Feb 5 • Jo Cox-Brown

Managing Chemsex-Related Risk in Cities and Accommodation: A Practical Guide for Hotels, Short-Term Lets and Local Authorities

Chemsex has become an increasingly visible issue in many cities worldwide.

It sits at the intersection of drug use, sexual health, mental health, housing and community safety, which means hotels, Airbnb / short-term lets and city authorities are often drawn into it sometimes without realising what they’re dealing with. 

This guide offers a high-level overview of what chemsex is, why it matters, and how cities and accommodation providers can respond safely, in partnership with specialist services and communities. 

What is 'Chemsex'?

“Chemsex” is a term used to describe sexual activity that is deliberately combined with psychoactive substances to facilitate, prolong or intensify sex. It has been particularly documented among gay, bisexual and other men who have sex with men (GBMSM), but is increasingly seen in other communities too.

Common features include: 
  • Use of specific drugs such as crystal methamphetamine, GHB/GBL and mephedrone, sometimes alongside other substances and erectile-dysfunction medicines. 
  • Encounters arranged via dating / hook-up apps, often with multiple partners.
  • Sessions that may last many hours or days, frequently taking place in private homes, hotels, short-term lets, saunas or sex venues.

For cities and accommodation operators, chemsex is relevant not because they are “hosting chemsex parties” intentionally, but because their spaces can be used for them, sometimes with associated medical, safeguarding, or nuisance risks.  

Why does Chemsex need to be managed safely?

Chemsex is associated with a cluster of health, safety and community impacts: 

  • Overdose and medical emergencies – particularly with GHB/GBL, which has a very narrow margin between a “recreational” dose and overdose, and when multiple substances are combined. 
  • Increased risk of HIV and STIs due to prolonged sessions, condomless sex and multiple partners. 
  • Mental health harms including anxiety, depression, dependency, psychosis, and trauma – often linked to stigma, isolation and minority stress. 
  • Violence, exploitation and crime, including sexual assault, theft, coercion, and, in some tragic cases, deaths linked to chemsex sessions. 
  • Neighbour and community impact – noise, high footfall at odd hours, and visible emergency responses can affect perceptions of safety and liveability. 

From a governance and business perspective, unmanaged chemsex-related risk can lead to: 

  • Reputational damage for accommodation brands and districts 
  • Legal and regulatory consequences if safeguarding duties are not met 
  • Staff exposure to distressing situations without training or support 

For these reasons, cities and accommodation providers cannot ignore chemsex; they need frameworks to respond safely and compassionately, without stigma. 

Practical steps cities, hotels and short-term lets can take

The aim is not to police private behaviour, but to reduce harm, protect guests, and meet legal and safeguarding duties. Key actions include: 
01

Acknowledge the issue in policy: 

Recognise chemsex as a known risk scenario in your city drug and sexual-health strategies, night-time economy plans and hotel / STR (short-term rental) risk assessments. Integrate references to drug- and sex-related harm, exploitation and emergency response into existing safeguarding, guest-behaviour and “house rules” policies. 
02

Train frontline staff: 

Staff don’t need to be experts in chemsex, but they do need to recognise:
  • Signs of acute distress or overdose (unconsciousness, breathing difficulties, seizures, severe confusion) 
  • Indicators of exploitation or coercion (someone appearing very intoxicated, distressed, or trying to leave but being blocked) 
  • When to escalate to management, security or emergency services 

Cities can support by commissioning joint training for hotels, short-term let agencies, BIDs and night-time operators, linked to local sexual health and harm-reduction services. Toolkits from UNAIDS, regional HIV services and European harm reduction networks all stress the value of non-judgemental engagement and clear referral pathways
03

Video Conferencing

 Hotels and STR managers should have:
  • A simple protocol for when staff should call emergency services (e.g. unresponsive guest, suspected overdose, serious injury or assault). 
  • A process to direct emergency responders quickly to the right room/flat. 
  • Guidance on preserving privacy and dignity while ensuring safety. 

This can be integrated into existing first-aid, fire safety and critical-incident procedures. 
04

Strengthen safeguarding and guest welfare: 

Build in welfare checks where there are repeated noise complaints, prolonged “Do Not Disturb” signs, or visible signs of distress. 

Have a clear process for what staff can do if they are worried about a guest’s immediate safety – including involving security, managers or the police. 

