Chemsex: common drugs & their effects


Chemsex is using drugs to enhance sex, increase desire and reduce inhibitions. While it can feel amazing, it can affect judgment and lessen inhibitions and make you more likely to engage in high-risk sex. It can also lead to dependence and affect your physical and mental health. Here are the most commonly used substances and their effects.


What is it?
Alcohol is the ingredient found in beer, wine and spirits that causes drunkenness. It is classed as a depressant, meaning that it slows down vital functions – resulting in slurred speech, unsteady movement, disturbed perceptions, and an inability to react quickly.

What does it do?

  • Reduces a user’s ability to think rationally and distorts judgment. This can also lead to loss of inhibition and higher sexual behavior.
  • Although classified as a depressant, the amount of alcohol consumed determines the type of effect. Most users drink for the stimulant effect, such as a beer or glass of wine to “loosen up.” But if a user consumes more than the body can handle, they then experience alcohol’s depressant effect. They start to feel “stupid” or lose coordination and control.
  • Alcohol overdose causes even more severe depressant effects (inability to feel pain, vomiting, unconsciousness and even coma or death from severe toxic overdose). These reactions depend on how much is consumed and how quickly.


What is it?
Methcathinone (also known as mephedrone) is an addictive psychoactive substance and is one of the most commonly used illicit drugs in South Africa. Some users believe that what they are taking is produced from the Khat plant but the cat in South Africa is mainly produced in homemade labs producing a cheap but dangerous and toxic drug. There are also reports that it gets imported illegally to South Africa. Cat is snorted with a straw or a banknote.

What does it do?

  • Makes users initially feel alert and elated.
  • The user becomes talkative with an increase in empathy.
  • Suppresses appetite.
  • Lead to periods of insomnia.
  • Shaking of the limbs.
  • Increased heart rate, blood pressure, risk of stroke or heart attack.
  • Both decreased and increased sexual function and desire.
  • The more the user uses the more it causes anxiety and agitation.

COCAINE: Powder, C, Charlie, Coke, Dust, Lady, Snow, White, Chanel, a Line

What is it?
Cocaine is a white powder derived from the leaves of the coca shrub, a plant that grows in South American countries. It is often cut up into short lines and then sniffed up the nose through a rolled-up piece of paper or straw. Sometimes it is rubbed on the gums with a finger. Because the effects can wear off quite quickly, heavy users can get through several grams of cocaine in a relatively short time. Cocaine is sometimes taken by wrapping a dose in paper and then swallowing (bombing). Some users sprinkle cocaine with marijuana and smoke it. It can also be used to make “crack’ which can also be smoked. Cocaine may also be turned into a liquid and injected, which is the most dangerous way to take the drug.

What does it do?

  • Cocaine makes users feel more alert, energetic, confident, physically strong and that they have great mental capacities. It also makes the user feel horny.
  • Common physical effects include dry mouth, sweating, loss of appetite and increased heart and pulse rate. At higher dose levels users may feel very anxious and panicky.
  •  The effects from snorting cocaine can start quickly but only last for up to 30 minutes. The effects come on even quicker when smoking crack but are not as long-lasting.
  • Large doses or quickly repeating doses over hours can lead to extreme anxiety, paranoia and even hallucinations. These effects usually disappear as the drug is eliminated from the body.
  • The after-effects of cocaine include fatigue and depression as people come down from the high.
  • Excessive doses can cause death from respiratory or heart failure.
  • Though it doesn’t cause physical addiction and withdrawal symptoms like heroin, it does lead to psychological dependence. Chronic users will become tolerant to the drug and on stopping will start to feel tired, panicky, and unable to sleep, often causing extreme emotional and physical distress. Many chronic users are aware of these symptoms and so are reluctant to stop using the drug.

Using cocaine with alcohol can be risky as they combine in the body to produce a metabolite called cocaethylene. This combination enables the user to drink more with getting as drunk as usual. Cocaethylene puts extra stress on the heart and liver with potentially serious consequences.

CRYSTAL METH – Tik, Tina, Crystal, Xtina, Meth, Glass

What is it?
Crystal meth (methamphetamine) comes in powder or crystal form. It has a similar euphoric effect to cocaine but a much longer high. People may smoke it on foil or a small pipe (called a Lollie), swallow it in capsule form, snort it with a note or straw and some inject it intravenously known as ‘slamming’. Globally, methamphetamine is the second most used illicit drug, after marihuana.

