Chemsex and cathinones

The term chemsex refers to the practice of sexual relations under the influence of various types of illicit drugs, in particular new psychoactive substances (NPS), but also drugs consumed before or during the sexual act, thus leading to a combined experience of drugs and sex, allowing sexual pleasure to be prolonged and intensified. This phenomenon is widespread in certain communities, such as men who have sex with men (MSM), or the LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer) communities. Two studies carried out in France have shown their incidence, with 232 cases recorded between 2018 and March 2023 leading to medicolegal investigations, these cases being the cause of severe intoxication, death, or chemical submissions. Among MSM, chemsex has been shown to play an important role in risky behavior, leading to an increase in sexually transmitted infections (STIs). The substances most commonly used in chemsex are cathinones, followed by cocaine, methylenedioxymethamphetamine or MDMA (ecstasy), methamphetamine (crystal), ketamine, and erectile dysfunction drugs inhibitors of phosphodiesterase type 5 (PDE-5) inhibitors. The gamma-hydroxybutyrate/GHB and its chemical precursor gamma-butyrolactone/GBL ("liquid ecstasy"), not investigated in our study, are also widely used. The impact of these new drugs on road traffic offences and accidents in France is not known, as they are still not investigated in road traffic accidents. (c) 2023 l'Acad'emie nationale de m'edecine. Published by Elsevier Masson SAS. All rights reserved.