chemsex harm reduction

You will find here:

1. General chemsex harm reduction tips
2. How to reduce risks when taking G - How to avoid passing out
3. How to reduce risks when slamming 
4. Alternatives to slamming
   • Booty Bumps
   • Eating / swallowing / bombing
   • Snorting
   • Smoking
5. How to reduce risks when fisting
6. Harm reduction and HEP-C, HIV and other STI's
   • HEP-C prevention in chemsex
   • HIV and other STI's prevention in chemsex 

We are all aware that the best way to avoid any negative consequence associated with Chemsex practices is not to get involved in them, but this is not always the option that everybody chooses. In those cases, having a good understanding of how to reduce the potential risks is very important, considering that so many things can go wrong in these scenarios. 

1: CHEMSEX HARM REDUCTION TIPS

If someone has finally decided that they wants to engage in a Chemsex session after checking pros and cons, and they are determined to do it, it’s very important to remember that unfortunately, in those scenarios, sometimes bad things happen, and many of the effects of those challenging experiences can be avoided, or at least, minimised. You can find here general tips that can be very helpful for you to play safer:

• In order to prevent problems with the quality of your supplies, try to choose a dealer who you trust and who knows what they are selling.
• To be safer, try to play with someone who you know and trust, if possible. Someone who will look after you if something bad happens, and who you can support if they are the one who is having a vulnerable time.
• If you decide to invite people to your place who you don’t know, it’s advisable to keep your money and valuables in a safe place. Unfortunately, not everybody is kind and nice, and it’s always better to be cautious.
• Try to explore and set boundaries when you are sober regarding what you want and what you don’t want to do when involved in sexual activities, chems that you don’t want to use or their route of administration, people who you want to interact with, etc. Boundaries that you can remember to keep when you are high.
• Before playing, try to collect everything that you might need for a long session: lots of condoms, lube, big amount of needles of different colours in case that you are with different people, each participant with a different colour, to prevent mixing them, leading to share needles accidentally.
• After 2 days without sleeping, it is very common to suffer from paranoia, hallucinations, psychotic episodes … to prevent this from happening, don’t play for too long.
• To avoid depression, high levels of anxiety, panic attacks, weight loss, memory loss, etc., it’s better not to play very regularly
• Despite the difficulty, keeping hydrated and eating something is very important, and your body will be VERY thankful if you take care of it.
• Sometimes when we get used to having only Chemsex, after a while, having sober sex can be challenging. To avoid this, it’s better not to stick only to Chemsex, but having dates, sober sex encounters as well, etc.
• If you are going to meet other people at their places, try to keep your favourite food ready at home, everything as tidy, clean and welcoming as possible. Sometimes it’s not easy to go back home, and you can stay out for longer than what you would like to. Thinking of home as a safe and welcoming space can make things easier to shorten sessions that you are no longer enjoying.

2: HOW TO REDUCE RISKS WHEN TAKING G (GHB/GBL)

G is the name that people use to call the drugs GHB (gamma hydroxybutyrate) and GBL (gamma butyrolactone). They are both depressant drugs and many times people who use them think that they are both the same. The reality is that:  

• GHB is a white crystalline powder which can be mixed with water to produce a clear liquid, which is how sometimes it is presented. It is odourless and it has a slightly salty taste
• GBL is a liquid with a chemical smell and taste. GBL is a precursor to GHB, which means that it is not psychoactive itself, and it's converted to GHB inside our bodies after drinking it. This is why both drugs are taken to get the same effects.

It's very important to remember that GBL is around two to three times stronger than GHB, which means that 1ml of GBL may be the equivalent of taking 2 or 3 ml of GHB. Taking the difference of the strength into account is crucial to prevent overdoses.

