are useful in training, planning, or advocating harm reduction measures and policies. HA-REACT had 22 partners, representing 18 EU Member States, with additional expertise provided by 14 collaborating partners, including the European Centre for Disease Prevention and Control (ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).
Training manual on HIV and HCV rapid testing in low-threshold settings for PWUD
In the following - to use restaurant vocabulary - the ingredients of our delicious and carefully prepared products are briefly described. The best before date of these delights is not even near. Please enjoy them while they're fresh and tasty.
On our menu, we have:

This manual was designed to be a complete tool for providing staff in low-threshold settings the knowledge, skills, and techniques needed for testing people who use drugs for HIV and HCV and linking them to needed care. The manual includes eight modules with descriptions of content to be taught and tips for practical exercises. These modules introduce basic information about HIV, HCV, and TB, different types of tests which can be used, pre- and post-test counselling, gender-specific approach to testing and treatment, as well on how to build links to care. The modules can be used together as a complete 3-day training or independently.

The manual is available in English and in Russian.
The same training material has been converted to an e-learning tool which is available here!

As part of HA-REACT's activities in Latvia and Lithuania, a complete Harm reduction training package was created and tested. The whole package includes policy seminars, face-to-face trainings, study visits to best practice harm reduction services, guidelines, manuals, and leaflets. The package is well documented here and its different parts can be copied and tailored to other countries, regions, and contexts.

As part of the training package development, HA-REACT prepared the booklet Everything you ever wanted to know about drug-related harms but were afraid to ask. The booklet is based on interviews with people who use drugs, social workers, clinicians, nurses, NGO workers, and researchers. It is available in English, Lithuanian, Latvian, and Russian.
Very juicy.

Sister materials of this booklet are the brochure and the video What is Harm Reduction? which explains in a clear and visualised way what harm reduction is about, and how it benefits people who use drugs, as well as their families and communities.

Harm reduction services for people who inject drugs are too seldom offered in European prisons; prison-based harm reduction was also one of HA-REACT's focus areas. The web site contains a variety of materials and online courses about harm reduction in prison settings, with an emphasis on continuity of care. The courses cover the following topics: condom provision, needle and syringe exchange in prisons (PNSP), opioid substitution treatment (OST), and harm reduction in prisons.

Toolkit on models of care and quality. Many studies have been conducted to explore the barriers faced by PWID when accessing HIV, HCV, and TB services. These barriers can have important consequences not only for their health and the lives of their families, but also for their communities and for public health in general. Frequent delays in receiving appropriate care mean higher prevalence of HIV, TB, and other infections, as well as higher healthcare costs. A related policy brief and the toolkit on implementing integrated models for PWID addresses both barriers and solutions to overcome them.

For those with more thirst for knowledge, deeper analysis about the service access barriers in Europe can be found from another HA-REACT Report: An assessment of barriers to access to HIV and HCV services for people who inject drugs in Europe

One barrier for well-working services is a lack of money. To help find solutions for this, HA-REACT produced a Guide to funding mechanisms for harm-reduction programmes in European Union Member States. This guide outlines funding sources and mechanisms for programmes that provide harm reduction and other health services to people who inject drugs (PWID) in the European Union.

It covers funding sources ranging from municipalities to international organisations and private donors. The document provides brief examples to illustrate the variety of funding arrangements, which are often quite complex.

Tuukka Tammi

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On Today's Menu: Fresh Delights for Harm Reduction Training and Advocacy

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by Tuukka Tammi Too often, the materials that projects produce are eventually hidden somewhere, forgotten and unused as the project ends. That is a pity, not to mention a waste of resources. To avoid this, we have tried to preserve our materials in places which stay alive and kicking after our project has ended, and the people who worked on it have moved on to new.

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Philip A. Yeon, MD, MPH&TM and Helmut Albrecht, MD

Methamphetamine use is already influencing the HIV/AIDS epidemic in the U.S. and could have an even greater impact in coming years.

Crystal methamphetamine (CM) is an extremely addictive stimulant that increases sexual arousal while reducing inhibition and judgment. Its use is associated with a range of high-risk sexual behaviors that increase the likelihood of acquiring or transmitting HIV. Given the relatively high prevalence of CM use among people living with HIV and among men who have sex with men (MSM), there is great concern that this drug is fueling the HIV epidemic. Equally worrisome are the effects that CM use can have on the prognosis and overall health of HIV-infected patients.

Background

Known by various street names (most commonly, "ice" and "glass"), CM can be smoked, snorted, injected, swallowed, or inserted into the rectum. Compared with other illegal drugs, CM is inexpensive, readily available, and provides a stronger, longer-lasting "high" (8-24 hours). 1 Prevalence of use in the U.S. is difficult to pinpoint, but estimates of past-year use from national cross-sectional surveys range from 1.5% to 2.8% among young adults. 2 Estimates of past-year use are even higher among MSM - 9.7%, according to one San Francisco study ( ACC Sep 28 2005) 3 - in part because the drug is now deeply embedded in the MSM "circuit party"culture. 4

Commonly cited reasons for using CM, aside from peer pressure, are increased sexual sensitization, mood enhancement, and disinhibition. However, the drug is also used to provide an escape from stress, depression, alienation, and loneliness, all of which are common among people living with HIV. Furthermore, many HIV-infected MSM report using CM as a way to deal with their illness or with homophobia or prejudice. 4, 5 Consequently, CM use is highly prevalent among people living with HIV. In a San Francisco study, 19% to 39% of HIV-infected people reported using CM during the previous year. 6 This high prevalence is alarming because CM use can increase the risk for HIV transmission and also contribute to poorer health outcomes in HIV-infected users.

Methamphetamine Use and HIV Transmission

CM use increases the risk for HIV transmission and acquisition in a number of ways.

First, the drug lowers sexual inhibitions, impairs judgment, and provides the necessary energy and confidence to engage in sexual activity for long periods of time. As a result, methamphetamine users are more likely than nonusers to engage in unprotected anal sex and to have sex with injection drug users, HIV-positive partners, and those of unknown HIV status; they also tend to report a greater number of sex partners and to have a history of other sexually transmitted diseases (STDs). 3, 7, 8

Second, CM use is a well-documented cause of erectile dysfunction, which can lead users to engage in even higher-risk sexual activities. For example, users who cannot sustain an erection may switch to receptive anal sex ("bottoming"), which carries a higher risk of HIV acquisition than does insertive anal sex. Alternatively, users may take erectile-dysfunction drugs, and the combination of these with CM can lead to longer, more-aggressive periods of sex, potentially resulting in condom breaks or mucosal tears, which can cause bleeding and increased risk of HIV transmission.

Third, CM causes mucosal dryness, which increases the risk for tissue tears. Additional damage to rectal tissues can occur when CM is inserted into the rectum ("keistering," "booty bumping").

Finally, when CM is injected, needle sharing can greatly enhance transmission of HIV and hepatitis viruses.

Numerous cross-sectional studies have demonstrated an association between CM use and increased risk for HIV infection, but only a few studies have prospectively assessed seroincidence. In the largest of these, the Multicenter AIDS Cohort Study, the relative risk for HIV seroconversion was 1.5 among CM users compared with nonusers and was even higher (3.1) among men who used both methamphetamine and poppers ( ACC Apr 13 2007). 9

Methamphetamine Use and Progression of HIV Disease

In addition to facilitating HIV transmission, CM use is associated with detrimental behavior changes that can affect the prognosis and overall health of people living with HIV. For instance, current methamphetamine use decreases adherence to HIV treatment and medical follow-up. 10 Frequent CM use has also been associated with increased risk for antiretroviral resistance, particularly to NNRTIs, with the obvious implications for treatment and transmission risk. 11 For example, CM use is thought to have contributed to the acquisition of triple-class-resistant virus by the New York City patient described in 2005 ( ACC Sep 1 2006). 12 In addition, some patients use CM to treat HIV-associated symptoms, such as fatigue, instead of seeing a physician. Such self-medication may lead to underdiagnosis and undertreatment of HIV and to important complications such as anemia and hypogonadism. 5, 10

CM use may also influence progression and complications of HIV disease more directly. For example, animal studies have shown that CM can impair the immune system 13 and increase HIV replication, 14 and human studies suggests that it can accelerate the progress of HIV-related dementia. 15

Other Consequences of Methamphetamine Use

Other consequences of CM use that are particularly harmful to HIV-infected patients include deterioration of the teeth and gums (a result of dry mouth and grinding of the teeth), reduced appetite, poor eating habits, and weight loss. Furthermore, many users "crash" after using CM for several days straight and are left with little energy and the very feelings they were trying to avoid - depression and isolation.

Other adverse effects of CM use include intense cravings for CM when not taking it; tachyphylaxis; increased risk for heart attack and stroke (because of increases in blood pressure, heart rate, and body temperature); impaired memory, reasoning, and ability to process information; and psychological problems, such as depression, psychosis, aggressive behavior, hallucinations, and paranoia. Chronic use can also cause skin lesions and damage the cardiovascular system, lungs, liver, muscles, and nerve cells in the brain.

Although methamphetamine is not known to affect HIV medications, some PIs increase absorption and decrease metabolism of CM, leading to severe reactions or overdosing. 16, 17

Preventing and Treating Methamphetamine Addiction

Prevention of methamphetamine use is hampered by a relative paucity of epidemiologic data that would enable us to assess the magnitude of the current problem adequately and to evaluate the efficacy of various interventions. Despite federal efforts to restrict pseudoepinephrine imports and a nationwide decline in small methamphetamine laboratories, the drug continues to be widely available. A report from the National Drug Intelligence Center suggests that Mexican drug traders have relocated their labs from the U.S. to Mexico and have expanded distribution to the midwestern and eastern U.S., underscoring the difficulties of drug enforcement in the era of global trade. 18 Developing methamphetamine prevention "task forces" (involving community members and representatives from at-risk groups, STD treatment centers, health departments, and law enforcement) is a reasonable approach, despite a lack of efficacy data. 19 Educational campaigns should be tailored to specific target populations, and care should be taken to help ensure that such campaigns do not increase cravings in CM-addicted patients. 20

Given the high prevalence and dire consequences of CM use among HIV-infected patients, clinicians should be sure to ask patients about past or current use. Drug testing is recommended for all patients who have a history of, or are suspected of, using CM.

Few data are available to recommend any one method of methamphetamine treatment over another. 21 Cognitive behavior-based interventions (Matrix Model), 12-step programs, drug testing, and contingency management interventions have been used by different treatment centers, with varying degrees of success. Nevertheless, treatment of CM addiction can be successful in decreasing risky sexual behaviors and should be an integral part of any HIV prevention effort. 21, 22

Conclusion

All current data underscore the potential of methamphetamine to substantially worsen the current HIV epidemic, with some studies indicating that this potential is already being realized. Methamphetamine use is an important public health problem and is associated with risky sexual behavior; increased rates of transmission of HIV, other STDs, and hepatitis; serious adverse events; and poor adherence to antiretroviral treatment. Prevention efforts not only must encompass traditional education and awareness campaigns but also will require local, national, and international policy changes, including allocation of appropriate resources and funding. Comparative trials of different treatment approaches are needed, as are better evidence-based protocols for treatment.

Citation(s):

1. Centers for Disease Control and Prevention (CDC). Methamphetamine use and risk for HIV/AIDS [fact sheet]. Jan 2007. ( http://www.cdc.gov/hiv/resources/factsheets/meth.htm)

2. Iritani BJ et al. Crystal methamphetamine use among young adults in the USA. Addiction 2007 Jul; 102:1102.

3. Buchacz K et al. Amphetamine use is associated with increased HIV incidence among men who have sex with men in San Francisco. AIDS 2005 Sep 2; 19:1423.

4. Kurtz SP. Post-circuit blues: Motivations and consequences of crystal meth use among gay men in Miami. AIDS Behav 2005 Mar; 9:63.

5. Semple SJ et al. Motivations associated with methamphetamine use among HIV+ men who have sex with men. J Subst Abuse Treat 2002 Apr; 22:149.

6. Mitchell SJ et al. Methamphetamine use and sexual activity among HIV-infected patients in care - San Francisco, 2004. AIDS Patient Care STDS 2006 Jul; 20:502.

7. Frosch D et al. Sexual HIV risk among gay and bisexual male methamphetamine abusers. J Subst Abuse Treat 1996 Nov/Dec; 13:483.

8. Celentano DD et al. Associations between substance use and sexual risk among very young men who have sex with men. Sex Transm Dis 2006 Apr; 33:265.

9. Plankey MW et al. The relationship between methamphetamine and popper use and risk of HIV seroconversion in the Multicenter AIDS Cohort Study. J Acquir Immune Defic Syndr 2007 May 1; 45:85.

