Date rape is just a pill away, and too often, men who have sex with men are most likely to do it.

Consent by both parties during sex is not only the right thing to do as Plus has reported – it’s mandatory and punishable by law in most countries. And too often, men who are victims of sexual assault or date rape fail to come forward out of shame stemming from drug abuse or the fear of being ridiculed.

The 2nd European ChemSex Forum was held on March 22-24 in Berlin, Germany. The first forum was held in 2016. Non-consensual sex among partners in the chemsex world, a problem that Europe shares with the United States, was the event’s signature highlight.

The first day of the Forum began with a training day for frontline staff from the World Health Organization (WHO) European region, and then two days of presentations with discussions for up to 250 participants. Many of the discussions revolved around the rampant prevalence of non-consensual sex.

“While chemsex responders and concerned service and care providers have been able to encourage practical responses to chemsex trends in some key cities in Europe, overall the response to chemsex has not kept pace with its developing impact across Europe,” an announcement from the International Drug Policy Consortium read, “chemsex ‘mature’ cities like London, Paris, and Amsterdam are mounting joined-up responses from both community and health services. Not so much in other cities however, where chemsex and its harms are still not fully acknowledged as a normal part of life in their gay communities.”

Gamma hydroxybutyric acid (GHB) is often used in tandem with crystal meth, and both drugs are used to supposedly enhance sexual pleasure. While crystal meth slowly and often irreversibly destroys the human body, mental health and relationships with family, friends and career, GHB can kill you instantly. People who practice chemsex also use GHB to induce a coma-like state – all for the pleasure of sex. GHB is a central nervous system depressant and can be used as a date rape drug or as an alternative to roofies (flunitrazepam) which is more similar to Xanax.

“We have heard many stories of men who, during sexual marathons that last for days, pass out on GHB or GBL, while the sex continues to take place,” said keynote speaker Leon Knoops of Mainline, a Dutch harm reduction organization. “When they come around, they often have no recollection of what happened. Men have spoken from two sides of the coin, and many wonder if this could be considered rape or if it’s just a part of the game. This often triggers immense shame and guilt.”

Other more recent illegal drug offerings like bath salts can cause similar — and sometimes worse — effects.

In Knoops’ keynote speech notes, he emphasized that he is not necessarily focused on drug users who are stable, whom he calls “the happy user,” but the drug users who end up in problematic and often dangerous situations. Knoops goes into great detail as to why certain drugs are attractive to homosexual men. It’s important to understand why people begin taking the drug in the first place.

Dr. Chris Ward of the Manchester Royal Infirmary and the city’s chemsex support clinic said he has asked drug users questions like “Have you ever received any unwanted sexual attention at parties?” and found that most men are afraid to come forward about sexual misconduct.

When Ward first confronted men with a set of questions, only 5 of 30 men disclosed non-consensual sex. But recently, after revising his set of questions, Ward said that 23 of 60 men attending the chemsex clinic have disclosed non-consensual sex.

Using drugs to enhance sex can put oneself in a compromised situation — and you may never be able to hit “rewind.”