Chemsex is a recognised phenomenon within Italy's gay communities, particularly in Milan and Rome. Italy has some good harm reduction infrastructure, and the Checkpoint network is beginning to address chemsex more explicitly alongside sexual health work. Getting support here is possible.
The Drug Landscape in Italy
Crystal meth (cristallo, metanfetamina) — Present in Milan and Rome's gay scenes. High dependence potential.
GHB / GBL (G, gamma) — Present and dangerous. The margin between a recreational dose and an overdose is narrow. GHB has no antidote and no reversal agent.
Mephedrone (mef) — Synthetic stimulant, present in party and chemsex contexts.
Cocaine — Widely present in Italian nightlife generally; appears in some sexual contexts.
Italy has drug possession laws that criminalise personal use in principle, though health-oriented responses are well-established and enforced differently in practice. Seeking medical help for an overdose will not result in prosecution.
GHB Emergency
If someone loses consciousness or cannot be woken after taking G:
Call 118 (ambulance) or 112 immediately.
Recovery position — on the side, airway clear. Stay with them. Tell the emergency operator what was taken. Time matters.
Support Resources
Milano Checkpoint Via dei Transiti 23, Milan Web: milanocheckpoint.it Milano Checkpoint increasingly addresses chemsex as part of its sexual health remit. They can provide referrals to appropriate support services and have staff who understand the intersection of drug use, sex, and gay identity.
BLQ Checkpoint — Bologna Web: blqcheckpoint.it Similar approach — non-judgmental, community-run, can navigate you to support.
SERD (Servizio per le Dipendenze / Drug Dependency Services) Italy's public drug treatment services (SERD) exist in every ASL area. Free, confidential, and increasingly harm-reduction oriented. Not LGBTQ+-specific, but accessible. Ask Arcigay's local chapter whether they know of a SERD with a more affirming reputation in your area.
Arcigay Web: arcigay.it Local chapters can provide referrals and peer connection for people dealing with substance use alongside LGBTQ+ identity.
Harm Reduction
Never use G alone. The overdose risk from GHB/GBL is uniquely high when there's no sober person present.
Do not mix G with alcohol. Even a small amount of alcohol combined with GHB dramatically increases overdose risk.
Know your doses. GHB from different sources varies significantly in concentration. Start low if from an unknown source.
Test your drugs. Reagent test kits are available online and can identify whether substances contain what you think they do. Italy doesn't have widespread drug checking services.
Stimulants and sex: Crystal meth and mephedrone suppress pain signals, thirst, and exhaustion cues. Take genuine breaks. Dehydration and overheating are real risks during extended sessions.
PrEP and testing: Chemsex dramatically elevates STI transmission risk. If you're on PrEP, take it consistently. After a session, get a full STI panel — throat, rectal, urethral swabs plus blood — at a Checkpoint.
The Mental Health Dimension
The post-session crash — shame, depression, anxiety — is common after chemsex, amplified by Italy's Catholic social context and whatever personal relationship you have with your sexuality. This is a neurological and psychological consequence, not evidence that you're a bad person.
Checkpoint teams are experienced with this. Arcigay can connect you with peer support. The Mental Health in Italy article has more on accessing affirming support.