{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:21:16Z","timestamp":1791400876598,"version":"4.3.3"},"reference-count":102,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Chemsex is a phenomenon involving the intentional use of psychoactive substances before or during sexual activity, especially among men who have sex with men (MSM). It is associated with various health risks, including substance dependence, risky sexual behaviors, and both mental and somatic disorders. Despite its growing prevalence and public health relevance, chemsex lacks a clear definition and is not recognized as a distinct diagnostic entity. This narrative review synthesizes clinical, epidemiological, and technological evidence on chemsex; argues for its classification as a form of mixed addiction; and preliminarily proposes diagnostic criteria for a potential entity in the International Classification of Diseases, 12th Revision (ICD-12). This paper highlights key psychotropic substances used in chemsex, patterns of use, and their neurobiological, psychological, and behavioral consequences. It explores the relationship between chemsex and compulsive sexual behavior disorder (CSBD), current diagnostic frameworks (ICD-10 and ICD-11), and challenges in clinical practice. Therapeutic strategies discussed include cognitive behavioral therapy (CBT), digital interventions, and emerging applications of artificial intelligence (AI) in prevention and treatment. Attention is also given to epidemiological trends, sociocultural influences, and barriers to seeking help. This review concludes by identifying research gaps and advocating for a more integrated, multidimensional approach to classifying and treating chemsex-related syndromes.<\/jats:p>","DOI":"10.3390\/jcm14176275","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T12:18:18Z","timestamp":1757074698000},"page":"6275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Chemsex as a Diagnostic Challenge: Toward Recognition in ICD-12 and Integrated Treatment Approaches\u2014A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Justyna","family":"\u015aniadach","sequence":"first","affiliation":[{"name":"Department of Psychiatry, The Faculty of Medicine, Medical University of Bia\u0142ystok, 15-272 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiktor","family":"Orlof","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Faculty of Medicine, Medical University of Bia\u0142ystok, 15-272 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justyna","family":"So\u0142owiej-Chmiel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Faculty of Medicine, Medical University of Bia\u0142ystok, 15-272 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Kicman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Faculty of Medicine, Medical University of Bia\u0142ystok, 15-272 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylwia","family":"Szymkowiak","sequence":"additional","affiliation":[{"name":"HCP Medical Center in Pozna\u0144, 61-485 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7021-5133","authenticated-orcid":false,"given":"Napoleon","family":"Waszkiewicz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Faculty of Medicine, Medical University of Bia\u0142ystok, 15-272 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104398","DOI":"10.1016\/j.drugpo.2024.104398","article-title":"Exploring Practices to Enhance Benefits and Reduce Risks of Chemsex among Gay, Bisexual, and Other Men Who Have Sex with Men: A Meta-Ethnography","volume":"127","author":"Hawkinson","year":"2024","journal-title":"Int. J. Drug Policy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"104795","DOI":"10.1016\/j.drugpo.2025.104795","article-title":"A Systematic Review of Intervention Strategies Aimed at Chemsex Users","volume":"140","author":"Riquelme","year":"2025","journal-title":"Int. J. Drug Policy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s40429-023-00488-1","article-title":"Chemsex: Review of the Current Literature and Treatment Guidelines","volume":"10","author":"Malandain","year":"2023","journal-title":"Curr. Addict. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00115-021-01116-x","article-title":"Chemsex: Eine neue Herausforderung der Suchtmedizin und Infektiologie","volume":"93","author":"Gertzen","year":"2022","journal-title":"Nervenarzt"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Moreno-G\u00e1mez, L., Hern\u00e1ndez-Huerta, D., and Lahera, G. (2022). Chemsex and Psychosis: A Systematic Review. Behav. Sci., 12.","DOI":"10.3390\/bs12120516"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1159\/000534898","article-title":"Prevalence and Characteristics of Chemsex: A Cross-Sectional Observational Study","volume":"30","author":"Bellomi","year":"2024","journal-title":"Eur. Addict. