Addiction is now recognized as a disease that significantly impacts brain function. It is characterized not only by a compulsion to use a substance or engage in certain behaviors but also by chronic changes to the brain’s reward system. These changes impair an individual’s ability to control impulses and make decisions, making it challenging to stop despite negative consequences.

• Strong desire or compulsion to use a substance.
• Impaired ability to control consumption.
• Continued use despite harmful effects.
• Prioritizing substance use over other responsibilities.
• Increased tolerance levels.
• Experiencing withdrawal symptoms.

Addiction often arises from a mix of genetic vulnerability, environmental factors, and exposure to substances or behaviors that stimulate the brain’s reward system. Dopamine, a neurotransmitter that regulates pleasure and reward, plays a central role. Repeated exposure to substances or behaviors leads the brain to adapt, requiring larger quantities to achieve the same effect.

Attachment theory, introduced by John Bowlby, explains how early relationships shape emotional regulation and stress management. A secure attachment fosters resilience, while insecure attachments, such as avoidant or ambivalent types, may increase the likelihood of turning to external coping mechanisms, including substance use. Individuals with insecure attachments may struggle with trust and emotional regulation, increasing vulnerability to addiction.

Childhood trauma, genetic predisposition, and environmental factors all contribute to addiction risk. Unaddressed emotional distress and a lack of healthy coping mechanisms often lead individuals to seek relief through substances or risky behaviors. Early intervention and comprehensive treatment addressing both trauma and addiction can improve outcomes.

AA (Alcoholics Anonymous)
Looking for support to manage alcohol addiction? AA holds regular meetings in Malmö and other locations across Skåne. Their 12-step program offers guidance and support for living sober alongside others with shared experiences.
Website: www.aa.se

NA (Narcotics Anonymous)
Struggling with drug addiction? NA hosts meetings where you can connect with others who have faced similar challenges. Together, participants share experiences and motivate one another on their recovery journey.
Website: www.na.org

Maria Malmö
This service supports young people up to 25 years old dealing with alcohol or drug problems. They provide advice and assistance to both youths and their families.
Phone: +46 40-33 71 70

AVB Rehab
Structured outpatient treatment for alcohol, drug, and gambling addiction.
Phone: +46 40-43 77 67
Website: www.avbrehab.com

• National Institute on Drug Abuse (NIDA) – The brain’s response to addiction.
• American Psychiatric Association – DSM-5 diagnostic criteria for addiction and substance use disorders.
• ICD-10 World Health Organization (WHO) – Diagnostic criteria for addiction (ICD-10).
• Public Health Agency of Sweden (Folkhälsomyndigheten) – Information about risky use, substance abuse, and addiction in Sweden.
• Bowlby, J. (1988). A Secure Base: Clinical Applications of Attachment Theory.
• Van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.
• Alcoholics Anonymous Sweden – AA.
• Narcotics Anonymous – NA.
• Maria Malmö – Local support services for young individuals with substance use issues.
• Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiological Advances from the Brain Disease Model of Addiction, New England Journal of Medicine.

LSD, also known as acid, blotter, lucy, or tabs, is a powerful hallucinogenic drug that alters perception and consciousness.

Emojis like can be used to represent LSD and the distorted sensory experiences and hallucinations experienced during an LSD trip. is primarily used for psilocybin mushrooms, also known as “magic mushrooms” or “shrooms,” but can sometimes also represent psychedelic drugs in general, including LSD.

LSD is primarily a psychedelic drug, meaning it mainly affects perception, consciousness, and mood in a unique and often profound way. However, it can also be seen as an “uplifting” drug due to its stimulating effects.

There is a risk that taking LSD can set off mental health problems or make them worse for people already experiencing them. If you have an underlying mental health condition or you are in a bad mood, feeling depressed or worried avoid taking LSD, as taking LSD can lead to a bad ‘trip’. There have been instances where people harm themselves due to bad ‘trips’.

LSD (lysergic acid diethylamide) is a synthetic substance discovered in the 1940s. It is one of the most potent hallucinogens and is used in both therapeutic and recreational settings.

LSD typically comes in the following forms:

• Blotter paper: Small square papers impregnated with LSD, often with colorful patterns or symbols.
• Liquid: LSD can also be found as a clear, colorless liquid that is dropped onto sugar cubes or directly onto the tongue.
• Tablets and capsules: Though less common, LSD can also be found in tablet or capsule form.

LSD is most commonly consumed orally:

• Blotter paper is placed on or under the tongue and dissolves.
• Liquid can be dropped directly onto the tongue or mixed into a drink.
• Tablets or capsules are swallowed directly.

The effects of LSD typically begin within 30 to 60 minutes of ingestion and can last up to 12 hours. Users may experience:

• Intense visual and auditory hallucinations
• Altered perception of time
• Enhanced sensory experiences
• Euphoria and a sense of profound insight
• Altered perception of reality

LSD is sometimes used to enhance sexual experience and intimacy. The hallucinogenic effects can make experiences more intense and emotional. However, LSD can also lead to confusion and impaired judgment.

Safer Sex with LSD

• Talk to your partner(s) beforehand to ensure you are on the same page, and bring protection such as condoms, lubricants, gloves, and cleaning supplies for sex toys.
• You might also have another strategy for safer sex, such as regularly testing yourself and your partner(s).
• Be aware that LSD can affect your judgment and ability to make decisions that would normally feel good for you

LSD can cause both short-term and long-term side effects:

• Short-term effects: Unwanted sensory disturbances, negative emotions or thoughts, mental confusion, anxiety, nausea, dizziness, tremors, and increased heart rate.
• Long-term effects: Flashbacks, prolonged psychological stress, and potential triggering of latent mental illness.

LSD is an extremely potent substance that is active at very low doses and difficult to dose accurately. A typical dose ranges between 50 and 150 micrograms (µg). An overdose of LSD is rare but can be extremely unpleasant. Signs of having taken too much include:

• Severe hallucinations
• Panic attacks
• Confusion and disorientation
• Elevated body temperature
• Heart palpitations

If an overdose is suspected:

• Try to keep the person calm and safe.
• Create a secure and comfortable environment.
• Seek medical help if symptoms are severe or persistent. You can call 112 in Sweden, the number works in all the EU countries

LSD has a low risk for physical dependence but can lead to psychological dependence. Users may develop a desire to re-experience the intense effects.

Combining LSD with other drugs can be dangerous:

• Alcohol can increase the risk of negative psychological effects.
• Stimulants (such as methamphetamine, amphetamine, cocaine, MDMA, etc.) can increase anxiety and paranoia.
• Depressants (such as benzodiazepines, GHB/GBL, alcohol, etc.) can enhance the hallucinogenic effects and lead to confusion.

