Lethal Lust: Suicidal Behavior and Chemsex—A Narrative Review of the Literature
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Case Reports
3.2. Cross-Sectional Studies
4. Discussion
4.1. Strengths and Limitations
4.2. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Author and Year | Title. Journal (DOI) | Country | Study Design | Objective of the Study |
---|---|---|---|---|
Berg et al., 2020 [35] | Links between chemsex and reduced mental health among Norwegian MSM and other men: Results from a cross-sectional clinic survey. BMC Public Health (10.1186/s12889-020-09916-7) | Norway | Cross-sectional | To investigate the link between chemsex and mental health among MSM. |
Bohn et al., 2020 [34] | Chemsex and Mental Health of Men Who Have Sex With Men in Germany. Frontiers in Psychiatry (10.3389/fpsyt.2020.542301) | Germany | Cross-sectional | To describe aspects of mental health of MSM who engage in chemsex and to describe potentially adverse consequences of chemsex behavior. |
Brogan et al., 2019 [33] | Canadian results from the European Men-who-have-sex-with-men Internet survey (EMIS-2017). Canada Communicable Disease Report (10.14745/ccdr.v45i11a01) | Canada | Cross-sectional | To assess needs related to sexually transmitted infections of gays, bisexuals, and other MSM. |
Dolengevich-Segal et al., 2019 [32] | Drug-related and psychopathological symptoms in HIV-positive men who have sex with men who inject drugs during sex (slamsex): Data from the U-SEX GESIDA 9416 Study. PLOS ONE (10.1371/journal.pone.0220272) | Spain | Cross-sectional | To describe the physical and psychopathological symptoms of sexualized intravenous drug use (slamsex). |
Dolengevich-Segal et al., 2016 [25] | Severe Psychosis, Drug Dependence, and Hepatitis C Related to Slamming Mephedrone. Case Reports in Psychiatry (10.1155/2016/8379562) | Spain | Case report | To describe the case of a patient who developed psychotic symptoms after months of slamming mephedrone. |
Garcia-Fuentes et al., 2022 [27] | Attempted suicide with intravenous methamphetamine and chemsex. Revista Colombiana de Psiquiatría (English ed.) (10.1016/j.rcpeng.2020.09.002) | Spain | Case Report | To report a case that encompasses polysubstance use disorder, chemsex, psychotic symptoms, undiagnosed ADHD, and depressive disorder with a suicide attempt. |
Malandain et al., 2020 [26] | First case report of tDCS efficacy in severe chemsex addiction. Dialogues in Clinical Neuroscience (10.31887/DCNS.2020.22.3/lmalandain) | France | Case report | To report the case of a patient with severe chemsex addiction who was treated with tDCS. |
Maxwell et al., 2020 [31] | Pre-exposure prophylaxis use among men who have sex with men who have experienced problematic chemsex. International Journal of STD & AIDS (10.1177/0956462420906927) | United Kingdom | Cross-sectional | To examine the biopsychosocial characteristics associated with PrEP use among HIV-negative MSM who have experienced problematic chemsex. |
Scholz-Hehn et al., 2022 [30] | Substance Use and Chemsex in MSM—A Latent Class Analysis. Journal of Drug Issues (10.1177/00220426211040564) | Germany | Cross-sectional | To identify subgroups based on the consumed substances and to assess their psychosocial and health-related characteristics, including sexual risk behaviors. |
Schreck et al., 2020 [29] | Cathinone Use Disorder in the Context of Slam Practice: New Pharmacological and Clinical Challenges. Frontiers in Psychiatry (10.3389/fpsyt.2020.00705) | France | Cross-sectional | To characterize cathinone use disorder through analyses of slam cases and to expand the knowledge of slam practice based on data on drug use, risk taking, and harmful consequences. |
Stevens et al., 2020 [28] | Chemsex-related drug use and its association with health outcomes in men who have sex with men: A cross-sectional analysis of Antidote clinic service data. Sexually Transmitted Infections (10.1136/sextrans-2019-054040) | UK | Cross-sectional | To assess associations between CDU and a range of health outcomes and to determine whether MSM seeking assistance for CDU are a higher risk population than MSM presenting for any other drugs. |
Tan et al., 2021 [24] | Delineating patterns of sexualized substance use and its association with sexual and mental health outcomes among young gay, bisexual and other men who have sex with men in Singapore: A latent class analysis. BMC Public Health (10.1186/s12889-021-11056-5) | Singapore | Cross-sectional | To classify patterns of sexualized substance use among young MSM, and to investigate its association with sexual and mental health outcomes. |
Author and Year | Study Population | Sample Size (N) | Chemsex Users (%) | Age | Drugs Included in Chemsex Definition of the Study | Main Results | Statement on Suicidal Behavior and Chemsex |
---|---|---|---|---|---|---|---|
Berg et al., 2020 [35] | Male attendees of an STI clinic (51% MSM) | 1013 | 14 | Mean = 33 | Cocaine, GHB/GBL, methamphetamine, ketamine, mephedrone | 21% * of the men had reduced mental health. Chemsex users (slightly more MSM), had two times greater odds of reduced mental health. | Suicidal ideation b: 3.3% * Suicide attempts b: 0.5% * No difference between those who engaged in chemsex and those who did not |
