The drug of choice is typically methamphetamine, commonly referred to as crystal meth, tina, or T.[4] Other substances like mephedrone, GHB, GBL,[5][6] ketamine, and alkyl nitrites (known as poppers) are also used.
[8] Studies indicate that individuals participating in such activities have a higher likelihood of acquiring sexually transmitted infections, including HIV/AIDS, due to unprotected sex with numerous partners.
[6] A study of sauna participants in Barcelona, Spain, in 2016, found that the most commonly used drugs in chemsex are "GHB/GBL, cocaine, ecstasy, silver bars (MDMA), poppers and Viagra".
[14][15] These drugs tend to inhibit penile erection,[11][12] a phenomenon known by the slang term crystal penis or tweaker dick.
Popular discourses of "disinhibition" provide a commonly accepted alibi for activities engaged in when under the influence of stimulants.
[citation needed] The same drug-induced loss of inhibitions makes PNP enthusiasts more vulnerable to more immediate threats, such as robbery, date rape, assault, or murder, by someone whom they meet for sex.
Open wounds or damaged mucous membranes can turn typically low-HIV-risk sex acts such as oral sex into much-higher-risk sexual activity[21] unless all HIV-positive participants are undetectable on HAART, and all HIV-negative participants are taking pre-exposure prophylaxis in strict accordance with prescription instructions.
[24] From the early 2000s, historic venues of gay socialization such as bars, clubs, and dance events reduced in number in response to a range of factors, including gentrification, zoning laws, licensing restrictions, and the increased number of closeted or sexually labile men who are under the influence of drugs and the increasing popularity of digital technologies for sexual and social purposes.
[citation needed] While PNP sessions tend to be organized around sex, there is some evidence that they can serve a range of social purposes for their participants, including the opportunity to meet other gay men, become friends, and engage in erotic play and experimentation.
In some instances, PNP sessions play a part in the formation of loose social networks that are valued and relied upon by participants.
[24] For other men, increasing reliance on hookup apps and websites to arrange sex may result in a sense of isolation that may exacerbate the risk of drug dependence, especially in the context of a lack of other venues for gay socializing and sexual community-formation.
[6][26] It has been observed that reliable data and relevant research are generally lacking and this situation is generating a climate of moral panic.
In an opinion piece published by The Guardian, it has been argued that an exaggerated reporting might give the public a distorted impression of the magnitude of this phenomenon and that may increase the level of collective anxiety.