LSD does not directly affect HIV treatment but can impair adherence to medication by altering the perception of time and judgment.

Take your HIV medications regularly. Set an alarm or reminder on your phone if needed. Take substances and HIV medications at different times to reduce the risk of side effects. Use low doses of substances when taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and LSD.

Benzodiazepines, also known as benzos, are a class of medications used to treat anxiety, insomnia, and certain other medical conditions. They are also common in recreational drug use.

Benzodiazepines are depressants (downers) that provide calming and anxiety-reducing effects.

Benzodiazepines have a high risk of addiction, especially with long-term use. Physical dependence can lead to severe withdrawal symptoms when discontinued.

Benzodiazepines are a class of psychoactive drugs that affect the central nervous system and enhance the effect of the neurotransmitter GABA, which produces a calming, anxiety-reducing, and sleep-inducing effect.

Medically, benzodiazepines are used to treat anxiety, insomnia, muscle spasms, and seizures (such as in epilepsy). Examples of medications in the benzodiazepine group include Sobril, Stesolid, and Temesta.

Nowadays, it is less common to use benzodiazepines for sleep disorders because the substance remains in the body for longer and can lead to dependence. If prescribed, it should be for short-term sleep issues and not longer than three weeks.

Benzodiazepines come in several forms:

• Tablets that are usually small and white, but can be colored and have various shapes depending on the manufacturer.
• Capsules, commonly gelatin capsules containing powder or liquid.
• Benzodiazepines can also come in liquid form. The liquid form is used for oral or injectable administration, predominantly used in hospital and medical care

Benzodiazepines can be taken in various ways:

• The most common method is to swallow tablets or capsules
• Some tablets dissolve under the tongue for faster effect.
• The liquid form can be injected, usually in medical settings.

The effects of benzodiazepines can vary depending on the dose and individual tolerance. Users may feel:

• Calm and relaxed
• Reduced anxiety
• Drowsiness
• Muscle weakness
• Improved sleep

Benzodiazepines can be used to reduce anxiety and increase relaxation during sex. However, they can also lead to decreased sexual desire and performance. They can also affect the ability to make sound decisions.

Safer Sex with Benzodiazepines

• Communicate with your partner about your intentions and boundaries.
• Use condoms and lube to reduce the risk of STIs.
• Be aware that benzodiazepines can affect your ability to make sound decisions.

Benzodiazepines can have both short-term and long-term side effects.

Short-term effects may include drowsiness, dizziness, confusion, memory problems, and coordination issues.

Long-term use can lead to increased side effects and risks, such as:

• Increased fatigue, difficulties with concentration, memory, or balance
• Development or worsening of mental health issues like anxiety, worry, and depression
• Tolerance development
• Risk of addiction
• Withdrawal symptoms upon discontinuation
• Increased risk of falls and accidents
• When combined with opioids, there is also a risk of serious or fatal overdose

Coming off benzodiazepines can be very challenging; it’s best to consult with a doctor to develop a plan to cut down your dose slowly. Gradual reduction is crucial to minimize the risk of withdrawal symptoms. Even with a slow process, there is still a risk that withdrawal symptoms may persist for a period.

• It’s important not to stop abruptly, as sudden discontinuation can be dangerous. Gradually and slowly reduce the dose.
• Avoid alcohol and other drugs, as these can worsen withdrawal symptoms and make tapering more difficult.
• Regular physical activity, a healthy diet, and adequate sleep can help reduce withdrawal symptoms.
• Be kind to yourself. Tapering off can be a long and challenging process. Be patient and take care of your mental and physical health.
• Ask for help. For more information on support and tapering off benzodiazepines, click here.

An overdose of benzodiazepines can be dangerous and requires immediate medical attention. Signs of overdose include:

• Extreme drowsiness
• Confusion
• Impaired breathing
• Unconsciousness
• Blue-tinted skin (cyanosis)

If an overdose is suspected:

• Call emergency services immediately (112 in Sweden and EU).
• Keep the person awake and monitor their breathing.
• Try to obtain information about what and how much the person has taken, in order to provide accurate information to medical professionals. This is important so that the person can receive the appropriate treatment.

Benzodiazepines have a high risk of addiction, especially with long-term use. Users can develop tolerance, meaning they need larger doses to achieve the same effect.

Physical dependence can lead to severe withdrawal symptoms when benzodiazepines are discontinued. Common withdrawal symptoms include:

• Palpitations
• Sweating
• Tremors
• Sleep disturbances
• Nausea or vomiting
• Transient hallucinations/illusions
• Restlessness
• Anxiety
• Seizures

Not everyone will experience withdrawal symptoms.

Combining benzodiazepines with other drugs can be extremely dangerous:

• Alcohol enhances the sedative effect and can lead to respiratory depression.
• Depressives such as Opiates increase the risk of respiratory depression and death.
• Stimulants (MDMA/Ecstasy, cocaine etc.) can mask the effects of benzodiazepines, increasing the risk of overdose.

Benzodiazepines can affect HIV treatment by impairing adherence to medication. Long-term use can lead to forgetting to take medication regularly.

Take your HIV medications regularly. Set an alarm or reminder on your phone if needed. Take substances and HIV medications at different times to reduce the risk of side effects. Use low doses of substances when taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and benzodiazepines.

Cocaine is a powerful central stimulant that is produced from coca leaves and is also known as Charlie, Kola, Coke, Powder, White, or Snow. Emojis such as the snowflake are often used to represent cocaine.

Cocaine is an “upper” that provides rapid and intense euphoric effects.

Cocaine triggers a strong craving for more and has a high potential for psychological addiction.

Cocaine and crack are both popular in recreational drug use and are quite well-known. Usually, cocaine and crack are not included in “chemsex drugs,” but they are often used in a sexual context to increase energy, endurance, and enhance sexual experiences. It is common to use cocaine in combination with other substances.

Cocaine is typically a fine, white crystalline powder. The powder can be mixed with other substances, which can slightly alter its appearance.

Crack is a freebase form of cocaine made by processing cocaine powder with sodium bicarbonate (baking soda) and water, resulting in a solid, crystalline form that looks like white or yellowish lumps or small rocks that can be smoked.

Cocaine is most commonly snorted, providing a gradual onset of effects. Cocaine is rarely injected, as injection provides a quicker and more intense effect.

Crack is smoked, resulting in an almost immediate and intense high.