What does it do?

  • Makes users feel alert, energetic, confident and powerful.
  • May feel anxious and confused, be unable to sleep, have mood swings, and become violent.
  • Other possible side effects may include nausea, panic attacks, compulsive repetitive behaviour and jaw clenching.
  • Users may become paranoid and hear and see things that aren’t there. They may think about hurting themselves or others. They may also feel like insects are crawling on or under their skin. This known as methamphetamine psychosis.
  • Withdrawal symptoms can include depression, anxiety and an intense craving to reuse.
  • Makes users feel very horny, can affect judgment and lessen inhibitions which heightens high-risk sexual behaviour.
  • Depending on how much is taken, the ‘high’ can last 4-12 hours, followed by a severe come-down.
  • Regular use of methamphetamine can lead to a strong psychological dependency, with increased tolerance to the effects.

Psychiatric problems have been associated with methamphetamine use, with symptoms resembling those associated with paranoid schizophrenia, such as paranoia, hallucinations and suicidal thoughts. Drug users who inject the drug are at risk of infection from HIV, hepatitis C and hepatitis B if they share needles and other injecting paraphernalia.


What is it?
GHB is an anaesthetic with sedating rather than painkilling properties. It is often called ‘liquid ecstasy’, although it has no relationship to ecstasy. GBL is closely related to GHB but is not the same. GBL often gets sold under the name GHB (or G). Once GBL enters the body, it is converted into GHB very quickly. GHB is an odourless, oily liquid that looks like water and has a slightly salty taste. GBL looks like GHB but has a very distinctive chemical odour that smells a bit like paint thinners. Users often swallow them mixed with water or other soft drinks. When intended for illicit use, they are sold in small bottles or capsules.

What does it do?

  • Produces a mild high in smaller doses and sedation in higher doses.
  • Users feel euphoric, with a loss of inhibitions, increased confidence and higher libido. Most users report that the experience is very similar to being drunk on alcohol.
  • It is very easy to overdose on these drugs, both because the strength can vary from bottle to bottle and the difference between a recreational dose and overdose may only be a matter of millilitres.
  • Overdosing on GHB/GBL can be very dangerous and deadly. Nausea and vomiting, seizures, convulsions, disorientation and stiffening of muscles may occur, and coma and respiratory collapse may follow. Combining alcohol or Viagra with GHB can be fatal.

You can become physically dependent on GHB and GBL. While this is rare, dependency can be severe, with a rapid onset of unpleasant withdrawal symptoms which may include delirium, psychosis, tremor, insomnia and severe anxiety. Dependence can develop after a just weekend of severe bingeing or may result from regular use over a longer period.

MDMA – E, Molly, Disco Biscuit, X

What is it?
MDMA is a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions) and is also known as “ecstasy” or “molly”. MDMA is a white or off-white powder or crystals and sold in capsule or little bags. Ecstasy is in a pill form and often has a symbol or picture on it (like a playboy, dove or star). Since MDMA is unregulated, anything sold as “molly” or “ecstasy” could include other drugs or even contain no MDMA at all. You can never be sure what is “cut” into an ecstasy pill.

What does it do?

  • A user may experience the intoxicating effects of MDMA within 45 minutes or so after taking a single dose. These include an enhanced sense of well-being, increased extroversion, emotional warmth, empathy toward others and a willingness to discuss emotionally charged memories.
  • In addition, people report enhanced sensory perception as a hallmark of the MDMA experience like feeling music in a heightened manner.
  • It releases Dopamine which produces increased energy/activity and acts in the reward system to reinforce behaviors.
  • It releases Norepinephrine which increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems.
  • It releases Serotonin which affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust.
  • Other effects may include nausea, muscle cramping, involuntary teeth clenching, blurred vision, chills, sweating, high blood pressure, panic attacks, loss of consciousness, seizures.
  • It can cause potentially fatal overheating especially when dancing as it interferes with the body’s ability to regulate temperature.
  • MDMA’s effects last about 3 to 6 hours, although many users take a second dose as the effects of the first dose begin to fade.
  • Over the course of the week following moderate use of the drug, a person may experience irritability, impulsiveness, aggression, depression, sleep problems, anxiety, problems with memory and attention, decreased appetite, decreased interest in and decreased pleasure from sex.

• For advice on harm reduction (tips to make chemsex / substance use safer) click here.
• For resources and info about substance use help and support click here.