(107) Chemsex: The Neuropharmacology of Pleasure and Risk
The Journal of Sexual Medicine June 1, 2026 M Almada, R Neto, A Pinto et al.
Chemsex—the intentional use of psychoactive drugs to enhance or prolong sex—has grown from a niche practice in late-1990s club scenes into a global public health concern, especially among men who have sex with men (MSM). Common substances include methamphetamine, mephedrone, synthetic cathinones, GHB/GBL, MDMA, and sildenafil, often used in polydrug patterns. These drugs act on dopamine, serotonin, and GABA systems to boost arousal, endurance, and emotional connection, but also raise risks of infectious disease, cardiovascular strain, psychiatric problems, and dependence. Among MSM in Western Europe, chemsex prevalence ranges from 5–15%, with emerging reports in heterosexual and digital networks. The review calls for integrated harm-reduction, digital outreach, and culturally competent care.