Drugs

Research in this area is still limited and much of what is known is based on experience and personal stories. Many of the drugs described here are illegal, but we have chosen to present them in as neutral and factual a way as possible.

We do not provide a comprehensive review of all the substances available. Instead, the focus is on the substances that are most common in club, travel and sex contexts in Sweden, with the aim of providing an overview of how they are used, what effects they can have and what risks are important to be aware of.

Amphetamine

Amphetamine is a chemical stimulant drug, sometimes called an 'upper'. It comes in powder or tablet form and can be swallowed, snorted or slammed (injected). Amphetamine affects the brain's dopamine and noradrenaline systems, increasing energy, alertness and confidence. It increases heart rate and blood pressure, reduces hunger and the need for sleep, and may also initially increase sex drive and stamina. Some people use it as a counterbalance to downers such as GHB/GBL or ketamine. Combining uppers and downers can be balancing but is risky as the body is pushed in two directions at once.

The risk of addiction is high, both psychologically and physically. With regular use, the positive effects are replaced by depression, anxiety and fatigue. Dose strengths can vary greatly, increasing the risk of accidental overdose. Symptoms of overdose may include paranoia, severe anxiety, seizures or, in the worst case, collapse due to cardiac and respiratory effects. Combining it with alcohol is particularly risky as it puts strain on the heart.

Sharing syringes or injection equipment carries the risk of spreading infections such as HIV and hepatitis. Snorting tubes can also pass on hepatitis. Syringe exchange programs are available in several locations in Sweden to reduce the risks.

Involuntary effects include muscle twitching, teeth grinding, chewing and dry mouth. After the high, depression, anxiety, paranoia and mood imbalance are common. With prolonged use, problems can become more severe, with the risk of chronic mental illness and cognitive difficulties.

Desired effects

• Increased energy, stamina and confidence
• Reduced fatigue and hunger
• May be perceived to enhance sex drive and stamina
• Compensates for depressants such as GHB/GBL or ketamine (risky)

Undesirable effects

• High risk of mental and physical dependence
• Overdose can cause paranoia, seizures, heart problems or death
• Risk of HIV and hepatitis when sharing syringes and tools
• After the high: depression, worry, anxiety and difficulty sleeping

Benzodiazepines

Benzodiazepines (benzo) are a group of drugs prescribed for anxiety, insomnia and epilepsy, but also used illegally as intoxicants. They can be swallowed as tablets or dissolved in liquid.

In recreational settings, benzo is often used to calm anxiety, to come down from a high or to enhance the effects of other drugs. They can provide relaxation, anxiolysis and sleep - but also strong blackouts. Combination with alcohol, GHB/GBL or opioids is very dangerous as it can lead to respiratory arrest.

Benzodiazepines are highly addictive and rapidly tolerated. Withdrawal is risky and can lead to seizures and psychosis, especially if stopped suddenly after regular use. It may therefore be useful to seek help from addiction services if you want to stop.

Desired effects

• Reduced worry and anxiety
• Relaxation and drowsiness
• Sleep-inducing
• Can dampen the ignition from uppers

Undesirable effects

• Severe addiction risk and severe withdrawal
• Memory lapses and loss of time perception
• Coordination difficulties, risk of accidents
• Very high risk of overdose in combination with alcohol, GHB/GBL or opioids

Cannabis

Cannabis is a collective name for products from the hemp plant, the most common forms of which are hashish (often in the form of cookies or oils) and marijuana (dried plant parts that may resemble tobacco or grass). Cannabis can be smoked, eaten or drunk.

The effects vary widely depending on the person, dose and situation. Many people first experience a feeling of relaxation, giggling and may become more talkative. Later on, the high often turns into calmness, thoughtfulness or tiredness. The intoxicating substance is called THC (tetrahydrocannabinol), which is fat-soluble and can therefore be stored in the body for a long time. However, the high itself lasts only a few hours, although traces of THC can be detected for several weeks.

