Dr. Frank Spinelli: Cruise Control

BY Frank Spinelli, M D

February 18 2011 3:20 PM ET

Agents who searched a suspected dealer’s cabin reported finding more than 140
ecstasy pills, nearly three grams of methamphetamine, a small quantity
of ketamine, and about $51,000 in cash. While waiting for the suspect in
his cabin, two more passengers stopped by seeking drugs, according to
agents.


When I read the article online and spoke to passengers upon their
return, I felt angry. In a time when gay men and women want to be taken
seriously so that we can serve openly in the military and have the legal
right to marry, isn’t counterproductive to read about the drug busts
and overdoses on a floating circuit party? Or maybe we just want it
all — the rights we deserve and the option to choose which, if any, fit
into our particular circumstances and plans.


The normal reward system in the brain serves a vital evolutionary
purpose. As this center matures it helps us deal with the terrifying
realities that face us in the modern world. This world also includes
access to illegal drugs and risky sex. If these signals continue to
trigger the reward system, they may lead to anxiety, depression and
addiction. On the other hand, the cognitive control network is the part
of the brain that acts like our moral conscience. In teenagers, the
reward-system network matures rapidly due to the rush of hormones. These
hormones do not speed up the cognitive control network. In fact,
cognitive control matures slowly. So then why doesn’t an adult gay man
have the cognitive control to chaperon their risk-taking behavior? One
explanation is that most gay men do not feel the same pressures of
responsibility as most heterosexual men. Gay men who enjoy circuit
events are more likely to be single. If they are in a relationship, the
couple often negotiates rules that include three-ways or sexual
encounters outside their relationship. More often these men do not have
children. This freedom supports exploratory behavior to indulge in sex
and drugs. For most teenagers, gaining control of the reward-system
center comes with maturity, especially as their cognitive center
develops. Unfortunately for some gay men, the strong impulses of the
reward-system center often outweigh the associated risks that face the
average partygoing male.


If 5,400 people, mostly gay men, go on an Atlantis cruise, what
percentage will succumb to the impulses of the reward system by using
recreational drugs, drinking alcohol, and engaging in unsafe sex? Now
take that number and multiply it by 10. Despite the arrest, Atlantis
announced that it will repeat the trip in 2012. I hope it’s over a
weekend when I’m not on call.





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