• Overdose, coma and death are real risks with G. Passing out might be something that you are familiar with having experiencing it before, or having seen people in that state, but that doesn’t make it less dangerous.
• Avoid mixing GBL with alcohol, Ketamine, Diazepam, sleeping tablets or any other drug with sedative effects. The chances of passing out are higher even just having very low doses of G.
• Take appropriate doses, at appropriate time intervals. A little bit more or a little bit less … count 5 minutes before or 5 minutes later for example.
• If you are likely to forget the exact time you had a dose of G, note it down or set the alarm on your phone. Sometimes if we are not sure when we took the last dose, we take the risk of taking more too soon, causing overdoses very easily, and that can be avoided if we keep records.
• Use a measured dropper bottle or syringe to measure your doses. Always pour your own dose in your own drink and make sure that there is no G already in the cup.
• You can’t be sure about how strong the G that you are taking is, so try to be patient if it takes a bit of time to work. Passing out sometimes happens because we take more G thinking that what we took wasn’t enough, and we don’t give time for the first dose to work.

Don’t forget that overdoses can happen:

• ACCIDENTALLY: because you take too much or you take too soon after your last dose, maybe because you think that you can take more than what your body can tolerate, or perhaps because you don’t remember when you last had some. There are some tips that can help you to avoid this situations:
  • As we have mentioned, don’t forget to note down how much you are taking and when.
  • Make sure that the cup that you are going to use to have your dose of G is empty. Sometimes accidents happen because there was some G on the bottom of the cup that we were about to use, and because G is transparent, we don’t realise.
  • Try to make sure that what you are going to use to measure your dose has clear visible markings, so you know the exact amount of G that you are pouring. G is corrosive, and it’s not unusual that those marks in a barrel or a dropper get deleted. Measuring roughly is often the cause of an overdose.
• PROVOKED. We can’t deny the reality, not everybody who you are meeting is going to be nice and kind. There are people who you might meet that are simply not like that, and sometimes they may have an agenda. This is the reason why it’s so important that you look after yourself, to prevent sexual assaults, physical assaults, thefts, being filmed without consent etc. Don’t forget that these situations can happen more easily if you suffer from an overdose and you lose consciousness, and you probably won’t even remember after. Here are some tips that can help you to avoid these situations:
  • Measure and pour your own doses of G. Don’t allow anyone to do it for you. It’s not rude not to accept it, it’s actually very wise, and you know it’s not difficult to say that you are used to serving your own G.
  • Sometimes these overdoses happen because G is mixed with lubricant and administered anally without us knowing. We just think it’s normal lube and we use it because we are going to have anal sex, but it might be that the person who you are with is actually using a  ready-made tampered mix. It’s important to be aware of this, and having your own lubricant or using individual lubricant sachets that you open and use as and when you need it are less easily tampered with.
  • You can be overdosed through booty bumping. You might think that the content of the barrel is water with Tina, or Mephedrone, etc, and some people might mix the water, or even lube, with G. This is happening, so if you are booty bumping, make sure you know what the barrel has inside before allowing anyone to do it.

3: HARM REDUCTION AND SLAMMING 

• Always prepare the space where you are going to slam, to be clean and tidy. Messy environments very often bring chaos and problems that could be avoided.
• Washing your hands thoroughly and potential sites of injection prior to preparing your shot, will greatly reduce the amount of germs around and thus their potential for getting into your body.
• If someone else is injecting you, make sure you see the equipment come out of a sealed packet. Try not to inject when you are alone, it’s important to have someone around just in case your body reacts in a way that you don’t expect, so that person can assist you.
• Always use your OWN equipment; don’t share (needles, spoon, filter or water). This will avoid infections. Don’t touch the filter or the needle with your fingers to prevent bacteria or blood getting on it. Never put a cap back on a used needle if you can avoid it, to prevent needlestick injuries and/or infections.
• Make sure that you are going to have enough equipment for your session. If for some reason you run out of needles and you decide to re-use one, use one of the ones that you used previously yourself, and wash it carefully.
• Use a new needle for each slam. Have a look at how needles look after the first slam.

• Alternate and rotate your injection sites. Always try to inject at least one inch from your previous injection site.
• Make sure that the site is not swollen, sore or tender. Never inject into your hands or feet.

