Addictive disorders and correlates in the context of chemsex practices: A French online survey

Existing evidence shows that chemsex practice can contribute to adverse health outcomes. However, the presence of addictive disorders based on DSM-5 criteria remains underexplored in this population. The present study aimed to assess the overall prevalence and associated factors of substance use disorders (SUDs) and chemsex addiction among individuals engaged in chemsex, using an online self-report questionnaire.

The sample included 132 French adults having engaged in chemsex within the previous 12 months. Sociodemographic characteristics, substance use patterns, DSM-5 criteria for substance use disorders and DSM-5 criteria adapted to assess chemsex addiction, associated consequences, and sexual practices were collected. Univariate analyses and logistic regression models were conducted to explore factors associated with substance and chemsex-related addictions.

The most frequently used substances were synthetic cathinones, followed by GHB/GBL and stimulants. Addictive disorders were highly prevalent, particularly cathinone use disorder and addiction to chemsex practice, which were associated with increased negative consequences, notably mental health problems and suicidal ideation. The presence of cathinone use disorder was associated with GHB/GBL use disorder, loss of control over sexual behavior, craving for sex, and chemsex addiction. Both cathinone use disorder and craving for sex significantly predicted chemsex addiction.

This study highlights the importance of assessing addictive disorders in the context of chemsex by integrating both substance and behavioral addictions, given the strong interconnection between substance use and sexuality. Multidimensional and integrated treatment approaches are needed to adequately prevent and manage specific addictive patterns and associated risk-taking behaviors among individuals engaged in chemsex.