Wed 21 Mar 2007 In: Living Well View at Wayback View at NDHA
Overcoming Crystal Methamphetamine Addiction Steven Lee New York: Marlowe: 2006 This book is written by someone familiar with the particular nuances of P/crystal meth abuse and HIV/AIDS in the context of theUS gay community, but it is not limited to our communities alone. One of the anecdotes that opens this book deals with a gay male professional lawyer who got involved with club drugs. P/crystal meth increased his sexual drive, but contributed to reckless use of online sex to the point where he had an unsafe sexual episode that resulted in an HIV+ diagnosis. Lee has an interesting theory about the relationship between P and online sexual hookups. He argues that whereas methamphetamine has always increased horniness, online sexual opportunities have expanded the scale, and the risk. Class inequalities, rural poverty, deunionisation and the dance party scene have all contributed to the rise of P/crystal meth as a social problem with the United States, inside and outside the US gay community alike. However, what counters P/crystal meth education? As with the HIV/AIDS epidemic that it facilitates, preventative education is important, as is self-evaluation of the role that the drug plays in one's life, after one has completed detox. As for the origins of the P/crystal meth epidemic, it's a familiar story. Crystal meth use began at circuit dance parties that were ironically inaugurated to assist funding for HIV/AIDS prevention, education and treatment services, but also acted as distribution points for E, ketamine and gamma hydoxybutyrate (GHB). From dealer networks, there came crystal meth, which could either be snorted or smoked, and it was taken to increase energy levels, feel sexy and get laid. What was worse, it was soon found to be the case that anal application of P/crystal meth resulted in anaesthetic effects on the anal area, leading to longer, harder- and unsafe- sexual interludes. Finally, online sexual opportunities emerged again, with text codes provided for those who wanted to have 'crystal sex,' and even worse, bareback under the influence. Why did it happen? Even in the case of some affluent gay professionals, internalised and bruising earlier homophobic encounters may act as a corrosive influence through personal self-devaluation, and heighten risks from P/crystal meth fuelled unsafe sexual opportunities. Is it possible that in the case of the gay community, the US Christian Right has cultivated such a toxic social environment that narcotic abuse occurs to escape its effects? What does it feel like? Sure, the highs are intense, but so are anxiety attacks. Sure, it enables focus and concentration, but it also leads to activity repetition, and loss of workplace efficiency. For HIV+ people, dance parties and crystal sex are fuelled, at the cost of nutrition, or taking HIV meds, which ironically results in a wasted, haggard appearance and muscle tone decay. Furthermore, prolonged P/crystal meth use will sabotage your CD8 and B lymphocyte immune cell production, and levels of interlleukin 2 and gamma interferon within your body. It also increases tumor necrosis factor. There are other consequences from long-term usage that include intestinal collapse, kidney failure and the onset of violent, psychotic reactions of long intensity and duration, as the drug causes excessive production of the neurohormone dopamine. Lee is at his most useful when he suggests that there are ways to get clean and stay off the drug. He advocates keeping a personal log of the amount of P/crystal meth consumed, financial costs, intensities of highs, notable events related to the high, and crash intensity. The user should weigh up the advantages and disadvantages of their (ab)use of the drug in question. When having sex, they should check that their partners condom is securely attached, intact, and that they use plenty of silicone-based lube. (Note: I completed this review article before I could ascertain if the named treatment medications below are available in New Zealand. If not, perhaps Pharmac and MedSafe should be lobbied for access, pending the result of clinical trials regarding their efficacy in the United States and elsewhere. If one has decided to detox, then clonidine, pregabalin, buproprion and amantidine may be useful in getting down high dopamine levels, and avoiding psychosis. As for staying clean once this has happened, self-reward programmes, exercise and stressful incident avoidance can help. Personally, I found description of the saturation of P/crystal meth fuelled West Coast US gay communities frightening. Fortunately, due to the time lead in proliferation of the noxious substance in question here, we don't have as blase an attitude about the presence of this dangerous drug. However, it also means that we lack recovered addict groups for gay men in this situation as well. As for addiction treatment medications, topiramate, gabapentin and naltrexone are used to treat alcohol and opiate recreational drug abuse, and are being trialled for P/crystal meth addiction relief in the United States at present. Modafinil may ease dopamine surges caused by trigger situations that could lead to relapses into addiction. What can we learn from Lee's book? For many gay men, coning out isn't the end of coming to terms with ourselves. We may be carrying a lot of internal baggage around, and still experience moments of self-hatred as a result. We need to individually and collectively challenge those, and stop deluding ourselves that we are somehow imperfect or faulty human beings due to our sexual orientation. We need to create clean and safe social networks, that do not encourage use of this drug. When you're having sex, slow down and feel the intimacy and focus on communication and mutual connection. In the early days of the HIV/AIDS epidemic, gay men collectively organised to combat its effects. It's time we did so again, to combat the latest phase in this epidemic, to prevent the nightmare that Lee describes in his book occurring here. Recommended: http://www.KnowCrystal.org General information about P/crystal meth AIDS Project Los Angeles Crystal Meth Programme: http://www.apla.org/prevention/crystal_meth.html Crystal Meth Treatment: http://www.crystalmethtreatment.org Callen-Lorde Community Health Centre: http://www.callen-lorde.org Gay Mens Health Crisis Substance Use, Counselling and Education: http://www.gmhc.org/programs/suce.html Craig Young - 21st March 2007