Crystal's destructive path: gay men continue to be systematically ravaged by the deadly drug as officials try to stop an epidemic.
Charles, who declined to give his last name to The Advocate, flashes back to that night when a man he had met through the Internet gave him crystal meth during a sex date. On his first try, Charles was hooked in a rush of euphoria, of well-being, of being comfortable in his own skin for the first time. The other man, who was HIV-positive, insisted he and Charles bareback. Inspired by a sense of invulnerability brought on by the drug, Charles said yes.
Six weeks later he suffered high fevers, body aches, and violent migraines. He'd seroconverted.
Meth then devoured the rest of his life. He began bingeing daily, and his career floundered: It had been common for trim to pull in $1,000 a day as a consultant, but there was now a habit to support. He racked up $50,000 in credit card debt.
Tales like Charles's are becoming frighteningly common as crystal meth rages through the gay population, pushing HIV rates higher and compelling health officials to search for the best way to stop the epidemic. "We should be able to talk about crystal meth without maligning the users," says Ana Oliveira, executive director of New York City's Gay Men's Health Crisis, which has petitioned the city government to declare the local epidemic an emergency. "We need to launch educational campaigns about the pain and the addictive properties and where you can get help--without saying that people who are using crystal are bad, further adding to the feelings of depression and worthlessness that are the underlying causes.
The crystal meth wave, which began in the late 1970s, is neither a new problem among gays nor confined to gay enclaves. Most notably, it has destroyed the lives of many people in poor communities, especially in the rural Midwest and South.
Still, the increase in meth use among gay men is stunning. In the 1990s about 10% of the gay population reported using crystal meth at least once in the past three months. That number is now near 20%, says Perry Halkitis, a New York University associate professor and codirector of the Center for HIV/AIDS Educational Studies and Training. Recent research shows that 65% of gay men who describe themselves as club-drug users say they had used crystal meth in the past four months.
In New York City, Crystal Meth Anonymous now holds 18 meetings a week in three different locations, attended by more than 120 people, a spokesman says. Five years ago the group held just one meeting a week, typically attended by four or five people.
Public-health officials are particularly alarmed about the overlap between crystal use and HIV transmission. According to Halkitis, some research indicates that men who use are more than twice as likely to contract HIV as those who do not. A 1998 Los Angeles study on early HIV detection showed that nearly 60% of the men it surveyed had been infected while on crystal meth.
"We know from [HIV-]positive men that they are using meth in order to go out there and feel good and have lots of hot, unprotected sex," Halkitis says, adding that HIV-negative men are using the drug to socialize and also to have unsafe encounters. "Meth attracts a certain kind of man who Ls highly sexual to begin with, mid this substance allows the person to have the kind of sex he desires."
Addiction to crystal meth can set in within a week or two, experts say. After the high wears off, users tend to cash and become disconsolate, necessitating another binge. The cycle becomes endless, and long-term use can lead to cognitive impairment, paranoia, and memory loss.
"There is a feeling that you are being clear and functional, but in fact you are incoherent," says psychologist Barbara Warren, director of organizational development, planning, and research for the Lesbian, Gay, Bisexual, and Transgender Community Center in New York. "The stimulant gets ahead of you."
Another effect crystal has on HIV-positive men is an apparent weakening of their anti-HIV medications--if they can manage to keep taking them--and a consequent strengthening and replication of the virus, experts say. That means those seroconverting during unsafe crystal meth sex are likely to wind up with a virus resistant to anti-HIV drugs.
Behind gay men's meth addiction is a complicated array of psychosocial factors that include masking severe feelings of depression, isolation, low self-esteem, and shame about being gay. "Gay men internalize the shame and stigma associated with the sex they want to have," says Eric Altman, associate director of the institute for Gay Men's Health, a division of GMHC. "Crystal numbs that feeling of shame and silences it, while it enhances the feeling of being valuable and fabulous and not being damaged goods."
Crystal meth also mysteriously entwines with gay identity, sexuality, and HIV status, in that sexual pleasure is enhanced through a kind of orgiastic sexual risk-taking that leads to social bonding.
Scott, 35, who 'also declined to give his last name, was introduced to crystal at a circuit party in the mid '90s. "I wanted to use it because everybody else was," he says. He first took it to stay awake and party four days straight and to stay close to a love interest. That weekend turned into a yearlong addiction as he found that "the only people you can relate to are those you are doing drugs with."
For gay men who decide to quit, experts agree that a combination of education, outreach, and Weatinent is essential. Crystal meth is so addictive that users often need to make several attempts to break their habit. Some programs stress "harm reduction": that is, an addiction maintenance plan that attempts to minimize the drug's most destructive consequences, such as the tendency to overuse or have unsafe sex. Faith-based programs like Crystal Meth Anonymous, which stresses complete abstinence from the drug, are another approach.
Meanwhile, "there are a lot of guys who do crystal meth and who are not necessarily addicted, but they may be putting themselves at risk for HIV transmission," says Michael Siever, director of the Stonewall Project, a crystal meth recovery and HIV outreach organization in San Francisco. His group strand Tweaker.org, a Web site devoted to spreading information about crystal and HIV transmission as well as how to use responsibly. As controversial as this approach seems, it makes sense to some people.
"Everyone who has a negative experience with crystal moth wants to tell everyone else how horrible it is, and then there's all the name-calling and judgment," says a man named Michael, 30, who notes he's an occasional user now, though he went through a period of heavy use, then even a period of quit ring for about three years. "It is not that big a deal, really, and it's manageable."
But for those like Charles, occasional use is impossible. "I don't believe you can maintain a casual relationship with crystal," he says. "You're lying to yourself. That is my experience. I was obsessed with using and when I would use again."
Others who are frustrated with the lack of public education about the drug have taken matters into their own hands. Last October officials with the San Francisco Department of Public Health gave $425,000 to two nonprofits that provide health services to meth users. Experts estimate that up to 40% of that city's gay men have used the drug. "We have funds designated for HIV prevention--and my belief is, keeping people from becoming addicted to meth is one of the best ways to prevent new HIV infections," says Bevan Dufty, a San Francisco city and county supervisor.
In New York City, AIDS activist Peter Staley, who started AIDSMeds.com, spent $6,000 to take out ads about the threat of crystal meth use and HIV to display in three phone booths in the predominantly gay Chelsea neighborhood. The ads depict a buff man with a glimmering disco ball in place of his head. The text reads, HUGE SALE: BUY CRYSTAL, GET HIV FREE.
"This is an issue that we should be discussing as a community," says Staley, a recovering crystal meth addict and HIV-positive himself. "I am doing an inventory of my sexual history, and it is rather remarkable that there has been so little sober sex in that history, and this is very true of most gay men," he says. "At what cost is the sexual liberation that we hold so dearly as a community? What is it costing us?"
Quittner has written for Business Week, The New York Times, and the New York Post.
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|Publication:||The Advocate (The national gay & lesbian newsmagazine)|
|Date:||Mar 16, 2004|
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