Nearly one in four men who have sex with men use drugs during sex, including cannabis at 18%
A meta-analysis of 238 studies found that 22% of men who have sex with men engaged in chemsex, with cannabis (18%) being the second most commonly used substance after alkyl nitrites (23%).
Quick Facts
What This Study Found
Pooled prevalence of chemsex was 22% and sexualized drug use overall was 25% among MSM. Cannabis had a pooled prevalence of 18% for use during sex. Other substances: alkyl nitrites 23%, GHB/GBL 13%, cocaine 10%, ecstasy/MDMA 9%, methamphetamine 8%.
Key Numbers
238 studies, 380,505 participants. Chemsex prevalence: 22%. SDU prevalence: 25%. Cannabis for sex: 18%. Alkyl nitrites: 23%. GHB/GBL: 13%. Cocaine: 10%. Methamphetamine: 8%.
How They Did This
Systematic review and meta-analysis of 238 studies covering 380,505 participants. Random-effects model used. Subgroup analyses by MSM population category, region, and time period.
Why This Research Matters
Cannabis is often overlooked in discussions of sexualized drug use, yet it ranks second among substances used during sex in this population. Understanding its role in chemsex contexts is relevant for sexual health and harm reduction programming.
The Bigger Picture
Chemsex is associated with increased HIV/STI risk, mental health challenges, and substance use problems. Cannabis's high prevalence in sexual contexts among MSM has been underrecognized compared to "harder" substances like methamphetamine and GHB.
What This Study Doesn't Tell Us
High heterogeneity expected across 238 studies with different definitions, populations, and measurement methods. Self-reported data subject to social desirability bias. Cannot determine whether cannabis use during sex is associated with the same risks as other chemsex substances.
Questions This Raises
- ?Does cannabis use during sex carry similar sexual health risks (reduced condom use, STI transmission) as other chemsex substances?
- ?Should harm reduction programs targeting chemsex include cannabis-specific messaging?
Trust & Context
- Key Stat:
- pooled prevalence of cannabis use during sex among MSM across 238 studies
- Evidence Grade:
- Large-scale meta-analysis with 380,505 participants provides strong evidence of prevalence, though heterogeneity across studies is expected.
- Study Age:
- 2025 publication.
- Original Title:
- Prevalence of chemsex and sexualized drug use among men who have sex with men: A systematic review and meta-analysis.
- Published In:
- Drug and alcohol dependence, 275, 112800 (2025)
- Authors:
- Georgiadis, Nikolaos, Katsimpris, Andreas(2), Vatmanidou, Maria A, Vassilakou, Tonia, Beloukas, Apostolos, Sergentanis, Theodoros N
- Database ID:
- RTHC-06526
Evidence Hierarchy
Analyzes all available research on a topic using a structured method.
What do these levels mean? →Frequently Asked Questions
What is chemsex?
Chemsex refers to intentional use of drugs before or during sex to facilitate, enhance, or sustain the sexual experience. It is particularly prevalent among men who have sex with men and typically involves stimulants and psychoactive substances.
Why is cannabis included in chemsex research?
Cannabis is one of the most commonly used substances during sex among MSM, ranking second after alkyl nitrites. While less associated with acute risk than methamphetamine or GHB, its high prevalence makes it relevant for sexual health programming.
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Cite This Study
https://rethinkthc.com/research/RTHC-06526APA
Georgiadis, Nikolaos; Katsimpris, Andreas; Vatmanidou, Maria A; Vassilakou, Tonia; Beloukas, Apostolos; Sergentanis, Theodoros N. (2025). Prevalence of chemsex and sexualized drug use among men who have sex with men: A systematic review and meta-analysis.. Drug and alcohol dependence, 275, 112800. https://doi.org/10.1016/j.drugalcdep.2025.112800
MLA
Georgiadis, Nikolaos, et al. "Prevalence of chemsex and sexualized drug use among men who have sex with men: A systematic review and meta-analysis.." Drug and alcohol dependence, 2025. https://doi.org/10.1016/j.drugalcdep.2025.112800
RethinkTHC
RethinkTHC Research Database. "Prevalence of chemsex and sexualized drug use among men who ..." RTHC-06526. Retrieved from https://rethinkthc.com/research/georgiadis-2025-prevalence-of-chemsex-and
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.