Bohn et al., 2020 [34] | MSM recruited via LGBT-related platforms, websites, social media channels and HIV/sexual health clinics | 1050 | 27 | Mean = 40.2 | Methamphetamine, mephedrone, GHB/GBL, ketamine | The chemsex group showed significantly higher mean scores for depression, anxiety, and somatization, but the effect sizes were low. Mean scores were below the cut-off for clinically relevant symptoms. | Suicidal ideation a: 12.7% ** Suicide attempts a: 9.7% ** No difference between the chemsex and non-chemsex groups |
Brogan et al., 2019 [33] | MSM recruited via gay-related “dating” platforms, websites, social media, and community-based organizations | 5165 | 21.5 | Median = 36 | Ecstasy/MDMA, cocaine, amphetamine, methamphetamine, mephedrone, ketamine | Participants experienced high levels of intimidation, verbal abuse and physical violence related to their sexual orientation. Mental health problems, substance use, high-risk sexual practices were high. Only few men actually used PrEP. The comprehensive STBBI testing was low. | Suicidal ideation c: 26.1% * No data on suicidal ideation in chemsex users in particular |
Dolengevich-Segal et al., 2019 [32] | HIV-positive MSM recruited from HIV clinics | 742 | 29.1 | Median = 38 | Mephedrone, MDMA, methamphetamine, GHB/GBL, ketamine, cocaine | Slamsex is associated with current psychiatric disorders, high-risk sexual behaviors, polydrug use, diagnosis of STIs, and severe drug-related and psychiatric symptoms. | Suicidal ideation: 15.3% ** Suicide attempts: 13.8% ** Slamsex user experienced more suicidal behaviors. |
Dolengevich-Segal et al., 2016 [25] | Patient of a psychiatric ward | 1 | 100 | 25 | Mephedrone | The psychotic symptoms gradually began to improve and disappeared after four weeks of treatment. | Patient was treated in the emergency room after attempting suicide by drug intoxication. |
Garcia-Fuentes et al., 2022 [27] | Patient of a psychiatric ward | 1 | 100 | 44 | Methamphetamine, mephedrone | After his psychiatric drug treatment was adjusted, the patient showed gradual affective improvement. | Patient presenting with 2nd time suicidal high-risk attempt. After the treatment, suicidal ideation ceased. |
Malandain et al., 2020 [26] | Patient of a psychiatric ward | 1 | 100 | 43 | Synthetic cathinones (3-MMC, mephedrone) | Chemsex behavior disappeared after 5 days of daily sessions of right prefrontal cortex stimulation and did not return after 8 months of follow-up. | Patient was hospitalized in the context of a suicidal crisis. |
Maxwell et al., 2020 [31] | HIV-negative MSM recruited from an alcohol and drug service | 165 | 100 | Median = 36 | Methamphetamine, GHB/GBL, mephedrone, cocaine, ketamine | 34% had ever used PrEP. These were men who had engaged in higher risk sexual behaviors than men who had never used PrEP. | Suicidal ideation: 49% ** Suicide attempts: 27% ** No difference between those who ever used PrEP and those who never used PrEP. |
Scholz-Hehn et al., 2022 [30] | MSM recruited via websites and social media channels directed at gay community members | 597 | 7.2 | Mean = 38.2 | Methamphetamine, GHB/GBL, ketamine, mephedrone | LCA revealed four different clusters: Use of mainly (1) amyl nitrite and cannabis, (2) MDMA, cocaine and amphetamine, (3) chemsex-related drugs, (4) polyvalent drugs. | Suicidal ideation: 23.7% *, 31% ** Suicide attemptsa: 9.5% *, 7.1% ** Clusters did not differ in the percentage of suicide ideation. Prevalence of suicide attempts was higher in the polyvalent cluster. |
Schreck et al., 2020 [29] | 39 Notifications of MSM by health professionals collected at an addictovigilance center | 34 | 100 | Median = 38 | Synthetic cathinones, GHB/GBL, poppers, cocaine | 39 slam notifications were collected. The severity of cathinone use disorder was mild, moderate, and severe for 18%, 12%, and 58% of the patients, respectively. | Suicidal ideation: 11% ** |
Stevens et al., 2020 [28] | MSM recruited from an LGBT drug and alcohol service (Antidote) | 2137 | 88 | Median = 35.2 | Mephedrone, GHB/GBL, methamphetamine | MSM seeking assistance for chemsex-related drug use are a high-risk population. Alcohol is an underappreciated drug of concern. | Suicidal ideation: 15% * Presenting for CDU is associated with a decreased risk of suicidal ideation. Those selecting mephedrone are less likely to have suicidal ideation. |
Tan et al., 2021 [24] | Young HIV-negative MSM recruited via online (e.g., social media) and offline (e.g., community-based organizations) channels | 570 | 4 | Mean = 21.9 | Methamphetamine, GHB/GBL, erectile dysfunction drugs | LCA revealed three clusters: Use of (1) only alcohol, (2) primarily amyl nitrite, and (3) mostly chemsex-related drugs. Those in the chemsex group were more likely to report poorer sexual and mental health outcomes. | Suicidal ideation a: 54% *, 83% ** Participants who were in the chemsex class were more likely to report a history of suicide ideation. |
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Strasser, M.; Halms, T.; Rüther, T.; Hasan, A.; Gertzen, M. Lethal Lust: Suicidal Behavior and Chemsex—A Narrative Review of the Literature. Brain Sci. 2023, 13, 174. https://doi.org/10.3390/brainsci13020174
Strasser M, Halms T, Rüther T, Hasan A, Gertzen M. Lethal Lust: Suicidal Behavior and Chemsex—A Narrative Review of the Literature. Brain Sciences. 2023; 13(2):174. https://doi.org/10.3390/brainsci13020174
Chicago/Turabian StyleStrasser, Martina, Theresa Halms, Tobias Rüther, Alkomiet Hasan, and Marcus Gertzen. 2023. "Lethal Lust: Suicidal Behavior and Chemsex—A Narrative Review of the Literature" Brain Sciences 13, no. 2: 174. https://doi.org/10.3390/brainsci13020174