Drugs such as methamphetamine, GHB/GBL or others used to enhance or prolong sexual experiences can often promise euphoria, connection and disinhibition. For many, they offer an escape from shame or anxiety tied to sex, identity or intimacy. But behind the intense highs, chemsex can quietly and powerfully disrupt the very systems that give us pleasure, connection and our stable sense of self.
At its core, chemsex hijacks the brain’s arousal system. Neurochemicals like dopamine and oxytocin, which are typically released during sex, touch and closeness are flooded artificially during chemsex. Over time, the brain learns to associate sexual arousal not with intimacy or attraction but with the presence of specific substances. As tolerance builds, natural arousal becomes harder to access without chemical assistance. Sex without drugs can feel dull, emotionally vacant or even impossible. Pleasure is no longer about connection; it becomes about performance, intensity and escape instead. But the impact goes deeper than the body’s wiring. Chemsex can leave people feeling hollow, disconnected and ashamed. The disinhibition that feels freeing at first can later feel violating. Boundaries may be blurred or ignored and there can be deep regret about experiences during or things done while high. Especially if those experiences conflict with your values or sense of self. This is often where self-worth takes a hit. As the body chases dopamine, the mind can spiral into self-doubt, anxiety or depression. Relationships may suffer, work may decline and shame can grow.
For some, the chemsex cycle becomes a trauma loop, first used to numb oneself, then regretting, withdrawing and then using again to escape the guilt or shame. My clients talk about the impact of ‘relapsing’ or going back to chemsex to help ease the pain, yet the pain only gets worse, as does the guilt and the shame.
This isn’t about moral judgment. It’s about understanding how the brain and heart respond to disconnection, stress and stigma—especially in LGBTIQA+ communities where experiences of marginalisation, loneliness or rejection can make the lure of chemsex all the stronger.
Recovery from chemsex isn’t just about abstinence from drugs. It’s about reawakening the nervous system to safety, touch and joy without needing to be chemically disarmed. It’s about helping people rebuild trust in their own desires and needs and reclaiming their right to pleasure, intimacy and self-worth on their own terms.
And most of all, it’s about compassion not just from others but from within. Because beneath the chemsex cycle is often someone simply seeking connection, affirmation and wanting to feel fully alive. Re-learning your body and your non-chemical arousal triggers play an important part of recovery, as does time.
Andrew Macdonald is a clinical psychotherapist at https://www.jeffersonplace.com.au/
