The second European Chemsex Forum, recently held in Berlin, highlighted a number of difficulties and harms experienced by chemsex users, including non-consensual sex. “We have heard many stories of men who, during sexual marathons that last for days, pass out on GHB or GBL, while the sex continues to take place,” said Leon Knoops of the Dutch harm reduction organisation Mainline. “When they come around, they often have no recollection of what happened.

“Men have spoken from two sides of the coin, and many wonder if this could be considered rape or if it’s just a part of the game. This often triggers immense shame and guilt.”

Dr Chris Ward of the Manchester Royal Infirmary and the city’s chemsex support clinic (Reach at the Hathersage Centre) said that it is already known that male victims of sexual assault or rape often do not report the incident to police or to healthcare professionals. Under-reporting may be linked to concerns about masculinity, the stigma of being a victim of sexual assault, a fear of being not believed, or not being aware that what has happened was a crime.

In the context of chemsex, many men feel that their drug use or being in a highly sexualised environment blurs the line around consent. Overdosing means that men might drift in and out of consciousness or may cycle between pleasure and distress while having sex.

Nonetheless, under UK law, a person who is incapacitated through drink or drugs, or is unconscious, cannot give their consent to a sexual act.

Chris Ward said that the way chemsex users are asked about the issue is important. When his clinic asked about being raped or being forced into sex (the same language used with women), it was under-reported. Men involved in chemsex tend to describe their experiences in different terms.

“The presentation is much more subtle,” he said. “When we learnt how to ask the question properly, over a third of people in our chemsex clinic reported being a victim of a sexual offence.” Read more via AIDSmap