This is not a design shop, despite its glass front with a transparently printed logo. Here, the Spot offers chemsexers information, specific RdR equipment (Roule ta paille, pipettes, dosers, syringes) and collective self-help evenings: on Tuesdays at 7:30 p.m., the “chillout chemsex Chemsex covers all the relatively new practices that have appeared among some men who have sex with men (MSM), mixing sex, most often in groups, and the consumption of synthetic psychoactive products. » is an opportunity to discuss the consumption of psychoactive products in a sexual context and the possible difficulties that they can cause. All in a self-support format between peers.
In addition to the chillout, the Spot offers individual interviews to talk about sexuality, product consumption, PrEP Pre-Exposure Prophylaxis. PrEP is a strategy that allows an HIV-negative person exposed to HIV to eliminate the risk of infection by taking, continuously or “on demand”, an antiretroviral treatment based on Truvada®. the intervention of health professionals (sophrologist, sex therapist, infectiologist, addictologist) and referral to partners and addiction services for stays and/or consultations. At Spot Beaumarchais, the team is leading a “mental health addict chemsex” project as part of a collaboration between Aides and 190, a sexual and reproductive health center. CeGIDD Free information, screening and diagnostic center (CeGIDD) for infections by human immunodeficiency viruses, viral hepatitis and sexually transmitted infections. These centers have replaced the anonymous and free screening centers (CDAG) since January 1, 2016.
Chemsexers are welcomed, directed after an initial interview towards addiction monitoring (at 190 or outside, with a psychologist, a doctor, a support worker, etc.); specific risk reduction consultations and/or a Reinforced Community Support Program (Parc).
Intended for chemsexers followed at the Spot by a doctor or a companion, but requiring additional support, the Park offers multidisciplinary consultations and workshops (adapted sport, visual arts, writing, hypnosis, etc.) to limit the symptoms of addiction and (re)learn how to make connections outside of chemsex and applications. Thibaut Jedrzejewski, director of 190, details the expectations.
What does the Parc system consist of?
Thibaut Jedrzejewski : It is a system that lasts three months, renewable once, or 6 months maximum. We started in the fall of 2021; 25 people have been supported since then. We try to include around ten people each time; about half of them do a first Park and then a second… It is a more flexible system than a hospital system that offers qualitative support. There is nothing obligatory. Several regular appointments are offered: an appointment with a speaker at least once a week – community support workers, nurses, psychologists, sexologist. And workshops: adapted sport, theater workshops, visual arts, group hypnosis, writing… depending on needs and budgets.
There are two discussion groups per month: a group to take stock of the Park, group dynamics, expectations, workshops and a free discussion space “the psy café” led by psychologists. We have two specific consultations: one for auriculotherapy, sometimes using the NADA protocol (National Acupuncture Detoxification Association) used for the craving among consumers of stimulant products in certain Csapa, notably in Gaia.
The other is foot reflexology, to work on the reappropriation of the body, in people for whom touch is complicated. We have very good qualitative feedback on these two consultations. They allow us to work on the relationship with the body with trained caregivers.
Chemsexers realize that they have not been touched for a long time. Settling down, feeling sensations other than very directly sexual ones opens doors to sexuality without products.
The goal is sexuality without products?
TJ: The objective is specific to the people. To enter the system, there must be a desire for change, in relation to the products, the rate of consumption or sociability, to find work again… On the addict side, the goal is not to stop completely, but for the person to find a relationship with the products that suits them, more serene… The chemsexers that we see are very often isolated, desocialized, consumption can reinforce or trigger this. The idea is to empower people, to show that there are other ways of forming a group, of meeting, than being in a direct relationship with sexuality, in the absence of desire, but in sexual excitement, to reinvest differently the bond that we create with people. The idea of the workshops is to take pleasure differently, in other circumstances.
Who is the audience for this device?
TJ : Chemsexers. We start from the definition of chemsex as a use of products in a sexual context specific to MSH Man having sex with other men. trans and non-binary people. They must have a problem because of chemsex and be seeking care. There are exclusion criteria: we do not integrate people who could put the group in difficulty, or vice versa, because the objective is to create a dynamic group, a space in which links develop, where people meet… We go through the prism of the social, sexual, emotional context of these populations.
How did this idea come about?
TJ: We were overwhelmed by events at 190, even when following patients together, we quickly felt limited in what we could do. Thomas l’Yavanc, an addiction specialist at 190, was inspired by outpatient day hospitals, to offer workshops and an almost daily presence to people in difficulty. We worked for two years on setting up the project with the Spot team. It took us a while to coordinate, around the idea of a community support center from Aides and a community health center like 190… The specificity is to manage to combine a community response, medical and non-medical, whereas generally these two centers are not used to working together.
What is missing from your program?
TJ : Funding! We operate as a health center with fee-for-service billing to health insurance and mutual insurance companies. We received partial funding from the ARS addiction fund. Everything else is currently compensated by Aides. But this system is expensive and we need to find other sources of funding to develop additional, more sustainable workshops… Above all, what is missing is a link with enough professionals who know the context and issues of chemsex. Caregivers need to address sexological and community issues: coming out and how one experiences one’s sexual orientation can be decisive in the complications of chemsex. There is a lot of confusion between chemsex and chemsex complications, between addiction and complications. Finding sensitive caregivers who offer comprehensive care is complicated. What is also missing is prevention: detecting problems before they arise. We could do screening and prevention through consultations HIV Human Immunodeficiency Virus. In English: HIV (Human Immunodeficiency Virus). Isolated in 1983 at the Pasteur Institute in Paris; recently discovered (2008) and rewarded by the Nobel Prize in Medicine awarded to Luc Montagnier and Françoise Barré-Sinoussi. or PrEP. But caring for people who have complications requires huge, multidisciplinary systems, with regular, time-consuming consultations that are trying for caregivers. And we need a community response: spaces to recreate connections other than through the question of sexual arousal, spaces where there is room for desire.
RdR tools
Tim Madesclaire, community facilitator at Spot Beaumarchais, is an expert on chemsex issues. He worked on the Apaches study (see Swaps n 92-93) and contributes observations and testimonies to the OFDT Trends reports on gay and other party spaces associated with chemsex.
With the Arpa project, he is developing self-assessment tools for “happy chemsexers”, who do not necessarily have a problem with the practice. “We are currently building a decision-making scale inspired by what Checkpoint does in Berlin,” he explains. “This tool allows us to draw lines between what we can do and what we no longer want to do in relation to chemsex. Those who do not have problems with chemsex cannot complete the picture… We could use it as an interview tool, but also distribute it on the internet, in bars.”
Spot Beaumarchais also offers the possibility of testing its products with the support of the TREND-SINTES Île-de-France system and the association “Analyse ton Prod’ Idf”. These analyses show that since the classification of 3-MMC as a narcotic in the Netherlands in September 2021, 3-MMC seems to be increasingly frequently replaced by 3-CMC or other cathinones with similar effects (3-MMA, 2-MMC, 4-MMC, DMBDP, etc.). Even if this substitution is sometimes unknown to the consumer who purchased the product, and to resellers who obtain supplies on the internet…
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