TWEAKED
Crystal Meth, Sex, and HIV
By Tara Lohan

It started with a “key bump” in a bathhouse in Chicago. It started with snorting just a bit of it off a key and then smoking it and then injecting it. It started with one hit and a six-hour high and it did not end for four and a half years. It did not end when friends and family disappeared or jobs and money were lost. It did not end with being homeless. It did not even end with being diagnosed as HIV positive. It takes more than hitting rock bottom for someone to quit.

Sean (not his real name) is beautiful. He is 31 and has a wide smile and gorgeous eyes. He does not look like someone a year into recovery from a drug addiction that cost him almost everything.

“I once said that using it was like getting an all-day ride pass at the amusement park. But I realized that you pay for that ride with your life,” he said.

Crystal, meth, tina, methamphetamine, are all names for the drug that triggers the release of norepinephrine and dopamine. It has been wreaking havoc in gay communities across the country and in some places, such as Los Angeles, San Francisco, and New York, has been reported by health agencies to be responsible for over a third of new HIV infections. The website Tweaker.org, a clearinghouse of information on meth, explains that the drug first gained popularity in gay communities in Los Angeles in the early 1990s and then moved to New York and Miami and just about every town in between.

The drug keeps people awake, makes them feel sexual, and limits inhibitions. Ramon Johnson of About.com’s Gay Life called it the “fastest growing drug in the gay community” and Charles Karsters, the prevention manager at Being Alive HIV/AIDS Action Coalition, called meth the “perfect gay drug.” However, it has also been a deadly combination for many gay and bisexual men because normal safety precautions disappear in the blur of the drug.

Sean is among a growing number of gay men to sample the drug and then get hooked. For almost five years he would use, and then quit for two or three months, and then use again. But each time he used, like many who take meth, he would go on a binge for several weeks at a time.

Sean’s job required that he travel. After his first introduction to meth when he was in his mid 20s, he was hooked. “Every city I went to I would go to a bathhouse and find meth or I would go to bars and ask,” he said. “I would get to recognize what people looked like when they were ‘tweaking.’ I would look at their eyes and I would just find it. I would stop at nothing to find it.”

Crystal meth is reported to be a powerful stimulant that affects the nervous system. The Office of National Drug Control Policy reported that, “It increases energy and alertness…and can lead to psychotic behavior, paranoia, and hallucinations.” Sean’s experiences were similar. “You don’t sleep. I would stay up for five days, if I had enough. And when you start to fall out you want more,” he said. “Physically it eats you up. First of all, you are putting poison into your body; you are up and not eating. You are emaciated, dehydrated, and sleep-deprived. You get crazy real quick. By the second day I start hallucinating. Shadows become people. Street signs become people. Trees are people. Then I get paranoid by the third day and that is when I would constantly think I heard police sirens.”

What you do at night follows you when the sun comes up, Sean learned. When he finally came out of a binge he would find himself in excessive pain. After sleeping for a day, he’d wake up sick and in a depression that was unrivaled. “It is horrifying. You want to die. You feel like you are almost dead because you haven’t had any nutrients for so many days,” he said.

The drug makes it difficult to keep friends and jobs. Sean moved to different cities and learned to find other “tweakers” who were up all day and night as well. What he found in meth was a place to hide. “As a drug addict and alcoholic, I like to escape, and that combination of sex escape and drug escape was very appealing,” he said. “But your sexual inhibitions and your safety precautions are just out the window. You are a slave to meth, to the sexual urge, that craving. So I would have sex with two to eight people a night or a day, who knew what was what.”

Sean believes that HIV has been glamorized lately in the magazines with hot, buff guys advertising the newest “cocktail” and positioned under lettering that says, “HIV is no longer a death sentence.” Sean grew up just after the worst of the epidemic and knew that he was supposed to use condoms. At 15 he volunteered at New Mexico AIDS Services. “Then you get desensitized,” he said. “And there is no longer an urgency in our community for the younger people because we didn’t have the loss and we didn’t suffer the heartache. You forget about it and it is so easy to justify not using a condom when you are high. You just don’t care. The need to satisfy your selfish and self-centered craving takes over, and life preservation is the last thing on your mind. I lost all strength, all will, all respect for myself.”

The Advocate recently reported that the Centers for Disease Control revealed an 11 percent increase in HIV diagnoses for gay and bisexual men between 2000 and 2003. “Anti-HIV drugs that mask the disease, Internet sex partnering, and increased methamphetamine use means that ‘old prevention messages no longer work,’” the article reported, quoting Dr. Jeffrey Klausner of the San Francisco Department of Public Health.

The Los Angeles Gay and Lesbian Center (LAGLC) released a study showing that one-third of those newly diagnosed as HIV positive had used meth. The study also showed that gay and bi men who used the drug were 300-400 percent more likely to test positive.

A new concern over meth use and HIV occurred in February when a man in New York City tested positive to a highly resistant and rapidly progressing strain of the virus that is believed to have been spread at New York sex parties where meth use is prevalent.

Jean Malpas, a psychotherapist in New York City who has many gay clients, believes the use of meth in the gay community is linked to many deep-seeded issues, including internalized homophobia and depression.