The effects of cocaine are felt within minutes (faster when smoking crack) and provide an intense feeling of euphoria, increased energy, and mental clarity. The effects last about 30 minutes to 1.5 hours. Common experiences include:

• Restlessness, a strong desire to move, talkativeness, and increased self-confidence.
• Significantly reduced inhibitions and fears, and decreased pain perception, which can lead to greater risk-taking.
• Increased sexual arousal.
• Decreased appetite or thirst.

Cocaine can also cause the following side effects:

• Increased heart rate, blood pressure, and body temperature.
• Feelings of nervousness, anxiety, restlessness.
• Memory problems and disorientation.
• Aggression

Coming down from cocaine can be unpleasant, with feelings of mental and physical exhaustion, low mood, and depression being common. Because cocaine triggers a strong craving for more, it can be difficult to stop once you start coming down.

In chemsex, cocaine is used to prolong sex sessions, increase endurance, and enhance sexual pleasure. Cocaine can also help users let go of sexual inhibitions, leading to risk-taking (e.g., not using condoms or exceeding one’s comfort zone). A reduced pain threshold can lead to physical injuries and overexertion.

Cocaine is often used together with other substances like GHB/GBL, ketamine, or methamphetamine to modulate and enhance the effects.

Safer Sex with Cocaine

• If using a condom during sex, change it after 30 minutes to prevent tears and breakage
• Ensure you have what you need, such as condoms, lube, gloves, and cleaning supplies for dildos and plugs
• Always talk to your partner(s) about consent, preferences and boundaries

Cocaine and common chemsex-drugs

Combining GHB/GBL and cocaine should be avoided as the effect of G can be suppressed when used simultaneously. The risk of overdose increases because the effects are not felt, leading to taking too much or too quickly.

The risk of overstimulation is high when using cocaine and other strong stimulants like methamphetamine and mephedrone together.

• The combination can lead to extremely high blood pressure and heart rate, increasing the risk of heart attack, stroke, and other cardiovascular problems.
• Concurrent use can cause anxiety, paranoia, and hallucinations.

With more regular use, the risk of long-term health problems increases. Withdrawal symptoms can include exhaustion, severe mood swings, difficulty concentrating, delusions, or depression.

Long-term use of cocaine can also lead to a weakened immune system, irritation or inflammation of the nasal mucosa (from snorting), and impact on the heart, liver, and kidneys.

It is difficult to know how much cocaine can cause an overdose. An overdose can be very harmful and, in some cases, life-threatening. Signs of overdose include:

• Chest pain
• Rapid or irregular heartbeat
• Seizures
• High body temperature
• Nausea and vomiting
• Severe anxiety or panic attacks, including paranoia and hallucinations
• Violent behavior
• Unconsciousness

If an overdose is suspected, it is important to:

• Seek emergency care: Call for an ambulance (112 in Sweden, which also works in all EU countries).
• Monitor breathing: Ensure the person is breathing and keep their airways clear.
• Keep the person calm: Try to ensure that the person does not harm themselves or others during hallucinations or confusion.
• Provide accurate information: Try to obtain information about what and how much the person has taken, so you can give the correct details to medical personnel. This is important to ensure the person receives appropriate treatment.

Cocaine has a high addiction risk due to its strong euphoric and short-term effects. Regular use can quickly lead to both physical and psychological dependence. Users develop tolerance, meaning they need larger doses to achieve the same effect.

Addiction can lead to serious health problems, including cardiovascular diseases, mental disorders, and social consequences.

Cocaine can affect HIV treatment, weakening the immune system, altering the drug’s effect, and increasing the risk of side effects. Long-term cocaine use can lead to forgetting to take medication, reducing the effectiveness of HIV treatment.

Always have your HIV medications with you. If you often forget to take your medication, set an alarm or reminder on your phone. Take substances and HIV medications at different times to reduce the risk of side effects. Always take low doses of substances when taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and cocaine.

Mephedrone, also known as 4-methylmethcathinone (4-MMC), is more common in chemsex outside of Sweden. Chemically altered variants of 4-MMC (3-MMC, 3-CMC etc.) are becoming more common.

The substance is also referred to as Meow Meow, M-Cat, Drone, or M. Mephedrone is a central stimulant with effects similar to amphetamine and MDMA (ecstasy) as it belongs to the same chemical class as these (cathinones).

Mephedrone is an ‘upper’ often used for its euphoric and stimulating properties.

There is a high risk of psychological dependence associated with mephedrone use. Many users experience strong cravings after taking mephedrone.

Mephedrone, also known as 4-methylmethcathinone (4-MMC), is a synthetic stimulant that typically appears in the following forms:

Powder: Mephedrone is usually a white or yellowish powder. The texture can vary from fine to more crystalline.

Crystals: It can also appear in larger crystalline forms, resembling small, transparent, or white crystals.

Tablets and capsules: Sometimes mephedrone is sold as tablets or capsules. The tablets can be white or various colors and sometimes embossed with logos or symbols. Mephedrone can also be found in capsules, with the powder enclosed in a gelatin or plant-based capsule.

Regardless of the form, mephedrone often has a chemical smell reminiscent of cat urine or flowers.

Users typically take the drug by snorting the powder, swallowing capsules or tablets, or sometimes dissolving the powder in liquid and drinking it.

Using mephedrone can produce intense physical and psychological experiences, ranging from euphoria and energy to increased social interaction and sexual arousal.

However, it can also cause effects such as heart palpitations, muscle tension, and subsequent fatigue and depression.

Mephedrone use should always be approached with caution, aware of the potential health risks and negative side effects.

The effects of mephedrone usually do not last very long (about 2-4 hours), which can lead users to take repeated doses over a short period to maintain the high.

3-MMC (3-Methylmethcathinone) and 3-CMC (3-Chloromethcathinone) are both synthetic cathinones. Both substances are chemical modifications of 4-MMC, and are manufactured to bypass drug classification by slightly altering their chemical composition.

3-CMC has gained popularity after 3-MMC became classed as narcotics. In Sweden it has become more prevalent, especially during the pandemic (covid-19) as the substance was easily ordered online.

It can be hard to keep track of what ‘substances’ are legal or not. Many have been under the impression that 3-CMC is legal, but both 3-CMC and 3-MMC are classed as narcotics in Sweden.

Substances are often sold online under “mephedrone” or 3-MMC but the actual variant of the drug may be 3-CMC or another chemical composition. With new substances the risk is higher as the effects and possible dangers are less known.

