Clarity about crystal: in Tweaked, his compelling expose and memoir, ex-addict Patrick Moore exposes the spiritual origins of say men's fondness for crystal meth. A revealing conversation with novelist Felice Picano.

Crystal meth use is epidemic, a pestilence that, while not specific to gay men and lesbians, is particularly harsh for us. Books and TV films (like Gia) about the devastating effects of the drug on people's lives are beginning to have some efficacy--what was seen a decade ago as recreational drug use is now beginning to be viewed as a wide and perilous path to gay self-destruction.

In the midst of all this, activist and author Patrick Moore's new book, Tweaked (Kensington Books), stands apart. Its literary quality is apparent, and it's a really artistic leap forward from even his excellent 2004 examination of the gay male sex culture, Beyond Shame.

It is Moore's sly melding of his own personal experience as an alcoholic and meth addict that really strikes home in the book. I've known Moore for some time and spoke with him about this mysterious and potentially deadly pandemic. (Find a longer version of this conversation by clicking on ISSUE ARCHIVES at Advocate.com.)

Picano: Having now read Tweaked, I'd like to know what you think causes the abuse of substances such as crystal meth.

Moore: I think addiction is a spiritual disease. The inclination to use drugs, at least for me, came out of a feeling of not belonging--not being connected to some feeling of well-being. I asked a kabbalah teacher once if his belief system had an explanation for addiction. He said our intention when we use drugs is to communicate with God, but because we're not spiritually equipped to do that, we're damaged when we try that shortcut. It's like a child seeing a beautiful flame and wanting to touch it, not knowing it will burn them.

So is crystal meth use a direct response to a pathology of coming out wrongly?

No, I think the issue isn't coming out. I think the issue is that what gay men come out into is a meaningless gay culture that is no longer about liberation or hope but about invisibility and conformity.

How can it be worse than what my generation faced? When we came out, there was no one else, and there was a great deal more resistance from the culture.

You weren't coming out so much as creating a gay world. That meant something. My coming-out meant membership in a world that was defined by one thing: AIDS. To come out into a culture defined by AIDS creates a hopelessness. That's what the world was to me in the early '80s. My generation came out into a gay society that had already been put together but that happened to be in flames. The place that should have been safest for us turned out to be the most dangerous.

For me, the most vivid portions of Tweaked were when you wrote about rehab sessions you were involved in. But they also struck me as extremely ego-destructive for the participants. Is that really part of the process? Is it essential?

First, a rehab is not the same as a 12-step meeting. Many of the people I see in rehab have tried for years, facing unbelievable consequences, to get sober--and yet they continue to get high. To get through to them involves a kind of therapy that from the outside seems brutal. No hand-holding is appropriate when people are at death's door because of their own willfulness--because of their own ego.

So their ego needs to be destroyed?

Yes, ego is the most destructive part of the addict's personality.

So a general reader is going to say, "I have a friend who is maybe using and I don't know what to do." What does he or she do?

This will also sound brutal: If you think someone is addicted to drugs or alcohol, you have to let them go. You have to tell them that you can't be in their life. There is nothing you can to do to help them. They are the only person who can help themselves. Of course, if they get sober, then your love and forgiveness can mean everything. But anyone who believes that they can love someone sufficiently to get them sober is fooling themselves. My own personal experience is that the friends who let me go because of my addiction helped me the most. That got my attention.

Picano has been nominated for three Lambda Literary Awards. Learn more about his work at FelicePicano.com.