More and more gay men are turning to needles to inject drugs and sexual enhancers (slamming). Many do not realise that they also run a high risk of HIV and hepatitis. So it's high time to practise the safer use rules in order to reduce the risks when injecting. By Florian Winkler-Ohm
For many gay men, alcohol and other drugs have always been part of (sex) parties. Recently, however, needles and cannulas - which are "traditionally" associated with heroin addicts - have become increasingly common in places where men have sex with men.
Splashing is now called slamming
With the so-called Slammingas the intravenous consumption of substances is known in the scene, in most cases methamphetamine is involved, meth for short (also known as crystal meth, tina, meth, glass, ice, sick or tweak). The substance, first produced in Japan at the end of the 19th century, was used by millions of German soldiers at the beginning of the Second World War under the name Pervitin: "Panzerschokolade", "Hermann Göring pills" or "Stuka tablets" were intended to keep soldiers awake and take away their fear in battle.
For some time now, perhaps for the last two years, crystal seems to be on the rise again in the party scene, at least according to the press. It is increasingly being consumed intravenously, i.e. by injecting it into a vein, whereas it was traditionally smoked, swallowed or taken through the nose. Consumers want to experience sexual pleasure and sex more intensely - and stay "fit" for a long time, which can also manifest itself in insomnia, sometimes lasting for days. A study by the Centre for Interdisciplinary Addiction Research at the University of Hamburg, commissioned by the Federal Ministry of Health, is currently investigating the actual prevalence and consequences of methamphetamine use.
But apart from the immediate physical and psychological effects of the drug, which not only has a high dependency potential but can also lead to physical and mental deterioration in the long term, there is also "collateral damage". Whether injected or otherwise consumed: The increased willingness to take risks and the suppression of the feeling of pain increase the likelihood of long and hard "sessions", during which no condoms are used and the mucous membranes are heavily strained. The risk of HIV, hepatitis and other infections is high - according to recent studies, up to 75 per cent of those who use crystal are HIV-positive. In addition, it is easy to forget to take HIV medication during long sessions, which can lead to resistance that requires a change in therapy.
When the syringe is cheaper than Viagra
But it's not just drugs that are increasingly being injected. More and more gay men are also injecting drugs such as Caverject or Androskat into their penile erectile tissue to achieve reliable potency; this is now cheaper than Viagra and comparable substances. The effect is an erection lasting one to two hours - if used and dosed correctly. Overdosing and hypersensitivity to the erection-promoting active ingredients can lead to a painful permanent erection. If this lasts longer than four hours, there is a risk of damage to the penile tissue, which can lead to permanent loss of erectile function, among other things.
But these are not the only risks associated with potency injections. As the contents last for up to three applications, it is not uncommon for syringes to be passed on to one or more partners during a sex session. Tibor Harrach, pharmacist and drug expert, warns urgently against this "needle sharing": "A small amount of bleeding can occur at the injection site during the injection. This can increase the risk of transmitting the infection to a partner in patients who suffer from a blood-borne infectious disease. With hepatitis B and C in particular, even an invisibly small amount of blood is enough to cause an infection."
Never share your syringe with anyone else
Harrach calls for clear prevention messages, such as those that have been in place for years for heroin users: "Never share your syringe with someone else" would be the most important one for him. He also advocates dealing with the scene in a way that is not based on accusations and demonisation, but on education and counselling. And last but not least, he recommends vaccination against hepatitis A and B and regular testing for hepatitis C: "If hep C infections are detected early, you can usually prevent them from becoming chronic - and from being transmitted to other people."
Information on the Risk minimisation on drug use and important rules for dealing with various substances can be found on our Drugs topic page. You can find instructions on how to do this in the "Safer Use" brochure. You can download this download here.
