Fact Sheet 9 – 10-minute chemsex decision tree

Objective

Provide an ultra-practical sequence for brief consultation, without trying to "treat" everything at once.

Opening (30 seconds)

• « My objective today: safety + a simple plan. »

1. Quick assessment (2 minutes)

• Context : frequency, session duration, solo/group, app/locations, isolation.

• Products : stims, GHB/GBL, cathinones, cocaine, poppers, alcohol/benzos, others.

• Routes : oral/sniff/inject (slam).

• Harm : loss of control, STI/HIV/HCV, consent, somatic, crash, psych.

➡️ If slam : activate slam sheet + screening/care.

2. Emergency triage (1 minute) — “Is there a recent or probable vital risk?”

Yes if:

• coma/black-out/difficult waking up, worrying breathing (GHB)

• chest pain, seizures, hyperthermia, dangerous delirium (stims)

• violence / immediate danger / acute suicidal thoughts

➡️ If yes: emergency plan + call 15/112 + securing + rapid referral.

3. VAS craving (2–3 minutes) — sheet 3

• Rate 4 moments (average/peak/current/trigger)

• Max VAS = safety level

  • 0–3: basic HR (harm reduction)

  • 4–6: organization (buddy, spacing, return)

  • ≥ 7 : written safety plan (sheet 4)

4. Safety plan (2–3 minutes)

If VAS ≥ 7 or high-risk party: fill in buddy + STOP + return + consumption rules + when to call.

5. Referral / care (1 minute)

According to needs:

• CEGIDD : PrEP/PEP, screening, vaccinations

• CSAPA/addiction center : craving, reduction/stopping, groups, support

• Psych : anxiety, mood, trauma, psychosis, suicidality

• CAARUD : slam, sterile equipment, wound care, support

6. Closing (30 seconds)

• « We keep this plan for 2–3 parties. We take stock afterward. »

• Schedule a short next contact (or message) + indicators: max VAS, incidents, sleep/crash.