By Dean J. Connolly, Santino Coduri-Fulford c, Katherine Macdonald , Gail GilchristLuke Muschialli

Sexualised drug use (SDU) is a highly prevalent phenomenon of increasing public health significance in communities of men who have sex with men (MSM). This prospectively registered PRISMA-ScR-adherent systematic scoping review examines the current state of knowledge surrounding violence amongst MSM in the context of SDU. A broad search was conducted across four databases, with no restrictions. Studies citing or cited by all database-identified records retained for full-text review were retrieved and screened. Three journals were hand searched across the past five years, and three searches were conducted on Google Scholar. In addition, 13 key opinion leaders were contacted via email to request any additional published or unpublished data. The twentyeight studies included in the final synthesis reported mostly qualitative data from geographically diverse nonrepresentative samples, predominantly relating to sexual violence with other typologies seldom investigated or reported. Although quantitative data were limited, sexual violence appeared common in this context and was directly associated with impaired mental health and suicidality. Some participants reported first- or second-hand accounts of non-consensual administration of incapacitating doses of GHB/GBL to men who were subsequently raped. This was frequently perpetrated by men whose age, status, or financial privilege afforded them power over their victims. While reports from some participants suggested context-specific blurring of the lines of consent, a few quotes demonstrated a dearth of knowledge surrounding the centrality of consent in lawful sex. Given the historical denigration of MSM, any efforts to further investigate or address this issue must be community-led.

International Journal of Drug Policy

Volume 136, February 2025, 104706

By Drug Policy Alliance

We all want people living with addiction to get the help they need. At the Drug Policy Alliance, we believe that everyone should have access to the substance use disorder (SUD) supports that they choose to improve their physical and mental health — and that effective services should be available when and where people are ready for them, without hurdles like cost or preconditions to get help. In short, SUD supports should be voluntary, effective, affordable, accessible, and appealing.

Unfortunately, the United States has neither prioritized on-demand care nor ensured that available SUD supports are effective or beneficial. Having failed to provide even remotely sufficient access to the kinds of health-centered approaches that research shows are most effective (e.g., medications for opioid use disorder, or MOUD, and contingency management for stimulant use disorder, or CM), some ill-informed policymakers are advocating for expanding the power of courts to force people into existing SUD services, against their will and not of their choosing. This is not entirely new. Forced treatment has been a familiar practice in criminal courts for decades — where criminal defendants have had the “choice” to opt for court-ordered SUD services or face traditional sentencing, often including incarceration

New York: Drug Policy Alliance, 2024. 32p.