Tyler Mark, Ward Lindsey, Grosse Susan
Eurofins Forensic Services, Toxicology Department, 1 Dukes Green Avenue, Feltham TW14 0LR, United Kingdom.
Forensic Sci Int. 2025 Oct;375:112553. doi: 10.1016/j.forsciint.2025.112553. Epub 2025 Jul 3.
The colloquial term "chemsex" (or "party and play") has appeared within the media and scientific literature within the past decade or so. It has been described as "sex, sometimes long sessions with multiple partners, under the influence of psychoactive drugs (particularly mephedrone, GHB, GBL and crystal meth). Subjects are reported to be mostly, but not exclusively, men who have sex with men (MSM). The study presents toxicology data from 21 deaths in the United Kingdom (between 2017 and 2022) considered within the "chemsex" scenario.
Each case (n = 21) involved the anecdotal report of using drugs with sexual activity. The age of the decedents was 19-62 years (median age = 42). 17 males died after pre-arranged meetings with other males. 2 males died after apparently engaging in sex acts alone. 1 male died after meeting a female. 1 female died after meeting a male. Volatile substance abuse and physical restraints were mentioned in some cases ("poppers", ethyl chloride). Post-mortem samples were analysed in 19 cases. In 2 cases, the subject was found alive, but died later. Ante-mortem blood samples were analysed in these 2 cases. Analysis was carried out for alcohol, drugs of abuse, medicines and a range of sedative substances using conventional chromatographic methods including Gas Chromatography with Flame Ionisation Detector (GC-FID), Gas Chromatography Mass Spectrometry (GC-MS), Gas Chromatography with Tandem Mass Spectrometry (GCMS/ MS), Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS) and Liquid Chromatography with High Resolution Accurate Mass Spectrometry (LCHRAM).
Methamphetamine (methylamphetamine, MA, n = 16) and GHB (n = 14) were the most common drugs detected. The concentration range for MA was 0.025-13 mg/L, and for GHB was 22 to > 800 mg/L in blood. 1 case contained mephedrone (0.19 mg/L). Other drugs detected included: sildenafil/tadalafil (n = 9); cocaine/benzoylecgonine (n = 7); alcohol (n = 4); ketamine (n = 4); cannabis (n = 3); diazepam (n = 1); quetiapine (n = 1); diphenhydramine (n = 1). Poly drug use was common. The most common combination was MA and GHB (n = 11). The cause of death was predominantly given as Drug toxicity/Drug-related death. Ischaemic heart disease/coronary atherosclerosis was listed as an additional complication in some cases.
Methamphetamine and GHB were the most common drugs observed. Poly-drug use is common in deaths associated with chemsex. Little use of mephedrone was found. Volatile use/asphyxia may be a significant factor. We believe this is the first single study providing toxicology data in a series of chemsex-related deaths in the UK.
通俗术语“化学性爱”（或“聚会与滥交”）在过去十年左右出现在媒体和科学文献中。它被描述为“在精神活性药物（特别是甲麻黄碱、γ-羟基丁酸、1,4-丁二醇和冰毒）影响下进行的性行为，有时与多个伴侣进行长时间性行为。据报道，相关对象大多但并非全部是男同性恋者（MSM）。该研究展示了英国21例死亡案例（2017年至2022年期间）在“化学性爱”情境下的毒理学数据。
每个案例（n = 21）都涉及使用药物与性行为相关的传闻报告。死者年龄为19 - 62岁（中位年龄 = 42岁）。17名男性在与其他男性预先安排的会面后死亡。2名男性在明显独自进行性行为后死亡。1名男性在与一名女性会面后死亡。1名女性在与一名男性会面后死亡。一些案例中提到了挥发性物质滥用和身体束缚（“Poppers”，氯乙烷）。19例进行了尸检样本分析。2例中，对象被发现时还活着，但后来死亡。对这2例进行了生前血液样本分析。使用包括带火焰离子化检测器的气相色谱法（GC - FID）、气相色谱 - 质谱法（GC - MS）、串联质谱气相色谱法（GCMS / MS）、串联质谱液相色谱法（LC - MS / MS）和高分辨率精确质量液相色谱法（LCHRAM）等常规色谱方法对酒精、滥用药物、药品和一系列镇静物质进行了分析。
检测到的最常见药物是甲基苯丙胺（甲基安非他命，MA，n = 16）和γ-羟基丁酸（n = 14）。血液中MA的浓度范围为0.025 - 13mg/L，γ-羟基丁酸的浓度范围为22至>800mg/L。1例含有甲麻黄碱（0.19mg/L）。检测到的其他药物包括：西地那非/他达拉非（n = 9）；可卡因/苯甲酰爱康宁（n = 7）；酒精（n = 4）；氯胺酮（n = 4）；大麻（n = 3）；地西泮（n = 1）；喹硫平（n = 1）；苯海拉明（n = 1）。多药联用很常见。最常见的组合是MA和γ-羟基丁酸（n = 11）。死亡原因主要列为药物毒性/与药物相关的死亡。在某些情况下，缺血性心脏病/冠状动脉粥样硬化被列为额外并发症。
甲基苯丙胺和γ-羟基丁酸是观察到的最常见药物。多药联用在与化学性爱相关的死亡中很常见。发现甲麻黄碱使用较少。挥发性物质使用/窒息可能是一个重要因素。我们认为这是第一项提供英国一系列与化学性爱相关死亡案例毒理学数据的单一研究。