Malpas is careful to point out that gay communities are not the only ones using meth. Urban 75 reports, “Once very big amongst some of the U.S. gay community but now spreading fast into mainstream culture, meth was originally used by bikers and truckers to stay awake on long journeys. Crystal is made of highly volatile, toxic substances (based on such chemical ‘precursors’ as methylamine and amyl amine) that are melded in differing combinations, forming what some have described as a ‘mix of laundry detergent and lighter fluid.’”

Malpas believes that each community needs to look at the problem contextually. “It is important to look at the social and political reasons, including a lack of equality for gay people,” said Malpas. We are still learning, he said, what the long-term multigenerational impacts of HIV/AIDS will be on the community and on the emotional impacts of being gay today.

Many in the gay community are beginning to address the problem, sometimes called “the other epidemic,” including meth-specific support groups that have been formed at lesbian and gay centers. New advertising campaigns such as, “Buy Crystal, Get HIV Free,” highlight the multiple dangers of using meth.

Once hooked, it is difficult to shake the drug. For Sean, it only took a few years before he progressed from snorting the drug to shooting up, the ultimate rush, and the place from which there is usually little chance to ever turn back. Most “tweakers” who inject don’t teach other people how to do it, explains Sean. “If you ask, they say ‘Your life is over once you start shooting up, you know that right?’”

Someone did teach him to inject, though.

Of course, he learned that it is not glamorous. If you miss a vein, it goes into your muscle and you get a golf-ball size lump that turns red, burns and it impairs your nerve function.

There is a progression with a meth addiction. It is a road that leads quickly from excess to scarcity. It begins, Sean explains, when you have lots of money and you are in a nice hotel with lots of friends and drugs and having great sex. And then slowly you have less money and consequently fewer friends and fewer drugs. The hotels get cheaper and cheaper until you find yourself in a motor lodge in Reno.

“You have blotchy skin and you are thin as hell and weak and you have been living on beer, crystal meth, and cigarettes. You can’t even have sex anymore, you are just a tweaky mess and a shell of your former self,” he said. “And then you don’t even have money for that and those friends are gone and you are depressed and you are still up and wandering the streets. That is a living nightmare that I would not wish on any of my young gay brothers.”

Of course not everyone is going to end up an addict, but you don’t know if you will be that person. Stop AIDS Project in San Francisco reported that meth is more addictive than heroin and many develop a full-blown addiction just six months after trying the drug. People move rapidly from feeling like they have it all, to actually having nothing. Crystal Meth Anonymous, which began in 1999 in New York City, has 24 meetings a week now and sometimes 100 or more people at a meeting.

“If you put 30 people in a room and give them alcohol every day maybe two or three are going to become alcoholics,” said Sean. “But if you take 30 people and put them in a room and give them crystal meth, every single person is going to come out of there craving crystal meth, and if you have a predisposition to be an addict, it is hell crawling out of that. It is hell.”

Sean has been in recovery for a year. He has been HIV positive for two years. He has been working to deal with the shame that comes with addiction — the shame of having hurt loved ones and himself.

If you haven’t ever tried the drug, don’t, Sean says. Don’t smoke it or snort it or put in it your veins. “You lose yourself, you lose your strength and your ability to rationalize and respect yourself as a strong gay man,” he said. “You become a slave to it. You see it on those sleazy talk shows — and before it happens to you, you think, ‘how could someone do that?’ And then it happens to you and it doesn’t make sense until this thing turns your life inside out and you are a prisoner. All the strength you thought you had, all the stuff you thought wouldn’t happen to you … well, you are it, you are the now the guest on ‘Maury Povich’ and it is pathetic and you can’t stop until you get into recovery.”

Sean finally realized that he was powerless over the drug. People in his life were saying, “The definition of insanity is doing the same thing over and over and expecting a different result.” Sean had been using and swearing he would quit and then using again for years. And finally he gave up and realized he needed help.

With a 12-step program and the support of family, he is putting his life back together again — something that is possible for addicts, if they can admit they need help, he said. “I was lucky. There were one or two people who did not give up on me.”

Sean still has using dreams at night, and he has regular trips to the doctors to check his health. Physically, Sean feels good right now. He is not on any medications for the virus and his T-cells are high. “But reality sets in when I go for my three month doctor appointment and I see people who are very sick around me, and I think, ‘that is what I have to look forward to, maybe.’ And the drugs are no picnic, from what I hear, they are just a nightmare to take, and I get very nervous when I visit the doctor. I wonder if this is the month the virus is starting to take over my T-cells,” he said.

Sean doesn’t date right now, especially because he is in his first year of recovery and is working on paying back debts — both emotionally and financially. “Sex is not a free, fun, casual thing anymore now that I’m positive,” he said. “I don’t think about being positive every day but it is there. Today I have a cold. It is just a cold, but I’m terrified.”

But Sean also has a second chance, too. “Life is fabulous and there is so much out there, and I like being conscious for it now and contributing something useful to the world. It is a lot better than shame. Shame is toxic,” he said.

Right now, recovery is life or death. “I go to meetings to remind myself even when I’m feeling great that all it takes is one time and I’m right back to being homeless. I am homeless so fast, because I don’t stop,” he said. “It is all because I did a ‘key bump’ a couple years ago.” 

For more information on methamphetamine addiction and treatment visit www.lifeormeth.org; www.tweaker.org; or contact Crystal Meth Anonymous (213) 488-4455 or www.crystalmeth.org.

Tara Lohan is a freelance writer and the editor of a queer newspaper. She lives in Northern New Mexico. She can be reached at tlohan@hotmail.com.