According to users, the high from 3-MMC is more stimulating and less intense compared to 4-MMC. This could lead users to take higher doses to compensate. While 4-MMC has a similar effect to MDMA, 3-MMC is more similar to cocaine.

Mephedrone is used in chemsex contexts, particularly among men who have sex with men (MSM) and transgender women.

• Mephedrone enhances sexual arousal and can intensify the sensation of sexual pleasure, leading to longer and more intense sex sessions.
• Users often experience a strong sense of connection and social interaction, making it easier to form emotional and physical bonds with others.

Risks and side effects

Increased sex drive and reduced inhibitions can lead to crossing boundaries and taking risks that one would not normally take when sober. This can include having sex with multiple partners, not using condoms, engaging in sexual activities beyond one’s comfort zone, and having difficulty communicating with partners about safer sex (harm-reduction). These factors can increase the risk of sexually transmitted infections (STIs) and HIV.

It is important to remember that harm-reduction and strategies for safer sex vary from person to person

The combination of mephedrone with physical exertion during sex can increase the risk of dehydration, overheating, and heart problems.

After the effects of mephedrone wear off, users may experience severe depression, anxiety, and a sense of emptiness, which can negatively impact mental health.

Safer sex with mephedrone

• Sex on mephedrone can be more aggressive; use only enough to recognize your partner’s defense signals and to protect yourself.
• The sex can last much longer since the sense of pain and touch is reduced, making it harder to climax. If using a condom, change it after 30 minutes to avoid wear and breakage.
• Ensure you have everything needed, such as condoms, lube, gloves, and cleaning supplies for sex toys.
• When on mephedrone, you might do things you normally wouldn’t; talk with your partner(s) beforehand about what sexual activities are acceptable and what are not.

In the event of a mephedrone overdose, prompt medical intervention is critical.

Symptoms of an overdose include:

• Severe agitation and anxiety
• Hyperthermia (elevated body temperature)
• Serious heart issues such as tachycardia, high blood pressure, and potential heart attack
• Seizures
• Psychotic episodes

Always take signs of overdose very seriously. If an overdose is suspected:

• Call for an ambulance: Dial 112, Sweden’s emergency number, which also works in all EU countries. Inform them that you suspect an overdose and describe the symptoms as accurately as possible. It’s crucial to be honest about what and how much the person has taken, as this helps medical staff provide the right care quickly
• Keep the person awake and calm: If possible, try to keep the person awake and calm. Ensure they are breathing and keep their airways clear. Sit or lay them in a comfortable position. If they are unconscious, place them in the recovery position to keep the airways clear and reduce the risk of choking
• Keep the person cool: Ensure the person is in a cool environment; you can open windows, doors, or turn on a fan. Use cool, damp towels on areas where major blood vessels are close to the skin, such as the neck, forehead, armpits, and groin. Offer water in small amounts. Avoid using extremely cold water or ice directly on the skin, as this can worsen the condition
• In case of seizures: Protect the person from injury during the seizure, but do not hold them down. Place something soft under their head, ensuring it doesn’t obstruct their breathing. After the seizure, lay the person on their side with their head slightly tilted back (this helps with breathing and allows saliva to drain from the mouth)
• Stay with the person: Regularly check their breathing and pulse. If breathing becomes irregular or stops, or if the pulse is weak or cannot be felt, you may need to perform CPR. If you’re unsure how to do this, follow the instructions from the emergency operator (112)

At the hospital, sedatives such as benzodiazepines may be administered to manage agitation and seizures.

Mephedrone is known to be highly addictive due to the following:

• Mephedrone can produce a strong and rapid sense of euphoria, making users quickly want to repeat the experience. People may be more inclined to use mephedrone in chemsex contexts as the substance also provides a sense of increased energy and enhanced social interaction.
• The short effects (2-4 hours) of mephedrone can lead users to take repeated doses over a short period to maintain the high.
• Users can quickly develop a tolerance to mephedrone, meaning they need to take higher doses to achieve the same effects, increasing the risk of addiction.
• Strong cravings for mephedrone can make it difficult to stop using the drug despite negative consequences.

Combining mephedrone with other drugs or alcohol can be very dangerous and increase the risk of serious medical complications, including heart problems, hyperthermia, mental disorders, respiratory issues, and overdose.

Alcohol

• Both mephedrone and alcohol burden the liver, which can lead to severe liver damage.
• The combination can cause dehydration, amplifying the negative effects of both substances.
• Alcohol can mask the effects of mephedrone, increasing the risk of overdose.

Cocaine

• Both drugs are strong stimulants, leading to dangerously high blood pressure, heart rate, and the risk of heart attack or stroke.
• The combination can also cause anxiety, paranoia, and psychotic symptoms.

MDMA (Ecstasy)

• The combination can lead to dangerously high body temperature (hyperthermia), which can cause organ damage or death.
• There is an increased risk of dehydration and imbalances in the body’s fluid regulation, affecting heart function.

Opioids (e.g., heroin, fentanyl)

• Mephedrone can mask signs of opioid overdose, increasing the risk of fatal overdose when the stimulant’s effect wears off.
• High doses increase the risk of respiratory depression.

Benzodiazepines (e.g., diazepam, alprazolam, oxazepam)

• Benzodiazepines can alleviate anxiety from mephedrone, potentially leading to overdose as warning signs are masked.
• High doses of benzodiazepines can lead to respiratory depression, especially when combined with other depressants.

Cannabis

• The combination can increase the risk of paranoia and hallucinations.
• Both drugs can increase heart rate, which can be dangerous for people with heart conditions.

Mephedrone and HIV medications are broken down by the same enzyme system (CYP450) in the liver, leading to interactions between the substances.

Combined use can stress the liver and cause liver damage, affecting liver function.

HIV medications can increase or decrease mephedrone levels in the body. Increased levels can lead to heart problems and psychosis.

Depending on which HIV medications are used, mephedrone levels may increase or decrease. Some NNRTIs, such as efavirenz, nevirapine, etravirine, and rilpivirine, can reduce mephedrone’s effect, leading to increased consumption and overdose risk.

Always have your HIV medications with you. If you often forget to take your medication, set an alarm or reminder on your phone. Take substances and HIV medications at different times to reduce the risk of side effects. Always take low doses of substances when taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and mephedrone.

Ketamine, also known as K or ket, is a sedative drug sometimes used in chemsex contexts as it can enhance sexual feelings and desire. Emojis like on hookup apps can indicate an interest in using ketamine in sexual contexts.

Ketamine is a dissociative anesthetic, meaning it can cause a feeling of separation from reality or one’s body.

