Alcohol and the gay community Words by Stuart Haggas | @GetStuart Photos © Chris Jepson www.chrisjepson.com If you’ve perused any gay media over the last couple of years, you might have come to the conclusion that the greatest singular challenge gay men face today is chemsex and its impact on sexual health. While chemsex may warrant the coverage and debate it generates, by being such a dominant story it risks drawing attention away from other issues. One of those other issues is alcohol. Alcohol is something that most gay men consume on a weekly, or even daily, basis. And there’s evidence from the likes of Stonewall which show that gay and bi men drink alcohol more, and more often, than straight men. The number of gay men who use and abuse alcohol is far greater than those who take chems. Yet, perhaps because of the legal status, alcohol risks being the forgotten problem. WHAT’S THE WORST THAT CAN HAPPEN? Of course we’re not saying that all gay men have a problem with alcohol – far from it. Although lots of us probably drink more than the recommended level, overall we are mostly in control of our drinking. Some of us may occasionally overindulge and do things we wouldn’t do sober, like hightailing down the high street on a ‘Boris bike’ at 4am in the morning, stealing a traffic cone for a laugh, or leaping off a wall as if you’re Superman – but as it’s just a bit of innocent, inebriated fun, does it really matter so long as no-one gets hurt? However, the jäger-bombshell is that some of these drunken misadventures can have serious knock-on effects, particularly when sex is also involved: sex with random strangers, sex with multiple partners, sex you can’t remember, sex that leads to HIV and STIs. Then there are those who use drink to mask other problems. And those who rely on booze so much that things get out of control. Not to forget those who mix alcohol with drugs. Perhaps it’s time to sober up a bit. THE FACTS “Just about all of the comparative studies show higher levels of drinking in LGB communities,” says Monty Moncrieff, Chief Executive of London Friend, the UK’s oldest LGBT charity, and home to the UK’s only LGBT drug and alcohol service, Antidote. “In the UK, Stonewall’s research showed that 42% of gay and bi men drank three or more times a week compared with 35% of men in general. The LGBT Foundation found that 34% of gay and bi men binge drink at least once a week compared with 19% of men in general.” When FS asked readers to tell us about their relationship with drink, 1,200 gay and bi men responded – the second biggest response ever to an FS survey. Of the men we spoke to: 89% drink alcohol, with most drinking 2 to 3 times per week on average. 93% of these men drink alcohol while out socialising in pubs and clubs. Home consumption is also extremely popular, proving that the alcohol consumption of gay and bi men doesn’t only happen on the gay scene: 76% drink alcohol at home. 64% drink alcohol at friends houses. Spirits are the drink of choice for most gay men with 71% saying that’s what they drink. Wine came second with 68%, with beer on 65%. Alcopops were the least favourite tipple with only 8% saying they drink them. When it came to how many drinks gay men tend to have in one session, most gay men were likely to have ‘three to four’ drinks in one go (29%), followed by ‘five to six’ drinks (25%), and then ‘seven to nine’ drinks (17%). 15% of gay and bi men admitted to having ten or more drinks in one session. Only 14% said they have ‘one to two’ drinks when they consume alcohol – the recommended amount. “New UK guidelines have just reduced the level of ‘safe’ drinking for men to 14 units per week, the same as it has been for women,” says GMFA’s Chief Executive, Matthew Hodson. “This is equivalent to about nine small 125ml glasses of wine, or fourteen single measures of spirits, or seven pints of lager or beer. It’s not uncommon for some of the gay men I know to get through that in an evening. So, as a health concern, yes, it seems pretty clear that alcohol contributes to a range of health problems that gay men suffer. In addition, alcohol (like drugs) can alter your perception of risk, so you may end up doing things that you wouldn’t do when sober, including not being able to stick to your personal rules about safer sex. So even the men who feel that they’re in control of their drinking may well be damaging their health.” BITTER COCKTAIL One effect of alcohol is that it lowers inhibitions, helping us to relax and be more sociable and flirtatious. When we asked how much readers agreed or disagreed with a series of statements relating to alcohol: 68% of gay men agreed with the statement: “Alcohol gives me confidence”. 37% agreed: “Alcohol makes me feel better about myself”. 15% agreed: “Alcohol makes me feel bad about myself”. 21% agreed: “Alcohol makes me feel depressed”. 16% agreed: “Alcohol makes me a worse person”. 45% agreed: “Alcohol allows me to do things I wouldn’t do sober”. When it came to alcohol and sex: 53% agreed: “Alcohol makes me want to have sex”. Only 18% agreed: that “Alcohol improves my sex life”. 