Authors: Dirk Sander & Axel J Schmidt.
Suggested citation: Sander D, Schmidt AJ (2025). Zur regionalen Verbreitung von Chemsex in Deutschland (EMIS-2024). Deutsche Aidshilfe, Berlin.
Abstract:
Chemsex—the use of psychoactive stimulant substances to enhance and prolong sexualised social encounters—has become a significant public health issue in recent years. Member organisations of the AIDS service sector have implemented targeted support services and provide education and training for counselling, care, and peer-led self-help.
For the planning and delivery of health interventions, it is essential to understand how many people are affected by health impairments associated with substance use in sexual settings. Such information determines the level and distribution of resources required across prevention, counselling, self-help, and therapeutic services in order to prevent or reduce health-related harms.
Accordingly, this analysis uses data from EMIS-2024, together with population estimates, to describe the prevalence of chemsex-related behaviours in Germany, differentiated by federal states and selected larger cities.
Our calculations indicate that the alignment between existing services and potential needs points to a marked underprovision. Existing services should therefore be expanded and new approaches developed. These approaches must be capable of reducing existing stigma related to (homo)sexuality and substance use, thereby facilitating access to services for those affected.
Available online in German, as a longer text with literature, and as a poster.
See also the German-language news segment produced by Hessischer Rundfunk, with a more focused version available on YouTube.
The Chemsex Emergency We Refuse to Acknowledge
Co-author Dirk Sander published another article on the topic in the German men’s health magazine Checkmag on 4 May 2026, titled The Chemsex Emergency We Refuse to Acknowledge (Notfall Chemsex: Was wir nicht sehen wollen).
The article argues that chemsex is too often treated as a moral failure rather than a public health and social issue. It criticises the tendency to only discuss drug use once it has already become a crisis, which reinforces shame and discourages people from seeking help.
The author explains that chemsex—the use of psychoactive drugs to intensify or prolong sex—is closely linked to modern urban gay culture, dating apps, and the shift from public nightlife into private spaces. Rather than being a fringe phenomenon, it is presented as part of broader social and cultural changes.
A central point of the article is that people often use substances for understandable emotional and social reasons: to reduce inhibitions, cope with shame, feel intimacy, or experience belonging. According to the article, many gay men involved in chemsex have histories of exclusion or internalised shame related to sexuality. Drugs can temporarily ease these feelings, but stigma often deepens the cycle of isolation afterwards.
The piece also highlights the hidden scale of the problem. It cites estimates suggesting that around 50,000 gay and bisexual men in Germany are affected by problematic involvement in chemsex. Consequences can include overdoses, anxiety, depression, psychological crises, and suicide—yet many cases remain invisible because affected people fear judgment and therefore avoid seeking support.
Finally, the article calls for a shift in perspective: away from moral condemnation and toward understanding, harm reduction, and structured support systems. The author argues that chemsex should be treated as a health, social, and cultural issue requiring better counselling, therapy services, and national emergency plans.