Chemsex and First Aid

Page last reviewed 1.10.2026

During chemsex and while under the influence of substances, accidents and other incidents may occur more easily. Dangerous situations may arise not only from the substances themselves, but also from impaired judgment, coordination, or reduced pain perception due to intoxication.

It is good to be prepared for injuries and other emergencies by keeping first aid supplies available and refreshing first aid knowledge and skills. This helps ensure that those present know how to care for one another and how to seek help when needed. When participants can trust that they will be taken care of in case of emergency and no one will be left alone, it’s easier to relax and enjoy yourself.

Since chemsex and the use of illegal substances are strongly stigmatised in our society, seeking treatment for situations related to these may feel challenging or even frightening. Many worry about how the situation will be perceived in healthcare settings. However, it is particularly important to seek help in time when it is needed. This way, even greater and more serious harm can be avoided. Everyone deserves help and proper, humane treatment.

• CIt is good for chemsex parties to have first aid supplies, such as an up-to-date first aid kit. This allows minor accidents, such as wounds, burns, or sprains, to be treated immediately. It is important for the location of the first aid kit to be known to all participants.
• It is important for all participants to know the exact address of the party location so that participants know how to call for help and direct it to the right location if needed.
• If you encounter someone in a poor condition, move them to a quieter space if possible. Do not leave the person alone; stay with them to monitor their condition, provide support, provide basic first aid if needed, and call for help when necessary.
• If you or another participant is in a worrying condition, immediately call for help from the emergency number 112. Paramedics will arrive to the scene because of the participants’ health, not the illegality of the substances used. They are also bound by confidentiality. In health-related situations, the police do not usually come to the scene unless there is suspicion that it would not be safe for the emergency services to arrive by themselves or a crime, such as assault, has occurred.
• It is advisable to download the 112 app to your phone in advance, through which you can make an emergency call so that your phone transmits your location to the emergency centre, and help can find its way.
• Stay and monitor the person in need of help until the emergency services arrive. Call the emergency centre again if there are changes in the person’s condition.
• If you’re unsure whether the situation requires urgent medical help or not, you can always ask for advice by calling the Finnish Medical Helpline 24/7 at 116117. You can also call them for first aid or self-care instructions.

Overdoses

Overdose symptoms vary depending on the substance used and its properties, such as whether the substance stimulates or depresses the central nervous system. The combined use of different substances increases the risk of overdose.

In addition to other substances, the possibility of overdose is influenced by the purity and strength of the substances used, dosage, frequency of dosing, the user’s tolerance to the substances used, and underlying physical and psychological symptoms. The method of use also affects the risk of overdose. Intravenous use particularly increases the risk of overdose.

If you suspect an overdose in yourself or another person, or if you are unsure whether it could be an overdose, call for help from the emergency number 112. In the case of overdoses, the principle “better safe than sorry” applies when calling for help—you may save a fellow human’s life.

If you suspect an overdose or notice even one or more symptoms of overdose, it is time to call for help from the emergency number 112.

Symptoms of an overdose of central nervous system stimulants may include: 

• High body temperature, heatstroke, fever
• High or irregular heart rate
• Chest pain
• Rapid breathing, breathing difficulties
• Respiratory arrest
• Muscle twitching, seizures
• Sudden, severe headache
• Difficulty standing, loss of coordination
• Decreased level of consciousness, responds weakly to stimulation or shaking
• Unconsciousness or coma
• Severe agitation, restlessness, panic, or aggression
• Delusions, paranoia, psychosis

Symptoms of an overdose of central nervous system depressants may include:

• Slowed or irregular breathing
• Snoring, gurgling, or choking sounds
• Respiratory arrest
• Decrease in body temperature
• Bluish or purple lips or fingertips, pale skin
• Tremors, seizures
• Confusion, difficulty speaking
• Drowsiness, desire to go to sleep
• Lethargy, weakness
• Decreased level of consciousness, responds weakly to stimulation or shaking
• Unconsciousness or coma

Often, overdoses may also involve the combined use of different substances, which can cause unpredictable symptoms. Some substances can also act as either central nervous system stimulants or depressants depending on the dosage. Therefore, it is best not to spend too much time trying to interpret symptoms. Instead, call the emergency centre.

