Is My Chemsex Use Worth Looking At?

Asking whether your chemsex use is worth looking at is not the same as answering the question, and it is certainly not the same as a diagnosis. For most men the difficulty is not the answer. It is that the question arrives tangled up with a label, and nobody wants a label they did not choose.

It is possible to look at your use honestly without deciding that you are an addict, and without committing to stop anything. Many men use chems without it becoming a problem. Others notice, over time, that something has quietly changed and that they would rather understand it than keep managing it by not thinking about it.

What the question is really asking

Three different questions tend to get bundled together, and separating them makes the whole thing easier to think about.

• Is this causing harm, to my health, my work, my relationships or my money?
• Do I have control over when and how it happens, or does it increasingly decide itself?
• Do I have something I would need to name, and possibly get help with?

The answer to the first two can be yes, partly yes, or occasionally, without the third being yes. You do not have to settle the third question before you look at the first two.

Behaviour that is often worth noticing

The signs that matter are usually less dramatic than the ones people expect. A few of the things men tend to notice first:

• Using more, or for longer, than you intended at the start of the night.
• Using on days you had decided not to, and being mildly surprised by your own decision.
• Using mainly to change how you feel: anxiety before a social situation, loneliness on a Sunday, flatness that has been sitting there for weeks. That is common, and it does not automatically mean trouble, but it can become a sign if it is your main tool for managing how you feel.
• Escalation. The amount that used to be plenty stops producing the same effect, so you increase. This is ordinary physiology, and it is also the point where nights start costing more.
• Sex during a session that you would not have chosen sober, and that you regret afterwards.
• A recovery day that becomes two, or plans, work and training quietly losing their place.
• Using alone when you would rather be with someone, or with people you would not choose otherwise.
• Wanting to take a break for a period, and finding that you do not.
• Money and time you would rather have spent differently, noted and then not mentioned again.

Any one of these can happen to someone who is essentially fine. Patterns and accumulation tend to say more than a single episode, which is why looking over a couple of weeks is more useful than judging yourself on the last Saturday.

What is less useful to go by

• Quantity or frequency on their own. Twice a month that you enjoy and recover from is a different thing from twice a month you dread on the way home. Context is the point.
• Morality or willpower. Framing this as weakness tends to produce hiding rather than change. Shame is a poor motivator with a long half-life.
• Comparison with other people. You know their weekends, not their Tuesdays.
• "I am functioning." Functioning at work is compatible with things that are worth looking at.
• One bad night. A single bad night can be a bad night. It is information, not a verdict.

What a professional would actually look at

If you see a therapist, a GP or a sexual health clinician about this, an assessment is usually concerned with the pattern over time, the function the use serves, how much control you have, and the consequences across health, work, relationships and money. It also looks at sleep, mood, anxiety, and any history of trauma, because those are frequently part of the picture rather than separate from it.

A diagnosis of a substance use disorder is a clinical judgement made against defined criteria, and it is not something a questionnaire or an article can produce. The word addiction is used loosely in general conversation and carries more weight than it can hold. You do not need the label to make use of a conversation, and you do not need to want abstinence in order to start one. In fact, clinics and therapists are usually more interested in what you want to be different than in whether you would describe yourself that way.

Questions worth sitting with

These are not a test. They are the kind of questions an assessment opens with, and they work just as well on a notebook page.

1. When did you last choose not to, and what happened that night?
2. What is usually going on in the hours before you decide to use?
3. What does the following day look like, honestly, in mood, sleep and plans?
4. What do you tell yourself afterwards, and is it the same sentence each time?
5. What has this cost you in the last year, in money, time, health or trust?
6. If nothing changed over the next year, would that be acceptable to you?
7. What would you want to be different in three months, and could you describe it in plain words?
8. Who could you say any of this to out loud?

If you decide to look at it

Looking tends to start with information rather than a decision. Two honest weeks, noting what you used, how much, with whom, and how the following two days felt, is usually more revealing than months of thinking about it. Setting a limit before a night works better than negotiating one inside it. A planned month off is worth treating as an experiment rather than a test of character: what you notice, what you miss, when the urge arrives, and how you sleep are all information, whatever you conclude at the end.

Talking to a GP or a sexual health service is a reasonable early step. They ask about drug use routinely, including chems, without judgement, and they can also talk through interactions with any medication you take. Therapy with someone who works with this area is the other obvious option, and it does not require you to have decided anything in advance.

Free places to start

• The Free Reality Check is free and private, takes about three minutes, and asks 10 questions about patterns rather than asking you to label yourself. No email required: https://check.chemsexfreedom.com
• The free workbook, "Am I Addicted to Chems or Chemsex?" is a written exercise you can work through at your own pace: https://chemsexfreedom.com/free-guide
• The 90-Day Programme is a therapist-developed online programme offering about 30 minutes of guidance a day through short video lessons, written exercises and a workbook. It is private and works at your own pace, and starting does not require a commitment to abstinence. It costs US$495, or three payments of US$165: https://chemsexfreedom.com/programme

The question of whether your use is worth looking at is answerable. The answer does not have to be a label, and looking is not the same as stopping. Most people know considerably more after two honest weeks than after two years of wondering.

Justin David Duwe is a psychotherapist and sexologist, BACP accredited, and author. This article offers general information and is not medical advice or a diagnosis.