53% agreed: “Alcohol kills my sex drive”. 24% agreed: “I tend not to care about safer sex after drinking alcohol”. 10% agreed: “I only have unsafe sex after drinking alcohol”. We also asked about the overall health of gay men who drink alcohol: 37% said that “I tend not to care about my health while drinking alcohol”. 15% told us they were not in control of their drinking. 11% of gay men told us they have a problem with alcohol. When you mix confidence and sex with poor decisions, the resulting cocktail can leave a bitter aftertaste. Readers told us that, while under the influence of alcohol, they’ve slept with people they wouldn’t have done had they been sober – including ex-boyfriends, men they didn’t find attractive, and members of the opposite sex . “The type of people that I have sex with whilst drunk aren’t the type of people I would usually choose to have sex with if sober,” says Tom, 20 from Birmingham. “I was unfaithful to my partner,” admits Oliver, 22 from Manchester. “I drank so much I couldn’t remember the night before and woke up in someone else’s bed.” “I went out with my boyfriend and woke up in his friend’s bed,” says Thomas, 18 from Lincoln. “It didn’t go down well.” “I once slept with a girl I am friendly with, even though I’m gay,” says Callum, 21 from Norwich. “It seemed a good idea at the time.” “I’ve had sex with people I really don’t find attractive,” says Alex, 26 from London, “because drunk Alex is an attention whore!” MORNING AFTER Do drunken liaisons inevitably leave a bitter taste in the morning? “At the time while drunk I feel happy and confident with my choice,” says Paul, 25 from London. “When sober I feel ashamed, guilty and confused as to why I keep making the same choice whilst drunk.” “I felt as if I didn’t have control of the situation,” adds Chase, 24 from London, “and with the room spinning slightly already, I wasn’t in a position to say anything more than, ‘I’m into this, but only as long as I can stay awake.’” “It makes me nervous and worried,” admits Jason, 27 from Glasgow. “I may have had a fun time but it’s such a dangerous practice. Not just STIs but also the danger of physical or sexual violence.” But not everyone wakes up with regret. “Oh I feel I should feel worried, uptight and remorseful – but I don’t,” admits Matthew, 55 from Bath. “I usually had a damn good time.” LESS SAFE Being unsafe while under the influence of alcohol is a big concern for many of those who took our survey. In fact, 52% acknowledge they’ve had sex that was less safe than they would want it to be as a result of drinking alcohol. “I’m a lightweight when it comes to alcohol,” admits Michael, 29 from Essex. “It takes a few drinks and then I’m drunk. If I’ve had just the one glass then I can say no, but when I’m really drunk it feels like I have no self control – I’m totally helpless to say no to unsafe sex.” “I don’t think about it while in the moment,” adds Tom, 20 from Birmingham, “but afterwards there is always the fear. I went to get checked after a few weeks and again after three months was up.” “The intoxication numbs your body and you assume it’s OK,” says Callum, 19 from Harrogate. “I’m less aware if there was a condom – but I will say at the beginning that he must put on a condom before touching me. I wouldn’t recommend it. Drunken sex is shit anyway!” “I feel guilt mostly, but also feel as if I have been taken advantage of,” explains Alex, 24 from London. “More than once I have had sex while drunk with men using protection, only to find they had taken the condom off during sex. I had an experience like this months ago, and I still think about it and worry. I find myself less in touch with my sexuality because I cannot trust my sexual partners when drunk.” “I am HIV-positive and successfully on meds for over ten years, so there is a minimal risk of passing it on,” says Clive, from Luton. “In day-to-day sex condoms are negotiated in the light of my status. When drunk, that negotiation probably doesn’t take place – then I feel guilty the next day even though my gut feeling is the risk is so much lower than with someone who doesn’t know and is not on meds.” “Before I got HIV I was anxious and worried about having unsafe sex when drunk,” says Paul, 48 from Cardiff. “And after I got HIV I’m anxious, worried and guilty.” ALCOHOL: THE MOST WORRISOME DRUG “There’s been a lot of focus on chemsex in recent years, but it’s likely that the drug which has most contributed to people not staying as safe sexually as they intend to is alcohol,” acknowledges GMFA’s Matthew Hodson, “just because alcohol use is so prevalent among gay men, much more so than chems.” “Plenty of people tell us about taking sexual risks after drinking too much,” adds Monty Moncrieff of London Friend adds, “and in fact the Chemsex Study research in 2014 found that alcohol was the drug most gay men were worried about (over 21%). Trying to get a bit more control of your drinking can help you take fewer risks: having some soft drinks in between alcoholic ones will leave you feeling less drunk at the end of the night – so if you go home with someone or to a sauna, you can be more in control of the sex you’re having, or even decide that going home on a work night is a better idea, for example.” ALCOHOL AND SEXUAL HEALTH Several readers admitted that the reason for either becoming HIV-positive or picking up an STI was down to the decisions they made while drinking alcohol. “I was on a night out with some mates and got really horny after drinking,” says Frank, 23 from London. “I ended up ditching my mates and headed for a gay bar that I knew had a darkroom. After a couple more drinks my inhibitions dropped so low I really had no idea what I was doing. I couldn’t tell you how many partners I had in a short few hours but two weeks later I was diagnosed with gonorrhoea and chlamydia.” Eric, 27 from Manchester told us: “I hadn’t had sex for nearly six months and was feeling really bad about myself. I know I was HIV-negative as I tested the previous month. I was home alone, drinking, when I logged on to Grindr and got an invite to someone’s house. I was very drunk and probably shouldn’t have went over. When I got there I was offered another drink. We ended up in bed together and didn’t use protection. “I woke up severely hung over and couldn’t really remember what happened,” Eric continues. “About a month later I started to get symptoms of a cold and didn’t think too much about it. I then noticed a rash on my leg and thought I should get it checked out. The doctor recommended that he do a HIV test and I was diagnosed with HIV. Getting HIV was totally my fault. I can’t blame the person who passed it on to me – he didn’t know he had it. The decision I made was influenced by the amount of alcohol in my system. Lesson to take from this: don’t get so fucked up that it makes you do things you’d never do sober.” ALCOHOL AND DRUGS Poor choices about sex aren’t the only poor choices that can be made when drunk. “There’s lots of discussion about alcohol being a ‘gateway’ to other drugs,” explains Monty of London Friend. “It’s probably the drug most of us try first, so whether it ‘leads’ to others is debatable. We know that for some people a night out drinking may be the thing that makes them think ‘fuck it, I’m going to do chems’, and then they find they’ve lost a weekend and might regret that decision.” It certainly seems that many gay men combine alcohol and drugs on a night out. Of the men we surveyed, 56% admitted to taking drugs while drinking alcohol. The most popular drugs taken when drunk are cocaine (72%), poppers (68%), cannabis/weed (63%), MDMA/ecstasy (63%), mephedrone/meow meow (38%), ketamine (31%), GHB and GBL (21%) and crystal meth (11%). “I always take alcohol before taking further drugs,” says Paul, 25 from London. “For me alcohol is the gateway drug. I never want other drugs having not had alcohol beforehand. Drugs allow me to keep drinking longer, but then I can get stuck in a cycle. I need to keep drinking to balance out the side effects of some of the drugs I have taken. What can start out as one drink can turn into a whole weekend of drink and drugs.” ROCKY RELATIONSHIP Despite the correlation between alcohol and other drugs, it’s often a rocky relationship. Readers expressed varied opinions on what they think are good and bad combinations. “GHB and mephedrone don’t go well with booze,” explains Alex, 25 from London. “Well, no drugs are particularly safe with alcohol, but I’m much more strict with those two.” “Weed and alcohol is good,” adds Rolins, 35 from London. “Alcohol with poppers - that’s not so useful. Other drugs overwhelm the tipsy effect of alcohol, so it’s pointless drinking.” Does the mix of alcohol and drugs lead to good or bad experiences? “Both,” says Nuno, 26 from London. “I had one of the best sex experiences under the influence of alcohol and drugs, and also once almost ended up in the hospital.” “It’s generally pretty good,” says Ryan, 21 from London. “It prolongs sex.” “I tried MDMA once after drinking,” says Sean, 47 from Cork. “I really enjoyed it and ended up having a group sex session with some people I barely knew. It was very enjoyable though.” “When taking cocaine with booze, I feel intense and euphoric,” says Callum, 19 from Harrogate. “I can dance all night and have an absolute blast – but I feel extremely paranoid and off my face. The comedown I get with cocaine and booze is so lethal I hardly ever do it. I’ve taken coke under bad circumstances as well. I snorted half a gram one time alone after feeling lonely and abandoned by my friends on a night out. I just hated everything and thought fuck it, let’s just get shit faced and not care about anyone any more. I’ve mixed weed with booze and I will never do that again. I white out every time, I feel depressed, lonely, paranoid and off my face. During the past year I’ve been taking drugs and booze as some sort of escapism, because I felt unfulfilled in life and felt I had no friends.” “I never felt like alcohol was affecting the effects of the drugs, apart from weed,” says Nicolas, 24 from London. “I threw up a few times because of the mix.” “Cannabis