Tue 24 May 2005 In: Living Well View at Wayback View at NDHA
Are New Zealand gay or bisexual men at risk from a possible secondary HIV/AIDS cascade epidemic related to P, or crystal meth, unless we act now? As I read Frank Sanello's recent anecdotal accounts of the effects of crystal meth on the lives of US West Coast gay men, I hoped not. While Sanello's book has been criticised for its lack of evidence-based data, its P/crystal addict stories do help to bring home the personal devastation that it causes. Could it happen here? It could be argued that apart from the Sydney Mardi Gras, Australasia has no equivalent of the US "circuit parties," where there are mass contexts for P distribution, circulation and use, and an upsurge in P-fuelled unsafe sex. In some of those cases, ecstacy was spiked with P contaminants or deliberately substituted by unscrupulous dealers or gangland suppliers. However, Ecstacy and P have real differences. Ecstacy is amenable to harm reduction and risk minimisation procedures and might even have some therapeutic possibilities for victims of sexual assault. P is not as benign as its fellow amphetamine. Are New Zealand gay or bi men at risk if they don't do clubs or overseas dance parties? It could be argued that although we are dealing with gay youth suicide as a serious community issue, male homosexuality hasn't been only recently decriminalised in New Zealand, unlike the backward United States. However, we do lack a comprehensive national network of lesbian and gay youth groups, lesbian and gay youth shelters, and school anti-harrassment policies, as well as transgender-inclusive anti-discrimination laws that may force transwomen out onto the streets to support themselves through street sex work. It could become the case that young gay men, lesbians or transwomen become susceptible to methampetamine to blot out experiences of school or workplace discrimination unless we develop comprehensive youth anti-discrimination and advocacy policies in New Zealand. Last year, the Expert Advisory Committee on Drugs reported to our Minister of Health (Hon.Annette King) about mephamphetamine risks, and recommended outreach to "the dance party scene." At the same time, Chris Wilkins, Krishna Bhatta and Sally Casswell published a paper on the subject of New Zealand's growing problems with P abuse within the Journal of the New Zealand Medical Association. However, neither the EACD or Wilkins, Bhatta and Casswell focused on specific community-based initiatives that might be used for risk reduction and harm minimisation. Canada, the United States and New Zealand have all criminalised the domestic manufacture, distribution and use of P and its precursor, constituent compounds. Pseudoephedrine, ephedrine and phenylpropanolamine are subject to regulation under the Misuse of Drugs Act 1975. We lack a land border, so possible South East Asian sources of methamphetamine supply are subject to border controls, but our own gangs have taken up the slack, given police statistics about the proliferation of illicit methamphetamine lab busts. What can our communities do to avoid a secondary HIV/AIDS cascade epidemic if P is allowed to gain a foothold within them? Firstly, I'd like to thank one recent dance party co-ordinator who congratulated me on publishing my first Gaynz.Com article on the risk that P poses to our communities. It's good to see that grassroot community concern about HIV/AIDS risk is still alive and well in our communities, as is our sense of collective responsibility. We need to familiarise ourselves about the facts related to P and its harmful effects. Secondly, we need to update ourselves on the current status of the US West Coast P-fuelled new wave of HIV/AIDS exposure, which is why the Crystalneon and Tweaker websites are essential reading. We need to establish our own prevention networks and develop targeted health promotion resources. Secondly, we should not stigmatise P users, given that this is an intensely addictive drug, and given the current absence of local gay/bi/men who have sex with men- related health promotion resources, unless users assault or actively pursue unsafe sex with others. Thirdly, the AIDS Foundation needs to establish a standing committee and apply for Ministry of Health funding to develop the aforementioned resources, and run community prevention workshops on the subject. Fourthly, the gay male community needs to own that there might be a problem, unless we move quickly toward pre-emptive awareness, education and prevention projects that will curtail any prospective risk of a secondary, P-fuelled epidemic created through intoxication and inability to accurately gauge personal risk from unsafe sex. Dance party co-ordinators and venue owners might want to institute zero tolerance policies toward P distribution and supply within their venues. They should remember that this might include bulk ephedrine, pseudo-ephedrine and phenylpropanoline handovers, so keep an eye out for suspiciously large amounts of apparent "medication" that might include such compounds. If you find P, call the police at once so that they can apprehend the distributor. In the past, we've taken a libertarian attitude toward drugs. Unlike medicinal cannabis and (possibly) therapeutic ecstasy, P is a qualitatively different narcotic that might undo all the effort that our HIV prevention and health promotion activities have undertaken against that epidemic. It distorts risk perception and causes risky behaviour that could trigger a further round of HIV/AIDS exposure. In 2002, Parliament moved to make P a Class A substance under the Misuse of Drugs Act 1975. Users are liable to six months imprisonment, while producers and distributors face fourteen years imprisonment. Given the toxicity and contingent risks of P, they were wholly justified. Recommended Reading: 1. New Zealand Expert Advisory Committee on Drugs: Advice to the Minister [of Health] on Methamphetamines [2002]: http://www.ndp.govt.nz/committees/eacd/meth-paper.pdf Ministerial Action Group on Drugs: Methamphetamine Action Plan: 22 May, 2003: http://www.beehive.govt.nz/anderton/mephamphetamine-action-plan.pdf Chris Wilkins, Krishna Bhatta and Sally Casswell: "Emergence of Amphetamine Use in New Zealand: Findings From the 1998/2001 National Drug Surveys" Journal of the New Zealand Medical Association: 22 November 2002: 115: 1166. New Zealand Parliamentary Library "Background Note: Methamphetamine (Speed and P) in New Zealand" Wellington:New Zealand Parliamentary Library (2003/05) 2. United States: Michael Gorman "Crystal: Speed Use and HIV/AIDS Transmission" [1996]: http://www.tweaker.org/tweaker-arc/science.html Lee Klonski "Crystal: Facts" [1996]: http://www.tweaker.org/tweaker-arc/facts.html Frank Sanello: Tweakers: How Crystal Meth is Devastating Gay America: Boston: Alyson Books: 2005. Craig Young - 24th May 2005