Ensure your policies are explicit about sexual exploitation, trafficking, and child/young person safeguarding, drawing on existing hotel guidance on exploitation as a baseline.
05

Provide information and signposting: 

Working with public health partners, cities can help hotels and STR operators to:
  • Display or discreetly offer information cards signposting local sexual health clinics, emergency numbers, mental-health and LGBTQ+ support services. 
  • Include links to local helplines and services in digital guest guides or check-in emails. 

Evidence from chemsex toolkits in Europe and Asia-Pacific suggests that non-judgemental, clearly signposted support encourages earlier help-seeking and reduces harm
06

For Airbnb and short-term lets: 

Platform hosts and professional STR managers can: 

  • Set clear house rules about maximum occupancy, parties and noise, and enforce them consistently. 
  • Provide guests with basic local safety information (emergency numbers, nearest emergency department, local complaints procedure). 
  • Have a process for responding to repeated neighbour complaints that balances guest privacy with community safety. 

Cities can support by working with platforms and professional managers to align expectations and communication around nuisance, safeguarding and emergencies. 

Who needs to be involved?

A safe, effective response to chemsex is inherently multi-agency. The following partners have important roles: 
  • Local authorities / city governments – setting policy, coordinating partnerships, and embedding chemsex within wider drug, HIV/STI, mental-health and night-time economy strategies.
  • Public health and sexual health services – providing clinical care, outreach, health promotion, and specialist chemsex support where available
  • LGBTQ+ and community organisations – offering peer support, advocacy, and culturally competent harm-reduction messaging
  • Hotel groups, STR operators and BIDs – adopting consistent policies, training staff, and sharing learning and data (within privacy laws). 
  • Police and ambulance services – co-designing response protocols focused on safety, not automatic criminalisation of guests seeking help. 
  • Platform companies (e.g. OTA and STR platforms) – incorporating safety expectations, reporting routes and information-sharing mechanisms in line with local regulations. 
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 Examples of emerging best practice:

1

London, UK

Sexual health services in London have pioneered dedicated chemsex support pathways, combining sexual-health care, mental-health input and harm-reduction advice. Some clinics have developed chemsex safety kits (with information, safer-use materials and contacts) to reduce harms among those already engaging in chemsex.
2

Asia-Pacific

A recent Asia-Pacific chemsex toolkit for clinical service providers, developed with UNAIDS and regional partners, offers structured guidance on non-judgemental engagement, risk assessment, and integrated sexual-health and mental-health responses.

Although aimed at clinicians, it demonstrates how clear, regionally adapted standards can support services that people trust and use. 
3

Barcelona, Spain

Qualitative research on chemsex in Barcelona has informed understanding of how and why people engage in chemsex, what harms they experience, and what prevention they say they need. This has been complemented by training programmes for health professionals on chemsex (including role-play workshops on clinical response). For cities, this kind of evidence-informed, capacity-building approach is a strong model to emulate. 
4

South East Asia

Community groups such as Lighthouse in Vietnam and others in Eastern Europe and Central Asia have developed peer-led outreach, online content and helplines tailored to MSM and transgender communities involved in chemsex, including digital campaigns and Q&A services.

For local authorities and hotel sectors, partnering with such organisations can provide trusted referral routes and culturally competent support for guests and residents. 

5

Europe

European networks have produced harm-reduction manuals for chemsex that emphasise the importance of low-threshold services, non-stigmatising communication and the provision of appropriate equipment to reduce high-risk behaviours.

These documents don’t excuse or endorse drug use; they aim to prevent deaths, infections and long-term harm, which ultimately benefits communities and services. 
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Final thoughts

For cities, hotels, Airbnbs and short-term let operators, chemsex is not just a “niche” issue, it sits squarely within public health, safeguarding, night-time economy management and brand reputation. 

A constructive response doesn’t mean condoning illegal activity; it means: 
  • Recognising chemsex as a real and evolving phenomenon 
  • Equipping staff to respond safely and compassionately 
  • Building clear partnerships with health, community and emergency services 
  • Protecting guests, neighbours and staff from preventable harm 

Handled well, this becomes part of a wider commitment to safer, more inclusive nights, where people feel able to seek help early and where cities balance freedom, privacy and safety with care. 
#Chemsex #HarmReduction #PublicHealth #Safeguarding #NightTimeEconomy