By David Stuart @davidastuart

Photo © Chris Jepson,

While the AIDS epidemic was ravaging our gay communities in the 80s and 90’s, and when (pre-smartphones) we still had to leave the house to find a shag, many of us were cutting our teeth on ecstasy and ketamine in after-hours clubs and chillouts. Good times.

Those innocent highs helped us party through years of disease, trauma and inequality; they gave the shy and awkward among us the confidence to congregate, they gave freedom of movement to bad dancers and they facilitated a community cohesion that had never been so robust and proud and united. 

So now it’s 2015, and we’ve upgraded our equality laws, our technology… and we’ve upgraded our drugs. Ecstasy is a rarity (crap when you can find it), and we’ve kindly handed ketamine over to the straight ravers. In their place, we’ve taken Tina and meph to our hearts as our enablers-du-jour, and G has pride of place in our kitchen cabinets alongside the coffee and Candarel.

The online disagreements continue, about our right to do drugs, and the degree of harm they do or don’t cause. Are Tina, meph and G simply the modern equivalent of the innocent highs we enjoyed in the 90s? Or are these drugs the seriously hardcore equivalents to heroin and crack, devastating the wellbeing of our gay brothers and our communities?

It’s interesting, that during the ecstasy years, HIV rates among gay populations around the globe stabilised. It was hailed as a roaring success of gay men adopting safer sex practices, and absorbing vigilant health promotion messages.

Interesting too, and unfortunate, that as Tina, meph and G became popular on gay scenes, HIV rates among gay men began climbing, doubling in the last five years in London.

Just a coincidence, perhaps. There are plenty of possible explanations for the increase. Nonetheless, our vigilance must ‘up’ a gear use condoms, know our status, de-stigmatise HIV, campaign for the availability of PrEP, raise awareness of PEP (too many of us just don’t know what it is, or  don’t access it in time); and of course, play as safely as possible when using chems.

The ultimate, best way for us to address the HIV epidemic in our communities is to have a robust sense of what makes for an awesome sex and romantic life; knowing what we’re worth, what our partner/shag is worth, understanding our sexual and emotional needs, knowing how to form intimacies in all sexual settings, knowing the role sex and intimacy play in our wider lives, and within our communities. Including having an enthusiastic sense of our future, and protecting that future through the choices we make today, and in bed.

If we could all manage this, HIV would be stopped in its tracks. Bring it on.

Playing safe

Quite often, the chem-high can mean parking all our boundaries and self-care at the door, and pushing all the fun, risky limits that chemsex offers to the max; it’s only a few days after that these consequences catch up with us, and they can include HIV, hep C, missing days at work, seeing less of our friends, depression, and sometimes guilt, shame and regret. It’s wise to set some boundaries before getting high, discuss them with our shags, and avoid self-medicating our way through the consequences.

VIDEO>> Pre-setting boundaries


VIDEO>> Pay the price


VIDEO>> Boundaries


Why make changes at all?

Disease, dependence and psychosis are not the only consequences of chemsex. There are some other, somewhat insidious consequences that we may be less aware of, and that can creep up on us losing the ability to have sober sex, or to form relationships, a lack of enthusiasm for life, friendships, career, or becoming isolated and depressed.

VIDEO>> Subtle messages

VIDEO>> The Rose

VIDEO>> Sexy things

Ready to make changes?

Making changes doesn’t have to mean a loud declaration of addiction, and changing your life and friends forever; it can be as simple as having the odd weekend off (or the odd month off). There’s a huge sense of accomplishment that comes with taking a small break, and it can give you a feeling of being in control again. The trick is to be alert to your cravings, know how to manage them when they hit, and respond to them differently.

VIDEO>> Small achievable goals

VIDEO>> Cravings

VIDEO>> Three minutes

Sober sex

Chem-free sex can be quite a scary or unenjoyable experience when we’re accustomed to the chem-high, and especially if it’s been more than a few months since we’ve tried it. Attempting it can be very triggering, often causing us to use (or ‘lapse’) when we we’re trying to have a break.

Chem-free sex is not the same as chemsex, and we shouldn’t try to replicate it when we attempt it. It invariably works better when we have a kind of ‘click’, or connection with our partner; being able (and brave enough) to say to our lover that we haven’t done it chem-free for a while, and that we’re a bit nervous, will definitely help. It can be really sexy when we connect that way.

VIDEO>> Sober sex

VIDEO>> The Book


David Stuart is the Substance Use Lead/Health Advisor at 56 Dean Street.

Chemsex support at 56 Dean Street: for gay men who use drugs for sex. Walk-in appointments Tuesday evenings, Thursday afternoons and two Saturday afternoons each month. For details visit

Get to know: COKE

What is cocaine? (also known as coke)

Cocaine or coke is a drug made from coca plants. It is a stimulant that comes in a flaky, white and odourless powder and is usually snorted in small amounts (in a line or a bump) through a straw or a rolled up bank-note. You can also spread it on your gums (less common), heat and inhale it or inject it intravenously in its soluble form. Cocaine can easily be found on the London gay scene but in recent years its quality has decreased as it is often mixed with other substances. Taking a few lines of coke will often make you feel wide awake, chatty and confident. It’s also known to make users horny but it’s harder to sustain a hard-on when high on it.

How does cocaine affect my health?

Having a line from time to time is not a big deal, and many gay men in London use it. Some people take it further and use coke on a regular basis which leads them to become psychologically addicted. If you get yourself high on coke, you could end up making poor choices around your sexual health, as it’s a drug that makes you feel all-powerful and you may think that a condom is not necessary. Coke acts as an anaesthetic and some gay men put it up their bums, which makes them able to get fucked for longer. If you are not using condoms and enough lube, this can increase the chance of spreading or catching HIV and hep C.

Regular cocaine use can also lead to anxiety, paranoia, depression and insomnia, especially in the comedown period a day or two after using it. Snorting cocaine too frequently can also damage your nasal cavity.

Can I mix cocaine with alcohol and other drugs?

Many gay men mix coke with alcohol regularly with little side effects but, because cocaine counteracts the effect of alcohol, it makes you think that you can drink more. Mixing too many drugs together also adds extra strain to your heart and brain which could potentially be dangerous.

What do I need to know if I am planning to take cocaine?

Taking coke on an occasional basis is not exceptionally dangerous. The problem comes if you start using it too often. If you are going to take it, keep track of how much you take, start with a smaller line at longer intervals and perhaps ask a friend to keep an eye on you. If you are using a straw or a banknote, don’t share it but use your own one every time you snort. This will reduce your risk of catching hep C if there is infected blood residue on the utensil you use to snort. If you are planning to inject it, make sure you don’t share needles to avoid transmission of HIV and hep C. Drink plenty of water.

What else is cocaine known as?

Some of the most common names for cocaine around the scene are Charlie, coke, snow, white, nose candy, blow and sniff.

To get more information on drugs, visit

Antidote helpline: To discuss your drug or alcohol issues call 020 7833 1674 (10am-6pm, Monday to Friday). Ask for one of the Antidote team.