BY DUNCAN OSBORNE | Deaths from methamphetamine overdoses increased 160 percent from 2013 to 2014 in New York City, according to data from the city health department.
The department reports that “methamphetamine-involved overdose deaths” went from 13 in 2013 to 34 in 2014. The department does not have final data on 2015 deaths. Ninety percent of the 2014 deaths were among men, and the greatest increase in deaths was among New Yorkers aged 35 to 54. In an email, the department wrote that 64 percent of the deaths were among whites, but did not supply other demographic information.
The data comes from a surveillance system that the health department maintains with the cooperation of hospital emergency departments that allows it to monitor increases and decreases in illnesses, deaths, and other public health conditions.
More potent crystal meth that is made and distributed by drug trafficking organizations in Mexico may be causing more deaths. As federal and state laws regulating the ingredients used to manufacture meth have made producing the drug in the US more difficult, the drug trafficking organizations are making purer methamphetamine and shipping it into the US. The speculation is that traffickers are flooding America with cheaper product to create demand.
It could also be that the deaths result from more crystal in New York City and more gay and bisexual men using the drug.
Data from the National HIV Behavioral Health Survey that Peter Staley, a longtime AIDS activist, published on his blog on poz.com on February 2 indicate that meth use is increasing among men who have sex with men in the city.
The percentage of New York City gay and bisexual men in that survey reporting crystal use in the 12 months prior to taking the survey went from 13.8 percent in 2004 to 5.8 percent in 2008 to 4.3 percent in 2011 to 9.2 percent in 2014. Some of the increase may be due to researchers using different venues to recruit men for the study or changes in the demographics of the participants.
Other indicators support the view that there is more methamphetamine in New York City.
The federal Drug Enforcement Administration (DEA) told Gay City News that a measure of statewide drug seizures that the agency uses to make year-to-year comparisons is showing a significant increase in meth seized. The DEA seized 51 kilograms of crystal in 2014 and 56.7 kilograms in 2015.
In 2000, the agency seized less than a kilogram. Seizures climbed to 9.8 kilograms in 2005 and declined to 3.4 kilograms in 2010. The 2014 and 2015 seizures were typically bundled with large amounts of heroin and cocaine.
Other information also suggests that the availability of crystal in the city has increased.
Gay City News found 10 cases in federal court in Manhattan, some involving multiple defendants, dating to 2014 in which the defendants were charged with distributing crystal. The amounts the men were carrying at their arrests ranged from several hundred grams to multiple kilograms.
In 2004, 2005, and 2006, meth use among gay men in New York City received a burst of attention from AIDS and community groups, with the city and state funding anti-crystal campaigns. The DEA also made a series of high-profile arrests for meth distribution. Generally, the men in those earlier cases possessed far less crystal at their arrests than the amounts seen in the current cases.
The New York State Office of the Special Narcotics Prosecutor, which prosecutes felony drug cases throughout the city, told Gay City News that its meth seizures went from 22.4 kilograms in 2014 to 41.3 kilograms in 2015.
“They tell you that it’s rising and it has epidemic possibilities,” said Perry Halkitis, an associate dean at NYU’s College of Global Public Health and the founder of the Center for Health, Identity, Behavior, and Prevention Studies, referring to the DEA and city health department data. Halkitis has authored or co-authored more than 170 peer-reviewed journal articles on gay men’s health, including many studies of gay men and drug use.
If there are more meth users and more meth in New York City, it could have implications for the Plan to End AIDS, which aims to reduce new HIV infections from the current roughly 3,000 a year to 750 annually by 2020. Staley served on the task force that drafted the plan.
“It’s back to the drawing board,” Staley told Gay City News. “This is something New York State is going to have to add to its End the Epidemic portfolio. There’s no way to get to the numbers we want with an ongoing meth epidemic.”
In addition to the physical harm that it causes in users, meth is implicated in the spread of HIV because gay and bisexual men often use the drug in sexual networks. Meth use is associated with more condomless anal sex and greater risk for acquiring HIV. Men who are HIV-positive and using meth may have trouble adhering to their anti-HIV drugs, making them more likely to infect others.
“HIV incidence rates are double or triple among men who use methamphetamine, and it may be higher,” Halkitis said during a January 25 meeting with ACT UP.
The AIDS activist group recently created a committee to address meth use.
Should the state and city health departments and AIDS and community groups respond to crystal use among gay and bisexual men, those efforts will be complicated by the different needs and circumstances of African-American, white, Latino, and Asian men who use the drug. Halkitis’ research shows that African-American and white users tend to be poly-drug users, requiring any response to talk about more than just crystal. There is little research on drug use among Latino and Asian gay and bisexual men.