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EV0538

Chemsex as a silent epidemic: psychiatric emergency presentations and increasing complexity at a tertiary care hospital

CHEMSEX AS A SILENT EPIDEMIC: PSYCHIATRIC EMERGENCY PRESENTATIONS AND EMERGING COMPLEXITY IN A TERTIARY HOSPITAL

Chemsex-related psychiatric emergency presentations are reaching 1 to 2 cases per day, most commonly involving suicidal ideation and substance-induced psychosis, and are becoming increasingly complex.

The aim of the study was to describe psychiatric emergency presentations related to chemsex, defined as psychoactive substance use in a sexual context, and to highlight their increasing clinical complexity. A descriptive observational study was conducted in the psychiatric emergency department of a tertiary care hospital. Chemsex-related presentations were identified through clinical assessment; variables included demographic characteristics, substances used, psychiatric symptoms, and patterns of care and referral. The number of chemsex-related emergency presentations was estimated at 1 to 2 cases per day. Most patients were men aged 20 to 40, predominantly men who have sex with men (MSM); the most common reasons for presentation were suicidal ideation and substance-induced psychosis. Frequently reported substances included GHB/GBL, methamphetamine, amphetamines, synthetic substances such as tusi, and esketamine; use generally occurred in sexualized group settings organized through geosocial networking apps. Polysubstance use and escalation in routes of administration, such as progression to intravenous use, were common and associated with medical complications such as phlebitis; psychosocial vulnerabilities, including stigma and minority stress, were consistently observed. Most patients did not require psychiatric admission and were referred to addiction treatment programs or specialized HIV care services. In conclusion, chemsex is an underrecognized public health issue that requires coordinated, multidisciplinary interventions integrating mental health, addiction services, and infectious disease care.

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