FEATURE | It is midnight when Dr Ilias Adam Yee visits Jim at his home for a private consultation.

Jim, 43, has been very emotional this week. He is paranoid about his surroundings, but he nevertheless tries to welcome Yee with a smile.

Jim lives in a luxury condominium in the heart of Kuala Lumpur. He worked for a leading firm in his field, before he was sacked.

Life was good way before he started taking crystal meth, short for crystallised methamphetamine.

Now he battles schizophrenia, a severe mental disorder that affects how a person thinks, feels and behaves, causing a patient to lose touch with reality.

“A person with mental illness has very high tendency of doing drugs,” said Yee, a sexual health, HIV and addiction clinician.

“They take drugs to make themselves feel better. But then, the symptoms become exaggerated by crystal meth. If a person takes drugs in the long term, it could also induce psychosis.”

Jim’s house is well-renovated and fully furnished. There are dumbbells on the floor, befitting Jim’s in-shape physique.

“Come, let’s have a sit,” he said, but he appeared to be in a state of stupor, his eyes hardly concentrating on the people he is speaking to.

He lost his job after a psychotic episode prompted police intervention.

“I am supposed to fly home today,” he said. “But I burnt my identity documents last night.”

He says this as a matter-of-factly, and continues to share his thoughts on Malaysian politics before heading to the kitchen to bring out refreshments.

The chemsex scene

It has been years since Jim was first referred to Yee, who at the time was the only physician on the ground known for helping drug-addicted gay men in Malaysia.

After serving up a bowl of lychee soup, Jim took out a water bong from his room and placed it on the table next to the television set.

The bong is similar to that used for marijuana intake, but this one is meant for methamphetamine.

The users smoke up the methamphetamine vapour, rather than inject themselves with syringes, so as to avoid scars.

The bong is considered the best way to take meth into the body, as it takes less than 10 seconds, and the high is more intensified than swallowing or snorting.

Injections - or “slamming” as it is known - are becoming less popular due to the high risks of side-effects.

Bacteria from the syringes could lead to abscesses, while sharing needles can lead to various virus infections such as Hepatitis B, Hepatitis C and HIV.

“Do you want it?” Jim asked nonchalantly.

If not for the physician doing his rounds, this could be a scene for a chemsex party - short for chemical sex party referring to the sex under the influence of chemical drugs.

At chemsex parties, party-goers take hits of meth, growing more and more aroused, before engaging in sexual intercourse, either with a partner or in a group.

White collar worker by day, meth dealer by night

Smoking meth is a daily routine for Jim, leading to many sleepless nights. He would sometimes have several sex partners a day, usually strangers, at home.

It is not very difficult for him to procure the drugs as his housemate is one of the biggest dealers in the town. To the rest of the unsuspecting world, however, his housemate is a white-collar worker in a top firm in Malaysia.

Friends or family members of the drug addicts come to Yee seeking help, especially when these addicts have lost control of their lives.

“I’m not going to stop them from doing what they are doing,” Yee said.

“I help them to improve their lives, to enable them to function well, help them to sleep. They are adults, and they can decide what they want.”

In some cases, he would take the patients to see psychiatrists.

“Most of my patients are between ages of 20s and 40s. Many are white-collared workers, and they had good, professional jobs,” Yee said.

But addiction of crystal meth led them into self-destruction. Many of these active chemsex users are also poly-substance users, taking crystal meth with GHL, Viagra and sometimes other amphetamines.

The third day after the crystal meth high is commonly known as the comedown, during which the users suffer severe withdrawal symptoms.

Withdrawal from meth is like the opposite of the euphoria users feel while on the drug and clinically, this is likened to deep depression.

It is like a general dissatisfaction with life, accompanied by physical symptoms that can be very uncomfortable.

The drastic drop in dopamine in the brain during meth withdrawal is the biggest reason that withdrawal from meth is so difficult and disruptive.

Since the levels of dopamine drop so quickly, this has a dramatic effect on the pleasure centres of the brain.

‘Underaged boys’

Ezra Akbar, an assistant researcher with the Centre of Excellence for Research in AIDS (Ceria) interviewed more than 50 people participating in the chemsex culture in Malaysia in the past two years.

These participants are from different demographics and aged from 18 to 50s.

“When you are on crystal meth, even a gentle touch will make you feel aroused. Your sensation grows stronger,” Ezra said.

“Putting on a condom is like putting a layer between the skins. It is like a counteract for some.”

Some participants told Ezra that there are underaged boys who trade their bodies for crystal meth in Kuala Lumpur, but he could not verify this.

He said a few chemsex addicts still managed to control themselves by putting on a condom, but this is a very rare case.

Ezra said some take crystal meth to do their work, as the drug keeps one awake for a long time, but even this does not apply to everyone. Effects can vary from one person to another.

“We understand that some sex workers do take drugs. Some take it in order to perform,” he said.

“Having sex with one person can be exhausting. For some of them, they might have to serve 10 customers a day.”

In Malaysia, chemsex is becoming more prevalent, with dating apps making it convenient for users to find partners with the same interests.

But the stigma is still high, with many local prominent lesbian, gay, bisexual and transgender (LGBT) activists still hesitant to share their thoughts on this issue, worrying about the backlash after it turns into a spotlight among the public.

“Their biggest concern is they don’t want the LGBT community to have another point to be attacked,” Ezra said.

“But this is happening, and we do know sex is happening among younger and younger people. We need to start talking about it, either sex or drug use.”

Yesterday: How chemsex may be raising HIV spread in M’sia

Tomorrow: How chemsex gained a footing in KL in the 1990s