10. Reback CJ et al. Methamphetamine abuse as a barrier to HIV medication adherence among gay and bisexual men. AIDS Care 2003 Dec; 15:775.

11. Colfax GN et al. Frequent methamphetamine use is associated with primary non-nucleoside reverse transcriptase inhibitor resistance. AIDS 2007 Jan 11; 21:239.

12. Centers for Disease Control and Prevention (CDC). Investigation of a new diagnosis of multidrug-resistant, dual-tropic HIV-1 infection - New York City, 2005. MMWR Morb Mortal Wkly Rep 2006 Jul 28; 55:793.

13. In SW et al. Methamphetamine administration produces immunomodulation in mice. J Toxicol Environ Health A 2005 Dec 10; 68:2133.

14. Phillips TR et al. Methamphetamine and HIV-1: Potential interactions and the use of the FIV/cat model. J Psychopharmacol 2000; 14:244.

15. Flora G et al. Methamphetamine potentiates HIV-1 Tat protein-mediated activation of redox-sensitive pathways in discrete regions of the brain. Exp Neurol 2003 Jan; 179:60.

16. Antoniou T and Tseng AL. Interactions between recreational drugs and antiretroviral agents. Ann Pharmacother 2002 Oct; 36:1598.

17. Hales G et al. Possible fatal interaction between protease inhibitors and methamphetamine. Antivir Ther 2000 Mar; 5:19.

18. National Drug Intelligence Center. National methamphetamine threat assessment 2007. Nov 2006. ( http://www.usdoj.gov/ndic/pubs21/21821)

19. Mansergh G et al. CDC consultation on methamphetamine use and sexual risk behavior for HIV/STD infection: Summary and suggestions. Public Health Rep 2006 Mar/Apr; 121:127.

20. Nanín JE et al. Community reactions to campaigns addressing crystal methamphetamine use among gay and bisexual men in New York City. J Drug Educ 2006; 36:297.

21. Cretzmeyer M et al. Treatment of methamphetamine abuse: Research findings and clinical directions. J Subst Abuse Treat 2003 Apr; 24:267.

22. Lyons T et al. Stimulant use and HIV risk behavior: The influence of peer support group participation. AIDS Educ Prev 2006 Oct; 18:461.

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Crystal Meth and HIV/AIDS: The Perfect Storm?

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Philip A. Yeon, MD, MPH&TM and Helmut Albrecht, MD Methamphetamine use is already influencing the HIV/AIDS epidemic in the U.S. and could have an even greater impact in coming years. Crystal methamphetamine (CM) is an extremely addictive stimulant that increases sexual arousal while reducing inhibition and judgment.

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This service is primarily for users who need to use the interaction checker service in an older browser. Ideally, you should try to upgrade your browser to the latest version in order to use our full featured interaction checker.

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"I love smoking a spliff while my boyfriend goes down on me. It makes the experience, you know...tingly." Thirty-year-old Helen* and I have been friends for more than ten years. She's a wildly successful sales exec working for one of the UK's biggest tech companies. She's also a stoner ("and proud," she laughs). Though we've been friends for a long time, this conversation is uncharted territory. "We smoke most days, but sometimes make a point of doing it for sex purposes," she tells me matter-of-factly. "It definitely lowers inhibitions, you really relax into it. And I think it makes me feel more connected to my boyfriend - partly because it makes me more sensitive."

Last week a new report from academics at University College London alongside researchers at the Global Drug Survey sent ripples through the media with the announcement that we Brits are more likely than our counterparts in Europe and the US to combine drugs with sex. More than 22,000 people globally took part in the survey, which found that more than 60 per cent of British respondents had drunk alcohol before sex in the past year.

Admittedly, this isn't groundbreaking news - many of us would consider a large glass of red an excellent aphrodisiac (hell, some of us would even consider a large glass of vodbull an aphrodisiac), But, as Professor Adam Winstock, consultant addiction psychiatrist and founder of the Global Drug Survey, explains, "Part of the point of this report is to bust some unhelpful stereotypes which exist around the intersection between sex and chems [meaning all drugs, including alcohol]. Everyone seems obsessed by the idea that the only people who have 'chemsex' are gay men. It's unhelpful because almost everyone at some point has probably had sex on drugs - as researchers we need understand how and why people do it, so that we can offer the best harm reduction advice."

It definitely lowers inhibitions, you really relax into it

And as my chat with Helen illustrates - even if alcohol is the most common 'chem', it's certainly not the only one. Alongside cannabis (36 per cent of British respondents had combined it with sex), around 13 per cent of Brits surveyed had combined sex with cocaine and 20 per cent had combined sex with MDMA. My friend Rachel*, 28 and working in PR, is an advocate of the latter, arguing that it allows for a more "transcendental experience," she tells me. "I've had some great sex on MD, it's like this whole other, deeply emotional vibe but I've only done it with a partner - I've never just hooked up with someone while on MDMA," she explains. "I don't understand that at all; it makes you really empathetic, which I think adds to the sexual experience, but I wouldn't want to be baring my soul to someone I picked up in a club." In fact, according to one study of 35 recreational users, consuming MDMA led to an increase in desire for and satisfaction with a sexual encounter, but not in likelihood of orgasm. "I don't think orgasm is the point," says Rachel. "It's more about the journey. I know it sounds really hippy-dippy but if you do just a little with the right person, it can be great."

My own experiences have varied wildly. Recent research shows that about a third of women in the US have, like Helen, used marijuana before sex and those who did were twice as likely to say they had "satisfactory" orgasms. But personally, I couldn't think of anything worse than smoking cannabis while having sex. Through trial and error - emphasis on the error - I've found that cannabis makes me heart-palpitatingly anxious. I once took two tokes on a joint while on a beach in California and became so worried that I was getting sunburnt that I put my entire body (head, arms, legs, everything) inside my then-boyfriend's t-shirt. He came out of the sea to find me huddled like ET while everyone around me sunbathed happily and decided it was best to take me home.

As Winstock points out, "It's a really bad idea to try having sex on any drug you've never taken before, or on one which has led you to have a bad reaction. You're already in an emotionally charged situation without adding to that." MDMA too isn't one I can imagine taking in the pursuit of a "transcendental" shag. I don't like being pawed at at the best of times, let alone while high, something which Winstock points out is more common than people might think: "Some people become super sensitive, so touch can be intensified...I guess that comes down to who's touching you and in what circumstances, but it can be unpleasant," he says.

Taking a line or two with my then boyfriend, we had this wild, urgent, uninhibited sex

Then there's cocaine, which I stopped taking a while ago (when I became more cognisant of the hypocrisy of doing a line and then despairing over climate change and human trafficking), but is probably responsible for my only good chemsex experience. Taking a line or two with my then boyfriend, we had this wild, urgent, uninhibited sex. As with most drugs - including alcohol - one of its main functions is as a disinhibitor, it makes you feel more invincibile, which might be great in the moment, but it can lead to some poor decision-making. Luckily I was with a partner I trusted but I've had many friends wake up with deep regrets after a combination of wine and cocaine meant they did things they'd usually never dream of. (Notably one friend tried anal sex for the first time while on cocaine, and in the heat of the moment didn't realise that she'd sustained, erm, tearing. As well as stitches, she had to sit on a donut cushion for a week, which made for some awkward conversations at work.)

As for me, well, what goes up must comedown and the next day I woke up hungover and feeling emotionally bankrupt - which somewhat coloured the sexual experience. Was it worth it? In hindsight, with a blinding headache and a numb nose, probably not. Cocaine is also, often, a tricky one for men who want to engage in sexual activity. "When men choose which chems to use ahead of sex, it's all about their dicks," says Winstock. "Viagra, crystal meth...drugs that allow them to keep an erection for longer. In comparison, for women, the drugs that were rated most highly were those that promoted sexual intimacy, emotionality and sensuality. That's why they tended to favour drugs like cannabis and MDMA."

I started sweating, and my heart was hammering in my chest. I had to stop everything

Cocaine, however, is a notorious boner killer - as 24-year-old Josh* explains. "I met a girl on Tinder, and we came up with this plan to hang out, do cocaine and have sex. It seemed really dangerous, but kind of hot. I knew, though, that I couldn't keep an erection if I took it, so I decided to get some Viagra." In the year since Viagra was made available in the UK without prescription, more and more reports have surfaced of young men using it as a kind of sexual insurance policy against drink or drug-induced erectile dysfunction. "We got on the coke, chatted, were kissing and then I took the Viagra. After about an hour it still wasn't working, so I took another. And then all of a sudden," he pauses, "Boom. I had this...raging erection - to the point that it was painful. I started sweating, and my heart was hammering in my chest. I had to stop everything, and we opened the windows but I couldn't get cool. I was really panicking - asking for her to call an ambulance. I really thought I was going to have a heart attack."

Josh eventually had to get under a cold shower to cool his body down. "I was naked and whimpering in front of this girl I'd just met - it was the worst sexual experience of my life." Though he says he's unlikely to try cocaine again ("that was the fourth or fifth time I'd ever taken it, and the last,") he'll still keep a Viagra in his pocket "just in case".

Interestingly, none of the friends I speak to would consider what they do as chemsex. "I just imagine chemsex happening in a sex party environment," says Helen. Rachel adds: "There's something clinical about the term that I don't feel fits with what I'm doing, although, I guess it is what I'm doing..." Perhaps to this overstimulated generation (with our busted our dopamine feedback loops) the intersection of sex and chems offers another way to feel the kind of buzz the previous generations would have gotten from some simpler pastime. "I think for me," says Josh, "It felt like I could get to know this person in double time. We'd only met once before but then when the coke hit we were saying all sorts that we'd feel too embarrassed to be open about otherwise." Helen agrees: "This is the first time I've been with someone who likes to smoke weed, and I feel like it's made our relationship stronger and deeper in a much shorter amount of time. It's not for everyone, but that's the effect it's had on us."

So perhaps it comes down to the fact that we're too time poor (or impatient) to slow-grow our intimacy. But these shortcuts have a price. The chances of having a bad experience are certainly high - for every great chemsex encounter I hear of, there are three more like Josh's where someone panics, someone loses their erection or worse. I certainly don't plan on partaking again, but no judgement on anyone who likes it. As Winstock says, though, "Tread carefully."
*All names have been changed. The Independent's Millennial Love group is the best place to discuss to the highs and lows of modern dating and relationships. Join the conversation here.​

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Chemsex: a dangerous shortcut to intimacy

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"I love smoking a spliff while my boyfriend goes down on me. It makes the experience, you know...tingly." Thirty-year-old Helen* and I have been friends for more than ten years. She's a wildly successful sales exec working for one of the UK's biggest tech companies. She's also a stoner ("and proud," she laughs).

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Chemsex and the Coronavirus Lockdown
The Corona Virus pandemic has created an unprecedented situation in our social lives. The Government has issued guidance that we should stay at home to protect ourselves, the NHS, and others.
It is important this this is adhered to in relation to chemsex and other sexual activities.

Put simply - stay at home, have a wank.

Please remember that we are still delivering our services remotely, and you can contact us via email at antidote@londonfriend.org.uk and one of the team will get back to you. We can currently offer support via email, phone or online video.

Don't hook up

Firstly of course we advise that you do not engage in any chemsex hook ups, be that one to one or in a group setting, so that you limit the risk to yourself and others in terms of contracting or passing on the virus.

There is emerging evidence that suggests methamphetamine use and HIV may increase the risk of Covid-19 progression. We have also heard reports of arrests in Europe of groups of queer men who have ignored government advice on social distancing, and have got together for chemsex parties.

If you are living with your partner, or if you do choose to hook up, Terrence Higgins Trust, Prepster and BASHH have produced information regarding sex and Covid-19.

Take a break

This enforced period of social distancing offers opportunities to take a break from drug use. You can find information for making goals and dealing with cravings on our Antidote home care pages.

If you are currently dependent on GHB/GBL (using the drug on a daily basis) it is important you seek advice before suddenly stopping as withdrawals can be dangerous.

We've provided suggestions below for alternative activities to chems that you can access during lockdown.

Sexual Health Services

If you are still choosing to engage in chemsex activities at this time and are meeting others for sex, then please be aware of the following:

Sexual health services are working at reduced capacity and are only seeing patients in an emergency or urgent cases.

If you require PEP treatment then you should contact your local sexual health service for an emergency appointment.

If you are currently taking PReP, and are engaging in sexual activity then you should continue with this. Further information regarding PReP can be found on the Prepster website.

If you require STI testing then Sexual Health London are able to arrange home testing for you online.

Further advice on chemsex and sexual health can be found here.

Meeting online

Apps & Social Media

Apps and social media can offer a lifeline for some during this period of lock down, and can support you in feeling connected to others within our community. However we advise that you limit your engagement to online interactions and do not hook up with others in person to ensure that you continue to limit any risk to yourself or others.