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/09540261.2024.2432369","article-title":"Artificial Intelligence-Driven and Technological Innovations in the Diagnosis and Management of Substance Use Disorders","volume":"37","author":"Tassinari","year":"2025","journal-title":"Int. Rev. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Strasser, M., Halms, T., R\u00fcther, T., Hasan, A., and Gertzen, M. (2023). Lethal Lust: Suicidal Behavior and Chemsex\u2014A Narrative Review of the Literature. Brain Sci., 13.","DOI":"10.3390\/brainsci13020174"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"89","DOI":"10.12740\/PP\/OnlineFirst\/140141","article-title":"Who Has a Problem with Chemsex? Identity as a Missing Link in Support Services for Men Who Engage in Problematic Use of Psychoactive Substances for Sexual Purposes","volume":"57","author":"Dora","year":"2023","journal-title":"Psychiatr. Pol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1108\/DAT-10-2018-0058","article-title":"Chemsex: Origins of the Word, a History of the Phenomenon and a Respect to the Culture","volume":"19","author":"Stuart","year":"2019","journal-title":"Drugs Alcohol Today"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"101640","DOI":"10.1016\/j.legalmed.2019.101640","article-title":"Mephedrone and Chemsex: A Case Report","volume":"42","author":"Anzillotti","year":"2020","journal-title":"Leg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e717","DOI":"10.1016\/S2352-3018(22)00124-2","article-title":"HIV, Chemsex, and the Need for Harm-Reduction Interventions to Support Gay, Bisexual, and Other Men Who Have Sex with Men","volume":"9","author":"Strong","year":"2022","journal-title":"Lancet HIV"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3060","DOI":"10.1007\/s10461-024-04393-0","article-title":"The Risks for HIV and Sexually Transmitted Infections Among Men Who Have Sex with Men Who Engage in Chemsex in Low- and Middle-Income Countries: A Mixed Methods Systematic Review and Meta-Analysis","volume":"28","author":"Eustaquio","year":"2024","journal-title":"AIDS Behav."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1177\/1363460720986924","article-title":"Injecting as a Sexual Practice: Cultural Formations of \u2018Slamsex\u2019","volume":"26","author":"Race","year":"2023","journal-title":"Sexualities"},{"key":"ref_15","first-page":"36","article-title":"Chemsex and care planning: One year in practice","volume":"19","author":"Tomkins","year":"2019","journal-title":"Drugs Alcohol Today"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103090","DOI":"10.1016\/j.drugpo.2020.103090","article-title":"Service Provision and Barriers to Care for Men Who Have Sex with Men Engaging in Chemsex and Sexualised Drug Use in England","volume":"92","author":"Hibbert","year":"2021","journal-title":"Int. J. Drug Policy"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Schifano, F., Bonaccorso, S., Arillotta, D., Guirguis, A., Corkery, J.M., Floresta, G., Papanti Pelletier, G.D., Scherbaum, N., and Schifano, N. (2025). Drugs Used in \u201cChemsex\u201d\/Sexualized Drug Behaviour\u2014Overview of the Related Clinical Psychopharmacological Issues. Brain Sci., 15.","DOI":"10.3390\/brainsci15050424"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/hiv.12574","article-title":"The Positive Voices study group Sexualized Drug Use (\u2018Chemsex\u2019) and High-risk Sexual Behaviours in HIV -positive Men Who Have Sex with Men","volume":"19","author":"Pufall","year":"2018","journal-title":"HIV Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"\u00c1lvarez-Muelas, A., G\u00f3mez-Berrocal, C., and Sierra, J.C. (2021). Study of Sexual Satisfaction in Different Typologies of Adherence to the Sexual Double Standard. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.609571"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s10508-020-01741-8","article-title":"Psychological and Interpersonal Factors Associated with Sexualized Drug Use Among Men Who Have Sex with Men: A Mixed-Methods Systematic Review","volume":"50","author":"Lafortune","year":"2021","journal-title":"Arch. Sex. Behav."