Chemsex practice in France: An update in Addictovigilance data

Abstract

Background: Complications related to Chemsex practice (consumption of psychoactive substances in sexual context) were first assessed by the French Addictovigilance Network in 2014. In response to the deaths reported in 2016, a new expert report was commissioned to update the complications and evolution of Chemsex-related practices in France. Methods: Between January 2008 and August 2017, all Chemsex cases collected through the French Addictovigilance Network's epidemiological tools were analyzed. Comparison of data between two periods (before and after 2014) was performed to assess the evolution of practices. Results: Over the entire survey period, 235 Chemsex cases were identified, all of them in men, with a mean AE SD age of 39 AE 11 years, including 24 deaths (10.2%). An increase in the number of reported cases was observed from one in 2008 to 50 in the first 8 months of 2017. The main medical histories include human immunodeficiency virus (HIV; 45%) and hepatitis C (20%) infections, and substance use disorders (36%). In those 235 cases, 345 psychoactive substances were identified, mainly cathinones. Polydrug use was reported in 75% of cases. The main complications were substance use disorders (63%), acute neurological or cardiovascular intoxications (50%), various psychiatric disorders (39%), and viral and bacterial infections (18%). γ-Butyrolactone (GBL) was present in 95% of comas. An increase in the number of deaths was observed during the survey period. Conclusion:The French Addictovigilance Network, via this pharmacoepidemiological surveillance, warns public health authorities in order to support harm reduction programs and the management of Chemsexers.

Chemsex in HIV pre‐exposure prophylaxis users: Assessment of mood disorders and addictive behavior

“…1,33 In our study, the most frequently consumed cathinones for chemsex were 3-methylmethcathinone (3-MMC) and 4-methethylcathinone (4-MEC) that are currently used instead of mephedrone in France. 11 Moreover, methamphetamine, which is reported around 10% with a range between 3% and 22% of individuals disclosing chemsex practice in systematic reviews, was mentioned only by four of the people in the chemsex group in our study (4.2%). 1,6,7 In another French study, 14% of people who disclosed chemsex behavior self-reported using methamphetamine.…”

“…[8][9][10] In France, data from the French Addictovigilance Network show that substance use disorders and psychiatric complications are the main chemsex-related complications (63% and 39% of all individuals disclosing chemsex activities). 11 To reduce HIV transmission in HIV-negative people at high-risk, oral pre-exposure prophylaxis (PrEP) with a combination of two antiretroviral drugs (tenofovir disoproxil fumarate and emtricitabine; Truvada ® ) has been implemented in several countries including France since January 2016, especially in men having sex with men (MSM). 12,13 In France, in 2016, only doctors practicing in hospitals or in free screening centers could initiate PrEP, renewal every 3 months being accessible to any doctor: Since June 2021, any doctor can initiate PrEP.…”

Is There a Reduction in Chemsex Practice in Men Who Have Sex With Men During COVID-19 Lockdown? Results of the CheRRLock Study

“…In France, addictovigilance data found that 63% of 235 reported cases of people practicing chemsex also met criteria for substance use disorder (SUD). 25 Recently, Schreck et al found that 88% of 39 patients who slammed with cathinones also met criteria for a SUD, which was mild, moderate, and severe for 18%, 12%, and 58% of the patients, respectively. 26 The lockdown took place for a large part of the respondents in relatively good living conditions, as was also previously reported during the first lockdown in France.…”

“…In particular, cathinones increase the release of dopamine, noradrenaline, and serotonin and have powerful disinhibiting and entactogenic effects. 25 Without justifying it, the use of these particular substances may therefore have been particularly "adapted" to the period of confinement among people feeling isolated. However, the feeling of loneliness can also be a consequence of addiction.…”

Eligibility criteria vs. need for pre-exposure prophylaxis: a reappraisal among men who have sex with men in Amsterdam, the Netherlands

“…Given that the association between chemsex and CAS has previously been demonstrated (18), it could be argued that adding chemsex to the PrEP use criteria would be redundant. However, the RR was much stronger for chemsex than CAS and considering that 80% of MSM engaging in chemsex also had CAS, they could also represent a https://doi.org/10.1017/S0950268822001741 Published online by Cambridge University Press subset of individuals reporting CAS at heightened risk of HIV.…”