Common side effects include anxiety, restlessness, panic or paranoia. Short-term memory and concentration are temporarily affected, and with regular use these effects may become more prolonged. In some, there may be an increased risk of psychotic symptoms. Cannabis can also affect sex drive, often in the form of reduced drive, and smoking poses risks to the lungs similar to tobacco smoke. The combination of alcohol and cannabis can exacerbate dizziness, nausea and impaired motor skills.

Cannabis can lead to psychological dependence, although the degree varies between individuals. It is the most commonly used scheduled drug in Sweden. In chemsex, cannabis is uncommon as it usually suppresses sex drive, but some people use it to unwind, balance the effects of other drugs or aid recovery afterwards.

Desired effect

• Soothing and relaxing
• Can be used to unwind or sleep after using uppers
• Anxiolytic
• Getting giggly and chatty

Undesired effect

• Impact on short-term memory
• Negative impact on the psyche
• Smoking can cause lung damage

Ecstasy

Ecstasy is a street name for tablets that are usually marketed as containing MDMA (see MDMA), but the content can vary widely. Some tablets contain MDMA, others are mixed with different stimulants or completely different substances. This makes the potency and effect difficult to predict, even between different tablets with the same appearance.

Ecstasy tablets are common in the club and festival scene and are usually taken for the high they can provide: increased energy, euphoria, a sense of community and heightened sensory perceptions. At the same time, there are risks. Overheating, dehydration, heart palpitations, anxiety and paranoia are some of the most common problems. Combining it with alcohol increases the strain on the body and can amplify negative effects.

Because of the uncertainty of their contents, ecstasy tablets always pose an additional risk compared to pure MDMA.

Desired effects

• Can enhance the atmosphere on dance floors, at festivals and similar events.
• Often gives a feeling of increased closeness, empathy and enhanced touch.
• May be experienced as increased sexual desire and longer stamina, although the body does not always keep up.

Undesirable effects

• May make erections and orgasms more difficult; some mix with contraceptives (such as Viagra), risking heart problems.
• Risk of panic attacks, sweating and anxiety.
• Difficult to regulate fluid intake: both too much and too little water can be dangerous.
• As ecstasy tablets may contain substances other than MDMA, the effect is difficult to predict, increasing the risk of unpleasant or dangerous reactions.
• Depression and fatigue afterwards due to the effect on brain neurotransmitters (serotonin), recovery may take several days.

Fentanyl

Although fentanyl is not a common drug in the context of chemsex, we have chosen to include it here. The reason for this is that fentanyl is sometimes found mixed with other substances, but also in counterfeit tablets ('fake benzodiazepines' or 'fake oxys'), often without the user's knowledge. This makes the risk of accidental overdose very high, so it is important to know what fentanyl is and what the risks are.

Fentanyl is a synthetic opioid used in healthcare to treat severe pain, for example in cancer or after surgery. It is available as patches, tablets, sprays and in injectable form. Fentanyl is very potent - up to 100 times more potent than morphine - which means that the risk of overdose is very high, especially if it is mixed with alcohol, benzodiazepines or used in unknown doses. Fentanyl sticks are available that can be used to test whether a preparation contains fentanyl, which can reduce the risk of accidental overdose. Read also more about how Naloxone can reverse opioid overdoses in the paragraph on Naloxone.

On the illicit market, fentanyl is available both on its own and mixed with other drugs, often without the user's knowledge. This makes the risk of accidental overdose even greater.

When intoxicated, fentanyl can provide euphoria, pain relief and a powerful calm. However, the high can be painful, causing anxiety, muscle aches, restlessness and nausea. Fentanyl is highly addictive and can cause severe withdrawal symptoms.

Read more in the section on opioids.

Desired effects:

• Sedative and analgesic
• Euphoria and relaxation
• Sometimes mixed with other drugs to increase intoxication (very risky)

Undesirable effects:

• Very high risk of overdose
  Tough "coming down"
• Strongly physically addictive
• Severe withdrawal symptoms
  Particularly dangerous in combination with alcohol, benzodiazepines or other opioids

GHB/GBL

GHB/GBL (often called "G" or "gobbe") are colorless and odorless liquids with a salty taste. GBL is an industrial solvent that is converted into GHB in the body and is considered more potent. Both are classified as narcotics in Sweden and carry a high risk of harm.

