Clinicians must understand where sex, drugs and technology meet

More clinicians today are working with LGBTQ clients who have gravitated toward the “party and play” (PnP) lifestyle, according to Jeff Zacharias LCSW, CSAT, CAADC, clinical director of New Hope Recovery Center, speaking at the National Conference on Addiction Disorders in Denver Friday. Also referred to as “chemsex,” the destructive PnP behavior is often characterized by intense experiences that combine crystal meth or similar drugs and risky sexual activity.

Gay and bisexual men, including men who have sex with men but don’t identify as gay, are especially vulnerable to the trend. What’s more concerning is that the advent of GPS-based mobile apps has opened up a social channel for individuals to seek PnP opportunities.

“Social media is the new drug dealer, and your phone is the new corner spot,” Zacharias said.

Sites that are considered to be part of the “dark web”—an encrypted online channel that makes the user’s location impossible to track—are often sources for crystal meth, he said.

Clinicians can help

Zacharias recommended that clinicians keep in mind the fact that a chemsex client seeking treatment has most likely experienced trauma. Trauma in the LGBTQ community often begins early in life and can contribute to the individual’s feelings of isolation. The intensity of the chemsex culture becomes appealing because the person believes the experience can “take away” the feelings of depression, shame and stigma.  

“Part of the challenge for us as clinicians is: How do we help clients feel safe and like they have a ‘tribe’ but not one that involves bars or bath houses?” Zacharias said.

Zacharias recommended that clinicians:

• Begin by assuming that a client engaged in the chemsex culture has probably experienced trauma;
• Assess for mental health, suicide ideation, self-harm, etc.;
• Listen for buzzwords related to the chemsex culture such as “PnP” or “slamming,” which refers to intravenous use of drugs;
• Work with the client to figure out what feels calming for them, knowing that many in the chemsex culture have been driven by intense experiences and might not respond to yoga, for example; and
• Consider recommending the client for Truvada (emtricitabine and tenofovir disoproxil fumarate), a daily pharmaceutical treatment that reduces the risk of HIV transmission.