Online Video and Cam Services

Using online video and camming platforms is part of the way many people connect with others for chemsex related experiences. Using video does limit any Corona Virus health risk since interactions take place in a virtual space with no physical contact.

If though you are thinking about using these spaces to have chemsex experiences as an alternative to meeting in person, there are some things for you to consider as additional harms can arise in this scenario.

If you are using substances on your own at home, there is more risk of overdosing with no access to help.

Consent needs to be both considered and acquired during any online experiences you engage in. If you are unsure of what consent is then we have some advice here.

If you become unwell, or develop any mental health issue during a webcasting chemsex experience then we advise you to come offline and seek either medical or professional support rather than taking the advice of anyone you are webcasting with. Information regarding chemsex and mental health can be found here.

In all situations of chem use, we advise that you implement harm reduction advice into your sessions. Harm reduction advice can be found here.

A time to reach out

Consider making contact with family & friends by either phone or social media so that you remain connected to others. In light of the current lock down situation, most people would probably welcome the contact as there are many people in the UK who are also feeling cut off from the outside world.

In doing so there may be an opportunity to share your goals or any changes you have decided on with others. If you don't feel that this would be an appropriate step to take, then use the contact with others to share any difficulties you are having with being isolated, or just to take your mind off being at home 24/7.

Taking this step may result in developing, or deepening the connections you have with others.

Reducing Boredom & developing connection with others

Feeling bored can often result in a return to old behaviours, so if you have decided on implementing change into your chem use, it will be important to engage in different activities at this time. Also, if your chemsex engagement mainly took place within a group setting then you may need to be a part of different groups in order to continue to feel connected. The following online resources then may just help you achieve this, and we will continue to update over the coming weeks.

Galop have a list of Community links to LGBT+ organisations and online forums.

LGBTribe offers peer to peer online support for the LGBT+ community.

Outlife have various LGBT+ forums that you may interest you, and to help you keep connected to others.

Black Out UK offers online resources to support BAME community.

+Pals, a social group for gay and bisexual men who are living with HIV in London, are currently offering phone/online support.

The Trans Network London lists various Trans organisations is London, some of which are offering online support.

Simon is also running A Change Of Scene weekly check ins on a Friday evening. You can email Simon directly at achangeofscene@yahoo.com for more information.

As well as offering constant contact with family & friends, Facebook also has numerous interest groups and daily live events that may be of interest to you.

Netflix has so much to watch including lots of LGBT+ related content.

BBC iPlayer has all BBC content that has been on the BBC channels.

Youtube are currently streaming lots of online quizzes and interest themed events.

Instagram are streaming daily quizzes live, as well as other specific interest themed events.

Time out online have a new section titled 'Time in' with listings of the best things to do at home.

The National Theatre are offering free live streamed plays every Thursday via youtube.

The British Film Institute are offering a 14 day free trial of their BFIplayer.

The Apple App store have lots of fitness apps to support you in exercising at home.

Zoom is an online video platform, to help you keep connected to family & friends, and offers group facilities.

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Chemsex and the Coronavirus Lockdown - London Friend

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Chemsex and the Coronavirus Lockdown The Corona Virus pandemic has created an unprecedented situation in our social lives. The Government has issued guidance that we should stay at home to protect ourselves, the NHS, and others. It is important this this is adhered to in relation to chemsex and other sexual activities.

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COVID-19 is shaping the lives of all of us around the world. This new section provides information for PrEPster communities to learn more about COVID-19.

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Don't hook up during the COVID-19 lockdown

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Dr Michael Brady explains why finding pleasure in different ways is key to fight the spread of coronavirus.

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Clinic M (MSM Clinic) | Brighton & Hove Sexual Health and Contraception Service

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Clinic M offers a confidential sexual health service to gay and bisexual men and other men who have sex with men regardless of HIV status on Wednesday evening. There are 8 walk in slots from 17:00 - 18:00 and appointments from 18:00. This clinic is open on Wednesday evenings 17:00 - 20:00.

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Page created: May 2020
Last updated: August 2020
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Here you'll find a whole host of resources and guidance (and some things to do to fight the boredom that can go hand-in-hand with self-isolation), split by category. We hope it's of some help to you.

Trans-specific and LGBTQ+ resources

Trans resilience in isolation

Galop

Guide with ideas around maintaining wellbeing during social distancing, isolation and quarantine

Partying (at a distance!)

Queer House Party

Every Friday night - 9pm-1am

Does exactly what it says on the tin. 18+ space. We spoke about it here

Self-care

Help for You

Galop

LGBT anti-violence service - hate crime, domestic abuse, intimate person violence, sexual violence

can help you if you are experiencing violence and want advice or support

Learnest

digital mentoring for LGBT people

The Learnest team are currently delivering FREE online mentoring sessions to LGBT+ people.They will prioritise those in quarantine due to vulnerabilities to COVID-19., including advice for neurodiverse people who rely on daily routines to help keep stable and well!

Maytree

Emotional support

there to listen if you need emotional support

Renters' union

Renters' rights group

Many of us are going to end up on reduced hours or losing jobs, which can make paying rent difficult and put our homes at risk. This union will help you fight for your rights if the worse does happen

Please search for your local group online

Helping others

Delivering resources - to at risk people

Here is how to deliver items to people in a way that reduces the risk of also passing on the virus

Delivering resources - to infected people

Here is how to deliver items to people in a way that reduces the risk of catching the virus

Disinfecting

If you plan to give tinned food, toiletries or any physical object to someone who is at risk you will need to disinfect it. Here is how to

Leafleting

If you plan to give out leaflets letting neighbours know we are here to help its important to do this in a way that reduces the risk of infection from leaflets

Prescription Collection

How to pick up and deliver prescriptions to at risk or ill people

Protocol

Principles and assumptions for doing support actions during an epidemic

Protocol

Policy for doing support actions during an epidemic

Running a zoom meeting

Not all mutual aid is about giving physical things to people. Isolation and loneliness is a big issue too. Running social drop ins, skill sharing and playing games together is important for everyones mental wellbeing. A zoom group is an easy way to have group meetings

Giving to others

A list of organisations you can support through donations and volunteering.

Bloody Good Period

Sanitation support

Supply sanitary products to people who cannot access them elsewhere

Donations

Covid Mutual Aid

List of all locally organised mutual aid groups in the UK

It is important to look out for others in our communities through self organising

Volunteers

Covid19 Hardship Fund for marginalised LGBTQIA+ folks - London Bi Pandas

Hardship fund for marginalised LGBTQIA+ folks

In this global pandemic, Covid19 is going to disproportionately impact marginalise LGBTQIA+ people in particular.

Donations

DOTS

Homelessness support

Most homeless shetlers will not take dogs so homeless people with dogs often have no way off the streets leaving them vulnerable to an epidemic. DOTS are running hand cleaning stations for homeless people and giving them food, as well providing vetinary care and dog food for homeless people with dogs.

Donations

Gendered Intelligence

Support to trans young people and their families

The 1000s of young trans and gender diverse people Gendered Intelligence works to provide solace and solidarity for are now stuck at home without access to our in-person youth groups. For many of them, home is the tricky place, with no support.

Donations

London LGBTIQ+ COVID19 Mutual Aid

Organising group offering mutual aid

Find out who is in need of assistance in your local area

Volunteers

Made in Hackney

Free food for communities

Made in Hackney is a group that makes sure people in Hackney have access to healthy, affordable food that's good for people and planet. They have closed their kitchens and will be delivering food and supplies to people in need.

Donations and potentially food

The Outside Project

Homelessness and LGBT community support

1 in 4 homeless people are LGBT in England, yet there is only one LGBT homeless shetler in the UK: the outside project in London. They are running online community drop ins and actvities. As well as providing beds/rooms, food and sanitary products to LGBT homeless people in London

Donations - money

Rent Strike 2020

Renters rights group

Many of us are going to end up on reduced hours or losing jobs. While the PM is giving landlords breaks on paying their mortgages we are still supposed to pay our rent. This isnt fair and will leave people at risk of homelessness we need to fight for fairness and equality for the working classes as we are being exploited by landlords

Sign petition

Renters union

Renters rights group

Many of us are going to end up on reduced hours or losing jobs, which can make paying rent difficult and put our homes at risk. This union will help you fight for your rights if the worse does happen.

Members

🔗London Renters Union Twitter
🔗London Renters Union website

Street Kitchen

Homelessness and Free food for communities

Grassroots group working to help the homeless community, providing daily outreaches with food, clothing and information that benefits our streets. Need volunteers and supplies

Donations

🔗Streets Kitchen Twitter
🔗Streets Kitchen website

Trans Grocery Fund

Fund for trans & non-binary people living around Glasgow. This fund is crowd-sourced, for redistribution to trans people who are struggling due to coronavirus/work instability

In response to the coronavirus outbreak leading to work instability, Small Trans Library Glasgow has created a small groceries & supplies fund for trans people in Scotland who are out of work or struggling

Donations

UK QTIBIPOC Emergency Relief & Hardship Fund

Short term support to Queer, Trans and Intersex, Black, Indigenous, People of Color (QTIBIPOC) currently living in the UK who are affected by the outbreak and ongoing shutdown caused by Covid-19.

"For many in our communities, COVID-19 is only making worse what it already means to live as queer people of colour in Britain." "COVID-19, and the attendant lockdowns and policies, will disproportionately impact Black women, our elders, immigrants, refugees and people of colour in ways we all know too well already.-- UK Black Pride

Donations

Emotional support

Chill, distract, relax

This will have resources put in for people to enjoy and/or distract themselves as this is still important!

How to bake bread in a slow cooker on a budget

Cooking

How to pickle vegetables

Cooking

Free art lessons

Craft

Learn to knit

Craft

Zine making tutorials

Craft

Black trans archive

Culture

Concerts - Berliner Philharmoniker digital concert hall is streaming concerts, orchestras and operas for free

Culture

Digital Soane Museum - virtual museum tour

Culture

Digital Transgender Archives - look via the map for amazing free digital materials of trans + GNC material

Culture

Free queer films online

Culture

Magnum Photos Archive, including articles

Culture

Online Art Events

Culture

Opera - Metropolitan Opera House is streaming for free an opera each evening

Culture

Portal to materials / articles on black history

Culture

Wellcome Library Digital Collections

Culture

New York Public Libraries Digital Collection - including Pride photos

Culture / Reading

Queer Zine Archive Project - digitised queer zines to read online!

Culture / Reading

POC Zine Project - free digitised zines by POC

Culture / Reading

Free D&D workshops

Gaming

Make your own Games with Twine. Free program. Also has rich queer history (see Porpentine's twine games)

Gaming

Free online yoga classes

Health

High Intensity Interval Workout in Drag (you don't have to be in drag if you don't want to but the instructor is)

Health

Live Kickboxing Group Lessons

Health

Cambridge Core have made 700 of higher education textbooks in HTML format free to access online during the coronavirus outbreak.

Learning

Free online college/uni courses

Learning

Learn how to code for website creation

Learning

Skillshare Classes

Learning

Head space - covid specific mental wellbeing

Mental Wellbeing

A list of webcams you can access to watch cute animals if you are feeling like you want to see something other than your flat walls

Mental Wellbeing

Online laughter clubs

Mental Wellbeing

Free audiobooks from Audible

Reading

Free ebooks + e-audiobooks from your public library. In the UK they will use Borrowbox, Overdrive or Libby. If you have an existing library account you can sign in with these details on the apps and see what they have available. If you don't have a membership, a lot will take sign-up online. You can then read books and listen to audiobooks in-app (unfortunately, not on Kindles that aren't also tablets)

Reading

Free ebooks from Haymarket books

Reading

Free ebooks from Verso

Reading

LibraryThing - now free

Reading

Scribd - free one month trail

Reading

Useful Resources

Freelance resource lists

Resources

List of resources and where to go for help for people working in the freelance industry

Inclusivity - Support BAME Trans People

Resources

This guide on inclusive practices & guidance is particularly relevant now that the pandemic is exposing injustices more than ever.

Which Free Resources

Resources

News and advice on COVID-19, from protecting yourself and your loved ones to the financial support on offer and how to shop safely

Reliable Information

BBC Reality Check

Evaluates and debunks common misinformation

Corona Virus Information Center

Information on corona virus

Corona Virus Simulator - Washington Post

Information on how to slow the spread of covid19 and how this will save lives

Corona Virus Tech Handbook

Collating resources for support and information

Covid19 International Media Brief

Global perspective of media portrayal of epidemic

Doctors without borders

Latest updates on global situation

Flatten the curve

Information on how to slow the spread of covid19 and how this will save lives and on the virus in general

Full Fact

Evaluates and debunks common misinformation

University of Leeds COVID19 tracking

Graph showing daily updates of cases in UK and outcomes

World Health Organisation

Information, research, guidance, news

Staying in touch

Our youth groups here at Gendered Intelligence are moving online - see our page here for more information.