GHB/GBL are often used in chemsex contexts because they can increase sex drive, reduce inhibitions and act as muscle relaxants, which has made them popular with some people involved in activities such as fisting. However, they are known to be very difficult to dose. The difference between a desired effect and a life-threatening overdose can be as small as one-tenth of a milliliter, and different batches can have different potencies.

Overdose can cause sudden loss of consciousness - sometimes referred to as 'G-sleep' or 'G-hole'. Overdose can lead to respiratory arrest and death, and is also associated with an increased risk of abuse. The risk is further increased when combined with alcohol or other depressants such as benzodiazepines or ketamine.

The effects vary from person to person and are influenced by body weight, state of health, daily routine and dose. Many people also describe GHB/GBL as creating a craving for more once you've started, a bit like alcohol. To reduce the risk of taking too frequent doses, some people use a timer on their phone.

Common side effects include nausea, vomiting, dry mouth, drowsiness, clumsiness and in some cases psychotic features. After prolonged use, both physical dependence and strong psychological cravings may develop. It is therefore important not to stop abruptly if you have used a lot of GHB/GBL for a long time - withdrawal can be both severe and dangerous. Tapering off should be done with support, and help is available through the addiction clinic or other addiction services.

If someone has taken too much, it is crucial to call an ambulance immediately and not leave them alone. Stay close by and make sure the person is breathing and not at risk of choking if they vomit or become unconscious.

Desired effects

• Increased horniness/libido
• Muscle relaxation
• Reduced inhibitions
• May enhance or 'balance' the effects of other drugs

Undesirable effects

• Memory loss
• Drowsiness/clumsiness
• Difficult to have sex without the drug
• Mental and physical dependence
• Very high risk of overdose

Ketamine

Ketamine (keta, special K) is a drug used as an anesthetic in healthcare, but is also used as a drug. The high can be experienced as a trance-like state with hallucinogenic elements.

Most commonly in recreational use, ketamine is taken as a powder snorted through the nose. It can also be swallowed, but tablets are uncommon.

Ketamine is addictive. It affects balance and fine motor skills, increasing the risk of falls and injuries. Because ketamine is anesthetic, injuries may feel minor in the moment, but cause pain afterwards. Ketamine can facilitate harder sex practices, increasing the risk of injury and thus blood-borne infections such as HIV and hepatitis C.

An overdose is often referred to as a K-hole - a powerful dissociative state that can be very unpleasant. The person may become completely cut off, have difficulty moving or speaking and be at risk of abuse. The risk of respiratory impairment increases especially if ketamine is combined with other drugs such as alcohol, opioids, GHB/GBL or benzodiazepines.

Desired effects

• Muscle relaxation, numbing sensation
• Enhanced enjoyment
• Trans-like or hallucinogenic experiences
• May facilitate some sexual practices (e.g. fisting)

Undesirable effects

• Confusion, impaired motor skills and balance
• Difficulty speaking and swallowing (especially in K-hole)
• Panic disorder, depression and suicidal thoughts
• Short and long term memory effects
  Damage to liver and kidneys
• Long-term use can cause severe bladder damage (scarring, incontinence, need for surgery)
• Infections from shared tools (e.g. straws or syringes)

Cocaine

Cocaine is a stimulant drug that produces a short but intense high. The effects are similar to amphetamine, but last for a shorter time.

Cocaine is produced from the leaves of the coca plant and is most often taken as a powder snorted through the nose. It can also be swallowed, injected or smoked (crack). When cocaine is used, it blocks the brain's reuptake of dopamine, serotonin and noradrenaline. It gives a strong sense of well-being, confidence and energy. At the same time, the heart rate increases, blood pressure rises and blood vessels constrict.

