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FrancoAngeli Journals

Contributi Scientifici

No. 75 (2026)

Sessualità, uso di sostanze e dipendenza: un confronto clinico tra Sex Addiction e Chemsex

DOI
https://doi.org/10.3280/mis75-2026oa23671
Submitted
settembre 8, 2026
Published
2026-10-08

Abstract

This paper aims to provide a clinical and nosographic framework for sex addiction (Compulsive Sexual Behaviour Disorder, CSBD) and chemsex, examining their neurobiological similarities, clinical differences, and therapeutic implications.
Sex addiction – coded in ICD-11 as CSBD (6C72) under impulse control disorders, but absent from DSM-5 – is characterised by compulsive and recurrent sexual behaviours causing clinically significant distress and
functional impairment.
Chemsex, by contrast, constitutes a structured practice in which specific psychoactive substances (methamphetamine,
GHB/GBL, mephedrone) are intentionally used to amplify and prolong the sexual experience, predominantly among men who have sex with men (MSM).
Both conditions share a common neurobiological substrate – hyperactivation of the mesolimbic dopaminergic reward circuit – but differ in clinical complexity, at-risk populations, risk profiles, and therapeutic approaches.
Chemsex introduces a critical additional dimension: a dual craving (sexual and substance-related) alongside physical dependence on GHB/GBL, rendering treatment considerably more complex. Diagnostic criteria, psychiatric comorbidities, evidence-based therapeutic approaches, and the specific clinical challenges of each condition are discussed.

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