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"100465","DOI":"10.1016\/j.ijchp.2024.100465","article-title":"Psychological Characteristics Associated with Chemsex among Men Who Have Sex with Men: Internalized Homophobia, Conscientiousness and Serostatus as Predictive Factors","volume":"24","author":"Rieker","year":"2024","journal-title":"Int. J. Clin. Health Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1177\/13634607241267090","article-title":"Chemsex as Wild Self-Care","volume":"28","author":"Clay","year":"2025","journal-title":"Sexualities"},{"key":"ref_23","unstructured":"Waszkiewicz, N. (2022). Neurobiologiczne mechanizmy uzale\u017cnie\u0144 behawioralnych i ich wp\u0142yw na leczenie. Wsp\u00f3\u0142czesny Wymiar Uzale\u017cnie\u0144, Uniwersytet Medyczny w Bia\u0142ymstoku."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1080\/10826084.2023.2184207","article-title":"Chemsex Drug Use among a National Sample of Sexually Active Men Who Have Sex with Men,\u2014American Men\u2019s Internet Survey, 2017\u20132020","volume":"58","author":"Ivey","year":"2023","journal-title":"Subst. Use Misuse"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Coronado-Mu\u00f1oz, M., Garc\u00eda-Cabrera, E., Quintero-Fl\u00f3rez, A., Rom\u00e1n, E., and Vilches-Arenas, \u00c1. (2024). Sexualized Drug Use and Chemsex amongth Men Who Have Sex with Men in Europe: A Systematic Review and Meta-Analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13061812"},{"key":"ref_26","unstructured":"Stola, A. (2025, May 05). Psychospo\u0142eczne Uwarunkowania Zjawiska Chemsex w Polsce. 4. Available online: https:\/\/repozytorium.uw.edu.pl\/entities\/publication\/6dab4930-28b0-421f-aa59-4b86f1cc4d4c."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Pozo-Herce, P.D., Mart\u00ednez-Sabater, A., Sanchez-Palomares, P., Garcia-Boaventura, P.C., Chover-Sierra, E., Mart\u00ednez-Pascual, R., Gea-Caballero, V., Saus-Ortega, C., Ballestar-Tar\u00edn, M.L., and Karniej, P. (2024). Effectiveness of Harm Reduction Interventions in Chemsex: A Systematic Review. Healthcare, 12.","DOI":"10.3390\/healthcare12141411"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/j.drugpo.2015.07.013","article-title":"\u201cChemsex\u201d and harm reduction need among gay men in South London","volume":"26","author":"Bourne","year":"2025","journal-title":"Int. J. Drug Policy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.drugpo.2018.11.014","article-title":"Chemsex Behaviours among Men Who Have Sex with Men: A Systematic Review of the Literature","volume":"63","author":"Maxwell","year":"2019","journal-title":"Int. J. Drug Policy"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Evers, Y.J., Van Liere, G.A.F.S., Hoebe, C.J.P.A., and Dukers-Muijrers, N.H.T.M. (2019). Chemsex among Men Who Have Sex with Men Living Outside Major Cities and Associations with Sexually Transmitted Infections: A Cross-Sectional Study in the Netherlands. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0216732"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1136\/sextrans-2016-052674","article-title":"Substance use among men who have sex with men: Patterns, motivations, impacts and intervention development need","volume":"93","author":"Bourne","year":"2017","journal-title":"Sex. Transm. Infect."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1136\/sextrans-2019-054040","article-title":"Chemsex-Related Drug Use and Its Association with Health Outcomes in Men Who Have Sex with Men: A Cross-Sectional Analysis of Antidote Clinic Service Data","volume":"96","author":"Stevens","year":"2020","journal-title":"Sex. Transm. Infect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s10508-020-01674-2","article-title":"The Effects of Methamphetamine Use on the Sexual Lives of Gender and Sexually Diverse People in Dhaka, Bangladesh: A Qualitative Study","volume":"50","author":"Khan","year":"2021","journal-title":"Arch. Sex. Behav."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Del Pozo-Herce, P., Baca-Garc\u00eda, E., Mart\u00ednez-Sabater, A., Chover-Sierra, E., Gea-Caballero, V., Curto-Ramos, J., Czapla, M., Karniej, P., Mart\u00ednez-Tofe, J., and S\u00e1nchez-Barba, M. (2024). Descriptive Study on Substance Uses and Risk of Sexually Transmitted Infections in the Practice of Chemsex in Spain. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1391390"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"515","DOI":"10.32383\/farmpol\/199957","article-title":"Chemseks\u2014Og\u00f3lno\u015bwiatowy problem w zakresie zdrowia publicznego: Opis, zachowania ryzykowne, za\u017cywane substancje i skutki zdrowotne","volume":"80","author":"Zawilska","year":"2025","journal-title":"Farm. Pol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Lagojda, L., Ferreira De Jesus, D., Kinnair, D., and Chrysanthou, M. (2025). Mental Health and Drug Use Patterns Among Men Who Have Sex with Men (MSM) Engaging in Chemsex in the UK. Healthcare, 13.","DOI":"10.3390\/healthcare13070719"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"SH24173","DOI":"10.1071\/SH24173","article-title":"Comparing the Impact of Sexualised Drug Use with and without Chemsex on Sexual Behaviours among Men Who Have Sex with Men in China: A National Multi-Site Cross-Sectional Study","volume":"21","author":"Sun","year":"2024","journal-title":"Sex. Health"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Mundy, E., Carter, A., Nadarzynski, T., Whiteley, C., De Visser, R.O., and Llewellyn, C.D. (2025). The Complex Social, Cultural and Psychological Drivers of the \u2018Chemsex\u2019 Experiences of Men Who Have Sex with Men: A Systematic Review and Conceptual Thematic Synthesis of Qualitative Studies. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1422775"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"\u00cdncera-Fern\u00e1ndez, D., G\u00e1mez-Guadix, M., and Moreno-Guill\u00e9n, S. (2021). Mental Health Symptoms Associated with Sexualized Drug Use (Chemsex) among Men Who Have Sex with Men: A Systematic Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182413299"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"109741","DOI":"10.1016\/j.drugalcdep.2022.109741","article-title":"Chemsex and Chemsex Associated Substance Use among Men Who Have Sex with Men in Asia: A Systematic Review and Meta-Analysis","volume":"243","author":"Wang","year":"2023","journal-title":"Drug Alcohol Depend."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s00406-024-01856-2","article-title":"What Chemsex Does to the Brain\u2014Neural Correlates (ERP) Regarding Decision Making, Impulsivity and Hypersexuality","volume":"275","author":"Schwarz","year":"2025","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e29640","DOI":"10.5812\/ijhrba.29640","article-title":"A Qualitative Study of the Relationship Between Methamphetamine Abuse and Sexual Dysfunction in Male Substance Abusers","volume":"5","author":"Dolatshahi","year":"2016","journal-title":"Int. J. High. Risk Behav. Addict."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S573","DOI":"10.1192\/j.eurpsy.2021.1528","article-title":"Chemsex Drugs: More than Ghb, Mephedrone and Methamphetamine?","volume":"64","author":"Ramos","year":"2021","journal-title":"Eur. Psychiatr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"105435","DOI":"10.1016\/j.yrtph.2023.105435","article-title":"Gamma-Hydroxybutyrate (GHB), 1,4-Butanediol (1,4BD), and Gamma-Butyrolactone (GBL) Intoxication: A State-of-the-Art Review","volume":"142","author":"Dufayet","year":"2023","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1080\/02791072.2022.2081948","article-title":"Prevalence and Correlates of GHB Use among Adults in the United States","volume":"55","author":"Palamar","year":"2023","journal-title":"J. Psychoact. Drugs"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1080\/17405904.2021.1910052","article-title":"Crime or Culture? Representations of Chemsex in the British Press and Magazines Aimed at GBTQ+ Men","volume":"19","author":"Heritage","year":"2022","journal-title":"Crit. Discourse Stud."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s40262-016-0383-6","article-title":"Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthesia and Pain Therapy","volume":"55","author":"Peltoniemi","year":"2016","journal-title":"Clin Pharmacokinet."},{"key":"ref_48","first-page":"D7517","article-title":"\u2018Chemsex\u2019 [Chemsex: Health risks and the gap between healthcare needs and services among MSM]","volume":"167","author":"Chiu","year":"2023","journal-title":"Ned. Tijdschr. Geneeskd."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Corkery, J.M., Copeland, C.S., Ream, S., Streete, P., and Schifano, F. (2025). An Update on Deaths in the United Kingdom from \u2018Poppers\u2019 (Alkyl Nitrites), with a Particular Focus on \u2018Swallowing\u2019 Fatalities. J. Clin. Med., 14.","DOI":"10.3390\/jcm14020427"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"103546","DOI":"10.1016\/j.drugpo.2021.103546","article-title":"Queering Poppers Literature: A Critical Interpretive Synthesis of Health Sciences Research on Alkyl Nitrite Use and Canadian Policy","volume":"101","author":"Schwartz","year":"2022","journal-title":"Int. J. Drug Policy"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"111527","DOI":"10.1016\/j.mce.2021.111527","article-title":"Phosphodiesterase (PDE) 5 Inhibitors Sildenafil, Tadalafil and Vardenafil Impact cAMP-Specific PDE8 Isoforms-Linked Second Messengers and Steroid Production in a Mouse Leydig Tumor Cell Line","volume":"542","author":"Limoncella","year":"2022","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"ElHady, A.K., El-Gamil, D.S., Abdel-Halim, M., and Abadi, A.H. (2023). Advancements in Phosphodiesterase 5 Inhibitors: Unveiling Present and Future Perspectives. Pharmaceuticals, 16.","DOI":"10.3390\/ph16091266"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1136\/sextrans-2018-053933","article-title":"Psychosocial and Sexual Characteristics Associated with Sexualised Drug Use and Chemsex among Men Who Have Sex with Men (MSM) in the UK","volume":"95","author":"Hibbert","year":"2019","journal-title":"Sex. Transm. Infect."},{"key":"ref_54","unstructured":"Rosi\u0144ska, M., Zakrzewska, K., Szmulik-Misiurek, K., and Pawl\u0119ga, M. (2022). Zjawisko ChemSex w literaturze \u015bwiatowej. Nowe Zagro\u017cenia U\u017cywania Substancji Psychoaktywnych\u2014ChemSex, Narodowy Instytut Zdrowia Publicznego PZH\u2014Pa\u0144stwowy Instytut Badawczy."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"h5790","DOI":"10.1136\/bmj.h5790","article-title":"What is chemsex and why does it matter?","volume":"351","author":"McCall","year":"2015","journal-title":"BMJ"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1016\/S0140-6736(01)06888-X","article-title":"Effects of dose, sex, and long-term abstention from use on toxic effects of MDMA (ecstasy) on brain serotonin neurons","volume":"358","author":"Reneman","year":"2001","journal-title":"Lancet"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1111\/j.1743-6109.2012.02755.x","article-title":"Recreational use of erectile dysfunction medications and its adverse effects on erectile function in young healthy men: The mediating role of confidence in erectile ability","volume":"9","author":"Harte","year":"2012","journal-title":"J. Sex. Med."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Barba, T., Kettner, H., Radu, C., Peill, J.M., Roseman, L., Nutt, D.J., Erritzoe, D., Carhart-Harris, R., and Giribaldi, B. (2024). Psychedelics and sexual functioning: A mixed-methods study. Sci. Rep., 14.","DOI":"10.1038\/s41598-023-49817-4"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Platteau, T., Schrooten, J., Herrijgers, C., den Daas, C., Ventura, M., Strong, C., and de Wit, J. (2025). Polydrug use during chemsex: Single and intersecting sexual effects of commonly used drugs. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1618070"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1213\/ANE.0000000000006177","article-title":"Narrative Review of Kratom, an Emerging Psychoactive Substance with Perianesthetic Implications","volume":"135","author":"Garmon","year":"2022","journal-title":"Anesth. Analg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1080\/02791072.2023.2250342","article-title":"Chemsex and harm reduction practices among men who have sex with men in Malaysia: Findings from a qualitative study","volume":"56","author":"Palmer","year":"2024","journal-title":"J. Psychoact. Drugs"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s13181-011-0193-z","article-title":"The Toxicology of Bath Salts: A Review of Synthetic Cathinones","volume":"8","author":"Prosser","year":"2012","journal-title":"J. Med. Toxicol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.drugalcdep.2013.06.016","article-title":"Clinical and Pharmacological Aspects of Bath Salt Use: A Review of the Literature and Case Reports","volume":"132","author":"Miotto","year":"2013","journal-title":"Drug Alcohol Depend."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1080\/00918369.2023.2170757","article-title":"Chemsex Among Men Who Have Sex With Men: A Systematic Scoping Review of Research Methods","volume":"71","author":"Amundsen","year":"2024","journal-title":"J. Homosex."},{"key":"ref_65","first-page":"e20233315","article-title":"Sodium Nitroprusside as an Adjunctive Treatment for Schizophrenia Reduces Ndel1 Oligopeptidase Activity","volume":"46","author":"Nani","year":"2024","journal-title":"Braz. J. Psychiatry"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"563","DOI":"10.3109\/15563650.2016.1166508","article-title":"Clinical Characteristics of \u03b1-Pyrrolidinovalerophenone (\u03b1-PVP) Poisoning","volume":"54","author":"Umebachi","year":"2016","journal-title":"Clin. Toxicol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1002\/jms.1571","article-title":"New Designer Drug A-pyrrolidinovalerophenone (PVP): Studies on Its Metabolism and Toxicological Detection in Rat Urine Using Gas Chromatographic\/Mass Spectrometric Techniques","volume":"44","author":"Sauer","year":"2009","journal-title":"J. Mass Spectrom."