Unconsciousness and lifelessness

It is always important to keep an eye on participants who appear exhausted, unresponsive, or are showing other concerning signs, and to ensure that their condition is not the result of an overdose causing unconsciousness or unresponsiveness. Follow the instructions below and, if possible, share tasks with others present. One person can call the emergency centre and direct emergency services to the scene while others continue to provide first aid.

Seizures

Some substances affect brain functions in a way that seizures may occur more easily when using substances. A person may have seizures in an overdose situation or, for example, due to a brain function disorder, cerebrovascular disorder, cardiac arrhythmia, or metabolic cause triggered by intoxicants.

Chest pain and cardiac symptoms

Many substances used in chemsex significantly strain the heart and circulation. Substances can increase the risk of, for example, rapid heartbeat, arrhythmias, increased blood pressure, chest pain, heart attack, heart failure, or blood pressure regulation disorders.

Palpitations or an accelerated heartbeat is often temporary. However, any unusual cardiac symptoms or chest pain should be monitored carefully and taken seriously. Cardiac symptoms can be particularly serious in cases of combined substance use, overdose, long-term use, or in individuals with heart disease.

Regardless of the substance used or the underlying cause, a person experiencing sudden or severe chest pain requires immediate attention. Chest pain may also present as heavy breathing and a tight, squeezing or pressing sensation in the chest. Sometimes the pain can radiate from the chest towards the left armpit, arm, or neck. The person may also appear pale, clammy, and distressed, and may also experience nausea and vomiting. Symptoms can vary considerably between individuals.

Mental health

Substances often have strong psychological effects. Some of these effects may be desired, while others can be distressing, frightening, or destabilising to mental health.

• Substances can cause feelings of unreality, confusion, anxiety, fear, or panic attacks. If you notice someone becoming distressed or withdrawing from others, check on their well-being and do not leave them alone.
• If a person is experiencing psychosis and is not present in this reality—for example, expressing beliefs that they are disconnected from reality, showing signs of paranoia, or is experiencing hallucinations—encourage them to stop using substances and to rest. If possible, encourage them to sleep.
• If possible, guide the affected person to a calm space. Speak to them in a calm, reassuring manner and let them know they are safe. If the person is confused or disoriented, you can remind them where they are and what is happening around them.
• You can also help them take care of their basic needs, such as drinking water, eating, or taking a moment to rest. However, do not give the person water during if they are breathing very heavily.
• Psychotic symptoms can feel scary and confusing for the person affected and to those around them. It can be difficult to know how to respond in such situations. Remember that you can always call the emergency centre 112 for help. It’s especially important to call 112 if you believe that the person may be a danger to themselves or others, or if their condition lasts long and persists after the effects of the substances have worn off.
• If a person becomes restless and aggressive under the influence of substances, it is important to remain particularly calm yourself. Give the person space and avoid sudden movements. Listen to them and speak slowly and calmly. Avoid escalating the situation by arguing or forcing them to do something. If the behaviour becomes threatening or aggressive, ensure that you and others are safe, leave the situation and call 112 immediately.

Situations related to sexual activity

Substances can enhance sexual desire and make people more impulsive, uninhibited, or willing to experiment. They can also increase endurance in sexual activity and reduce the perception of pain. During chemsex, sexual activity may be more frequent, last longer, or be more intense or “rougher” than usual. While under the influence of substances, it may be more difficult to recognise when sex becomes too intense for one’s own body or is causing injury. Being under the influence of substances can also make it harder to recognise and respect both your own boundaries and those of others.

Long periods of sexual activity, along with substances that can strain the body, can lead to exhaustion, dehydration, overheating, and excessive sweating. Under the influence of substances, hunger, thirst, or exhaustion may go unnoticed, but these needs remain important. During chemsex sessions, it is important to take regular rest breaks, stay hydrated, consume something salty, and to cool the body, for example by taking a cool shower or going outside for fresh air.

Before engaging in sexual activity, it is important to clearly agree on boundaries and a safe word, and to ensure that the equipment used for sex is safe and appropriate. This prevents unwanted pain, injuries, or misunderstandings.