Cocaine can increase sex drive and make orgasms more intense, but can also cause erectile dysfunction. Combining it with alcohol is particularly dangerous as it causes the body to produce cocaethylene, a substance that increases the risk of heart and liver damage.

Cocaine is addictive and repeated use can quickly wear down the brain's reward system, causing strong cravings, depression, anxiety and paranoia after the high. Prolonged snorting damages the mucous membranes in the nose and can lead to tissue damage.

Cocaine is sometimes used to 'balance' the effects of other drugs, such as GHB/GBL. However, it can give a false sense of control and increase the risk of overdose, especially as the effects of cocaine wear off quickly while other drugs last longer.

Desired effects

• Increased energy and alertness
• Increased self-confidence
• More social and talkative
• Stronger physical endurance
• Intensified sexual feeling

Undesirable effects

• Increased body temperature, pulse and blood pressure
• Damage to the nasal mucosa from repeated snorting
• Physical and psychological dependence
• Post-intoxication depression, anxiety and paranoia
• Long-term damage to the heart and liver

LSD

LSD is a chemically produced psychedelic drug that affects the senses and can distort both the environment and one's own perception of reality. The effects vary greatly from person to person and from occasion to occasion - the high can be experienced as exciting and insightful, but also as confusing or frightening.

The high can last for many hours and sometimes feel like days. Drugs such as LSD are rarely used in noisy club environments because sounds, lights and movements can be amplified and distorted to unpleasant proportions. Sex on LSD can feel surreal, ecstatic or stiff and strange

LSD often comes in the form of small tablets or pieces of paper soaked in the substance. The effect depends very much on the dose, where even small differences can produce strong variations. Because LSD is produced illegally, it is difficult to know the strength of what you are taking.

It is recommended never to use LSD alone. Choose a safe environment with peace and quiet, preferably with a person you trust who can provide support and help if something goes wrong.

Common physical side effects include nausea, palpitations, high blood pressure, tremors, dizziness and chills. After the high, it is common to feel anxious or depressed. LSD can also cause recurring 'flashbacks' - brief hallucinations of times when the drug was not taken. In some cases, LSD can trigger psychotic states that can be long-lasting.

Desired effects

• Strong visual and auditory experiences
• Altered perception of time and space
• "Out of body experience"
• Calm, joy or sense of realization

Undesirable effects

• Paranoia and tripping
• Flashbacks (recurrent hallucinations)
• Post-drinking depression and anxiety
• Psychotic reactions that can be long-lasting
• Physical symptoms: nausea, palpitations, tremors, dizziness

MDMA

MDMA (3,4-methylenedioxymethamphetamine) is the chemical substance that is often the active ingredient in ecstasy. MDMA is also available in the form of crystals or powder, usually swallowed in a capsule or dissolved in liquid. In these cases, you know more precisely what you are taking, although the strength may vary.

The effect of MDMA comes after 30-60 minutes and lasts for several hours. Common effects include euphoria, feelings of closeness and empathy, increased energy and intensified sensations. At the same time, the body is affected: heart rate and blood pressure increase, body temperature rises and fluid balance is disturbed.

The risks of MDMA are mainly overheating, dehydration and mental overstimulation. This can lead to anxiety, difficulty sleeping, depression or anxiety afterwards. At higher doses, there is a risk of hallucinations, heart problems and, in rare cases, death. Regular use can be linked to long-term problems with memory, concentration and depression. Combining MDMA with some antidepressants can be dangerous, especially because of the risk of serotonin syndrome.

Desired effects

• Enhances the sense of euphoria, empathy and community.
• Sensory input and touch can be experienced more intensely.
• May increase feelings of attraction and sexual desire.

Undesirable effects

• Often makes erection and orgasm difficult, especially in men. Combination with Viagra means increased strain on the heart.
• May cause anxiety, panic, sweating and increased body temperature.
• affects the body's fluid balance - both too little and too much water can lead to serious problems (dehydration or water intoxication)
• Depletes the brain's serotonin stores which can lead to 'cravings' afterwards: tiredness, low energy, depression or anxiety that can last for days.

