There are social phenomena that, when they emerge, don’t just challenge clinical frameworks—they shake our understanding of human suffering, desire, the body, and connection. One of them is Chemsex: the intentional combination of psychoactive drugs with sex, usually among men who have sex with men (MSM), during prolonged sessions that may last for hours or even days. Though it may initially appear liberating or pleasurable, it often turns into a silent trap with deep repercussions for mental health.
What is Chemsex, really?
The term "Chemsex" comes from "chemical sex," and it refers to the deliberate use of substances such as methamphetamine, GHB/GBL, mephedrone, or ketamine to enhance sexual experiences. These drugs not only prolong the duration of sexual encounters but also reduce inhibitions, boost euphoria, and intensify feelings of connection or surrender. But all this comes at a cost.
Behind the immediate pleasure, Chemsex often reveals itself as a contemporary expression of psychic pain, of invisible wounds, unspoken trauma, and emotional isolation. Though it may look like desire and freedom on the outside, underneath, it often carries loneliness, inner emptiness, anxiety, and unresolved emotional pain.
A symptom of a deeper wound
Many people who frequently engage in Chemsex sessions carry personal histories of rejection, stigma, internalized homophobia, abuse, or trauma. In this context, drugs become a form of anesthesia—a way to silence the inner critical voices, to numb fear, and to avoid real intimacy. It’s an adaptive solution that, instead of resolving pain, ends up intensifying it.
These substances profoundly alter brain chemistry. Dopamine, the key neurotransmitter in the reward system, is released in huge quantities. But after the high, there’s the crash: the infamous “comedown,” often marked by depression, paranoia, depersonalization, or anxiety attacks. In some cases, people experience dissociative symptoms or deep existential distress, especially those with prior vulnerabilities.
Neuroscience of desire and trauma
From a neuroscience perspective, Chemsex stimulates the brain’s reward circuitry (notably the nucleus accumbens), but can also activate areas linked to threat and trauma. In individuals with a background of relational trauma or abuse, the body enters into a paradox: on one hand, it seeks ecstasy, contact, fusion; on the other, it activates protective mechanisms that lead to emotional dysregulation, compulsion, or emotional shutdown.
This can be understood through the lens of the structural dissociation theory, developed by Van der Hart and colleagues, which proposes that the self may fragment into functional parts as a survival strategy. In this light, Chemsex can be seen as a strategy used by parts of the psyche to avoid contact with overwhelming memories or intolerable emotions.
The void after the party
Many men who seek therapy for issues linked to Chemsex don’t initially come because of the drugs. They come for the anxiety, insomnia, guilt, inability to form authentic emotional connections, or the sense of being disconnected from themselves. Some describe a feeling of having “lost their compass” or of living life in “autopilot mode.”
Real intimacy—without substances—becomes unbearable. Ordinary relationships feel dull. The body becomes so used to artificially heightened stimulation that simple affection, silence, or sober emotional connection feels either insufficient or threatening.
The therapeutic approach: beyond abstinence
Addressing Chemsex only through behavioral or moralistic lenses is a mistake. It’s not just about stopping drug use—it’s about reconstructing an internal narrative, offering a safe space where emotions, life stories, and relational wounds can be explored and healed. Abstinence may be a goal, but it cannot be the only one.
Approaches like EMDR, somatic therapies, IFS (Internal Family Systems), or Gestalt therapy can help individuals reconnect with their bodies, identify the inner parts that seek anesthesia through drugs, and create bridges toward a more integrated and compassionate sense of self.
It’s also crucial not to pathologize sexuality or reinforce stigma. The key is to provide a compassionate space where people can explore the needs behind their substance use, and how it connects to their identity, their desires, their body, and their history of relationships.
A more human perspective
Chemsex isn’t just a drug issue. It’s often a silent cry born out of disconnection, shame, or lack of belonging. At the same time, it can be a desperate search for ecstasy, transcendence, and fusion. Like all forms of human suffering, it deserves a deep, compassionate, nonjudgmental approach.
Ultimately, each person who goes through this experience is seeking the same thing we all are: to feel seen, loved, free, and connected. Helping them find more sustainable and loving ways to get there may be the most healing act therapy can offer.
"The wound is the place where the light enters you." – Rumi