Our support line is still running as normal!

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Page created: May 2020 Last updated: August 2020-------------- Here you'll find a whole host of resources and guidance (and some things to do to fight the boredom that can go hand-in-hand with self-isolation), split by category. We hope it's of some help to you.

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If you shop Amazon Black Friday Week deals from 20th - 30th November, you can do more than discover great deals: Simply shop at http://smile.amazon.co.uk/ch/1174045-0 or with AmazonSmile ON in the Amazon Shopping app, and AmazonSmile donates to Spectra at no extra cost.

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If you shop Amazon Black Friday Week deals from 20th - 30th November, you can do more than discover great deals: Simply shop at http://smile.amazon.co.uk/ch/1174045-0 or with AmazonSmile ON in the Amazon Shopping app, and AmazonSmile donates to Spectra at no extra cost.

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Scientists have discovered that regular use of the party drug GHB, and especially unconsciousness following GHB use, is associated with brain changes including negative effects on long-term memory, working memory, IQ, and higher levels of stress and anxiety. This work is presented at the ECNP conference in Barcelona, following partial peer-review publication*.

GHB (gamma-hydroxybutyrate), also known as 'G', 'liquid ecstasy' (etc), is a central nervous system depressant. It is used extensively in clubs, but also in private house parties. It produces an initial feeling of euphoria in users, but it can also cause sleepiness, and users easily tip into a coma. Some regular recreational users will often fall into a coma, which can require hospital treatment: it is not unusual that regular GHB users have experienced more than 50 GHB-induced comas. Despite its limited recreational use, GHB overdose and coma is the third** most common drug-related cause for emergency medical attendance in Europe, after heroin and cocaine, and this trend is increasing.

To understand the effects of GHB on the brain, a team of scientists from the Amsterdam UMC, recruited 27 GHB users who had experienced multiple GHB-induced comas (with a minimum of 4 comas), 27 GHB users who had never had a coma, and 27 volunteers who had used drug combinations (polydrug), but had never used GHB. Each person was asked to complete an adult reading test as proxy for IQ, anxiety, depression and stress questionnaires and they performed different neurocognitive tasks while undergoing a brain scan (fMRI, functional Magnetic Resonance Imaging).

There were two main findings. Firstly, GHB use, even in those who did not undergo a coma, was associated with alterations in identification of negative emotions. Secondly, the presence of GHB-induced comas, but not the use of GHB per se, was associated with lower IQ (despite similar educational level), and altered brain processes during verbal long-term memory and working memory. Additional analyses showed that these findings could not be attributed to group differences in the use of drugs other than GHB.

Lead researcher, Filipa Raposo Pereira, said "Surprisingly little is known about the effects of GHB in humans, and as far as we know, these are the first functional MRI scans to gauge the effect of the regular GHB use and multiple GHB-induced comas. Our results indicate that there may be risks involved in regular GHB use. This is particularly relevant to regular users with multiple GHB-induced comas; we found that these users show differences in cognition to either those who don't fall into a coma, or drug users who have never used GHB.

In an as yet unpublished study, we show that those with multiple GHB-induced comas also have 63% more stress and 23% more anxiety, and alterations in long-term memory. MRI scans also show that there are changes to the brain, with some areas showing altered brain activity and connectivity between memory-related cerebral pathways. These results show that there are brain and cognitive changes associated with multiple GHB-induced comas. Most users experience only the feeling of elation followed by drowsiness or sleep, so they don't see that there might be any negative effects. This work indicates that might not be the case".

Commenting, Professor David Nutt (Imperial College, London) said: "This research is interesting and recreational users should be made aware of these findings. They probably reflect periods of hypoxia due to excessive GHB concentrations in brain. When GHB is used in a regulated fashion as a medicine-for example, for narcolepsy-there doesn't appear to be a similar risk, so patients on this medicine should not worry".

More information: Conference Abstract P718: The influence of GHB-use and GHB-induced coma on affect and the affective network

*This work includes new material, not presented elsewhere. It includes research from the peer-reviewed papers: Adverse effects of GHB-induced coma on long-term memory and related brain function, Filipa Raposo Pereira et al (published in Drug and Alcohol Dependence, Sept 2018) doi.org/10.1016/j.drugalcdep.2018.05.019 and Effect of GHB-use and GHB-induced comas on dorsolateral prefrontal cortex functioning in humans, Filipa Raposo Pereira et al (published in Neuroimage:Clinical, Sept 2018) doi.org/10.1016/j.nicl.2018.09.022 Other parts of the work have not yet been published.

**See European Drug Report, 2017, www.emcdda.europa.eu/system/fi ... 541/TDAT17001ENN.pdf Figure 3.8. Background information on GHB (from the European Monitoring Centre for Drugs and Drug Addiction, 2008) can be found at: www.emcdda.europa.eu/system/fi ... B_and_GBL_107300.pdf

Provided by: European College of Neuropsychopharmacology

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Research shows club drug GHB associated with brain and cognitive changes

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Scientists have discovered that regular use of the party drug GHB, and especially unconsciousness following GHB use, is associated with brain changes including negative effects on long-term memory, working memory, IQ, and higher levels of stress and anxiety. This work is presented at the ECNP conference in Barcelona, following partial peer-review publication*.

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PrEP (pre-exposure prophylaxis) | Terrence Higgins Trust

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PrEP is a drug taken by HIV-negative people before sex that reduces the risk of getting HIV. In England it is available as part of a trial. It is also available in Scotland and Wales.

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When I open the Grindr app on my smartphone, I see there's a 26-year-old man with tanned abs just 200 feet away. He's called "looking4now," and his profile explains that he wants sex at his place as soon as possible.

Scrolling down, I find 100 similar profiles within a one-mile radius of my apartment in Boston. I can filter them by body type, sexual position (top, bottom, or versatile), and HIV status.

As a gay psychiatrist who studies gender and sexuality, I'm thrilled with the huge strides we've made over the past decade to bring gay relationships into the mainstream. The Supreme Court ruled that same-sex marriage is a constitutional right. Today in Boston, two men can walk down the street holding hands without consequence.

But I'm worried by the rise of the underground digital bathhouse. Apps like Grindr, with 3 million daily active users, and others like Scruff and Jack'd, are designed to help gay men solicit sex, often anonymously, online. I am all for sexual liberation, but I can't stop wondering if these apps also have a negative effect on gay men's mental health.

Since there's little published research on the men using Grindr, I decided to conduct an informal survey and ask men why they're on the app so much and how it's affecting their relationships and mental health. I created a profile identifying myself as a medical writer looking to talk to men about their experiences. I received about 50 responses (including propositions).

It's a small sample size, but enough to give us some clues about how Grindr is affecting gay men. And it doesn't look good.

Apps like Grindr are designed to make finding sex easy. And that can make them hard to stop using.

The most common reason users gave for going on the app is that sex feels great and Grindr makes it accessible, right at your fingertips. The screen full of half-naked men excites users. With a few clicks, there's a possibility of meeting a sexual partner within the hour.

Neuroscientists have shown that orgasm causes activation of pleasure areas of the brain like the ventral tegmental area while deactivating areas involved with self-control. And these patterns of activationin men are strikingly similar to what researchers see in the brain of individuals using heroin or cocaine. So when a neutral action (clicking on Grindr) is paired with a pleasurable response in the brain (orgasm), humans learn to do that action over and over again.

This can be a normal pleasure response or it could be a setup for addiction, depending on the situation and individual.

Grindr, intentionally or not, also leverages a psychological concept called variable ratio reinforcement, in which rewards for clicking come at unpredictable intervals. You may find a hookup immediately, or you may be on your phone for hours before you find one.

Variable ratio reinforcement is one of the most effective ways to reinforce behavior, and it makes stopping that behavior extremely difficult. Slot machines are a classic example. Because gamblers never know when the next payout will come, they can't stop pulling the handle. They hold out hope that the next pull will give them the pleasurable sound of coins clanking against a metal bin, and they end up pulling for hours.

Now imagine a slot machine that rewards you with an orgasm at unpredictable intervals. This is potentially a powerful recipe for addiction and may explain why one user I spoke with stays on Grindr for up to 10 hours at a time, hoping to find the perfect partner for casual sex.

The phrase "addiction" continues to be controversial when it comes to sex and technology, But as John Pachankis, an LGBTQ mental health expert at the Yale School of Public Health, described the impact of Grindr to me: "I don't know if it's an 'addiction,' but I know it causes a lot of distress."

For now, it's hard to know just how many Grindr users feel their use of the app is problematic. Early research on app use and health has focused only on sexually transmitted infections, for instance, rates of HIV among Grindr users, using Grindr to get people tested for STIs, etc.

Just last week, Grindr announced that it will start sending users HIV testing reminders and the addresses of local testing sites (on an opt-in basis). In less pleasant news, BuzzFeed revealed on Monday that Grindr has also been sharing the HIV status of its users with third-party companies. (The company later said it would stop sharing the information.)

Though there is this new attention to sexual health, both Grindr and the research community have been silent on mental health. Yet since 2007, more gay men have died from suicide than from HIV.

This suggests it's time we start thinking about Grindr's health effects more broadly. Other dating apps, like Tinder, for example, are now the subject of early research looking at mental health implications. It's time to do the same for gay hookup apps.

Grindr may provide men with some relief from their anxiety and depression. But it's temporary.

For some users I talked to, the allure of Grindr was not just the rush to feel good. It was to stop feeling bad. Users told me they log on when they feel sad, anxious, or lonely. Grindr can make those feelings go away. The attention and potential for sex distract from painful emotions.

A staggering number of gay men suffer from depression, with some estimates as high as 50 percent. Because gay men's anxiety and depression often stem from childhood rejection for being gay, messages of affirmation from other gay men are particularly appealing. Unfortunately, these messages are typically only skin-deep: "Hey man, cute pic. Looking to ****?"

A recent survey of 200,000 iPhone users by Time Well Spent, a nonprofit focused on the digital attention crisis, showed that 77 percent of Grindr users felt regret after using the app.

The users I interviewed told me that when they closed their phones and reflected on the shallow conversations and sexually explicit pictures they sent, they felt more depressed, more anxious, and even more isolated. Some experience overwhelming guilt following a sexual encounter in which no words are spoken. After the orgasm, the partner may walk out the door with little more than a "thanks."

And yet they keep coming back for that temporary emotional relief. One user told me that he feels so bad after a hookup that he jumps right back on the app, continuing the cycle until he is so tired he falls asleep. Every once in a while, he deletes the app, but he finds himself downloading it the next time he feels rejected or alone.

"We see patients like this almost every day," Pachankis told me. "Apps like Grindr are often both a cause and a consequence of gay and bisexual men's disproportionally poorer mental health. It's a truly vicious cycle."

Not all Grindr users are addicted and depressed, of course. Some users I interacted with seem to use Grindr in a healthy, positive way. One man I interviewed met his fiancé there; they are excitedly planning their wedding. Some I spoke with said they use the app for sex but haven't suffered any negative consequences and have control over their use.

Using Grindr may keep men from finding lasting relationships

Why do so many of these men turn to Grindr to begin with? Perhaps Grindr's popularity is a sign we haven't made as much social progress as we think for same-sex relationships. The general population seems comfortable with the idea of gay marriage, but it's still difficult for a gay man to find a partner.

One 23-year-old user told me that the only places he can find gay men are clubs and Grindr, and both are hypersexualized. The cultures of both intimidate him. According to Pachankis, gay culture is often "status-focused, competitive, hierarchical, and exclusionary." He explains that these traits are common among men generally, but in the gay community, they become amplified in a group that "both socializes and sexualizes together."

The 23-year-old is afraid of rejection, and Grindr shields him from the pain of in-person turndowns. "My framework now is sex first. I don't know how to date people in person."

His relationships, he says, start with casual sex on Grindr. They first meet at 2 am for a hookup. He'll try to schedule the next sex date a little earlier, maybe 11 pm. Then the next step may be drinks.

But this sex-first approach hasn't led to lasting relationships for the men I interviewed and is affecting their self-worth and identity. "My self-esteem now is all about my sexual ability," the 23-year-old said. "I don't feel confident about myself as a partner in any other way."

Another user told me he downloaded the app hoping to find a husband. Now he says that when he and a boyfriend (he's gone through several) fight, his natural response is to open Grindr to "find an alternative" instead of working through problems. He can't maintain a monogamous relationship because he is constantly cheating.