is never good to mix with alcohol,” says George, 24 from London. “Cocaine, MDMA and other ‘uppers’ have had good effects on me at the time, but have left me feeling horrible the day after. It’s not worth the come down because it wipes me out for a day or two during which I can’t do anything productive.” “I almost passed out when mixing alcohol and GHB,” says Peter, 32 from London. “I had to go and rest for a bit in the club before I felt OK again.” “Not being able to get hard,” says Will, 31 from Aberdeenshire, “low inhibitions, unsafe sex.” “I had a bad experience,” says Alan, 42 from Dublin. “I wasn’t interested in the guy at the start of the night, but he kept flirting. After alcohol and cocaine, I gave in to save hassle and slept with him. I regretted it, as he knew some friends. It got awkward.” LONG-TERM RISKS Sex and drugs aside, there are long-term health risks associated with drinking excessive amounts of alcohol. “Apart from hangovers and the risk of something happening to you while you’re completely off your face, most of the risks of alcohol are long-term,” says Monty. “Drinking is linked to liver problems, various cancers, high blood pressure, heart attacks and strokes. Obviously all of that feels a million miles away when you’re on a night out, which makes harm reduction messages more difficult – but drinking less, or on fewer nights a week, can help you reduce the long-term risks now.” THE GAY FACTOR Why is it that gay men tend to drink more, and more often, than straight men? “It is still really common for people to go to a gay bar or club as their first experience when exploring their sexual identity, so alcohol (and often drugs) is around from the very start of them being openly gay,” Monty explains. Not only is drinking alcohol an intrinsic part of socialising on the gay scene, gay and bi men may face additional challenges in their everyday lives – pressures that some alleviate by drinking. “Often we are told that the reason that gay men take drugs, drink more alcohol, or have lots of random hook-ups is because we don’t really like ourselves; that the homophobia we have been subjected to in our childhood has been internalised, and so we seek to escape by losing ourselves in sex and drugs and rock ‘n’ roll,” adds GMFA’s Matthew. “I think that’s part of the story but I’m not convinced it’s the whole one.” For what other reasons do gay men drink? “Gay men drink alcohol for pretty much the same reasons that anyone else does: because it’s sometimes fun to let go and get a bit drunk,” Matthew continues. “Sometimes a drink’s going to help you to unwind after a stressful week, or give you the confidence you think you need to approach that hot guy at the other end of the bar. Sometimes it may be because you’re feeling down and the temporary oblivion that you can achieve from drinking can help with that. For many, drinking is just the natural accompaniment to our lives of child-free adventuring.” “Gay men drinking for pleasure mainly do so for the same reasons everybody does: it makes us feel relaxed and we have a laugh doing so,” agrees Monty. “If your drinking is more to help you cope with how you’re feeling then there may be some things specific to being gay or bi: coming out, the reactions of family and friends, HIV status, coping with prejudice or discrimination – all of these may be additional pressures for gay or bi men.” MINOR PROBLEM Ultimately, there are many reasons why a relationship, either open or monogamous, succeeds – or fails. The majority who completed our survey didn’t consider drinking to be a major problem for them. 73% say that no one (including friends, relatives and medical professionals) has ever suggested they cut down the amount they drink. 73% say that they’ve never injured themselves or others as a result of drinking. 56% have never cancelled arrangements with friends/family or called in sick to work, because of drinking. But on the flipside, 15% admit that during the past year someone (including friends, relatives and medical professionals) has been concerned enough to suggest they cut down the amount they drink. 11% have injured themselves or others during the past year as a result of drinking. And 8% admit they cancel arrangements with family/friends or call in sick to work at least once per month (and 2% at least once per week) because of drinking. These figures echo the findings of Stonewall’s gay/bi men’s health survey, as Matthew elaborates: “According to Stonewall’s survey, one in five (19%) gay and bisexual men have been drunk or hung over while working, going to school, or taking care of other responsibilities more than once in the last six months. One in seven (13%) have missed or were late for work, school, or other activities because they were drinking or hung over more than once in the last six months. One in twenty five (4%) have drunk alcohol even though a doctor suggested they stop drinking. Just 2% have ever sought help or advice from a healthcare professional about problems with drinking.” It’s possible that so few gay and bi men seek professional