Mephedrone

Mephedrone (meow meow, 4-MMC) is a synthetic stimulant drug in the cathinone family, related to amphetamine and MDMA (ecstasy). It usually appears as a white powder or crystals and can be snorted, swallowed or slurped (injected).

Mephedrone often gives a feeling of energy, euphoria and increased confidence. Many people also find that they become more talkative and social, and have a strong sense of closeness and affection for others.

The high is short-lived (usually 1-2 hours), so people often take repeat doses. This increases the risk of adverse effects. The high is often followed by a strong and unpleasant high. Common side effects include paranoia, nausea, anxiety, high heart rate and sometimes hallucinations. Long-term use can cause sleep problems, strong psychological dependence and depression.

Mephedrone is less common in Sweden than in countries such as the UK and Germany, but is used in chemsex. Availability has a big impact on how common it becomes.

Desired effects

• Euphoria and a strong sense of well-being
• Increased energy and alertness
• Feeling of increased self-confidence
• More social and talkative

Undesirable effects

• Short-term intoxication → risk of repeated dosing
• Heavy ignition
• High dependency risk
• Insomnia, paranoia and anxiety
• Physical effects: high heart rate, nausea, tremors

Methamphetamine

Methamphetamine (Tina, T, crystal meth, ice) is a strong central stimulant drug, related to amphetamine but with more powerful effects and higher addiction potential.

The drug is strongly linked to sex and chemsex environments as it can increase sex drive, stamina and confidence. Many people describe the high as an almost 'animal' sex drive, with strong sexual confidence and feelings of intensity and closeness. At the same time, it can be difficult to enjoy sex without the drug, as sex and drug use risk becoming strongly linked.

Methamphetamine can be swallowed, snorted, smoked or slammed (injected). It is common for people using the drug to forget to eat and drink, and the body can be pushed hard during long periods of intoxication. If you are using methamphetamine, it is therefore important to eat, drink and rest regularly. When injecting, clean needles and tools should always be used. Syringe exchange programs are available in several cities.

The drug is highly addictive and quickly wears down the brain's reward system, which can make it harder to feel positive highs from what would otherwise make you happy. After the high, depression, anxiety, paranoia and severe mood swings are common.

Desired effects

• Strong increase in sex drive (libido)
• Euphoria and well-being
• Increased self-confidence
• Reduced pain experience
• Reduced inhibitions and increased endurance

Undesirable effects

• Sleep disorders ("tweaking")
• Reduced appetite and severe weight loss (may also be a desired effect)
• Irregular heartbeat and high blood pressure
• Psychosis, paranoia and exhaustion
• Post-drinking depression and anxiety
• Risk of infections (HIV, hepatitis) in case of shared needles or mucosal injuries
• High risk of mental and physical dependence

Naloxone 

Naloxone is not a drug itself, but an antidote to opioids - but we still include it in the list because it can be crucial in case of an overdose.

Naloxone is a drug that reverses overdoses of opioids such as heroin, morphine and fentanyl by blocking the opioid receptors in the brain, thereby helping the person to breathe again. It is completely safe to use and does not cause intoxication. In Sweden, naloxone has traditionally been available only on prescription, but since July 2024, the nasal spray variant can be sold over the counter in pharmacies under the name Nyxoid.

Naloxone is still distributed through syringe exchange programmes and addiction services, usually in the form of a nasal spray, along with a short training on how to use it. The effect is temporary and lasts 30-90 minutes, so it is always important to call 112 even if the person wakes up. For strong opioids such as fentanyl, multiple doses may be needed. In people who are addicted, naloxone can cause acute withdrawal symptoms, but this is not dangerous - what matters is that breathing starts.

It is prudent to administer naloxone in all suspected overdoses, especially since drugs such as amphetamines or cocaine can sometimes be mixed with opioids without the user's knowledge. Used correctly, naloxone can be completely life-saving.