There may be ways to treat men with problematic Grindr use

The mental health professionals I spoke to are seeing problematic Grindr use in their clinics. And there is little published guidance on how to help those who are struggling.

Doctors I spoke to say the best available tools for treating problematic Grindr use are the ones they use in general sex addiction treatment. Citalopram, a common antidepressant, was shown in one small study to be helpful with sex addiction in gay men. Naltrexone, a drug commonly used for other compulsive behaviors, may work as well.

For more extreme cases, patients could request hormonal implants that turn off testosterone signaling, making sexual cravings less intense. However, even these treatments have modest empirical support at best, and none have been studied for hookup app use specifically.

Dr. Shane Kraus, the director of the behavioral addictions clinic at Bedford Veterans Hospital and an assistant professor of psychiatry at the University of Massachusetts Medical School, says the most promising treatment for problematic Grindr use is likely talk therapy techniques like cognitive behavioral therapy (CBT). CBT can teach patients to engage in other behaviors that are more productive (though often more difficult and time-consuming than Grindr) to help them feel loved or supported.

Another psychotherapeutic technique known as acceptance and commitment therapy (ACT) can help teach patients how to better tolerate the feeling of being alone without logging on to Grindr.

The dynamics of Grindr, though, are complicated, and it can take time to work through all the angles. Are you self-soothing anxiety? Are you addicted to sex? Have you lost interest in your monogamous relationship? Do you think you can't attain love, so you're settling for hookups? Did your parents tell you being gay is wrong and you're searching for acceptance? Ultimately, Kraus explains that therapy can help clarify these kinds of thoughts and feelings, and lead to insights that bring about a healthy change.

He also believes it's only a matter of time before states and the federal government sponsor research exploring Grindr use and mental health. Grindr did not respond to our request for comment on this piece. But if future data supports what I suspect about the link between Grindr and mental health problems, even small interventions like advertising mental health resources on the app may help to address these users' suffering.

As we continue to fight to bring gay relationships into the mainstream, we need to keep an eye on Grindr and how it both reflects and affects gay culture. The bathhouse is still around. It's now open 24/7, accessible from your living room.
Jack Turban is a physician and medical writer at Harvard Medical School, where he researches gender and sexuality. His writing has appeared in t he New York Times, Scientific American, and Psychology Today, among other publication s. Find him on Twitter at .

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We need to talk about how Grindr is affecting gay men's mental health

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When I open the Grindr app on my smartphone, I see there's a 26-year-old man with tanned abs just 200 feet away. He's called "looking4now," and his profile explains that he wants sex at his place as soon as possible. Scrolling down, I find 100 similar profiles within a one-mile radius of my apartment in Boston.

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A site for those looking for support with crystal meth addiction in the UK. We are a 12 step recovery programme with regular weekly meetings.

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It's an industrial solvent powerful enough to melt plastic - but some clubbers across Manchester have been mixing it into their drinks for years.

And for Patrick Ettenes, 36, the feeling induced by the drug known as 'G' became an addiction.

At his most dependent, he would take the drug four or five times a day, consuming huge doses.

"The feeling is quite euphoric to be honest", he said. "It's also a sex drug. It increases your horniness. Some people can't control themselves - they become very rampant."

When people buy 'G', they don't know what they are getting.

It could be GHB (Gamma-Hydroxybutyric acid) which was outlawed in 2003, or it could be its more easily available, even more dangerous relative, GBL (Gamma-butyrolactone), which was banned in 2005.

The two substances have been linked to the deaths of more than 90 people between 1993 and 2017, including young Mancunians, according to the Office for National Statistics.

In recent years 'G' has exploded in popularity on the gay scene, and is increasingly available in clubs and pubs, gay and straight, across Manchester, according to charities.

A millilitre of 'G' costs just £1 - and is more than enough to knock some people out cold.

Users have been known to add the odourless, colourless drug - also known as liquid ecstasy - into drinks in the same way you might add a dash of lime.

Regardless of the risks of misjudging a dose and slipping into unconsciousness, 'G' has become a staple of Manchester's 'chemsex' scene, in which people meet for drug-fuelled, private sex parties, experts believe.

'G' also has a nasty reputation as a date rape drug.

For Patrick, a campaigner and lecturer, the two became inextricably linked. He remembers waking up at a 'chemsex' party in Manchester with people stepping over him.

He had lost consciousness after his drink was spiked with a heavy dose of GHB or GBL.

"They gave me a high amount, I remember someone getting on top of me and that was it," he says.

"I woke up on the floor with people stepping over me like I was a piece of paper. I just went home."

Patrick never reported his rape to the police and didn't speak about it to anyone until recently. He has since sought therapy to help him with the trauma.

"It was at a time in my life when I was experimenting. A lot of people would say 'take it with me, you can trust me' and then they prey on you.

"I never spoke about it. If you're offered a drink make sure you ask questions, make sure you see everything that is happening. People relinquish that control."

The law puts GHB/GBL in the least category of seriousness - Class C - and their effects last around an hour, but doses are difficult to judge - making it particularly easy to accidentally overdose.

Now parents of one victim - Paddy Bloor, a Sheffield University student who died after taking GHB last year at a 'chemsex' party, are campaigning for it to be included in routine toxicology screening, and for it to be reclassified as a Class A drug.

The 'chemsex' scene is associated with some gay men who use substances like crystal meth, mephedrone and GHB to have lengthy sex sessions. Hedonism for some, but for others a way to blot out feelings of depression, low self-esteem and loneliness.

But 'G' has had terrible consequences for people from all walks of life, re-emerging in different scenes over the last three decades.

In 2009, a former user from Crumpsall revealed how she had been admitted to hospital dozens of times - sometimes unconscious - after taking GBL. She told how her looks were ravaged by the drug, which was at that time still legal.

And, back in 1997, Andrea Murphy, 25, was found dead at her Wigan home having taken a cocktail of amphetamines and GHB.

More recently, Kyle Burton, 22, from Partington, died after taking Ketamine, Mephedrone, Ecstasy and GHB at a party in Manchester.

Cases like Andrea's and Kyle's - where multiple drugs are involved - mean the true numbers of 'G'-related deaths are unknown, as it can be difficult to determine which drugs killed a person who has GHB or GBL in their system.

But mixing 'G' with other substances is common in Manchester, according to Patrick.

"I did sex parties for a while and it's very toxic," he says. "It's just a room full of people with a lot of problems.

"You would have GBL and Mcat (mephedrone) and viagra. Some sex parties they won't give anything to anyone after an hour. You have to be responsible.

"But the younger generation don't understand that. Some people will go out in the Village - they're drunk and horny and they will have G. You see them pass out or become violent and thrash about the place.

"I've heard stories where people have taken G, put it in ice cubes and freeze it to put in drinks to take advantage of people."

Duncan Craig, the CEO of Survivors - a charity which supports male victims of rape and sexual assault - says clients started to mention the drug to him around 2015.

"The first time as an organisation we came across it was when we were working with men who were at chemsex parties and GHB, crystal meth and mephedrone were being used," he says.

"Three or four clients in a short space of time were coming to get some support because they had been in a situation where they had used various different drugs, G being one of them, and they had lost some sort of awareness.

"They were not out cold but they really didn't know what was going on. They were not with it.

"They had realised something had been happening to them. They had been raped to use the legal term. It was not a consensual activity."

Around that time the so-called 'Grindr killer' Stephen Port was given a life sentence for raping and murdering four young men in London who he had met on the dating app. Port used G to render his victims unconscious.

Duncan says bosses across Manchester's night time economy need to wake up to the potential dangers of GHB.

"It's not just a chemsex drug. It feels like GHB is now just quite mainstream and nobody talks about it."

In spite of these fears and the anecdotal picture, prosecutions for possessing and dealing 'G' in Greater Manchester are rare.

But Salford University lecturer Karenza Moore hopes to conduct research into substance use in Manchester. She has already researched the use of 'G' in London gay clubs.

She says use of the drug has migrated north, and that it's wrong to stereotype it as a gay problem.

"There are so many misconceptions about it," she says.

"It's got this reputation as a date rape drug and is seen as a 'gay drug' so it has a reputation of being involved in the chemsex scene.

"But I think it's being used in some student clubs. And Scotland had a problem in some of the estates because it's so cheap. There are other groups of users.

"I think there's a very hidden after-party scene. That's one of the reasons it's quite hard to research."

GHB was initially developed as a sedative medication and an anaesthetic during the 1960s and used as a treatment for narcolepsy.

During the mid-1990s, bodybuilders started using GHB as a growth hormone and sleep aid and its ability to produce euphoria without a hangover saw it promoted as a club drug.

Patrick first started taking GHB before it became an illegal substance in 2003.

"When I was 18 or 19 it was sold in sex shops in poppers (amyl nitrate) bottles," he says. "In fact sometimes it was mistaken for poppers."

The problem, Patrick says, started when GHB became illegal and GBL - its stronger analogue - became more widely available.

"When people started taking that and drinking at the same time they were wiped out," he says.

"GHB gives you a fluffy feeling whereas GBL hits you straight away.

"GHB is odourless and tasteless. It's just salty. But GBL you can smell it because it's like a paint stripper.

"If it doesn't hit you straight away people will take another hit. Some people become very violent on it. It can cause psychosis and you lose consciousness and don't remember anything.

"In Manchester G is massive and we have a big chemsex scene here."

When Patrick had a breakdown he started talking to a counsellor and realised he had become reliant on G.

"Weaning myself off it was very difficult," he says.

"I knew I had run away from a lot of things and I needed to understand why.

"One day I threw everything down the toilet and that was it. Sometimes it takes a lot of shit in your life to say 'f*** it.'

"It was not actually the drug it was feeling the numbness that I was addicted to," he says. My addiction was to block out a lot of stuff in my mind. It kept me in the zone of being horny and it would block out the world.

"I think it was self-medicating."

He says: "The recovery part was hard. Because when I binged I really binged.

"In a way drugs kept me alive because I could escape and they took my life away. But I lost a lot of my life."

Patrick has not touched G, or any other drug for more than a year.

But he fears for clubbers and chemsex participants who still use the drug regularly, and in increasingly high doses.

"People don't talk these days - the younger generation. Grindr has killed off any social activity", he said.

"But there is no education or training on how to get out of something if you're in a bad situation. For the younger generation they don't know what they are stepping into when they meet someone and step into a room.

"You need to trust yourself, you need to know what it is you are being given and what you are taking."

Survivors Manchester want people to know they are not alone.

"It's not my job to tell people what to do," CEO Duncan Craig says. "It's my job to give people the information to make informed choices.

"It's not about victim blaming and saying 'if you do this and something happens to you it's your fault'. It's about saying 'how do I make sure I'm as safe as possible to do what I want to do?'

"Put your friend in a taxi. Have some water in between drinking situations. Don't consume something you don't know what it is. If you are taking drugs get the best advice. Go to drugs services, get some advice."
If you are a victim of rape - or know someone who is - you can call police on 101. Always dial 999 where there is a threat to life or a crime in progress. Alternatively you can call the charity Crimestoppers, anonymously, on 0800 555 111. Men who have been raped or sexually assaulted can visit http://www.survivorsmanchester.org.uk for more information about how to seek support. The LGBT Foundation provides advice for anyone who wants to inform themselves further about Chemsex, or needs support or assistance. Details are on their website here: https://lgbt.foundation/chemsex

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The £1 Manchester sex party drug with devastating consequences

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It's an industrial solvent powerful enough to melt plastic - but some clubbers across Manchester have been mixing it into their drinks for years. And for Patrick Ettenes, 36, the feeling induced by the drug known as 'G' became an addiction. At his most dependent, he would take the drug four or five times a day, consuming huge doses.

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What is chemsex?

Chemsex means using drugs as part of your sex life, and it's most common among gay and bi men. There are typically three specific 'chems' (drugs) involved. People say these drugs make them feel less inhibited and increase pleasure.

What are chemsex drugs?

The three main drugs people take as part of chemsex are methamphetamine, mephedrone and GHB/GBL.

Methamphetamine

Methamphetamine is a stimulant. It's also known as crystal meth, crystal, meth, tina and crank.

People take crystal meth by swallowing, snorting, injecting or smoking it. It makes them feel alert and aroused, but can also make them feel agitated and paranoid.

Methamphetamine can raise your heart rate and blood pressure which can lead to heart problems. There have also been reports of psychosis from taking methamphetamine. There is evidence of long-term mental health problems and brain damage. You can die if you overdose. It's highly addictive too.

Mephedrone

Mephedrone is a stimulant too. It's know as meph, drone or meow meow.

People usually take mephedrone by snorting it, but they also swallow, smoke and inject it too. It makes people feel alert, aroused, confident and euphoric. It can make people feel sick, anxious and paranoid too.