Ketamine does not have a particularly high risk profile when used in moderate doses with intervals between each use. Higher doses of ketamine can lead to what is known as a ‘k-hole’. Ketamine can be psychologically addictive for some, but it does not cause severe physical withdrawal symptoms.

Ketamine is fundamentally an anesthetic and has been used for both humans and animals. It is also known as “horse tranquilizers,” hence the emoji. Ketamine is also used in low doses to treat depression and other mental illnesses, although this is a relatively new development where the ketamine form esketamine is used in low doses.

Ketamine is most commonly snorted as a white or whitish powder or swallowed in tablet form. Users also sometimes ‘bump’ ketamine, meaning they roll the powder in a piece of paper and swallow it.

It can be difficult to distinguish between ketamine and other powder drugs like cocaine or amphetamine.

Ketamine can also appear as a clear, colorless liquid medication or as a nasal spray, both from medical production. Injecting ketamine is less common; the effect is immediate with injection, and both effect and after-effects last shorter compared to snorting or swallowing ketamine.

It takes 5-15 minutes to feel the effects after snorting ketamine, and the high lasts for about an hour. After-effects can last longer, and it is common to feel weak for 1-3 hours after use.

When swallowing tablets, the effect is felt after about 20 minutes, depending on how much you have eaten before (stomach contents), the high lasts for about 1.5 hours, and the after-effects can last 4-8 hours after use.

Many take ketamine and cocaine in similar doses, but ketamine should be taken in much smaller doses. This confusion often leads to many overdosing on ketamine and falling into what is called a ‘k-hole’.

Ketamine has psychoactive effects, including sedation, dissociation, and euphoria. The sensation is often intense. It can feel like the body and mind are separated; it is also common to experience a dreamlike state, affecting the perception of time and space. Hallucinations can occur, which can sometimes feel unpleasant and frightening.

People with mental health issues are at greater risk of experiencing hallucinations, impaired memory, and cognitive functions. Hallucinations in those with mental health issues can also feel more intense.

In chemsex, ketamine is often used to complement the effects of other substances. The effect of ketamine is individual and varies depending on body weight, tolerance, which other substances it is combined with, how much is taken, the strength of the ketamine, and other drugs.

Ketamine provides a floating sensation, relaxation, and disconnection. It blocks receptors that cause pain, leading to reduced pain sensation. This can facilitate harder sex or fisting, which can lead to injuries such as small tears or fissures in the anus, increasing the risk of hepatitis C and HIV.

The sexual feeling and desire are enhanced by ketamine, and one may feel more uninhibited. The sense of euphoria, happiness, and peacefulness can lead to greater relaxation and openness in sexual contexts.

Ketamine can make it harder to maintain an erection or reach orgasm. This leads many to use other substances, such as Viagra, in combination with ketamine to achieve the desired effect.

Safer sex with ketamine

• If someone has taken too much ketamine, they may find it harder to consent or defend themselves due to the strong dissociative and numbing effects. Be vigilant if someone needs help, and always use ketamine with people you trust
• If you or someone else has experienced assault, there is help available. If you have experienced something you do not feel comfortable with you can find out where to turn for support in the article support and connections
• If a condom is used during sex, change it after 30 minutes to avoid it tearing or breaking
• Make sure to have what you need, e.g., condoms, lubricant, gloves, cleaning products for dildos and plugs

Common side effects of ketamine:

• Impaired balance and fine motor skills, leading to easier falls and injuries
• Difficulty moving, paralysis
• Slower breathing
• Severe drowsiness
• Increased heart rate
• Reduced emotional experience
• Anxiety, panic (e.g., in a k-hole experience)
• Nausea, vomiting
• Unconsciousness

When coming down from ketamine, one can feel down, anxious, and weak. Memory issues, flashbacks, or visual hallucinations may occur.

Long-term ketamine use can lead to difficulty concentrating, memory problems, depression, and other mental issues. Problems with the stomach, intestines, and urinary tract can also arise.

High doses of ketamine over a long period can cause permanent organ damage.

A well-known effect of ketamine is the k-hole. It is a coma-like state characterized by dissociative and sedative effects. Some enjoy the effect of a k-hole, while others find it unpleasant. Several factors influence how you experience a k-hole, and it can vary from time to time depending on how much you take, if you mix it with alcohol or other substances, but also your environment and mental health.

Although it may feel unpleasant, it is good to know that a k-hole usually does not lead to further problems beyond some disorientation. However, it is also important to know that the effects of a k-hole can lead to increased vulnerability to sexual assault or accidents such as falling.

Signs of an impending k-hole include:

• Blurred vision
• Intense hallucinations
• Feeling disconnected from your body (e.g., feeling like you are just a floating head)
• Strong feeling that you are going to die

How can I help a friend in a k-hole?

Ensure the person is in a calm place without bright lights; it can help to speak calmly to them if they are experiencing anxiety and panic. Pay attention to the person’s breathing, and always call an ambulance if you suspect an overdose.

Signs of overdose include:

• Extreme confusion and disorientation
• Severe hallucinations and paranoia
• Involuntary muscle movements and spasms
• Respiratory depression
• Unconsciousness

If you suspect an overdose:

• Call an ambulance (112 in Sweden, the number works in all EU countries)
• Ensure the person is breathing and keep their airways clear
• Keep the person calm, try to ensure they do not harm themselves or others during hallucinations or confusion
• Try to get information about what and how much the person has taken to provide the right information to medical personnel. This is important so the person can get the correct treatment.

It is possible to develop a psychological dependence; the likelihood of developing addiction increases if ketamine is used daily. Currently, there is no research indicating that ketamine causes physical dependence.

In cases of psychological dependence, withdrawal symptoms such as anxiety, tremors, sweating, loss of appetite, nightmares, and depression can occur.

Ketamine should not be combined with sedative drugs like alcohol or GHB/GBL. The combination of ketamine, GHB/GBL, and alcohol can be dangerous as depressants enhance the sedative effects when used together. This can cause increased drowsiness, impaired motor functions, respiratory depression, and increased risk of memory lapses.

Be cautious when combining ketamine with methamphetamine, cocaine, and MDMA/ecstasy. The combination can cause harmful increases in heart rate, confusion, and risk of injury.

Booster medications such as Norvir and Tybost slow down the breakdown of ketamine. This can make ketamine more intense or longer-lasting and can also increase side effects.

Always have your HIV medications with you. If you often forget to take your medication, set an alarm or reminder on your phone. Take substances and HIV medications at different times to reduce the risk of side effects. Always take low doses of substances when taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and ketamine.