• Use alcohol wipes BEFORE every injection. They help you remove dirt and germs from your skin.
• Using a tourniquet makes the veins on the surface get bigger and easier to hit. Use a soft, flexible, easy-to-open tourniquet and remove it AFTER you have made contact with the vein but BEFORE you inject, to prevent bruising. NEVER INJECT WITH A TOURNIQUET ON! Try to have your own tourniquet, and wash it regularly to remove blood.
• Before slamming, try to drink lots of water or juice so that the blood can circulate through the veins better. This way, they will be more visible.
• Inject ONLY into veins, in the direction of the body’s blood flow, towards you heart, If the vein is close to the surface, it will be a blue-ish colour:
  • If you inject into an artery or a nerve, it’s going to hurt and you are wasting your shot. PULL OUT!
  • When you think you have hit a vein, pull back the plunger a little:
    • If dark red blood enters the syringe … YOU HIT A VEIN!
    • If bright red, frothy or powerful/spurting blood enters … YOU HIT AN ARTERY! If this happens, apply pressure on the injection site for a while with the arm held up, until the bleeding stops.
    • If no blood enters … YOU HAVE MISSED THE VEIN.
  • If you don’t hit a vein … PULL OUT IMMEDIATELY.
• Insert your needle at a 15 to 45% angle with the level of the needle facing up.
• Always apply pressure to the site after removing the needle.
• Don’t forget to dispose the needles in a safe place where nobody can use them again, or getting hurt by accident.

4: ALTERNATIVES TO SLAMMING

• This option is about mixing Tina or Mephedrone with water, put in a syringe without the needle, and then placed inside the anus to be squirted into it, or pushed up there with a finger.
• It absorbs quickly and like a suppository, and it works very well. The effects can be felt faster and stronger than when chems are swallowed or snorted.
• When booty bumping, there is a risk of irritation, bleeding and/or inflammation inside the arse, which makes infections more likely.
• Make sure that when you are going to use a barrel your chems are dissolved completely. It’s advisable to use sterile water, and in case you don’t have any, use freshly boiled water instead. To avoid impurities, the best idea is to use a filter when you are filling up the barrel.
• It is very important to clean everything completely and carefully, including your hands, immediately after booty bumping. There are some bacterial infections that can be spread specifically from the arse, such as Shigella and Giardia.
• Sharing a needleless syringe once it’s been inside someone else’s arse has a risk of passing STIs like HEP C between you, particularly if the lining of their arse has been damaged by arse play or drugs. Also, sharing the drugs dissolved in the same water that has been used by someone else is very risky. If this is your route of administration, use your own barrel and your own cup with your mix of water and chems, don’t fill your barrel from the same recipient where someone else took their dose from.
• Regular booty bumping can cause Haemorrhoids, rectal pain and bleeding, so if bottoming, be aware that you might be more prone to acquiring or transmitting an infection. You might also be numb from the drugs, and so unaware of additional trauma you are causing to the area, or more painful, if there is already trauma to the area.

EATING / SWALLOWING / BOMBING

• This is the safest way to take most drugs, it might take longer to get high and the intensity is not the deepest, but definitely the chance of becoming addicted to a substance is lower. It can be much longer acting than other routes of administration.
• You can dissolve the drug in a small amount of water or soft drink (this can cause a sore throat), wrap it in small rolling paper or a little piece of toilet paper, or put it in a capsule and swallow it as a 'bomb'. Bombing is the safest route of administration, to avoid any harm in the nostrils, veins and throat.
• Swallowing drugs in drinks or food can mean you have less control over the amount taken, so it’s important to be aware of how much you put it.

SNORTING

• The high when we sniff drugs is faster than if we swallow them, and it’s more intense, but the effects are less lasting.
• Snorting the drugs can cause nose bleeds, and microscopic amounts of blood can pass from one irritated or raw nose to another if you share equipment.
• It is always better to use post-it-notes or fresh individual drinking straws than keys or banknotes, to prevent cross infections.
• Crush the powder as fine as possible using something very clean such as two spoons. It won’t hurt that much when you snort the drug.

SMOKING

• Crystal Meth (not Mephedone) is mostly heated and then smoked in a glass pipe.
• Sometimes if the pipe is too hot, it might injure your mouth, and if you share them, it’s easy to transmit infections like HEP C.
• Smoking is a really fast route of administration accessing the brain and it provides a very intense sense of euphoria. Lots of people love the ceremony of smoking Tina, which can add to the intensity of the feelings, and can explain why this way is so addictive.