Desired effect

• Reverses opioid overdoses by blocking opioid receptors.
• Makes the person start breathing again.
• Life-saving in case of suspected overdose.
• Completely harmless and does not cause intoxication.

Undesired effect

• May cause acute withdrawal symptoms in dependent persons (anxiety, sweating, pain, nausea).
• The effect is temporary (30-90 minutes) - there is a risk that the overdose will return when the naloxone stops working.
• May need repeated doses, especially with strong opioids like fentanyl.

NPS (new psychoactive substances)

NPS (research chemicals) is a collective name for new synthetic drugs that are often sold online under names such as 'research chemicals' or 'legal highs'. They can mimic the effects of already known drugs, such as cannabis, amphetamines or LSD, but often have an unknown and unpredictable composition.

Common examples found in Sweden are synthetic cannabinoids ('spice'), new cathinones such as 3-MMC or 4-CMC, and different variants of psychedelic substances.

The risks of NPS are high because the content and potency can vary between batches and are often poorly understood. The effects can therefore be much stronger than expected, and side effects such as anxiety, psychosis, seizures and heart problems are not uncommon.

Desired effects

• Similar to the classic drugs they try to mimic (e.g. euphoria, relaxation, hallucinations)
• Easily accessible online

Undesirable effects

• Unpredictable effects and dose strength
• High risk of overdose
• Psychoses, anxiety and seizures
• Unknown long-term effects

Opioids (heroin, morphine, etc.)

Opioids such as heroin, morphine and various synthetic variants are mainly used for their analgesic and sedative effects. They are uncommon in club and chemsex settings as they often dampen energy and sex drive.

Their relevance here lies above all in the risk of mixing. Opioids - especially fentanyl - can appear as an additive in other drugs, such as powders or tablets, sometimes without the user's knowledge (read more in the section on fentanylThis poses a very high risk of accidental overdose.

In some cases, opioids are combined with stimulant drugs such as cocaine or amphetamines, known as speedballing. Some describe it as getting both stimulation and sedation at the same time, but this is an extremely risky mix. The stimulant can mask the opioid's sedative effect, making it difficult to tell when the dose is too high. When the high wears off, the opioid can kick in with full force and cause respiratory arrest.

When used, opioids often provide euphoria, relaxation and a sense of well-being. At the same time, there is a high risk of addiction and overdose, especially when combined with other depressants such as alcohol, GHB/GBL or benzodiazepines. Read more about how Naloxone can reverse opioid overdoses in the section on Naloxone.

Desired effects

• Pain relief and strong relaxation
• Euphoria and well-being
• Reduced worry and anxiety
• When speedballing: combination of energy and calm

Undesirable effects

• High risk of addiction and overdose
• Respiratory effects, especially in combination with other depressants
• Extremely high risk in case of speedballing (cardiac and respiratory arrest)
• Fatigue, nausea, constipation
• withdrawal with anxiety, sweating, pain and difficulty sleeping
• May occur as an admixture in other drugs (see section on fentanyl)

Poppers

Poppers (amyl/butyl nitrite) is a volatile solvent (nitrite) that is inhaled through the nose directly from the bottle. The effect comes within seconds and lasts for a few minutes.

Poppers are often used in the context of sex because they relax muscles in the rectum, which can facilitate anal sex, and provide a brief intense sensation of heat, dizziness and increased sensitivity.

The main risks are a drop in blood pressure, dizziness, headaches and nausea. Poppers can damage eyes, nose and skin if the liquid comes into direct contact. Combination with potency drugs can be life-threatening due to sudden drop in blood pressure. Poppers should never be drunk or swallowed as they are highly toxic and can be life-threatening

Desired effects

• Rapid intoxication and dizziness
• Muscle relaxation (especially in the anal muscles)
• Enhanced sexual sensitivity

Undesirable effects

• Headache, nausea, dizziness
• Risk of blood pressure drop and fainting
• Dangerous in combination with contraceptives
• Skin and eye damage by direct contact