• Ensure you have a safe place to take ketamine, avoiding places where you risk injury from falls.
• Always start with smaller doses to wait for the effects. If you swallow ketamine, the effect will come later!
• Avoid using ketamine if you feel depressed, anxious, or have other mental issues, as ketamine can enhance these feelings.
• Be careful when smoking while using ketamine, as motor skills are impaired, and there is a risk of starting a fire.
• Use ketamine with people you feel safe with.

GHB/GBL is also commonly referred to as “G”. The drug increases sexual desire and has a relaxing effect, making it popular in chemsex. Emojis like on hookup apps can indicate an interest in using GHB in sexual contexts.

GHB/GBL is a depressant (also known as ‘downers’)

The risk of overdose is high, with fatal overdoses mainly occurring when GHB is mixed with other drugs, especially central nervous system depressants such as alcohol, benzodiazepines, or opioids.

A lot of people who use methamphetamine in sexual contexts can do so in a controlled way. It’s important to be aware of potential harmful consequences and know how to avoid them.

GHB and GBL are commonly referred to as G, and are abbreviations for gamma-hydroxybutyric acid and gamma-butyrolactone. GHB/GBL is a neurotransmitter that affects body functions such as movement, mood, sleep, and cognition.

GHB is classified as a controlled substance and was initially used in medicine as an anesthetic. GBL is a corrosive liquid used as a solvent and cleaning agent. The effects of GHB and GBL are similar but differ slightly. GHB is the substance produced in the body when GBL is ingested. GBL has a stronger effect than GHB, but the high lasts shorter.

GBL is a clear, odorless liquid with a salty taste, and is slightly viscous. If the manufacturing process fails, the liquid can have a pungent smell and sharp taste. The substance is often stored in empty PET bottles (such as soda bottles) and dosed with pipettes or syringes. GHB is an odorless and tasteless white powder; homemade GHB is a water solution.

G is corrosive and must be taken in a very diluted form. G is dosed to the milliliter (1:100 ml) and then diluted in a non-alcoholic liquid using a pipette or syringe (without a needle). For every 1 ml of the concentrated substance (G), add 100 parts of a non-alcoholic liquid. The mixture is then swallowed in one gulp. For a more gradual effect, the dose can be added to an entire non-alcoholic drink and consumed over a short period.

Body weight, physical condition, and tolerance influence dosing. If you have low body weight, take G on an empty stomach, or feel physically exhausted, it is safer to take lower doses. Higher doses are often used by people who have already developed a tolerance to G.

Dosage can vary from 0.8-1.2 ml GBL or 1-2 ml GHB.

Since G is produced illegally, it is difficult to know the concentration of the substance, so it is good to start with half a dose and wait for the effect before taking more.

Sometimes G is dosed directly from the pipette or syringe into the mouth after taking a large gulp of liquid (without swallowing it). When G is diluted directly in the mouth, there is a risk of burns on the lips, tooth enamel, and throat because the substance is corrosive.

Never inject GHB/GBL (slamming), as the risk of overdose/poisoning and burns on the veins is high.

The effect varies from person to person, depending on how G is taken, how the drug is composed, dose, and other factors. Initially, the effect is stimulating, but with increased use and dose, the effect becomes more sedative/relaxing.

The effect of a typical GBL dose is felt after about 3-10 minutes, peaks after about 20-30 minutes, and decreases over 1.5-3 hours.

The effect of a typical GHB dose is felt after about 10-20 minutes, peaks after about 30-60 minutes, and decreases over 2-4 hours.

The high from G can be compared to alcohol but with a shorter duration, greater sexual stimulation, and mental clarity. When taking G, one may feel:

• Euphoric, happy, joyful
• Calm, less anxious
• More social and talkative
• Heightened sensory perceptions
• Sexually aroused, horny, others appear more attractive
• Inhibited

G is one of the most common drugs used in chemsex because it has a sexually stimulating and inhibiting effect. G also has a relaxing effect that makes receptive sex (bottoming) easier and more enjoyable. Since G has a sexually disinhibiting effect, users may take more risks during sex.

Safer sex with GHB/GBL:

• G can make it harder to climax (orgasm). If using condoms, remember to change them after 30 minutes as condoms wear out with prolonged use.
• Because G has a relaxing effect, it is harder to feel if you or someone else is getting hurt during sexual activities such as penetration, fisting, or using dildos or plugs. The anal mucosa is thin and delicate, making it easier for small tears or fissures to occur during sex, increasing the risk of transmission of hiv, hepatitis and other sexually transmitted infections (STI)
• Talk to your partner(s) about consent, preferences and boundaries and bring the things you need like condoms, lube, gloves, and things to clean toys with (like plugs and dildos)

G affects the central nervous system, including the part responsible for breathing. A high dose can cause life-threatening respiratory paralysis. High doses also affect memory during use, leading to memory lapses.

Frequent use of high doses can lead to depression, anxiety, and sleep disturbances.

Withdrawal symptoms occur 2 to 3 hours after the last dose and can last up to 12 hours. Symptoms experienced during withdrawal can include:

• Anxiety
• Seizures
• Insomnia
• Vomiting
• High blood pressure
• Increased heart rate
• Confusion
• Hallucinations

In severe cases, hyperactivity, paranoia, psychosis, seizures, and death have been reported.

Long-term consumption of G can damage the liver and kidneys, and prolonged use can cause memory difficulties.

The difference between the desired dose and an overdose is very small, making it easy to overdose on G unintentionally.

Overdoses can occur from 1.5 ml GBL or 2 ml GHB. Amounts greater than 2 ml GBL or 3 ml GHB can be fatal.

Initial signs of overdose may include:

• Nausea
• Vomiting
• Dizziness
• Yawning
• Difficulty speaking
• Involuntary movements or sounds
• Sudden fear

Signs of severe overdose may include:

• Muscle twitching
• Loss of bowel and bladder control (involuntary defecation/urination)
• Sudden sleepiness
• Coma, also known as deep unconsciousness, where the brain’s control over the body is largely impaired. Unlike deep sleep, a person in a coma cannot be awakened.
• A high overdose can lead to loss of ability to breathe, which is life-threatening.

