Picture proto-queers fortifying themselves against the dangers of tearooms with occasional nips from ankle flasks of hooch. Gay men, I suspect, have always coupled sex and substance use. Certainly the organized community has been wringing its collective hands about that exigency since the advent of an organized community.
Not without good reason. Although gay men have combined sex, drugs, and dancing with the skill, enthusiasm, and devotion of elite athletes, the consequences have been mixed. A lot of us have had the times of our lives. But our rates of substance abuse are also higher than those in the general population. Many of us have successfully used many drugs recreationally. But crystal meth is now kicking more and more of our asses.
Psychologist Jeffrey Parsons, co-director of the Center for HIV/AIDS Educational Studies and Training (CHEST), told me he is screening out far more men than he is accepting for a new study on “recreational” drug use and unsafe sex “because they’ve already reached a threshold of dependence.” That is, they’re already addicted to tweak when they arrive at his door. He gamely refers them to treatment programs like Center Care at the Lesbian, Gay, Bisexual and Transgender Community Center, where nearly 25 percent of the clients are dealing with crystal meth abuse, a 50 percent increase over just two years ago. There they are often put on a waiting list, due to the backlog of guys with party drug problems needing help.
Crystal meth is to gay sex what the Pope is to Catholicism: your personal intercessor to the transcendent. Even guys to whom it has laid waste often tell you there is nothing that compares to sex on crystal. Thanks to its peculiar psychopharmacology, guys on crank go at it harder, longer, and with a lot more buddies.
And they often go at it without condoms—with sero-discordant partners, at a rate nearly three times that of men who don’t use, according to a recent CHEST study—undermining HIV transmission prevention efforts and fueling, in part, the resurgence of an epidemic we once had under control. Of the men who test positive for HIV at the Callen-Lorde Community Health Center, half say crystal meth was a contributing factor in their seroconversion, according to Dr. Dawn Harbatkin, the medical director there.
For men who are already positive, crystal can be devastating, leading to laxity in prescribed anti-HIV drug regimens, toxic or even fatal interactions with those meds, dementia, and the transmission of drug-resistant strains of HIV, according to Dr. Tony Urbina, medical director for HIV/AIDS education and training at Saint Vincent’s Catholic Medical Center in Greenwich Village.
Whatever your serostatus, “Chronic meth use equals major depression,” Urbina said.
So why are we partying with such an efficient weapon of homo mass destruction?
“A drug that makes you feel sexy, strong, and invincible is very compelling, particularly for gay men who have been stressed out by HIV/AIDS personally and sociologically,” said Barbara Warren, the former director of mental health and social services at the Community Center, where she now oversees all special projects related to crystal meth. It’s also fast-acting, long-lasting, and remarkably versatile, she pointed out—you can snort it, shoot it, smoke it, swallow it, or shove it up your butt. And it’s cheap, too.
Although it has begun making inroads among younger guys and communities of color, the men who have made crystal meth their drug of choice up until now—white men in their 30s and 40s—likely could have paid to use whatever drug they wanted. And heroin and cocaine are pretty versatile, too. So what’s so irresistible about Miss Tina?
“Crystal meth is the perfect midlife crisis drug,” offered Peter Staley, a longtime AIDS activist and founder of AIDSmeds.com, an information clearinghouse for HIV treatments. For HIV-positive men who feel like “tainted meat on the sex market,” crystal meth grants entrée to a world where “no one asks about HIV status, and you’re a young guy again.” Staley should know. Forty-three, HIV-positive, and struggling with a nasty crystal habit for years, he finally managed to put down the pipe 19 months ago.
But if we are all Ponce de Leon and crystal makes us feel like Don Juan, Peter Pan, and Achilles rolled into one, it also aids the one thing we value even more than sex: our workout routines. Methamphetamine is related chemically to those diet pills Mom used to take. While heroin, marijuana, or alcohol make you lazy, if not fat, guys on crystal can often keep every washboard ab intact. A cocaine high just isn’t as enduring.
“If there are gay men working out at a gym, there are guys doing crystal in the bathroom stalls,” Staley noted wryly. And Jean Malpas, a counselor at Center Care, confirmed, “Some people start their use in April to be fit for Pride Day.” In combination with the steroids often available to people with HIV, it can produce impressive results—until your teeth fall out, you metabolize your muscle, and you become paranoid and psychotic. Pretty is as pretty does.
Still, “a lot of meth use happens within a psychological context of wanting to be connected,” Malpas added. “Crystal is a cultural thing—a way to define your identity.” If sex on crystal is stellar, sex with someone else on crystal is cosmic bonding. “It becomes a way to fit in: crystal is the key that opens the door,” Malpas continued.
Bruce Kellerhouse, a psychologist with a Manhattan-based practice comprised primarily of gay men, concurred, saying that crystal use “stems from an individual hunger for connectedness, validation, and community.” Alarmed by the recent spike in HIV infections among gay men, he co-founded the HIV Forum to explore issues underlying that phenomenon, and has hosted several town meetings in the past year. “We’re trying to shift a community norm away from crystal meth. [But] the more people who do it, the more and more it looks like everybody’s doing it,” he said.
One big underlying issue is bereavement.
“The psychological impact of more than twenty years of AIDS-related losses is underestimated,” Malpas, who works with crystal addicts, observed. “People are taking health risks that they don’t know how to address, and there’s a lot of shame about it. The community is depressed, and instead of talking or honoring its grief, it’s taking a big pill.”
Turning grief into action, perhaps, Staley has literally become the community’s anti-Tina poster child, launching a guerilla ad campaign aimed at letting Eighth Avenue know that if the party isn’t over, it ought to be. He and fellow activists also floated a billboard through last month’s parade. The slogan? “Crystal Meth: Nothing to Be Proud Of.”
Fair enough. But it’s nothing to be ashamed of, either. Crystal meth addiction is a big problem, but it is also a symptom.
Gay men have always valued hot sex and hot bodies, have always sought out new ways to bond. But even if we never consciously acknowledge all the HIV-related dislocation and havoc, the specter of disease lurks under the bed on every conjugal visit with another gay man. Crystal may have an uncanny ability to promise temporary respite from that certainty, but it is still just as true when we sober up. So why have so many of us never adjusted our expectations of ourselves physically and sexually in the wake of AIDS?
Men who cannot find community except through the communal use of drugs are looking for something they’re not going to find at the end of a pipe.
“You’re basically setting up this pornographic experience that isn’t real and can’t be duplicated,” observed Saint Vincent’s Urbina of crystal meth use. Worse, “it blunts your ability to feel those experiences without [it].”
That we have not found a safe way to grieve collectively is impinging on our creation of a healthy sexual space in which to interact. Fifteen years ago there was a sex club in the Meat Packing District where the lips-above-the-hips rule was enforced by amiable, shirtless safe-sex monitors. Today, there are barebacking parties that fetishize the very engine of our own destruction. Both are homemade constructions: proof that we control the design of our own sexual architecture.
Enhancing sexual pleasure with drugs now and then is one thing; addiction, HIV transmission, and mental illness are quite another. It’s time we began envisioning our community without crystal meth, so we don’t have to endanger our lives just to feel sexy, beautiful, and loved. To do that, it has to be safe to discuss not only our grief, but what we like about doing crystal in the first place. Pride and shame will likely get in the way of a dialog like that.
Andrew Miller can be reached at [email protected]z