5: HARM REDUCTION AND FISTING 

• Fisting is an intensely powerful experience and drugs accentuate these sensations. It’s important to remember that very often chems mask our sensitivity to physical damage and pain, both from the perspective of the fister and fistee, therefore increasing risk.
• Go slowly and gently, use PLENTY OF LUBE. It will never be too much.
• It’s very important to be able to negotiate boundaries and communicate how you are feeling, before, during and after fisting. If you are the receptor, don’t be scared of letting the inserter know if you are feeling any pain or you are not feeling comfortable.
• Gloves are highly recommended for fisting, to protect the area from STI’s transmitted through blood and faeces, and also from lots of bacteria that can live under the fingernails. Without gloves, the fister is exposed to the blood of the partner, and if they have an open cut or similar, viruses have a perfect access to their system.
• Gloves will also prevent from causing pain or discomfort for the receptor because of small bumps or hangnails on the fingers.
• In case that gloves are not used, it’s important that fingernails are short, filed smooth and very clean, with no hangnails or open cuts on hands to prevent infections, discomfort or pain.
• Once you are done, don’t forget to clean up your partner and check for blood, faecal matter and signs of prolapse. If it doesn’t look more or less the way it did when you started, there’s probably something wrong.

6: HARM REDUCTION AND HEP C, HIV AND OTHER STI’S 

HEP-C PREVENTION IN CHEMSEX

According to the “Chemsex and new HIV diagnosis in gay, bisexual and other men who have sex with men attending sexual health clinics” Study (St George’s University Hospital - 2018), men engaging in Chemsex are 9 times more likely to be diagnosed with HEP-C than other men who has sex with men (MSM).

It’s a fact that, even though the majority of people who are involved in these practices are very well informed about HIV and other sexual transmitted infections, there are some things to remember to reduce risk regarding HEP-C transmissions:

• HEP-C can be spread by direct blood to-blood contact.
• HEP-C can live outside the body for at least 16 hours and up to 4 days.
• The blood may not always be visible, so:
  • Sharing needles and syringes to inject drugs takes a very high risk of transmission.
  • Sharing syringes to practice booty bumps, or taking the drug dissolved in water from the same cup, sharing it with others, is also a very risky practice.
  • Sometimes if you are smoking and the pipe is too hot, it might injure your mouth; also, chapped lips can be a route of transmission. If you share pipes, HEP-C can be transmitted easily.
  • Avoid sharing notes or straws that are used to sniff drugs.
  • The highest sexual activity risk (excluding slamming) is unprotected fisting, so don’t forget to use gloves. When practicing fisting, sharing tubs of lube could be dangerous, as the pot can be contaminated with HEP-C coming from other people.
  • If you are playing with sex toys and you are not protecting them with a condom, it’s very important to wash them thoroughly with soap and water after using them.
  • As with sex toys, remember that multiple fist partners in the same session greatly increases risk infection, even if gloves are used (unless changed for each partner).
  • The virus can go from inside one arse into another from a douching kit.

HIV AND OTHER STI’s PREVENTION IN CHEMSEX

According to the same study, men engaging in Chemsex are 5 times more likely to be newly diagnosed with HIV, and 4 times more likely to be diagnosed with a Sexually Transmited Infection (STI) than other MSM.

To prevent this from happening, there are some tips that can be very helpful for you to keep safer:

• Don’t forget to have plenty of water based lubricant and lots of condoms available every time you decide to play.
• Use a new condom every time you play with a new sexual partner.
• If you struggle with the use of condoms in a Chemsex scenario at all times, accessing Pre-exposure Prophylaxis (PrEP) to prevent yourself from catching HIV is a very useful option to consider seriously. (IMPORTANT: this treatment does not protect the transmission of others STI’s, it only works for HIV).
• Regular testing is very important to keep yourself and your sexual partners safe. If you get any infection, the sooner you access treatment, the better.
• If you are living with HIV and you decide to play, set your alarm as a reminder to take your medication at the right time, as it was prescribed. In case you decide to travel and visit someone else, don’t forget to take your medication with you.