Crystal, Tina. Meth. No matter what you call it, methamphetamine use among gay men is once again on the rise, and the consequences are dire.
According to the National HIV Behavioral Surveillance Study, use of the drug in the New York gay community has more than doubled in three years. Similar findings are reported for Los Angeles and San Francisco. Meth is utilized for sexual enhancement among gay men, many of whom underestimate its danger or feel that they, unlike many others around them, will escape its destruction. Among gay men, meth is the most criminalized and least-understood drug, and all meth users experience stigma that impedes their recovery. In my book, Lust, Men, and Meth: A Gay Man's Guide to Sex and Recovery , I combine 20 years of therapy sessions with meth-using clients with personal research to document this drug's impact, providing users with a pathway to both physical recovery and healthy sex with intimacy. To end the meth epidemic, we first need to clarify meth misconceptions.
1. Meth recovery is impossible
Gay men believe that escaping meth's grasp is unattainable. But many men in recovery, as well as addictions professionals, know otherwise. Increasing numbers of treatment programs serve meth-using gay men. Crystal Meth Anonymous meetings in most urban areas are filled to capacity, and thousands of men have many years of recovery from meth. It is true that multiple relapses are typical, and I believe that harm reduction strategies such as needle-exchange, education, and outreach are essential on the way to abstinence. But with better information, treatment opportunities, and support resources in the community, gay men have the tools they need to get past meth.
2. "Meth addiction couldn't happen to me"
Every client of mine believed that they were fully capable of controlling this drug. They felt they could handle meth several times a year at circuit parties. Indeed, some could. Despite their best efforts, however, many saw their use increasing to the point that their lives were dominated by meth use and recovery from binges lasting for days. Nor is meth use restricted to young gay men. This year I had my first meth client in his 70s.
3. Meth permanently damages sexuality
Meth does indeed harm sexual functioning by quickly fusing intense, sexual desire with an intoxicated state. Users who are abstinent from the drug commonly experience post-meth fallout: a lack of sexual desire, problems with sexual functioning, and a belief that sex without meth is boring. This is not a permanent condition, but it requires reconfiguring your rituals around sexuality, dispensing with "meth-sex" habits, and no longer utilizing pornography previously associated with the drug. Sex without meth (or other drugs) may be frightening for gay men, yet sex and intimacy after meth is possible. In Lust, Men, and Meth, I document how, through diligent self-examination, reclaiming sex and intimacy after meth can be fully achieved. However, in his January 28 Bay Area Reporter review of my book, ( http://www.ebar.com/arts/art_article.php?sec=books&article=999) Mitchell Halberstadt describes these processes as "psychobabble," claiming they lack any grounding in hard science. Yet the impact of meth on the brain has been mapped by the National Institute on Drug Abuse, and the efficacy of cognitive behavioral therapy, mindfulness, meditation, and group processes is well established. Denying this is to divorce oneself from the best meth treatments available.
4. Meth allows gay men to authentically connect
Most gay men seek connection with other gay men. Having been stigmatized and shamed, we seek the safety and intimacy of relationships. While many of these connections are sexual, we also strive for authentic friendship and a supportive community. Connections on meth have the illusory feel of authenticity, but ultimately are self-destructive, exploitative, and degrading. They erode healthy relationships, leaving the user without partners, friends or social support when the drugs run out.
5. A dialogue about meth stigmatizes the community and meth users
One nationally known addictions specialist described meth as "the HIV of this generation," yet there is a puzzling reluctance to speak openly and frankly about this epidemic. Meth destroys careers, friendships, lives, and relationships. Discussing it impugns neither meth users nor our community. In his B.A.R. review, Halberstadt claims that I stigmatize meth users by pointing out their self-destructive behavior. I do exactly the opposite. As I note in Lust, Men, and Meth, "it's not the person who is bad or shameful; it's a very nasty drug that hijacks sexual desire and clear thinking, often with disastrous personal consequences." Let's help each other move past this epidemic.
David Fawcett, Ph.D., LCSW, a nationally-recognized psychotherapist in mental health and drug treatment, is author of the book Lust, Men and Meth: A Gay Man's Guide to Sex and Recovery (Healing Path Press). Learn more at http://www.david-fawcett.com/.