From 'chemsex' to substance use stigma, Montreal conference tackles dependencies

Police display amphetamine pills during a press conference in Bangkok, Thailand, Tuesday, April 3, 2018. (AP Photo/Sakchai Lalit)

The practice of "chemsex" needs to be taken seriously and addressed sensitively, said a Quebec PhD student in social work, Yannick Gaudette, who spoke on the topic at a recent conference in Montreal.

Chemsex, he explained in an interview with CTV News, is the use of psychoactive drugs in a sexual context. Substances like GHB, methamphetamine, and ketamine are among the substances usually consumed.

“It is a practice that is mostly among men who have sex with men (MSM) but also trans and non-binary people,” said Gaudette, a graduate student at UQAM studying the emotions linked to the practice of chemsex.

“They are mostly using it for sexual pleasure but also to connect with others, to be engaged in a community because some of the participants to our study show they’re experiencing isolation and loneliness,” he said.

Not everyone who tries it develops a dependence or an addiction.

“But we can’t say there are no issues around chemsex. There are people who after a period of time develop a problem with consumption of crystal meth,” Gaudette said.

It can also lead to mental health problems like anxiety. The person can become fearful, even traumatized if the drug use caused psychotic symptoms.

While there’s not enough data to determine how widespread the problem is in Quebec, a range of international studies show that between 7 and 12 per cent of people who describe themselves as men who have sex with men participate in chemsex, he said.

As a student researcher working for the Trajectories, Diversity, Substances (TRADIS) Canada Research Chair, he is particularly interested in studying the emotions around the behaviour.

“There are emotions associated with shame … people who will engage in chemsex, perhaps because of shame about their orientation but also shame about different sexual practices they may want to try,” said Gaudette.

As a result, he suggests professionals need to be wary of further stigmatizing already stigmatized individuals, while at the same time working with them toward harm reduction.

NEED TO TREAT PEOPLE IN A 'HOLISTIC' WAY

Speakers at the Montreal conference, held Wednesday and Thursday, covered a range of issues linked to dependencies, from the inappropriate use of opioids by some seniors living at home to services for the homeless population.

Christophe Huynh, a researcher at the Institut universitaire sur des dépendances in Montreal, spoke about the intersection of dependencies and mental health and how the health system should treat both health problems in tandem.

Of those who received a diagnosis of a substance-related disorder, 58 per cent also received a diagnosis for another mental health disorder, he said, according to 2017-2018 Quebec data.

“But the problem is that in the system we consider it as two separate entities, two separate problems when we should have a health system that takes care of both problems because they feed into each other, anxiety and alcohol use, for example,” said Huynh.

Huynh also examined mortality rates and found that people diagnosed with substance-related disorders are three times more likely to die in any given year than the general population.

Common causes are suicide, traumatic injuries and diseases related to their substance issue.

“These are preventable deaths," he said.

And he wants the health-care system to offer more support to people with dependencies because wellness is not just an absence of disease.

“We also have to make sure those people do their treatment but also receive everything they need … to also get a full life, a quality of life,” said Huynh.

That starts with offering health professionals more training in the area so they know how to broach the topic, and ask a patient about substance use in a non-judgmental way, "not in a stigmatizing or moral way," he said.