Crossed Paths: The Well-Traveled Intersection of Drugs and Gay Culture

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By Walter Armstrong

The first signs that the crystal-meth scourge may be lifting in urban gay America are finally emerging. The most credible, if narrow, report comes from San Francisco, the nation’s gay trendsetter. A joint effort by the city’s health department and Stop AIDS Project, the study found that of 4,600 gay men who were asked which drugs they had done before having sex in the previous six months, Tina use among HIV-negative men fell from 11.8 percent in early 2003 (when the study started) to 6.6 percent in mid-2006—a decline of almost 50 percent. The drop among HIV-positive men was less dramatic, from 24.8 percent in early 2003 to 19.9 percent in mid-2006, suggesting that even in matters of self-medication the serostatuses often occupy two separate worlds.

Willi McFarland, the HIV-prevention veteran who led the study, attributed meth’s falling out of favor among neggies to the city’s aggressive and innovative anti-crystal campaigns, which range from public bus ads to circuit-party and sex-club interventions. Coupled with the grotesque toll of meth addiction that many of us have witnessed close up, if not endured firsthand, these model efforts may be stigmatizing the dicey ice. If McFarland’s hypothesis is correct, crystal consumption may well be dropping all across big-city gay America—at least where health departments and community groups have mobilized to fight what public health officials have long acknowledged is an epidemic.

Still, it is too way too early to announce victory, especially over an enemy as powerfully addictive as meth. The relapse rate is as high as 90-plus percent, and only a full-bore regimen of rehab, talk therapy, antidepressant medication, and Crystal Meth Anonymous seems up to the challenge. And given meth’s enduring popularity since the '60s in many American subgroups, it will likely remain a temptation and threat to future gay generations.

Even as the San Francisco study was making headlines, research out of North Carolina confirmed that it would be a mistake to assume that meth is on the wane in small or midsize US cities. Among 1,500 30-and-under gay men with HIV, the use of all stimulants (meth, coke, and ecstasy) jumped from 12 percent in 2000 to 22 percent in 2005.


Do you use club drugs or have friends who do? We've featured information about a different popular club drug on each page of this article. For the full list of all popular club drugs, see Club Drugs: Effects, Risks, and Addiction
Street Name Crystal, meth, Crissy, Tina, crank, speed, glass, ice
What It Is A powerful stimulant. The active ingredient is ephedrine or pseudoephedrine (available in over-the-counter cold or allergy meds), and preparing it is easy but risky because additional ingredients (industrial solvents, for example) are flammable and corrosive.
What It Does Meth floods the brain with dopamine, a neurotransmitter associated with pleasure and desire, and adrenalin, a hormone that stimulates the “fight or flight,” or stress, response, causing heart to race, pupils to widen, muscles to tighten, and so on.
Dose The crystals are snorted, smoked, injected (“slammed”), or absorbed via a “booty bump.”
Duration An average dose lasts from four to eight hours.
Effects Feelings of euphoria, energy, strong disinhibition; an increase in physical and sexual motivation, focus and attention, confidence and aggression. Other bodily functions, such as hunger, thirst, and need for sleep, decrease.
Risks In the short term, the main side effect is the depression or anxiety that results from exhausting the brain’s supply of dopamine. Frequent use can heighten these negative feelings to the point of paranoia and hallucinations. Chronic use can cause permanent imbalance in the brain chemistry, leading to an inability to experience pleasure. This is one reason that kicking meth addiction is so difficult. Damage to the body can include high blood pressure, tooth decay (“meth mouth”), weight loss, and other health problems associated with the general collapse of self-care; if you have HIV, a weekend binge can mean a treatment interruption. Overdose is rare; symptoms include chest pain, elevated body temperature, rapid heart rate, and shallow breathing. Since meth is often used for marathon sessions of sex, it can double or even triple your risk of getting infected with HIV or other STDs. And since it both increases your sex drive and decreases your inhibitions, your sensitivity to pain, and your ability to maintain an erection, even hard-core condom users and “total” tops may find themselves bottoming with multiple partners and no latex. Sharing needles when slamming crystal can also transmit the virus.
Addiction Due to its ability to release large amounts of dopamine, the reward-system brain chemical implicated in all addictions, meth is easy to get hooked on, especially when injected or smoked. Many gay men say they became addicted at their first high; many also say they did not “hit bottom” until they got HIV. Further, many addicts are also addicted to the state of acute arousal that meth-fueled sex produces. To avoid relapse, former users have to mourn the loss of that experience at a time when their ability to experience “normal” pleasure has been burnt out. Crystal Meth Anonymous, based on the 12-Step abstinence model, has helped many gay men stay clean.