The UK’s only LGBT Substance Misuse Service10 year history serving the Substance Use

needs of London’s LGBTQ community8,000 contacts, 700+ people in treatment

each year

“Club Drugs” are Problematic Drugs

33

Our scenehighly

sexualised

44

Normalised Drug/Alcohol Normalised Drug/Alcohol useuse

on our Bar and Club Sceneon our Bar and Club Scene

55

From “Huggy” to From “Huggy” to Hardcore”Hardcore”

66

72 hour 72 hour clubbing,clubbing,sex-on-sex-on-premises premises venues,venues,On-line On-line

hook-ups,hook-ups,Crystal sex Crystal sex

parties…parties…

77

24 HOUR SAUNAS…24 HOUR SAUNAS…

88

The popularity of The popularity of BareBackingBareBacking

Shame around sex, intimacy anxiety,internalised homophobia

Sexual

SHAME

1010

Crystal Methamphetamine, Crystal, Tina.Crystal Methamphetamine, Crystal, Tina.

• 3, 4 + day “benders” of speedy, unboundaried 3, 4 + day “benders” of speedy, unboundaried chaotic sexual marathons.chaotic sexual marathons.

• Effects managed with GBL use.Effects managed with GBL use.• Repetitive GUM presentations.Repetitive GUM presentations.• Increased HIV/Hep C infections.Increased HIV/Hep C infections.• Drug-induced psychosis very common.Drug-induced psychosis very common.• High likelihood of psychological dependence.High likelihood of psychological dependence.

1111MANY more people now injecting..

1212

2 Distinct Issues2 Distinct Issues

Toxicity/Toxicity/OverdoseOverdose

Dependency/Dependency/

1313

Overdosing in clubs/saunas/ sex-parties.

Large numbers of peopleforming dangerous addictions, using hourly every day, just to avoidunmanageable and dangerous withdrawal symptoms.

1414

HOW dependence begins, HOW dependence begins, progressesprogresses

Used to sleep after a big weekend of Used to sleep after a big weekend of continual use, continual use,

leading to..leading to.. using to manage the comedown during the using to manage the comedown during the

week,week, leading to..leading to..

using to aid sleep at bedtime,using to aid sleep at bedtime, leading to..leading to..

using for any stress or discomfort,using for any stress or discomfort, leading to..leading to..

regular use/dependenceregular use/dependence

1515

““Keyworking” toolsKeyworking” tools• Identifying “Contemplation” or “Action”Identifying “Contemplation” or “Action”• Setting GoalsSetting Goals• Recognising TriggersRecognising Triggers• (Places, situations, people, emotional (Places, situations, people, emotional

states, stress, sexual arousal..)states, stress, sexual arousal..)• List of Pro’s and Con’sList of Pro’s and Con’s• Managing CravingsManaging Cravings• Recognise and anticipate Recognise and anticipate

triggers/associated situationstriggers/associated situations• Acupuncture, breathing, meditationAcupuncture, breathing, meditation• Remove yourself from situation “Time Remove yourself from situation “Time

Out”Out”• Delay, Distract, DecideDelay, Distract, Decide

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MORE TOOLSMORE TOOLS• Make a listMake a list• Saying “no” confidently/setting Saying “no” confidently/setting

boundariesboundaries• Anticipating certain invitations/situationsAnticipating certain invitations/situations• Encouraging other interestsEncouraging other interests• Communication skills.Communication skills.• Honesty/support from appropriate Honesty/support from appropriate

friends/familyfriends/family• Harm ReductionHarm Reduction• ReferralsReferrals• Listening is SupportListening is Support

2005 2011Crystal Meth 0% 39%

GHB GBL 3.2% 27%

Mephedrone 0% 14%Referrals from GUM clinics, A&E or statutory drug services

8% 63%

1717

1818

STATSSTATSOf the Crystal Meth, GBL and Mephedrone users at Of the Crystal Meth, GBL and Mephedrone users at

Antidote;Antidote;• 95% are using to facilitate sex95% are using to facilitate sex• 80% are injecting (Meth and Meph)80% are injecting (Meth and Meph)• 70% report having shared needles to inject (Meth and Meph)70% report having shared needles to inject (Meth and Meph)• Prefer to use “Bareback” sites to find sexual partnersPrefer to use “Bareback” sites to find sexual partners• Report an average of 5 sexual partners per “episode”Report an average of 5 sexual partners per “episode”

75% are HIV positive; of these,75% are HIV positive; of these,• 60% report being non-compliant with ARV’s while “high”60% report being non-compliant with ARV’s while “high”• 90% attribute their diagnosis to the use of drugs and alcohol90% attribute their diagnosis to the use of drugs and alcohol

Of the HIV Negative clients, more than half have Of the HIV Negative clients, more than half have hadhad

one or more courses of PEP in the last yearone or more courses of PEP in the last year

1919

Domestic Domestic ViolenceViolence

2020

Thank you for

listening.

Questions,

discussion…