“It all started on the last Saturday of September 2013. I was invited to a friend’s house in the Geneva countryside. There were four of us. I tried MDPV (a drug similar to ecstasy), and it completely changed my sexuality.” Since then, Patrick has never had sex without a substance. "At the beginning of my career, consultations were mainly related to pornography addictions or masturbation,” observes Dr Ahmed Ben Hassouna, sexologist and addiction specialist, head of the hospital unit of addiction medicine at CHUV. “Today, it’s almost exclusively for chemsex.” Over the past five years, he has treated around 150 patients, including Patrick, for addiction to chemsex, the practice of using drugs in a sexual context. According to Dr Ben Hassouna, chemsex is expanding, mainly within the gay community, especially in recent years. Dating apps have facilitated the arrangement of sexual encounters involving drugs, enabling faster connections with partners who practise chemsex. 

The majority of people who use drugs during sexual intercourse do not use them outside this context. For many, this habit is relatively controlled and does not cause problems. However, in some cases, chemsex can develop into an addiction, especially when there is a loss of control over the frequency of use or when the person has psychological vulnerabilities such as anxiety, depression or trauma.

The risks of sex under the influence of substances

Substance use can also impair the ability to give clear consent, which is problematic in sexual relations. "Some patients report finding themselves in situations they had not anticipated, with difficulty setting limits under the influence of substances," says Dr Ben Hassouna. "Some people woke up from a chemsex experience with one or two more people than they had initially agreed to,” the doctor points out. This loss of control affects both the circumstances of the encounters and the sexual practices involved.

"With drugs, we enter a world of increasingly intense sensations. We become sexual beings," says Patrick. But this quest for intensity, performance and disinhibition can have serious consequences, including contracting sexually transmitted infections, isolation, mental disorders, and, especially, overdose. "It’s always a shock to learn that people have died because of it," says the fifty-year-old. "I hope I’m smart enough to know where to draw the line.”

For Patrick, his practice also has financial repercussions. He admits to having spent up to 11,000 francs in one weekend, including remuneration for escorts, hotel costs, and drugs for himself and his partners. Becoming aware of this allowed him to slow down for a while. Other behavioural addictions, such as gambling addiction, also share the same addiction-related criteria as compulsive sexual behaviour disorder, including continuing the practice despite negative consequences. 

Beyond performance, disinhibition and intensity, sex under the influence of a drug is also sought to facilitate social connection. This approach may seem paradoxical, as the practice can also isolate those who practise it daily. Sexual addiction is not yet recognised as a behavioural addiction in its own right, a point Dr Ben Hassouna deplores: drugs are not always the cause of craving, or the irrepressible desire to consume a product, but rather a means to achieve sexual intensity. 

Comprehensive and complex support

As with any addiction, stopping chemsex remains a complex process. Follow-up includes psychotherapeutic support and medical care, while support from family and friends or the practice of new activities can also be part of the ways to overcome addiction. "I realise that I would like to be able to desire someone, to admire them," says Patrick. "Making love is beautiful, and I often miss it." Between the quest for intensity and the gradual loss of connection with others, chemsex suggests an ambivalent reality in which pleasure gradually gives way to isolation. To best support people struggling with chemsex addiction, Dr Ben Hassouna hopes to develop a network of specialised professionals.

“It all started on the last Saturday of September 2013. I was invited to a friend’s house in the Geneva countryside. There were four of us. I tried MDPV (a drug similar to ecstasy), and it completely changed my sexuality.” Since then, Patrick has never had sex without a substance. "At the beginning of my career, consultations were mainly related to pornography addictions or masturbation,” observes Dr Ahmed Ben Hassouna, sexologist and addiction specialist, head of the hospital unit of addiction medicine at CHUV. “Today, it’s almost exclusively for chemsex.” Over the past five years, he has treated around 150 patients, including Patrick, for addiction to chemsex, the practice of using drugs in a sexual context. According to Dr Ben Hassouna, chemsex is expanding, mainly within the gay community, especially in recent years. Dating apps have facilitated the arrangement of sexual encounters involving drugs, enabling faster connections with partners who practise chemsex. 

The majority of people who use drugs during sexual intercourse do not use them outside this context. For many, this habit is relatively controlled and does not cause problems. However, in some cases, chemsex can develop into an addiction, especially when there is a loss of control over the frequency of use or when the person has psychological vulnerabilities such as anxiety, depression or trauma.

The risks of sex under the influence of substances

Substance use can also impair the ability to give clear consent, which is problematic in sexual relations. "Some patients report finding themselves in situations they had not anticipated, with difficulty setting limits under the influence of substances," says Dr Ben Hassouna. "Some people woke up from a chemsex experience with one or two more people than they had initially agreed to,” the doctor points out. This loss of control affects both the circumstances of the encounters and the sexual practices involved.

"With drugs, we enter a world of increasingly intense sensations. We become sexual beings," says Patrick. But this quest for intensity, performance and disinhibition can have serious consequences, including contracting sexually transmitted infections, isolation, mental disorders, and, especially, overdose. "It’s always a shock to learn that people have died because of it," says the fifty-year-old. "I hope I’m smart enough to know where to draw the line.”

For Patrick, his practice also has financial repercussions. He admits to having spent up to 11,000 francs in one weekend, including remuneration for escorts, hotel costs, and drugs for himself and his partners. Becoming aware of this allowed him to slow down for a while. Other behavioural addictions, such as gambling addiction, also share the same addiction-related criteria as compulsive sexual behaviour disorder, including continuing the practice despite negative consequences. 

Beyond performance, disinhibition and intensity, sex under the influence of a drug is also sought to facilitate social connection. This approach may seem paradoxical, as the practice can also isolate those who practise it daily. Sexual addiction is not yet recognised as a behavioural addiction in its own right, a point Dr Ben Hassouna deplores: drugs are not always the cause of craving, or the irrepressible desire to consume a product, but rather a means to achieve sexual intensity. 

Comprehensive and complex support

As with any addiction, stopping chemsex remains a complex process. Follow-up includes psychotherapeutic support and medical care, while support from family and friends or the practice of new activities can also be part of the ways to overcome addiction. "I realise that I would like to be able to desire someone, to admire them," says Patrick. "Making love is beautiful, and I often miss it." Between the quest for intensity and the gradual loss of connection with others, chemsex suggests an ambivalent reality in which pleasure gradually gives way to isolation. To best support people struggling with chemsex addiction, Dr Ben Hassouna hopes to develop a network of specialised professionals.