Always take signs of overdose very seriously. If an overdose is suspected, it is important to:

1. Call for an ambulance: Dial 112, Sweden’s emergency number, which also works in all EU countries. Inform them that you suspect an overdose and describe the symptoms as accurately as possible. It’s crucial to be honest about what and how much the person has taken, as this helps medical staff provide the right care quickly
2. Keep the person awake and calm: If possible, try to keep the person awake and calm. Ensure they are breathing and keep their airways clear. Sit or lay them in a comfortable position. If they are unconscious, place them in the recovery position to keep the airways clear and reduce the risk of choking
3. Keep the person cool: Ensure the person is in a cool environment; you can open windows, doors, or turn on a fan. Use cool, damp towels on areas where major blood vessels are close to the skin, such as the neck, forehead, armpits, and groin. Offer water in small amounts. Avoid using extremely cold water or ice directly on the skin, as this can worsen the condition
4. In case of seizures: Protect the person from injury during the seizure, but do not hold them down. Place something soft under their head, ensuring it doesn’t obstruct their breathing. After the seizure, lay the person on their side with their head slightly tilted back (this helps with breathing and allows saliva to drain from the mouth)
5. Stay with the person: Regularly check their breathing and pulse. If breathing becomes irregular or stops, or if the pulse is weak or cannot be felt, you may need to perform CPR. If you’re unsure how to do this, follow the instructions from the emergency operator (112)

Regular use of G leads to rapid tolerance development (you need more of the substance to achieve the same effect).

Long-term use over several days or weeks leads to physical dependence. Physical dependence can occur quickly, even after using it for just three consecutive days.

Self-organized abrupt withdrawal without medical advice and supervision can be life-threatening. In the article support and connections, you can find out where to turn for medical detox and addiction treatment

GHB/GBL and HIV medications are metabolized by the same enzyme system (CYP450) in the liver, leading to interactions between the substances.

Since GHB/GBL and some NNRTI medications are metabolized in the liver, concurrent use can increase liver stress. GHB/GBL rarely causes liver toxicity with recreational use, but it’s essential to be aware of the potential risk.

Protease inhibitors (PI) used to treat HIV, such as darunavir, atazanavir, and etravirine, can cause lethal concentrations of GHB/GBL in the body, even at low doses of the substance.

Drug use can sometimes make it harder for people to adhere to their treatment plan, as it is easy to lose track of time and forget to take HIV medication. Inconsistent medication intake can lead to poor virological control.

Always have your HIV medications with you. If you often forget to take your medication, set an alarm or reminder on your phone. Take substances and HIV medications at different times to reduce the risk of side effects. Always take low doses of substances when you are taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and GHB/GBL.

DMT is a powerful hallucinogen often called “The Spirit Molecule.” It occurs naturally in certain plants and animals and can be synthesized as a white, crystalline substance. Emojis like on hookup apps can indicate that someone is interested in using DMT for spiritual or psychedelic experiences.

DMT produces intense and short-lasting hallucinatory effects. Users may experience visual and auditory hallucinations, altered perceptions of reality, and feelings of euphoria or self-insight.

DMT is not addictive in the traditional sense, but the intense experience can tempt users to use it repeatedly. Risks include anxiety, paranoia, and psychosis, especially in individuals with mental health issues. It can also be dangerous for people with heart problems due to increased heart rate and blood pressure.

Many who use DMT do so in controlled environments, often with the intention of gaining spiritual insights or self-understanding. It is important to be aware of potential harmful effects and to prepare to minimize these.

DMT is one of the most potent psychedelic substances, capable of producing powerful, short-lived psychedelic experiences. DMT is found in several plants and has been traditionally used in shamanic rituals, but it is also popular within modern psychedelic circles.

DMT most commonly appears as a white or yellowish crystalline powder. It can also be produced as a tar-like substance, depending on the level of purity and the extraction method.

DMT can be consumed in various ways, depending on the desired effect and availability:

The most common method is to smoke or vaporize it using a pipe or vaporizer. This produces an immediate effect and an intense experience lasting between 5 to 20 minutes.

The powder can also be snorted, but this is less common due to the burning sensation in the nose and a longer onset time for the effects.

DMT can be taken orally in combination with an MAO inhibitor (such as ayahuasca) to activate it. This results in a longer, more extended experience, which can last for several hours.

DMT is known for its extremely intense and rapid hallucinations. The effects include:

• Vivid visual hallucinations, patterns, and geometries
• Altered perception of time and space
• Feelings of “ego death” or loss of self
• Perceived encounters with otherworldly beings or “entities”
• Strong emotional experiences, ranging from euphoria to existential terror

When smoked or vaporized, the effects begin within seconds and typically last 5-20 minutes. When taken orally with an MAO inhibitor (e.g., as in ayahuasca), the experience can last between 2-6 hours.

Using DMT in a safe and prepared environment with reliable people is important to minimize risks:

• Have a “trip sitter” who does not use the drug and can assist if something goes wrong.
• Sit or lie down throughout the experience to avoid accidents.
• Ensure you are mentally and emotionally stable before use, as negative thoughts can be amplified during the experience.
• If you have heart problems or are taking medication, consult a doctor, as DMT can affect blood pressure.

Although DMT is not known to be addictive, it can have both short- and long-term effects:

• Short-term effects may include increased heart rate, changes in blood pressure, anxiety, confusion, and temporary disorientation.
• Repeated intense experiences can sometimes lead to flashbacks, anxiety, and difficulties readjusting to reality.

Do not combine DMT with other drugs, especially MAO inhibitors, without proper knowledge, as this can lead to dangerous interactions and increase the risk of serious health problems.

Nitrous oxide, commonly known as laughing gas, whippets, or nitro, is a colorless gas used for both medical and recreational purposes.

Nitrous oxide can be classified as a “stimulant” drug, providing short-term euphoric and dissociative effects.

Nitrous oxide (N₂O) is a chemical compound used medically as an anesthetic and analgesic. It is also used recreationally for its short-term euphoric and dissociative effects

In recreational settings, it is often inhaled from balloons or whipped cream chargers.

Nitrous oxide is typically stored in metal containers or cartridges, including:

• Whipped cream chargers: Small metal cartridges used in ready-made cream dispensers.
• Large gas cylinders: Used in medical and industrial settings.

For recreational use, the gas is often inhaled from balloons filled with nitrous oxide from a whipped cream dispenser or gas cylinder.

Inhaling nitrous oxide directly from the container is extremely dangerous, especially in enclosed spaces.

Lustgas används oftast genom att inhalera från ballonger eller kondomer där gasen har släppts ut från en vispgrädde tank eller gasflaska

Inhalation av lustgas direkt från behållaren är mycket farligt, särskilt om det görs i ett slutet utrymme

The effects of nitrous oxide are felt almost immediately and typically last for a few minutes. Because it is a short-acting drug, users often re-dose and consume more than intended. Users may experience:

• Feelings of euphoria and well-being
• Relaxation
• Laughter and giggling, hence the nickname “laughing gas”
• Dissociation from the body and surroundings
• Distorted sounds and vision
• Tingling sensations

Since nitrous oxide is often used in combination with other drugs, predicting its effects can be challenging.