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1016\/j.forsciint.2017.02.031","article-title":"The Effects of Synthetic Cannabinoid UR-144 on the Human Body\u2014A Review of 39 Cases","volume":"273","author":"Adamowicz","year":"2017","journal-title":"Forensic Sci. Int."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Jaspal, R. (2022). Chemsex, Identity and Sexual Health among Gay and Bisexual Men. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191912124"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1080\/10826084.2022.2148482","article-title":"Understanding Attachment, Emotional Regulation, and Childhood Adversity and Their Link to Chemsex","volume":"58","author":"Ibarguchi","year":"2023","journal-title":"Subst. Use Misuse"},{"key":"ref_71","unstructured":"Pawl\u0119ga, M., and Muska\u0142a, M. (2019). Chemsex\u2014Pr\u00f3ba Zdefiniowania Zjawiska w Polsce, Praesterno."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"\u015aniadach, J., Kicman, A., Michalska-Falkowska, A., Jo\u0144czyk, K., and Waszkiewicz, N. (2025). Changes in Concentration of Selected Biomarkers of Exposure in Users of Classic Cigarettes, E-Cigarettes, and Heated Tobacco Products\u2014A Narrative Review. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26051796"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Popiel, A., and Prag\u0142owska, E. (2022). Psychoterapia Poznawczo-Behawioralna. Teoria i Praktyka, Wydawnictwo Naukowe PWN.","DOI":"10.53271\/2022.098"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"89","DOI":"10.12740\/PP\/OnlineFirst\/140141","article-title":"Kto ma problem z chemseksem? To\u017csamo\u015b\u0107 jako brakuj\u0105ce ogniwo us\u0142ug pomocowych dla m\u0119\u017cczyzn problemowo u\u017cywaj\u0105cych substancji psychoaktywnych w celach seksualnych","volume":"57","author":"Dora","year":"2023","journal-title":"Psychiatr. Pol."},{"key":"ref_75","unstructured":"Kowalczyk, R., and Stola, A. (2023). Chemsex. Uj\u0119cie Wielodyscyplinarne, PZWL. Wyd."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Ruiz-Robledillo, N., Ferrer-Cascales, R., Portilla-Tamarit, I., Alcocer-Bruno, C., Clement-Carbonell, V., and Portilla, J. (2021). Chemsex Practices and Health-Related Quality of Life in Spanish Men with HIV Who Have Sex with Men. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081662"},{"key":"ref_77","unstructured":"European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2025, July 31). European Drug Report 2024\u2014Trends and Developments. EMCDDA. Available online: https:\/\/www.euda.europa.eu\/publications\/european-drug-report\/2024_pl."},{"key":"ref_78","unstructured":"Beck, J.S. (2011). Cognitive Behavior Therapy: Basics and Beyond, Guilford Press. [2nd ed.]."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1176\/appi.ajp.162.8.1452","article-title":"Behavioral Therapies for Drug Abuse","volume":"162","author":"Carroll","year":"2005","journal-title":"Am. J. Psychiatry"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s10608-012-9476-1","article-title":"The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses","volume":"36","author":"Hofmann","year":"2012","journal-title":"Cogn. Ther. Res."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Popiel, A., and Prag\u0142owska, E. (2022). Terapia zaburze\u0144 pourazowych: Model poznawczo-behawioralny. Psychoterapia Poznawczo-Behawioralna. Teoria i Praktyka, Wydawnictwo PWN.","DOI":"10.53271\/2022.098"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Popiel, A., and Prag\u0142owska, E. (2021). Terapia schemat\u00f3w w leczeniu zaburze\u0144 ze spektrum impulsywno-kompulsyjnego. Psychoterapia Poznawczo-Behawioralna. Teoria i Praktyka, Wydawnictwo PWN.","DOI":"10.53271\/2022.098"},{"key":"ref_83","unstructured":"Marlatt, G.A., and Donovan, D.M. (2005). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors, Guilford Press. [2nd ed.]."},{"key":"ref_84","unstructured":"Young, J.E., Klosko, J.S., and Weishaar, M.E. (2003). Schema Therapy: A Practitioner\u2019s Guide, Guilford Press."},{"key":"ref_85","unstructured":"Miller, W.R., and Rollnick, S. (2012). Motivational Interviewing: Helping People Change, Guilford Press. [3rd ed.]."},{"key":"ref_86","first-page":"273","article-title":"Zaburzenia zachowania seksualnego u m\u0142odzie\u017cy\u2014Propozycje terapii poznawczo-behawioralnej","volume":"45","author":"Matelska","year":"2011","journal-title":"Psychiatr. Pol."