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Home > Irish drug use findings from European Men-Who-Have-Sex-With-Men internet survey.

Millar, Sean (2020) Irish drug use findings from European Men-Who-Have-Sex-With-Men internet survey. Drugnet Ireland, Issue 75, Autumn 2020, p. 16.

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Most men who have sex with men (MSM) and who use recreational drugs do so on a sporadic basis, for specific purposes such as partying, socialising, or having sex. However, evidence suggests that among MSM who use drugs, there is a preference for ‘sex drugs’, including alkyl nitrites (‘poppers’), crystal methamphetamine (‘crystal meth’), club drugs (including ketamine and ecstasy), and new psychoactive substances.1 Use of these drugs is associated with higher-risk sexual behaviours and sexually transmitted disease acquisition.2 Little is known about the prevalence and determinants of drug use among MSM in Ireland. However, the number of HIV diagnoses has been increasing among MSM in Ireland in recent years and drug use among this population may be a contributory factor. 

European MSM internet survey

The European Men-Who-Have-Sex-With-Men Internet Survey-2017 (EMIS-2017) was part of ESTICOM (European Surveys and Training to Improve MSM Community Health) and funded by the European Commission Health Programme 2014–2020. The overall aim of EMIS-2017 was to generate data useful for the planning of HIV and sexually transmitted infection (STI) prevention and care programmes. EMIS-2017 was an online, behavioural surveillance survey designed to collect data from MSM living in 50 countries and included all 28 member states of the European Union. The EMIS-2017 study coordinators commissioned advertising on several dating platform apps that were used by MSM in each country. In Ireland, the EMIS-2017 survey was advertised on: PlanetRomeo, Grindr, Hornet, RECON, Scruff, Gaydar, Manhunt/Jack’d and GROWLr. Overall, 2,083 qualifying respondents were included in the Irish dataset and the results were recently published.3 The main findings regarding drug use among survey respondents are discussed below. 


Type of drug consumed

Participants were asked ‘When was the last time you consumed: cannabis (hashish, marijuana); synthetic cannabinoids; ecstasy; amphetamines; crystal meth; heroin or related drugs; mephedrone; synthetic stimulants other than mephedrone; ketamine; LSD; cocaine or crack cocaine?’ Overall, 41% of respondents used drugs in the last 12 months and 26% had used drugs in the last four weeks. The most commonly used drugs in the last 12 months were cannabis (34%), cocaine (20%), ecstasy pills (19%), and ecstasy powder (15%). In the last four weeks, cannabis and cocaine were used by 17% and 9% of respondents, respectively. Fewer than 1% of respondents indicated they had injected any drug to get high in the last 12 months and just over 1% of respondents had injected anabolic steroids in the last 12 months. 

Injecting drugs

Of men who indicated they injected drugs to get high in the last 12 months (n=17), 59% had done so three times or less and three-quarters of men had done it five times or less. Crystal meth was used by 83% of men who injected drugs, followed by ketamine (18%). Among men who had injected to get high in the last 12 months (n=17), 29% had injected with a used needle or syringe. 

Combining sex, drugs, and alcohol

Men who had sex with men in the last 12 months (n=1930) were asked ‘In the last 12 months, how much of the sex you’ve had with men has been under the influence of alcohol or any other drug?’ Over 45% indicated that they had some sex under the influence of alcohol or any other drug, while 12% said almost all or all sex was under the influence. Twenty per cent of all respondents had ever used stimulant drugs to make sex more intense or last longer and 14% had done so in the last 12 months. Stimulant drugs included in this definition were: ecstasy/MDMA, cocaine, amphetamine, crystal meth, mephedrone, and ketamine. Overall, 75% of men who had used stimulant drugs during sex in the last 12 months had experience of doing so with more than one partner at once, with 61% doing so in the last 12 months. 


The authors noted that the prevalence of stimulant drug use among MSM during or before sex (ever) was higher in Ireland compared with the overall European prevalence (15%). Additionally, 72% of men who used stimulant drugs to make sex more intense or last longer had done so with more than one partner and this was also higher than the overall European proportion (66%). As chemsex has been associated with increased HIV and STI transmission, additional work is required to better understand chemsex and how best to mitigate the negative outcomes associated with it.


1 McCarty-Caplan D, Jantz I and Swartz J (2014) MSM and drug use: a latent class analysis of drug use and related sexual risk behaviors. AIDS Behav, 18(7): 1339–1351.

2 Tomkins A, Ahmad S, Cannon L, Higgins S, Kliner M, Kolyva A, et al. (2018) Prevalence of recreational drug use reported by men who have sex with men attending sexual health clinics in Manchester, UK. Int J STD AIDS, 29(4): 350–356.

3 Casey C, O’Donnell K, Brady M and Igoe D (2019) EMIS-2017 Ireland: findings from the European Men Who Have Sex With Men Internet Survey      (Ireland). Dublin: Health Protection Surveillance Centre.

Item Type
Publication Type
Irish-related, International, Open Access, Article
Drug Type
Substances (not alcohol/tobacco), CNS stimulants, Cocaine, New psychoactive substance
Intervention Type
Harm reduction, Screening / Assessment
Issue Title
Issue 75, Autumn 2020
November 2020
Page Range
p. 16
Health Research Board
Issue 75, Autumn 2020

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