Nitrous oxide is sometimes used to enhance sexual experiences and sensations. However, it can affect judgment and coordination.

Safer sex with laughing gas:

• Always discuss consent and boundaries with your partner
• Make sure you have what you need, such as condoms, lubricants, gloves, and cleaning supplies for sex toys

Nitrous oxide can have both short-term and long-term side effects:

Short-term effects:

You may experience dizziness, nausea, and headaches. You can also feel confused and have impaired coordination, which can lead to accidents like falling or fainting.

Long-term effects:

Heavy and regular use of nitrous oxide can lead to vitamin B12 deficiency, which can cause nerve damage such as tingling and numbness in the fingers and toes. It may also result in memory problems and psychological dependence.

It is difficult to determine how much is safe to use and what effects you might experience from nitrous oxide.

An overdose of nitrous oxide is rare but can occur with excessive use. Signs of overdose include:

• Unconsciousness
• Severe confusion or agitation
• Respiratory depression
• Seizures

If an overdose is suspected:

• Ensure the person has access to fresh air
• Monitor their breathing and pulse
• If symptoms are severe or persistent, seek medical help. If you are unsure what to do or where to seek care, you can call 1177
• If the person stops breathing or is unconscious, call 112

Laughing gas has a low to moderate risk of psychological dependence. Regular use can lead to a desire to repeat the euphoric effects, although physical dependence is rare

Combining nitrous oxide with other substances can be dangerous:

• Alcohol increases the risk of nausea, vomiting, and unconsciousness
• Stimulants (like amphetamines, methamphetamine, mephedrone, cocaine, MDMA/ecstasy): Can cause confusion and impaired coordination
• Depressants (such as GHB/GBL, opioids, ketamine, benzodiazepines): Can enhance sedative effects, leading to respiratory depression

Laughing gas have no direct effect on hiv treatment, but could affect adherence to medication and overall health

Take your HIV medications consistently. Set an alarm or reminder on your phone if needed. Use substances and HIV medications at different times to reduce the risk of side effects. Use low doses of substances when taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and alcohol.

Alcohol is a legal substance found in beverages like beer, wine, and spirits. It is one of the most widely used and accepted drugs in the world

Alcohol is a “depressant” drug that produces relaxing and euphoric effects

Alcohol in beverages typically refers to ethanol (ethyl alcohol), a psychoactive substance that is the main component of alcoholic drinks. It is produced through the fermentation of sugars by yeast and is responsible for the intoxicating effects of drinks like beer, wine, and spirits.

Alcohol affects the central nervous system and can cause both stimulation and sedation depending on how much one drinks and individual tolerance levels.

Common types of alcoholic beverages include:

• Beer: A fermented drink with a low alcohol content, usually 4-6% alcohol
• Wine: A fermented drink made from grapes with an alcohol content of 12-15%
• Spirits: Distilled drinks like vodka, whiskey, and rum, with a higher alcohol content of 40% or more

Alcohol often has labels that provide information about the number of units in the drink. A unit is a way to express the actual amount of pure alcohol in a beverage, allowing for comparisons of strength between different types of drinks. This can also make it easier to understand how many units one is consuming.

Alcohol is typically consumed by drinking:

• Beer, wine, and spirits are often drunk from glasses, cans, or bottles
• Alcohol can also be mixed into cocktails or other beverages
• Spirits can be taken as a ‘shot.’
• Ready-to-drink mixers and alcopops are becoming increasingly popular; they may not seem strong but often contain more alcohol than typical bottles of cider or beer

The effects of alcohol can vary depending on the dose and individual tolerance. Users may experience:

• Euphoria and increased confidence
• Relaxation and reduced anxiety
• Impaired judgment and coordination
• Decreased motor skills and reaction time
• Drowsiness at higher doses

Alcohol is often used to reduce inhibitions and enhance social interaction, which can influence sexual behavior. Losing inhibitions may lead people to take risks they normally wouldn’t, such as not using condoms or engaging in activities they might otherwise avoid. It can also impair sexual performance, making it harder to achieve or maintain an erection.

Safer sex with alcohol:

• Communicate clearly with your partner about consent and boundaries
• Be cautious with mixing substances, as alcohol can negatively interact with many other drugs
• Ensure you have everything you need, such as condoms, lubricants, gloves, and cleaning supplies for sex toys
• If using condoms during sex, remember to change them every 30 minutes to prevent wear and tear
• Consider limiting your alcohol intake if it negatively affects your sex life

Alcohol can have both short-term and long-term side effects:

Short-term effects: Dizziness, headache, nausea, vomiting, blackouts

Long-term effects: Liver damage, heart problems, dependence, mental health issues like depression and anxiety, chronic diseases such as cancer

Alcohol poisoning, also known as alcohol intoxication, can be life-threatening and requires immediate medical attention. Signs of an overdose include:

• Confusion and unconsciousness
• Vomiting
• Irregular breathing
• Hypothermia (low body temperature)
• Cyanosis (bluish skin color)

If you suspect an overdose:

• Call an ambulance immediately (112 in Sweden and the rest of the EU)
• Keep the person awake and sitting up if possible, ensuring they are not in a position that could block their airways
• Place the person in the recovery position if they are unconscious but breathing

Alcohol has a high risk for both physical and psychological dependence. Long-term use can lead to alcohol addiction, where larger amounts are needed to achieve the same effect, and withdrawal symptoms occur upon cessation

Combining alcohol with other drugs can be extremely dangerous:

• Benzodiazepines and alcohol increase the risk of respiratory depression and death
• Opioids and alcohol enhance the sedative effects, leading to overdose
• Stimulants (such as amphetamines, methamphetamines, mephedrone, and MDMA/ecstasy) can mask the effects of alcohol, raising the risk of overdose

Always exercise caution and be aware of the potential dangers when mixing substances

Alcohol can negatively affect the immune system and complicate adherence to HIV medication. Long-term alcohol consumption may also lead to forgetting to take medication regularly.

Take your HIV medications consistently. Set an alarm or reminder on your phone if needed. Use substances and HIV medications at different times to reduce the risk of side effects. Use low doses of substances when taking medications simultaneously.

Talk to your doctor or an expert about interactions between HIV medication and alcohol.