By David Stuart | @davidaStuart - Photo by Chris Jepson | ©

Some decades back, when street-homeless heroin use started becoming more obvious around city streets, a couple of epidemiologists got together to screw in a light bulb. 

They remarked that this new phenomenon was increasing; they identified that it seemed to be closely associated with poverty and crime, and a little further research showed that injecting use was also rising, bringing with it HIV and hepatitis C risks that might spread to the wider population. They wondered if it was just a ‘flash in the pan’ kind of trend, and if there was anything that might be done to stop this drug problem in its tracks.

And as the light bulb flashed on, one of them observed that this may not be just a passing trend; that heroin was tapping into a cultural problem, and it was likely here to stay. And he looked to the future, and said “We may just have to get used to our streets being full of homeless, begging, injecting drug users; this problem isn’t going anywhere.”

Activists at the time trying to raise awareness were accused of being alarmist, asked to “hush the problem up” and struggled against a tide of stigma and unkindness.

“Why don’t they just get jobs?” 

“They’re giving us occasional cocaine users a bad name.” 

“I’m not giving them money, they’ll only spend it on drugs.”

“It’s their choice to do the drugs; I have no sympathy for them.”

“They’re ruining our neighbourhoods and bringing down house prices.”

It’s 2015. Heroin is still here, and it may have been the reason I was asked for change eight times while dining out on Old Compton Street yesterday. Some other drugs have come and gone over the last few years; passing legal high trends like ‘Benzo-fury’, ‘Go-gaine’ and ‘Ivory Wave’, hardly measured up to the public health concern of heroin (despite the scare stories in the media).

In 2010, that light bulb needed tending to again. The topic was chemsex: crystal meth, GBL and mephedrone. Just a flash in the pan? A distant memory by 2013? 

With each twist of the light bulb, the epidemiologists considered how these drugs tapped right into something at the core of gay men’s relationship to sex, identity and community. They observed how the attention spans, patience and courtesies associated with sex and dating were being affected by new technologies and smartphone apps. 

They watched as gay communities struggled with generational HIV stigma and confusing new HIV prevention methods. They saw in fact, fertile ground within which addiction could grow some firm roots. 

And as the light bulb flashed on, the words were uttered: “These drugs are tapping into something profoundly cultural; chemsex could be here to stay. We may just have to get used to sharing our cities with app-addicted, hyper-sexualised, psychotic, drug-injecting gay men.” Ouch.

And as the movement began to raise awareness and get support services responding effectively to the phenomenon, the same prejudices reawakened.

“Hush it up; it’ll cause a backlash from the straights.”

“We good gays are being tarred with the bad gays’ brush.”

“Those junkies are giving us recreational chem-users a bad name.”

“The straights will think we’re all like that.”

“There’s nothing wrong with drugs; it’s just those who can’t handle their drugs ruining it for everyone else.”

This is the real Groundhog Day. Intolerance. Stigma. Unkindness. Shame. Accompanying all the cultural upheavals throughout history, dividing communities, challenging the efforts of all those working for the betterment of affected populations... and always the greatest obstacles to change.

So here we are again, a divided community, beating each other up in PrEP debates, shaming our gay brothers over hetero-normative attitudes or promiscuity, hyper-defensive about how other people’s lifestyles reflect upon us.

And all this at the same time as a new Vice Media documentary cinema release about London chemsex trends. Part of the BFI London Film Festival, this film documents what it says on the tin. It’s raw and challenging to watch. It tells a story about a cultural phenomenon that is not going away. Will it make your mum think that this is what your sex life is like? Probably not. Will it embarrass you, as if it represents the sum of the gay community? No, you’re better than that. Think bigger. Will it cause a backlash from ‘the straights’? Good grief. This is a public health issue, and I think we can credit our heterosexual siblings in 2015 with a little objectivity and sensitivity here. Where that fails? We can handle it. What’s the alternative? Hush it up, keep our shameful dark secret hidden?

