“I read your blog about the meth crisis among gay men. I am a psychiatrist in Atlanta and have a significant gay male population. Of all the mental health disorders I treat – including the most severe forms of psychosis and other affective disorders – meth dependence scares me the most. When I am approached for help by these poor souls, my heart sinks. There is the traditional psychosocial treatment (i.e., 12-step recovery programs), which is great, but I cannot conceive of a more addicting and destructive substance to curse mankind, so I worry that this is not enough. What’s more, there is very little press about meth, in the straight or gay media, which leaves the susceptible with the tragic impression that this isn’t such a big deal. Yet, the horror stories I have heard – mind you, I am a psychiatrist and I thought I had heard it all – make my knees shake with utter terror.
The progress the gay community has made with HIV awareness, research and policy is miraculous. But I agree with you: it is all for naught unless we smother this monster to its evil core. That meth is a vector for HIV is a sad reality; I fear that its potential for total descruction makes it worse than any threat HIV/AIDS has ever presented. We need to see it for what it is: mean, nasty, dirty death.”
EMAIL OF THE DAY II: “I am 34, and just old enough to remember the period when people were dropping like flies. I would venture to guess that today at least half of the new infections are directly caused by meth use, and even more by secondary infections via other people who’ve been infected by them. I think that if you removed meth from the equation, the momentum of the epidemic would drop off dramatically. Unfortunately, there is not much of a commitment within the community to stopping the crystal epidemic. I think “harm reduction” has caused more damage than most people realize. My best friend is one of the casualties. He was once very talented and fun to be with, but has descended so far into psychosis that he is barely recognizable. I expect he will be dead within a year, in some ways, he already is.
I think what’s needed is a healthy dose of peer pressure, positive and negative, among young people. Forget the people who’ve already gotten into meth, they are beyond reason until they decide to get clean. I am more concerned with the younger guys who’ve heard so many scare stories they don’t believe how evil meth really is. Peer pressure worked in the early 90s. I felt there was tremendous pressure to remain safe, but without a lot of moralizing. Whatever was going on it worked, and it kept infection rates here very low for well over a decade, until the Internet caught on in the late 90s. Nancy Reagan did have a point, you can’t get addicted to something you’ve never used. People forget that.
I am convinced that the Internet changed the nature of drug addiction in large cities. Speed has been a problem here for decades. What the Internet did was enable people to create a subculture that changed the way people used drugs. Instead of getting high to go dance, they’d get high and look for tricks online. While I’ve always been critical of excessive drug use, at least way back in the 1990s people would generally use them for social/entertainment purposes, which did a lot to limit the damage they caused. If you were single, you generally had to leave your house to get laid, and you generally had to be somewhat presentable. The Internet upset that balance, and turned drug use into a more private activity.” Yes, the Internet undoubtedly played a critical part in the new meth subculture. It is also killing gay nightlife. So many gay men are at home, cracked out online that the bars and clubs are empty. Socialization has begun to disappear. Even if HIV were not here, this would be a curse. But the combination of meth and HIV is literally deadly.
The Dish 