Mephedrone can make you vomit or give you a headache. It can cause hallucinations, insomnia, reduced appetite, dizziness and sweating. It's also addictive.

GHB and GBL

GHB and GBL are sedatives. Their full names are gammahydroxybutyrate and gammabutyrolactone, and they're also known as G, gina, geebs and liquid ecstasy.

GHB and GBL are usually an oily liquid that people mix with a drink and swallow. They make people feel euphoric, less inhibited and sometimes sleepy too.

With GHB and GBL it's difficult to know how much of the drug you're taking so it's easy to overdose. The overdose can make you pass out and in some cases it can be fatal.

Is chemsex safe?

While there are ways to help keep yourself safe, there are some risks involved:

Injecting drugs is risky

Sometimes people inject or 'slam' crystal meth and mephedrone. With this there's an increased risk of injection-related infections and blood-borne viruses like HIV, hepatitis C (HCV) and hepatitis B.

It can lead to unsafe sex

If you're under the influence of drugs, you might not use a condom which can put you at risk of HIV and other sexually transmitted infections (STIs).

People who are high on certain drugs will often have rougher sex than usual, which can cause bleeding.

How to keep yourself safe

The LGBT foundation has some tips for reducing the risks if you're involved with chemsex, including:

Use condoms and lube

Set ground rules while you're sober about what you do and don't want

Don't share needles

Take PrEP to protect against HIV

Get tested regularly for sexually transmitted infections (STIs)

You should also avoid mixing drugs with alcohol or any other drugs, and try to use with other people around who you can trust.

For more information and advice, take a look at the links below.

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Chemsex means using drugs as part of your sex life, and it's most common among gay and bi men. There are typically three specific 'chems' (drugs) involved. People say these drugs make them feel less inhibited and increase pleasure. The three main drugs people take as part of chemsex are methamphetamine, mephedrone and GHB/GBL.

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UKLGIG - charity promoting equality and dignity for LGBTI people seeking asylum in UK, or those seeking to settle in UK with their same-sex partner.

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If it's your first time, well done. We know how nervous you might feel. But you have taken the most difficult step.

If you've called before, welcome back!

You can get it touch on the phone, by email or through Instant Messaging.

Who will answer the call?

There are about 160 trained telephone volunteers at Switchboard who all identify as lesbian, gay, bisexual or trans.

Can anyone call you?

The majority of those who call are LGBT+ but we also get lots of callers who are considering issues around their sexuality. And then there are friends, parents or family members of LGBT+ loved ones who are looking for some independent advice and support - we welcome them all!

What can I talk about?

We are here to listen to anything that you want to talk about. Nothing is off limits, and if you feel nervous when you hear that strange voice - there's no rush, take your time.

For over 40 years people have been talking to us about:

Sometimes it takes a while to get to the heart of an issue. We understand it might take you some time to get to the main thing you really want to talk about. We also believe you are best placed to know your situation and the answer that's right for you. We will listen while you talk through your options with you and hope that you'll feel empowered by coming up with your own solutions.

Safer sex

How long will it take for my call to be answered?

The helpline is staffed by volunteers and we answer thousands of calls a year. Some calls last a few minutes, others can last almost an hour. The speed with which you are answered can also depend on the number of volunteers available at the time of your call. We try to aim to have more volunteers on shift in the evenings and at weekends when demand is higher. We are also keen for you to use our Instant Messaging service. There is more than one way of getting in touch.

When you call us you are placed in a queue. We understand how frustrating that can feel, but please be patient.

Don't give up. Ring back. We want to take your call and we'll answer it as soon as we can.

Can I leave a message? Will you call me back?

When you call the helpline we do not have a caller display so we don't see your number. You are not able to leave a message and we aren't able to return calls. We hope you understand.

This is part of our commitment to ensure your confidentiality. Because even if we rang a number someone had left for us on a message, how could we be sure we'd be speaking to the person who'd left the message?

Where is Switchboard?

We're based in Islington, North London - a convenient location for many of our volunteers.

Switchboard's offices are fully accessible and were paid for by community fundraising and grants. A few years ago a volunteer's generous legacy meant that a new phone system could be installed. The legacy also allowed us to clear the outstanding debt on the building.

Switchboard is a bright, airy office with a dedicated phone room where volunteers answer the phones and connect with people through email and Instant Messaging. Usually there are a few volunteers on each shift so we can ask each other for advice and provide support for each other if necessary.

What if our helpline is closed?

We know that finding the right support is important, especially if you need someone to talk to right now. Switchboard operates from 10am to 10pm, 365 days a year but if we're not available to support you and you can't wait until we are Crisis Text Line and Shout can help.

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If it's your first time, well done. We know how nervous you might feel. But you have taken the most difficult step. If you've called before, welcome back! You can get it touch on the phone, by email or through Instant Messaging.

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Our Telephone befriending service is for LGBT+ people aged over 50 who would like to receive a weekly phone call.

We're currently taking referrals for those who would like a telephone friend, so if you're interested please get in touch by emailing [email protected] or calling 020 7239 0400.

What is Telefriending?

Telefriending is a free telephone befriending service where one of our lovely volunteers will call you around the same time each week for a chat of up to 30-minutes. The person who calls you each week will always be the same telefriending volunteer.

We know that not talking to someone regularly can be difficult and sometimes can increase feelings of loneliness; our telefriending service is here so you can regularly chat to someone familiar. We'll match you with someone like-minded where you share similar interests and are more likely to have things in common.

Our volunteers are not paid and don't have the same responsibilities such as a social worker, carer or doctor. Telefrienders are committed and caring community members who give their time and attention to people like you as part of our befriending service.
If you want to find out more about telefriending please email [email protected] to recieve our Telefriending Client Handbook.
Who is Telefriending for?
Telefriending is suitable for people who are:

Over 50 and identify as LGBT+

feel lonely and isolated

have their own landline or mobile phone

able to hear and be understood over the phone

able to commit to a regular weekly call at the same time.

Sometimes people have support needs that are not suitable for this scheme, perhaps because they are too complex, or the needs are not linked to being lonely and isolated. If you're not sure telefriending is for you, just give us a ring - the Befriending Coordinator is happy to talk things through with you.

How do I get a telephone befriender?

If you want to have a telephone befriender please call (020 7239 0400 - Monday to Friday 9am to 5pm), or email us at [email protected] and we will arrange a phone call with you.

If you want to refer someone you think could benefit, please fill in our external referral form and send to [email protected] . We'll then arrange a call to confirm that you (or the person being referred) is suitable for the service.

This service will prioritise those who are isolated due to frailty or physical impairments and have no regular meaningful social connections.

We are particularly interested in supporting those who are from underrepresented groups.

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Our Telephone befriending service is for LGBT+ people aged over 50 who would like to receive a weekly phone call. We're currently taking referrals for those who would like a telephone friend, so if you're interested please get in touch by emailing [email protected] or calling 020 7239 0400.

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Online peer support
Online peer support is a confidential FREE service available to anyone over the age of 16 living with or affected by HIV. The service is available across the UK and to British nationals living or working outside the UK.

We recognise privacy can be a barrier for some people seeking support. Working remotely can help overcome many of the concerns you may have. Online appointments can be delivered using text, voice or video calls, so you remain in control of your privacy which is very important to us. We use Skype or WhatsApp where you can 'meet' an experienced peer support volunteer in the comfort of your own home.

Appointments typically last approximately 50 minutes, and you'll always work with the same peer support volunteer. Our volunteers use a private space to ensure your conversations remain confidential at all times.

Register & booking your appointments
The registration process is in 2 parts. The first is a short questionnaire which helps us better understand the support you require. We ask for minimum of personal information when you register, which includes an email address, mobile number and a username which can be an alias or just your first name.

On completion of the questionnaire you'll be directed to the second part of the registration process, where you can book your first appointment and then set up your password protected account. After this last step you're done!

Making future appointments in very easy. Click on the appointment icon, choose the date and time from the calendar, sign in to your account to complete the process. You can also cancel or change any of your existing appointment in the same way. We'll send you a confirmation email and a reminder the day before your appointment.
Skype calls
Skype offers the flexibility of meeting your peer support volunteer from any device, be that a smartphone, tablet or desktop computer. For Skype our default is set to voice calls. Clicking the Skype icon will connect to our Skype account. Once connected you can add the video option if you wish.

If you don't already have a Skype account set up, please click on the set-up Skype icon and follow the instructions on the website to download Skype or visit the App store or Google Play for smartphone and tablet apps.
WhatsApp Calls
Some people prefer to use WhatsApp because of end to end encrypted security system. It's a little less flexible than Skype in that the voice and video services are only available on smartphone and tablet apps. WhatsApp web is a great way to chat using a laptop or desktop device.

Our default for WhatsApp is set to instant message chat. When you click on the icon, you'll be connected to our WhatsApp account with the pre-loaded message. You can switch to voice or video should you wish once your peer support volunteer is online.

If you don't already have WhatsApp set up, click on the set-up icon and follow the instructions on the website to download WhatsApp web, or visit the App store or Google Play for smart phone and tablet apps. If you have any difficulties, please email Peer.support@plushealth.org.uk

Read more about online peer support

What is peer support?

Peer support can take many different formats. In person, online, one to one, in group settings to name a few. Informal peer support networks often develop amongst our friends, work colleagues or wider community groups, and can be a very effective peer support networks. Formal or structured peer support can be defined as.. 'a voluntary, mutually beneficial and purposeful relationship, which is usually limited in time, where the person providing the peer support uses his or her own experience and knowledge to help others to move towards a goal or set of goals that enables that individual to meet their full potential'.

Peer support can be delivered as part of wider support services within some clinics, charities and other community organisations. Not everyone living with HIV will have access to 'face to face' services which is where online peer support can provide a convenient solution. We appreciate that some people living with HIV may not feel ready to meet others in a face to face situation, and this can be another great advantage of 'meeting' a peer support volunteer online.

How can peer support help?

It is well established that peer support should form an integral part of the care people living with HIV receive. This is particularly important for those individuals who are received a recent diagnosis, where having the opportunity to talk with someone living with HIV can be extremely beneficial and empowering. Some of the more important areas where peer support can be beneficial include:

Sharing of lived experience of life with HIV

Providing an authentic, up to date point of view of life with HIV

Develop an understanding that HIV is a manageable condition

Understand HIV treatment is well tolerated & easy to take

Understand of some of the practicalities of living with HIV

Develop a sense of community to avoid the feeling of isolation

What are the benefits of online peer support?

The use of online technology has been used to extend the reach of peer support services for many years and has been shown to be acceptable to people living with or affected by HIV. Some of the benefits of online peer support include:

Convenience and not having to travel to a particular venue

A feeling of safety as peer support takes place in the home environment

Anonymity can be guaranteed as peer support is remotely delivered

Development of the peer to peer relationship in a shorter time period

Allows partners and carers to be invited to peer support sessions

Provides a stepping stone into traditional in person support

You can find out more about peer support for people living with HIV by visiting the HIV peer support website

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Online peer support is a confidential FREE service available to anyone over the age of 16 living with or affected by HIV. The service is available across the UK and to British nationals living or working outside the UK. We recognise privacy can be a barrier for some people seeking support.

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LGBT+ people can experience domestic abuse regardless of age, class, disability, gender identity, caring responsibility, immigration status, race or religion.

If you identify as lesbian, gay, bisexual, transgender, and you are experiencing domestic abuse you can contact our LGBT+ team through our helpline on 01273 622 828.

We have a weekly LGBTQ+ specific drop-in, which is held:

Where: The Rainbow Hub, 93 St James's St, Kemptown, Brighton BN2 1TP

When: Every Monday 1pm-5pm

Resources from Galop:

This guidance is also useful for professionals and helpline operators who are receiving calls from friends/family who are LGBT+ either because they are being victimised by, or using violent/abusive behaviour towards their partner.

Galop also host an online LGBT+ Domestic Abuse Library, which includes direct links to resources relevant for LGBT+ people, service providers working with LGBT+ victims of domestic abuse and researchers interested in the topic.

Acknowledging that any partner, ex-partner or family member is an abuser is hard. This can be made even harder by threats of 'outing' or through fear of further isolation.

Are you worried a relationship you have is abusive? Here is a short checklist of abusive behaviour:

Does your partner, former partner, or a family member:

- Call you names, humiliate and criticise or belittle you?
- Use your gender or sexuality as a basis for threats, intimidation or harm?
- Control or discourage your contact with friends, family, work, or the LGBT+ community?
- Intentionally use the wrong gender pronouns?
- Deny you access to medical treatment or hormones?
- Minimises the harm caused by their behaviour?

If you answered YES to any of these questions, you may be experiencing domestic abuse. This list is in no way comprehensive. Please visit our page Am I being abused? for a longer checklist of abusive behaviours, or call our helpline on 01273 622 828.