We gay men have a little less objectivity around this issue. It hurts us. Embarrasses us. Makes us look at ourselves, without the rose-tinted glasses. It reminds us how much we might have relied on drugs ourselves, to facilitate connection, community; of that time we were a bit cruel to that shag, that time we didn’t use a condom, that time we were a bit unkind on Grindr. It raises issues about how we might neglect our own health and wellbeing, how remiss we are in showing tolerance for our own gay brothers. It reminds us, just how much we like being high.

So ask me then, if it will cause a backlash from within our own community. Hell yeah. The rainbow flag’s really gonna hit the fan.

And fair enough. I like to believe the reason we’re so hot under the collar or sensitive about chemsex awareness, is simply because... because we care so much. Because we want our gay brothers to be well and happy, to experience awesome sex and romantic lives. Because we know. We know how difficult it is ourselves. We seek joy, community, friendship, love and the closeness that comes from sex. We seek it while managing our own inadequacies and fears; we seek it despite our fear of disease and rejection that are normal parts of our lives. We seek it, all the while knowing that communicating any vulnerability or neediness labels us as unsexy, quickly followed by a rejection. We seek it despite the easy availability of, well everything but what we truly seek.

So looking ahead, what’s the future for chemsex within our communities?

Easy. We’ll eradicate it. Quicker than it started. We’ll do it through kindness, tolerance, and dialogue. We’ll do it by reflecting on what it means to be an awesome, great gay man, and by being productive, fearless contributors to a robust gay community. How many gay men does it take to screw in this lightbulb? Every single damned one of us, together. I have faith. See ya later chemsex, you’re licked. 

David Stuart manages the chemsex clinics at 56 Dean Street, and curates the Dean Street Wellbeing programme.

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: Mephedrone 

What is mephedrone?

Mephedrone (aka meow meow, meph, m-cat, plant food or drone) is a powder drug which is extremely popular on the gay scene because it’s easily available, inexpensive and very intense. It used to be the legal way of getting a similar high to MDMA. In 2010 it became illegal due to a number of deaths which were linked to it, but it is still popular, especially on the London gay club scene. Meow meow is a speed-like drug that comes in the form of whitish powder and is usually mixed with non-alcoholic beverages or sometimes snorted. In recent years, some people have started injecting it (‘slamming’). It can also be smoked or swallowed wrapped in paper or capsules.

How does mephedrone affect my health?

Even though mephedrone makes you feel excited, energetic and generally quite bubbly, it is actually quite a strong chemical drug. It can have a different effect from person to person each time they take it. Apart from making you gurn uncontrollably (so you look like you are about to chew your face off), twitch and sweat, mephedrone is a vascular constrictor that narrows the veins and makes your heart pump faster. Besides this, and the horrific comedown that follows a high, not too many people experience harms when taking mephedrone recreationally.

Many gay men use mephedrone for sex, staying up for many days either snorting or slamming. This can lead to a frightening drug-induced psychosis that can last for many days after you’ve stopped using and could have a severe impact on your work, finances and mental health. Many people experience no problems during and after getting high on mephedrone and you might recover in a couple of weeks if you stop using it, but the way it affects your body chemistry is very powerful and the comedown could be quite frightening. If you are going to slam, do not share equipment and needles as this is very high risk for the transmission of HIV and hep C.

Can I mix it with alcohol and other drugs?

Like most other drugs, mixing other substances with mephedrone is not advisable. Mephedrone dehydrates the body and drinking alcohol while high on it can further increase the likelihood of dehydration. It also adds extra strain to your heart and brain.

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

If you are planning to use it, avoid mixing it with other substances, especially alcohol. If you are on antidepressants containing MAOIs, avoid using mephedrone as well because it can lead to seizures or heart problems. If you are injecting it, make sure you don’t share needles or equipment to avoid catching or spreading HIV and hepatitis C.

What else is mephedrone known as?

Other names include miaow, meow meow, meph, MC, drone, bounce, 4-MMC, m-cat. Bombing is when you swallow a dose of mephedrone wrapped in paper.

Is mephedrone illegal?

As of 2010, following a number of highly publicised deaths allegedly linked to mephedrone, it became an illegal drug with maximum penalties of five years in prison for possession and up to 14 years for dealing.

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.

This article is from FS magazine #150