help or advice about problems with drinking because we believe it’s a problem we can handle and deal with ourselves – just like we’d buy Lemsip from the supermarket if we have symptoms of a cold, rather than seeing a doctor. But perhaps it’s time to reassess and rethink our relationship with alcohol. Either way, it’s something we shouldn’t allow ourselves to forget. LOOKING FORWARD Many gay men feel that admitting they drink too much or too often means they have to stop. “This is not the case,” said FS editor Ian Howley. “Admitting you might have a problem with alcohol doesn’t mean that you need to stop. It means you need to look at making slight changes to how much you drink. So rather than drinking five to six beers on a night out try and cut it down to three or four. Or rather than drinking on both Friday and Saturday night give your body a break and only drink one of those nights,” said Ian. Monty from London Friend adds: “If your drinking is causing problems or starting to impact on your life in other ways, then definitely get some support. “Speaking to a service like Antidote can help. We work with lots of people to get their drinking back under control, think about when and how much you’re happy with, and how to avoid the negative consequences.” Ian adds: “We all need to acknowledge that telling gay men to stop drinking or cutting back is difficult in a world where our community is so heavily linked to alcohol. “Many gay men blame alcohol for the poor choices they make. For the good of our health we all need to take a step back and check to make sure that we are doing our bit to help each other. Yes, drinking alcohol is about personal responsibility but we can all work together to help and support our community to make healthier decisions when sober and not so sober.” If you’re concerned about someone’s drinking, or your own, Drinkline runs a free, confidential helpline. Call 0300 123 1110 or visit www.alcoholics-anonymous.org.uk. Are you dependent on alcohol? A glass of wine with dinner, a beer after work, a cocktail in the sunshine on holiday. Alcohol makes an appearance in so many parts of our lives it can be easy to forget that, like many drugs, it’s addictive, both physically and psychologically. The NHS estimates that around 9% of men in the UK show signs of alcohol dependence. This means that drinking alcohol becomes an important, or sometimes the most important, factor in their lives and they feel they’re unable to function without it. But if you were ‘dependent’ on alcohol, you’d be stumbling around drunk every day, right? Not necessarily. There are varying degrees of alcohol dependence and they don’t always involve excessive levels of drinking. If you find that you ‘need’ to share a bottle of wine with your partner most nights of the week, or always go for a few pints after work, just to unwind, you’re likely to be drinking at a level that could affect your long-term health. You could also be becoming dependent on alcohol. If you find it very difficult to enjoy yourself or relax without having a drink, you could have become psychologically dependent on alcohol. Physical dependence can follow too – that is your body shows withdrawal symptoms, such as sweating, shaking and nausea, when your blood alcohol level falls. Four warning signs that you may be dependent on alcohol Worrying about where your next drink is coming from and planning social, family and work events around alcohol. Finding you have a compulsive need to drink and finding it hard to stop once you start. Waking up and drinking – or feeling the need to have a drink in the morning. Suffering from withdrawal symptoms, such as sweating, shaking and nausea, which stop once you drink alcohol. If you’re worried that you have any of these symptoms of alcohol dependence, talk to your GP or seek further information. Staying in control - here are four ways you can cut back: Try alternative ways to deal with stress. Instead of reaching for a beer or glass of wine after a hard day, go for a run, swim or to a yoga class, or talk to a friend about what’s worrying you. Keep track of what you’re drinking. Your liver can’t tell you if you’re drinking too much, but a special tool from MyDrinkaware can. It can even help you cut down. Take their self-assesment test to see what they say: www.drinkaware.co.uk/selfassessment. Give alcohol-free days a go. If you drink regularly, your body starts to build up a tolerance to alcohol. This is one of the main reasons why many medical experts recommend taking regular days off from drinking to ensure you don’t become addicted to alcohol. Test out having a break for yourself and see what positive results you notice. Ask a health professional for advice. Advances in alcohol research have provided new treatment options. A health care professional can look at the number, pattern, and severity of your symptoms, to help you decide the best course of action if needed. SUPPORT: Antidote at London Friend is the UK’s only LGBT run and targeted drug and alcohol support service. For more information, visit www.londonfriend.org.uk.