LGBT+ relationships

Our LGBT+ service for survivors of domestic abuse was the first in England.

LGBT+ relationships

We also provide one of the few dedicated LGBT+ refuge and housing support services, partnering with Manchester and London as part of a Government funded project. We also accept self-identifying women into our non-LGBT+ refuge.

For further support, you can also seek these organisations below:

* Allsorts: Young People's service. They do drop-in's, counselling and education on LGBTQI+ issues in school.
* MindOut: The offer a low cost counselling service, have an advocacy service and do several support groups including a peer support group, specific Trans support groups, and a group for those experiencing suicidal thoughts. They also have a peer to peer mentoring service.
* LGBT+Switchboard: They have support groups for older people, specific Trans and non-binary support and social groups, a help line for support.
* Terrance Higgins Trust: They support people with a diagnosis of HIV. They can offer counselling, support groups, mentoring, have a back to work programme, and financial advocates.
* Lunch Positive: They run a free lunch club social for anyone diagnosed with HIV every Friday.
* LGBT+ Community Safety Forum: They offer advocacy and casework for anyone within the LGBTQ+ community who is currently vulnerable, at risk, or just needs some support. They also have a specialist Hate Crime reporting service that can support you when reporting/considering reporting.
* Rainbow Hub: A one stop shop for support. They signpost to agencies in the city depending on the support you need. They also offer an advocacy service, as well as community connection programmes with other services, notably the police.

LGBT+ relationships
It is hard to put into words how much it has helped and changed my life being supported by RISE. After experiencing domestic violence and homelessness I had been left feeling hopeless and honestly believed, at 28 years old, that my life was over.

Read more

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LGBT+ people can experience domestic abuse regardless of age, class, disability, gender identity, caring responsibility, immigration status, race or religion. If you identify as lesbian, gay, bisexual, transgender, and you are experiencing domestic abuse you can contact our LGBT+ team through our helpline on 01273 622 828.

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Galop works with and for LGBT+ victims and survivors of abuse and violence in the UK

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LGBT Foundation – A national charity with LGBTQ+ health and wellbeing at the heart of everything we do.

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A national charity with LGBTQ+ health and wellbeing at the heart of everything we do.

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PrEP (pre-exposure prophylaxis) | Terrence Higgins Trust

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PrEP is a drug taken by HIV-negative people before sex that reduces the risk of getting HIV. In England it is available as part of a trial. It is also available in Scotland and Wales.

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We are an imperfect group of gay and bisexual men who came together 7 years ago to make films on health issues that matter to us, and films for the wider LGBT community. Some...

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If you believe someone has overdosed on GHB, call 911 immediately. If the person is unconscious, turn them on their side and stay with them until help arrives.
It's easy to overdose on GHB. The difference between a mellow high and GHB coma is sometimes as little as a few drops of the potent drug.

Overdosing on GHB is so common, in fact, that people who use the drug recreationally sometimes write "GHB" or "G" on their hand or wrist with a marker as a precaution in case they lose consciousness.

A survey of 76 Australians who used GHB recreationally found that more than half had overdosed on the drug, according to a report in the February 2003 issue of the journal Addiction.

Overdose was more common among those who used the drug more frequently and for longer periods of time, but GHB poisoning can happen to anyone. A GHB overdose can occur the first time a person uses the drug or in someone with a long-standing GHB addiction.

GHB Overdose Symptoms

GHB is a strong central nervous system depressant that's abused for its alcohol-like effects, but reactions to GHB can be unpredictable. Large doses of GHB can lead to respiratory depression, loss of consciousness, vomiting and death.

Symptoms of a GHB overdose include:

Nausea and vomiting

Dizziness or lightheadedness

Sweating

Irregular breathing

Slow heart rate

Low blood pressure

Unconsciousness or reduced consciousness

Irregular breathing

A suppressed gag reflex

Confusion and agitation

Urinary and fecal incontinence

Low body temperature

Hallucinations

Memory loss/Amnesia

Constricted pupils

Seizures

GHB poisoning can develop rapidly. People can pass out within minutes of taking GHB, and there are often no warning signs.

Unconsciousness or a drop in the level of consciousness were the most common initial overdose symptoms in an examination of more than 1,000 GHB and GBL overdoses in Norway, according to a 2017 report in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

GBL, a chemical cousin that converts to GHB in the body, has the same effects. GBL, gamma-butyrolactone, has been nicknamed "coma in a bottle."

One in 5 people who've used GHB report passing out from drug, according to the Global Drug Survey, the world's largest online survey of legal and illicit drug use.

How Much GHB Is Too Much?

Because GHB comes in a liquid form with variable amounts of the drug, safe dosing is extremely difficult.

Low doses of GHB - in the range of 1 to 2 grams - can trigger a high similar to an alcohol buzz, characterized by increased libido, lowered inhibitions, talkativeness and a mild euphoria. At slightly higher doses, the effects of GHB can make a person appear drunk, with slurred speech, a staggering gait and worse.

1-2 gramsEuphoria, lowered inhibitions, increased libido

1 gram or less

Relaxation similar to an alcohol buzz

2-4 grams

Slurred speech and difficulty moving

4 grams or more

Agitation, confusion, combativeness, loss of coordination, trouble breathing, vomiting, loss of consciousness, death

Recreational doses of GHB typically range from 1 to 5 grams of the drug dissolved in enough liquid to fill a soda bottle cap. But unless a person prepared the drug themselves, they are unlikely to know exactly how much GHB they are consuming.

GHB also impairs memory, so an individual may easily forget how much they've used and accidentally take too much.

Mixing GHB and Alcohol

Mixing GHB with alcohol and other drugs is extremely dangerous and increases the risk of overdose.

GHB has strong sedative effects that are amplified when combined with other central nervous system depressants, such as alcohol, opioid painkillers, benzodiazepines, or Ketamine. These combined effects may slow or stop a person's breathing or cause them to lapse into a coma.

In 2015, journalist Catherine Townsend wrote about her scary experience of chasing a beer with a capful of GHB at a New Year's Eve party years earlier when she was just 14.

For weeks, Townsend had been using GHB and marveled at the drug's seemingly magical effects. She could party all night, let her guard down romantically and function with just four hours of sleep. But all that changed when she decided to take an extra capful of the drug and drink a beer.

"Four hours later, I woke up in a puddle of my own vomit, and my concerned friends standing over me trying to find a heartbeat," wrote Townsend, who vowed to never touch the drug again.

Jarhett Wagner was not as lucky.

In 2004, the 21-year-old Florida man passed out at a party after drinking and using GHB with a group of friends and his brother. According to a tribute on Project GHB, a nonprofit drug awareness group, Wagner's friends tossed him and his brother on a bed to "sleep it off" - but Wagner never woke up.

His brother found him dead beside him the next day.

Overdose Treatment

A person exhibiting signs or symptoms of a GHB overdose needs emergency medical treatment and should never be left to "sleep off" the effects of the drug.

Unlike a heroin overdose, which can be reversed by administering a drug called naloxone, there is no reversal agent for a GHB overdose, but supportive care and monitoring may prevent death.

Supplemental oxygen is often needed and some individuals require mechanical ventilation. If a person's heart rate is too slow, they may also need IV drugs to prevent their heart from stopping. Intravenous fluids can boost low blood pressure.

Because GHB doesn't stay in the body very long, the effects of a GHB overdose usually wear off quickly. Most people wake up spontaneously and are discharged as soon as their symptoms resolve.

While most people recover completely within three to six hours, a GHB overdose can be a serious wake-up call to the dangers of the drug.

Unfortunately, quitting GHB is not always easy. Regular, chronic use of GHB can lead to addiction and physical dependence on the drug. If you or someone you love is having trouble quitting GHB, learn how GHB treatment works and how rehab can help.

View Sources

Busardò, F. & Jones, A. (2015, January). GHB Pharmacology and Toxicology: Acute Intoxication, Concentrations in Blood and Urine in Forensic Cases and Treatment of the Withdrawal Syndrome. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462042/

Cheves, A. (2018, February 2). We Can't Stop GHB and Meth Use. But We Can Make It Safer. Retrieved from https://www.advocate.com/commentary/2018/2/02/we-cant-stop-ghb-and-meth-use-we-can-make-it-safer

Codrea-Rado, A. (2017, June 15). GHB: An Explainer on the Most Stigmatized Club Drug. Retrieved from https://thump.vice.com/en_us/article/xw879j/ghb-explainer-club-drug-harm-reduction

Degenhardt, L., Darke, S. & Dillon, P. (2003, February). The prevalence and correlates of gamma-hydroxybutyrate (GHB) overdose among Australian users. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12534425

Dietze, P. et al. (2008, June 16). Patterns and incidence of γ-hydroxybutyrate (GHB)-related ambulance attendances in Melbourne, Victoria. Retrieved from https://www.mja.com.au/journal/2008/188/12/patterns-and-incidence-g-hydroxybutyrate-ghb-related-ambulance-attendances

Drug Enforcement Administration. (2013, January). GAMMA HYDROXYBUTYRIC ACID (Street Names: GHB, Liquid Ecstasy, Liquid X, Goop, Georgia Home Boy, Easy Lay). Retrieved from https://www.deadiversion.usdoj.gov/drug_chem_info/ghb.pdf

Le, J. & Richards, J. (2017, May 25). Toxicity, Gamma-Hydroxybutyrate (GHB, "G", Liquid X, Liquid E, Juice, Mils, Fantasy, Georgia Home Boy). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430781/

Madah-Amiri, D., Myrmel, L., Brattebø, G. (2017). Intoxication with GHB/GBL: characteristics and trends from ambulance-attended overdoses. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610436/

Minns, A. (2014). GHB. Retrieved from https://calpoison.org/news/ghb

Moser, M. & Purssell, R. (2000). Gamma-hydroxybutyrate overdose and coma: a case report. Retrieved from https://pdfs.semanticscholar.org/c02c/5df0e66a3a4a436603076d899184a29aedc4.pdf

National Drug Intelligence Center. (2004, September). Intelligence Bulletin: GHB Trafficking and Abuse. Retrieved from https://www.justice.gov/archive/ndic/pubs10/10331/index.htm

National Highway Traffic Safety Administration. (2004). Drugs and Human Performance Fact Sheets. Retrieved from http://www.cjcenter.org/idi/documents/drugsandhumanperformance.pdf

Palamar, J. (2018, January 26). The comeback and dangers of the drug GHB. Retrieved from http://www.chicagotribune.com/sns-the-comeback-and-dangers-of-the-drug-ghb-90736-20180126-story.html

Project GHB. (n.d.). Jarhett Cody Wagner. Retrieved from http://www.projectghb.org/content/jarhett-cody-wagner

Substance Abuse and Mental Health Services Administration. (2002, November). Substance Abuse Treatment/GHB: A Club Drug to Watch. ADVISORY. Retrieved from https://store.samhsa.gov/shin/content/SMA03-3766/SMA03-3766.pdf

Thai, D. et al. (2006, October). GHB and Ethanol Effects and Interactions in Humans. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766839/

Townsend, C. (2015, October 19). The Scary Reason GHB is Making a Comeback. Retrieved from https://www.thedailybeast.com/the-scary-reason-ghb-is-making-a-comeback?ref=author

Utah Poison Control Center. (2000). Utox Update: Gamma-hydroxybutyrate (GHB) Toxicity and Treatment. Retrieved from https://poisoncontrol.utah.edu/newsletters/pdfs/toxicology-today-archive/Vol2_No2.pdf

Winstock, A. (2017, November 1). GHB - going over and getting hooked. Retrieved from https://www.globaldrugsurvey.com/ghb-going-over-taking-a-g-nap-g-ing-out-getting-hooked-and-how-to-prevent-them/

Zvosec, D.L., Smith, S.W., Porrata, T., Strobl, A.Q., Dyer, J.E. (2011, March). Case series of 226 γ-hydroxybutyrate-associated deaths: lethal toxicity and trauma. Retrieved from https://www.ajemjournal.com/article/S0735-6757(09)00553-1/abstract

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If you believe someone has overdosed on GHB, call 911 immediately. If the person is unconscious, turn them on their side and stay with them until help arrives. It's easy to overdose on GHB. The difference between a mellow high and GHB coma is sometimes as little as a few drops of the potent drug.

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In today's world its not hard to see the divide; people living their lives, experiencing their world and all too often never reaching out to help one another. We believe that the time has come to break the taboos associated with drug use and to provide people with the resources they need in order to stay safe.