During sexual activity, it is important to check in regularly with sexual partners about their well-being and consent. If you experience any discomfort or pain during sex, it is important to communicate this to your sexual partner or partners. This allows adjustments to be made to enhance the sexual experience, such as using more lubricant, changing sexual position or activity, taking a break, or stopping sexual activity altogether.

Abrasions and wounds in the genital and anal area

Abrasions, ulcers, and bleeding in the genital and anal areas can be prevented by using plenty of lubricant and taking breaks from sexual practices that place strain in these areas. In fisting, it is also advisable to keep nails short, remove rings and other jewellery, and use gloves.

Seek medical attention for a wound in the genital or anal area if

• the wound is jagged, deep, or several centimetres long.
• there is a foreign object in the wound.
• bone, muscle or other tissue is visible in the wound.
• there is heavy bleeding, or the bleeding does not stop.
• there is dirt in the wound that you cannot clean yourself.
• the wound becomes inflamed.
• the tetanus vaccine is not valid.

Instructions for treating wounds other than in the genital area and large bleedings can be found here.

Object stuck in the rectum or vagina

Only objects designed for purpose should be inserted into the anus or vagina. Objects inserted into the anus should have a stopper or a widened base.

If an object becomes stuck in the anus or vagina and does not have sharp parts, the person may try to gently expel it using the pelvic floor muscles while themselves or another person very gently assists in removing it. If the object has sharp parts, or cannot be removed safely, emergency medical care should be sought immediately, or the emergency number 112 should be called.

Priapism

Priapism refers to a long-lasting, involuntary, and often painful erection. It is commonly caused by injectable erectile dysfunction medications, which may also be used in chemsex. Priapism can also be caused by other substances used in chemsex, such as cocaine, alcohol, and certain medications. Prolonged sexual arousal has also been considered a possible contributing factor.

If you notice that an erection has developed into priapism, you can first attempt to resolve the situation yourself. Moderate physical exertion, such as walking, squatting, or walking upstairs, followed by taking a cold shower, may help relieve priapism.

If priapism does not subside, it is essential to seek emergency care as soon as possible. After four hours, the condition often becomes more painful. If it continues longer, it can cause damage to penile tissue. Therefore, it is important to seek medical care, where priapism can be treated effectively.

Consent and sexual violence

Being under the influence of substances can also make it more difficult to ensure consent and clear communication between all parties. Therefore, even during sexual activity it is important to pause to agree in advance on what kind of sex is expected, and to check in during sexual activity on how everyone is feeling and whether to continue, change something, take a break, or stop sexual activity altogether.

During sexual activity, it is always important to ensure that no one’s boundaries are crossed or violated. This is especially important when under the influence of substances, as recognising and expressing boundaries can be more difficult. Under the influence of substances, people can become more impulsive and more likely to agree to or do things they would not do when sober. Clear communication and ongoing consent help prevent harmful experiences and sexual violence.

Have your boundaries been violated? Have you experienced sexual violence?

• Ensure that you are safe. Go to a safe, calm environment. If possible, stay in the company of safe people.
• The situation was not your fault. The events may bring up many difficult emotions, sometimes also guilt and shame. However, nothing justifies the violence or its attempt done to you.
• Call for help from the emergency number 112 if the situation has just happened and you are able to do so.
• Avoid washing or changing clothes after the incident, even if you feel the urge to do so.
• Seek professional help as soon as you can. It is particularly important that you receive the support and advice you are entitled to.
  • If the incident happened less than a month ago, contact the nearest Seri support centre as soon as possible. Seri support centres are support units for victims of sexual violence for all individuals over 16 years of age, regardless of gender. Making a crime report is not a prerequisite for seeking help from the support centre, although it is encouraged. If going to a Seri support centre is not possible, go to your local emergency room. You can take a close person with you to the services. 
  • If more than a month has passed since the incident, contact, for example, the Rape Crisis Centre Tukinainen, which serves all genders, Victim Support Finland, Mieli Crisis Centre’s local or online support or the health centre or mental health services of your well-being services county.
  • In all kinds of situations, you’re also welcome to talk about it confidentially at Hivpoint’s counselling service.
• Making a crime report is recommended and very important, as a crime has been committed against you. The crime report should be made at the police station. You can take a close person with you if you wish. You can look for the nearest police station here.
• You’re not alone in this. Talking about what happened can be difficult, but it can help. If there is a trusted person present, you can tell them about the incident immediately. Additionally, it is good to talk to a close person and a professional. You do not have to cope alone. Close people such as friends and family and professionals can support you in getting help and recovering.
• Give it time. It is natural that recovering from the situation may take time. Recovery is still possible, and you have the right to receive support in it from close people and professionals. You can also explore the Mielenterveystalo’s self-help program for recovering from sexual violence (in Finnish or Swedish).