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Popiel, A., and Prag\u0142owska, E. (2021). Terapia poznawczo-behawioralna w pracy z osobami z trudno\u015bciami w zakresie to\u017csamo\u015bci. Psychoterapia Poznawczo-Behawioralna. Teoria i Praktyka, Wydawnictwo PWN.","DOI":"10.53271\/2022.098"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"103187","DOI":"10.1016\/j.drugpo.2021.103187","article-title":"A Narrative Systematic Review of Sexualised Drug Use and Sexual Health Outcomes among LGBT People","volume":"93","author":"Hibbert","year":"2021","journal-title":"Int. J. Drug Policy"},{"key":"ref_89","first-page":"m458","article-title":"Drug Use in Sexual Settings (\u2018Chemsex\u2019) and HIV\/STI Transmission Risk among Gay Men","volume":"368","author":"Tomkins","year":"2020","journal-title":"BMJ"},{"key":"ref_90","first-page":"431","article-title":"Supporting Sexual Health and Wellbeing among MSM Engaging in Chemsex: A Review of Interventions","volume":"97","author":"Glynn","year":"2021","journal-title":"Sex. Transm. Infect."},{"key":"ref_91","first-page":"107548","article-title":"Digital Interventions to Reduce Sexualised Drug Use (Chemsex) among Gay, Bisexual and Other Men Who Have Sex with Men: A Scoping Review","volume":"138","author":"Schmidt","year":"2023","journal-title":"Addict. Behav."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.drugpo.2019.10.007","article-title":"Chemsex Is Not a Barrier to Self-Reported Daily PrEP Adherence among PROUD Study Participants","volume":"74","author":"Rice","year":"2019","journal-title":"Int. J. Drug Policy"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"102943","DOI":"10.1016\/j.drugpo.2020.102943","article-title":"Pharmacosex: Reimagining Sex, Drugs and Enhancement","volume":"86","author":"Moyle","year":"2020","journal-title":"Int. J. Drug Policy"},{"key":"ref_94","first-page":"50","article-title":"Telehealth as a Tool for Increasing Health Determinant Risk Assessment: An Analysis of the 2024 Physician Fee Schedule\u2019s New Health Equity Codes","volume":"28","author":"Hoyen","year":"2025","journal-title":"Popul. Health Manag."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Alhejaily, A.-M. (2024). Artificial Intelligence in Healthcare (Review). Biomed. Rep., 22.","DOI":"10.3892\/br.2024.1889"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.4338\/ACI-2016-06-R-0089","article-title":"Telemedicine for Developing Countries: A Survey and Some Design Issues","volume":"7","author":"Combi","year":"2016","journal-title":"Appl. Clin. Inform."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"171","DOI":"10.22432\/PJSR.2024.27.12","article-title":"Chemsex in MSM Biographical Experiences","volume":"27","author":"Dyr","year":"2024","journal-title":"Resocjal. Pol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1080\/00224499.2024.2377592","article-title":"Chemsex Among Men Having Sex with Men: A Scoping Review on Management, Support, and Harm Reduction Strategies","volume":"62","author":"Lemain","year":"2025","journal-title":"J. Sex Res."},{"key":"ref_99","first-page":"361","article-title":"Drug abuse in chemsex: Pharmacological risks of non-controlled psychoactive substances","volume":"158","author":"Farre","year":"2022","journal-title":"Med. Cl\u00ednica (Engl. Ed.)"},{"key":"ref_100","unstructured":"World Health Organization (WHO) (2025, July 31). WHO Technical Advisory Group on Alcohol and Drug Epidemiology. WHO. Available online: https:\/\/www.who.int\/news-room\/articles-detail\/who-technical-advisory-group-on-alcohol-and-drug-epidemiology."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1001\/archgenpsychiatry.2011.124","article-title":"Mirtazapine to Reduce Methamphetamine Use: A Randomized Controlled Trial","volume":"68","author":"Colfax","year":"2011","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_102","first-page":"1","article-title":"Artificial Intelligence\u2019s Evolution in Healthcare: Transforming Diagnostics, Treatment, and Patient Care","volume":"26","author":"Gupta","year":"2024","journal-title":"JK Sci. J. Med. Educ. Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6275\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:40:05Z","timestamp":1760035205000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":102,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14176275"],"URL":"https:\/\/doi.org\/10.3390\/jcm14176275","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}