We are TripSit - Our mission is to provide open discussion of harm reduction techniques and positive support. We promote the use of harm reduction tools such as test kits, and offer guidance and support with regards to harm reduction when using drugs. We encourage discussion of scientific, medical, philosophical understandings, and many of us can provide advice based on life experiences, an invaluable asset for someone who may be experiencing a similar issue. We are eager, willing, and prepared to guide or 'tripsit' users who may be having a hard time while under the influence of drugs.

Our experienced team understands the good and bad side of drugs and we understand that individuals will use drugs regardless of their current legality. Its for that reasons that we are here to help by reducing the risks associated with reckless or uninformed consumption of drugs in all environments while providing support and assistance to those who need it. Whether you need someone to talk to, advice on safe dosage, a simple water bottle, or supportive techniques for recovery we are here for you.

Our network is comprised of an IRC chat team dedicated to 24/7 live support from quick information to a friendly guide through difficult experience. We also offer a drug-information wiki for those seeking quick information and a live radio service for those seeking musical company.

Overall, the TripSit team is here to help you stay safe as possible if you choose to use substances. Even though we are not trained professionals, we are unpaid volunteers that take the time out of our day to support people in need. We are here for you. Whether you need information, someone to answer questions without judgement, a testing kit, or just a place to hang out and talk with friends we hope to be there.

We live in a day and age where the influence of drugs is as present in our lives as it has ever been and we strongly believe that there is a need to ensure that people have the same ease-of-access to the information and supplies needed to stay safe. So, from all of us here at TripSit: Stay safe, and learn.

Additional Information
We do not encourage the use or abuse of drugs. On the contrary: users who join our network are already intent on taking drugs, and we provide services to keep them safe. We do not condone the abuse of drugs or mixing of potentially dangerous combinations of drugs.
Our number one goal is to provide positive support and encourage harm reduction by providing techniques, advice, and in some cases, helping users deal with possible negative psychological consequences of their actions and experiences.
We have a zero tolerance policy on the abuse of dangerous drugs and any discussion of suicide or other psychological issues, and we do remove rule breakers from the community to ensure they do not become a bad influence on others.
There is often a conflation between a 'bad trip' and a medical emergency apparent with expert testimonials given in news reports. A bad trip refers to a situation in which someone may be feeling panicked, depressed, anxious, or upset while under the influence of psychotropic drugs and would like somebody to talk to in a supportive, positive, and relaxing environment.
TripSit is not intended to be a replacement for medical help, as we are not medical professionals. We strive to provide advice and positive support to users who are already engaged in drug use. We provide information concerning the consequences, side effects, and addictive properties of using and/or mixing potentially harmful drugs.

The implication that users who require our advice should not be using in the first place may, in some cases, be a valid point. The TripSit Network does not exist to promote the dangerous use or mixing of drugs. We do not categorically generalise drug use or its safety.

Due to the stigmatisation of drug users in general, many people are hesitant to seek advice when it may be needed. Many users do not have a solid support structure of friends and family or access to adequate social services. In some cases, TripSit is the only resource our users have to turn to for advice, support, and positivity. This advice and support can and has saved lives. TripSit provides an answer to these draconian views and attitudes towards drug use. We save lives where they will not.

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In today's world its not hard to see the divide; people living their lives, experiencing their world and all too often never reaching out to help one another. We believe that the time has come to break the taboos associated with drug use and to provide people with the resources they need in order to stay safe.

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Safer slamming (injecting)

Wash your hands and clean the injection site

Choose a quiet, safe place to inject

Ensure the surfaces you prepare on are clean

Whenever possible, use a sterile spoon and dry, clean filter available from needle exchange services and PIP PAC

Avoid torn filters or exposed fibres as they can end up being injected and cause problems

Never share your injecting equipment

If you have to re-use equipment make sure it's yours

Use a sharps bin whenever possible. If not available improvise; eg: use a plastic drinks bottle with cap

Only recap needles if a sharps bin or alternative is not available

It's always best to only recap your own needle to avoid risk of infection

Take your sharps bin to a needle exchange for safe disposal

Safer injecting crystal meth

Safer injecting crystal meth | Three Flying Piglets for MEN R US | 2014 | 3m 24s
Precautions D'injection: Crystal Meth | Français | Three Flying Piglets for MEN R US | 2014 | 3m 24s
Safer injecting mephedrone
Safer injecting mephedrone | Three Flying Piglets for MEN R US | 2014 | 3m 25s
Precautions D'injection: Mephedrone | Français | Three Flying Piglets for MEN R US | 2014 | 3m 25s
Needle and syringe supplies
You may find the simplest option is to buy supplies online. We mention Exchange Supplies because they have collaborated with us on PIP PAC (our safer chemsex packs) for several years. While gay men have usually given mainstream drug services a wide berth you can drop by your local service who should provide you with FREE needles, syringes, swabs and condoms etc without a load of hassle or questions.

PIP PAC 3.0 safer chemsex pack for gay men | PIP PAC
Injecting Supplies | Exchange Supplies
Drug and Alcohol Services: Search by Post Code | NHS
More
Further safer injecting tips and advice can be found here but bear in mind these are mainstream resources and don't address safer clamming and/ or chemsex specifically:

Injecting Advice | Injecting Advice
Safer injecting | drugs.ie
The Safer Injecting Handbook | Exchange Supplies

↑ Back to top

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Safer slamming (injecting) Wash your hands and clean the injection site Choose a quiet, safe place to inject Ensure the surfaces you prepare on are clean Whenever possible, use a sterile spoon and dry, clean filter available from needle exchange services and PIP PAC Avoid torn filters or exposed fibres as they can end up being injected and cause problems Never share your injecting equipment If you have to re-use equipment make sure it's yours Use a sharps bin whenever possible.

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Crystal meth is a super-strength amphetamine stimulant. Industrial chemicals and cleaning products which can be toxic often go into making it.

Used in chillouts, sex parties and during sex or clubbing, crystal releases the brain's stress hormone norepinephrine and 'feel good' chemicals dopamine and serotonin.

Meth comes as white or colourless crystals which can be crushed to make a powder. It can also come as a pill.

How it's used

Meth in its crystalline form can be smoked through a glass pipe.

Crystal as a powder is usually snorted, but can be mixed with water and injected. It can also be injected up the arse with a syringe with the needle taken off - this is known as a 'booty bump'.

Using meth is called 'tweaking' and injecting it is called 'slamming'.

Highs and lows of crystal meth

Meth is used for energy during non-stop sex or dancing sessions. It can make users feel high, euphoric, wide awake, self-confident, invincible, impulsive, less likely to feel pain and very horny with fewer inhibitions.

Crystal increases body temperature, heart beat and blood pressure - possibly to dangerous levels - increasing the risk of heart attack, stroke, coma or death.

Users may go for days without eating or sleeping because crystal meth suppresses the appetite and keeps them wide awake.

The comedown can leave people feeling exhausted, aggressive and paranoid, in some cases even suicidal. They can also develop stomach problems such as acid reflux or gastritis due to not eating for a long period of time. Many users develop bad teeth and gum problems due to their regular use of Crystal and their disinterest in their personal hygiene. Dehydration is also a common problem, as using 'Tina' masks feelings of thirst and hunger.

Depending on how Crystal is taken, it might also damage the lungs, nose and mouth.

The drug's bad reputation is warranted by the many casualties it's caused on the gay scene around the world, although not everybody who uses it develops problems. As with any drug use there is problematic and non-problematic usage, with some users being able to control their consumption and some not. It's also thought that the risks of dependency on Crystal may be linked to the way that it's been taken.

Sex on crystal meth

Crystal can make the user feel very horny, even sexually compulsive with a stamina during sex not felt when not using the drug. It can also stop them cumming or even getting a hard-on in the first place. Being on crystal for some guys means they take sexual risks that they normally wouldn't.

Long or rough crystal-fuelled sex sessions can cause a sore or bleeding arse, dick and mouth. These might not be noticed at the time but they mean that there's more risk of HIV, hepatitis C and other STIs being passed on.

Condoms are more likely to break after about half an hour of fucking. During long sex sessions on crystal, use plenty of silicon or water-based lube, check the condom remains intact and put a fresh one on after 30 minutes.

Sex on crystal has been described by regular users of the drug as 'the best sex in the world', 'intense' but also as cold, aggressive or disconnected.

A long-term relationship?

Tolerance to crystal meth builds up quickly and users need to take more to get the same high. The drug has a reputation for being quickly addictive, especially when 'slammed' or 'booty bumped'.

Even hardened gay scene party animals who can control their use of other drugs have found themselves out of their depth with crystal. It can become hard to think of having sex without being on meth and - like G and mephedrone - it can have a big impact on peoples ability to have sex sober.

People who were addicted and are now sober say that it is hard to deal with sex afterwards, often for many years. Problematic use of Crystal can cause severe negative effects, including job loss, financial problems and health issues including psychosis or lasting mental health problems, even after quitting the drug.

Quitting problematic use of Crystal can be very hard. Its effects on the brain can last long after giving the drug up, but users can turn this relationship around.

Tips to share with users about consuming meth

Consume only when they feel comfortable and it's best done when someone you trust is with you and who knows about your (mixed) consumption and could get help in an emergency.

You can't always tell with the naked eye what drug that line in front of you is. If something is offered to you, ask what that substance is.

Think about how long you want to stay awake. Do not take anymore when the party is over or you want to go home. It's not good to be exhausted and unable to sleep.

Using Crystal leads to increased facial motor skills in many users (teeth grinding). Chewing gum can help to protect teeth, gums and cheeks, but this does not help against developing sore muscles in your face from the chewing. Some users recommend magnesium and calcium for muscle relaxation.

Take rest breaks during your drug 'bumps' to avoid overheating and over-exertion. When dancing in the club, give yourself a little break and go out into the fresh air for a while.

Even if you feel fit and alert: do not drive a car under the influence of Crystal or perform other dangerous activities (such as operate heavy machinery for example) Do not underestimate how the drug can still be affecting you.

Using Crystal deprives your body of fluids, essential minerals and vitamins; therefore always drink enough water or vitamin-rich fruit juices. You can compensate for calcium deficiency by eating dairy products or beans. Vitamin and mineral drinks and tablets, as well as fruits, vegetables and nuts can be helpful during or after Crystal use in the short term.

Crystal is not a suitable diet. You can lose a lot of weight in a short time, but it's in a very unhealthy way.

If you consume Crystal on a regular basis, your tolerance to the substance increases really quickly meaning your body builds a tolerance and you have to take more to get the same high. This will mean that the nutrient and power reserves in your body continue to decrease. Therefore its highly recommended to take longer breaks between uses of Crystal, and it's really important to get sufficient sleep and a healthy diet. It also helps you to take care of your personal hygiene (which can be lost over long weekends of partying) and it's especially recommended to pay close attention to your teeth, gums and nose. A break of a couple of weeks between uses is recommended so that your body and mind can recover and regenerate sufficiently.

Crystal with other drugs

HIV drugs/PrEP

Protease inhibitors - especially ritonavir, but also some other drugs in this class - could cause a big, possibly fatal rise in levels of Crystal in the body. This is because ritonavir slows down the metabolisation of Crystal which leads to high levels of the drug in the bloodstream, making overdose more likely. If users are on these treatments it's recommended to start with low doses of all chems, not only Crystal.

If someone is partying the weekend away on crystal, they are more likely to be late with their meds or miss them entirely, so it may be useful to set alarms on clocks and phones as reminders of when to take meds.

Crystal also damages the immune system, as does going without food or sleep when you're on it.

Ecstasy, cocaine, poppers and Viagra-type drugs

All of these drugs put the heart under strain. If people are using crystal too they are pushing their heart even harder. Mixing those drugs can lead to:

sudden spikes in blood pressure

chest pains

heart attack

strokes.

Anti-depressants

Taking crystal while on antidepressants can make life-threatening reactions more likely, including dangerously high blood pressure and increased risk of serotonin syndrome (the levels of serotonin in your blood becoming too high). Users should check with their doctor before using antidepressants and crystal at the same time.

Useful information to know and share.

It's recommended that users avoid injecting, as it's the quickest way to getting addicted and runs the risk of serious health problems including skin abscesses, collapsed veins, blood poisoning and heart infections. There are other ways of using Crystal that are less problematic.

Sharing injecting equipment puts the user at a high risk of getting or passing on HIV, hepatitis C and other infections. Using hot pipes can injure the lips and lining of the mouth and if pipes are shared it risks passing on - through tiny amounts of blood - infections such as hepatitis C and HIV.

Next module: Mephedrone

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AKA: crystal, Tina, T, methamphetamine or meth (not to be confused with meph - mephedrone). Crystal meth is a super-strength amphetamine stimulant. Industrial chemicals and cleaning products which can be toxic often go into making it. Used in chillouts, sex parties and during sex or clubbing, crystal releases the brain's stress hormone norepinephrine and 'feel [...]