Heatstroke and hypothermia

Many substances affect body temperature. Stimulants often used in chemsex can raise body temperature and lead to overheating, excessive sweating, and, in severe cases, heatstroke. Central nervous system depressants, on the other hand, can lower body temperature and, in extreme cases, lead to hypothermia.

In heatstroke, the person’s skin often becomes hot and red, their pulse quickens, and they may be confused or lose consciousness.

Symptoms of hypothermia depend on how low the body temperature drops. Symptoms of mild hypothermia may include shivering, cold and pale skin, and restlessness while the person’s level of consciousness remains normal. As body temperature continues to drop, shivering may stop; however, consciousness may decrease, judgement may become impaired, and the person may become confused and drowsy. In severe hypothermia, a person may lose consciousness. Muscle stiffness and arrhythmias may also occur and, in severe cases, breathing and heart function may stop.

Accidents

When under the influence of substances, coordination and judgment are impaired, making us more prone to various accidents. Sometimes it’s about stumbling or recklessness caused by intoxication but can also involve more serious situations directly related to chemsex and substance use.

Abrasions, wounds, and bleeding

Abrasions, wounds, and bleeding can occur from accidents caused by intoxication, as well as from rough or prolonged sexual activity or BDSM sessions under the influence of substances, from broken or sharp tools, or from accidents related to injecting.

For superficial abrasions and scratches, rinsing with running water and keeping the area clean and protected from further injury is often sufficient. An over-the-counter antibiotic ointment from a pharmacy may also help. If the abrasion or scratch does not start to heal within a few days, it is advisable to have it assessed at a healthcare centre.

Seek medical attention for a wound if:

• the wound is jagged, deep, or several centimetres long. 
• there is a foreign object in the wound. 
• bone, muscle or other tissue is visible in the wound. 
• there is heavy bleeding, or the bleeding does not stop. 
• there is dirt in the wound that you cannot clean yourself. 
• the wound becomes inflamed. 
• it is a bite wound. 
• the wound is in the joint area or on the face. 
• the tetanus vaccine is not valid.

Burns

Heated equipment or inhaling hot smoke can cause burns. Some equipment can also cause a burn when placed, for example, in a pocket after use and burns the skin through the fabric. Burns can also occur when smoking while under the influence of substances.

If you are unsure whether you should seek medical care immediately for a burn, you can call the Medical Helpline 116 117 for advice 24/7.

Falls, head injuries, sprains, and fractures

While under the influence of substances, one is more prone to falling and stumbling. Falls that involve a blow to the head are particularly dangerous, and these situations should be carefully assessed. Instructions for first aid for head injuries can be found on this Finnish Red Cross website.

Falls can also lead to sprains or fractures. Instructions for first aid for sprains and joint injuries can be found here, and for fractures here.

Needlestick injury

A needlestick injury refers to a situation where a needle used by another person accidentally punctures the skin.

Skin infections

Skin infections that appear after chemsex are most often a result of injecting substances or side effects of drugs such as methamphetamine, which may include compulsive skin picking or scratching.

Mild, very localized inflammation can be treated by keeping the affected area clean and dry and applying an over-the-counter antibiotic ointment from the pharmacy.

The earlier treatment of inflammation begins, the better the outcome and the lower the risk of serious complications.

In severe cases, untreated inflammation can lead to sepsis, or “blood poisoning”, where microbes from the inflamed area spread into the bloodstream and cause an inflammatory response in the body that damages organs. The most common symptoms of sepsis include a rapid deterioration in general condition, high fever, and malaise. As the condition is life-threatening, the person affected must receive immediate treatment. If sepsis, or “blood poisoning”, is suspected, call 112 immediately.