The meth horror show

Do you want to be scared? Walk down New York City's gay promenade 8th Avenue early some Sunday morning and watch the meth zombies out looking for fresh meat.

They've been going all weekend, some of them, and they look like hell, but they just can't stop. They start at their dealer's place Friday night, smoke some tina, and maybe have a little sex there too. Then they are off to the bathhouse for a marathon session. Condoms? Doubtful. Fourteen hours later they scurry home, blinded by the daylight, and boot up the Macintosh. They invite three or four online hookups over, smoke another pipe, and go at it. Eating? Forget it. They may down some Gatorade, maybe some Ensure. ("The breakfast of drug addicts!" one guy told me, laughing.)

Those guys go away, some others come over.

Eventually, body parts are rubbed raw, jaws are grinding, and they are ready to stop, but they can't. They twiddle around online for five or six hours, not really wanting to hook up but still chasing the target, the scene, the hottie, the orgasm. By 6 a.m. Sunday morning, they know they are in trouble. Maybe they realize they've put themselves at risk for HIV or another sexually transmitted disease. Maybe they blew all the rent money. Their boss said if they call in sick one more Monday, they might as well not come in again, ever. They are exhausted, wired, paranoid, hearing things, sometimes literally psychotic. But on they go. Pretty picture, huh?

Want the creature double feature? Read some of the latest research about the nightmarish effects of meth on the body: the brain tissue turned to Swiss cheese, the flesh-consuming staph infections that won't go away even with antibiotics, the "suicide Tuesday" depressive crash, the constant irritability. Listen to doctors talk about the connection between meth use and new HIV infections. It's like something out of a Stephen King novel.

As a substance-abuse counselor at New York City's Lesbian, Gay, Bisexual, and Transgender Community Center, I sit pretty much at the epicenter of the city's crystal meth epidemic among gay men. I see the guys when they are good and scared. They call me when they are waiting for their HIV test results, after they've gotten fired, when their best friends won't talk to them anymore.

Unfortunately, it usually takes that level of damage before people are willing to reach out for help. What is it about gay men and crystal that creates such an unholy bond? This is the devil's gay marriage. We joke and use crystal's pet name "tina." We laugh and say she's such a bitch, so why are we so committed to her? And more important, how do we remove the talons, get a divorce, and get out of the abusive relationship?

One man I counseled, Jerry, owned his own business, had a wide and loyal circle of friends, had been in a stable relationship for years, and had managed to avoid HIV infection for a quarter century. Within nine months of hanging out with tina, all of that was flipped on its head--Bizarro Jerry was in charge. In our conversations about what happened, Jerry was dumbfounded. It was like a bomb had gone off in his life--Mr. Hyde came and stayed. We talked about the pressures of his relationship, of the AIDS epidemic and all his lost friends, the midlife desire for excitement and sexual adventure, but none of that seemed to make sense to Jerry. "I feel like I just handed over control of every aspect of my life to tina," he says.

Certainly, gay men lives aren't the only place where meth is wreaking havoc. But there are elements of the perfect storm with us and tina. The drug is relatively cheap, long lasting, and packs a punch. It lowers inhibitions and heightens concentration. Since it commonly results in erectile dysfunction, or "crystal dick," men on meth are more likely to engage in sex as the receptive partner, thereby increasing their risk of contracting sexually transmitted diseases, including HIV. For all men, but especially for those who already have HIV, meth's party-till-you-drop and forget to eat, hydrate, or take medication lifestyle combines scarily with the drug's overall suppression of the immune system.

Emotionally, gay men are also particularly vulnerable to tina's siren song. In a social climate of fierce and unattainable standards for looks, body, clothes, and lifestyle, meth makes anyone a porn star. Suddenly sex is so hot, so fulfilling, it becomes a true raison d'etre.

Spencer Cox, founder of the Medius Institute, a newly formed think tank creating innovative public health strategies for gay men, says tina is the best salesperson in the world, making promises she can't keep.

"On meth," he says, "you are always just about to have the perfect experience, the perfect orgasm. You need just one more hour, one more partner, one more hit on the pipe." Meth promises the supersize version of fulfillment many gay men crave: titanic self-esteem, a gold medal in the sexual olympics, and an intensity of experience that makes every moment a brilliant work of art.

In fact, what meth really promises is "fixing" homophobia. If gay marriage is supposed to equalize our relations and commitments as gay people, meth is supposed to make up for every slur, for every time we're not picked for the team, and for not attending prom with the true object of our desires.

With meth providing such a powerful, if physically and psychologically costly, rush of self-esteem and sheer pleasure, giving it up can leave people feeling completely bereft. In fact, many gay men, once they manage to kick tina out the door, experience a long period of sexual abstinence. It's as if they forget how to have normal sex or relate to another man's body without the high-octane chemical charge.

The only good thing about the meth horror show is that it is so intense and the outcomes are so nasty that the lucky ones get freaked out fast and cry uncle. But for anyone trying to give it up, I encourage you to act like Lassie: Go. Get. Help. Meth addiction is really tough to beat on your own. Swallow that gay pride and reach out. Get thee to Crystal Meth Anonymous; consider a formal treatment program.

Brian, a handsome 20-something marketing executive, spent two dismal years in the relapse cycle before reaching out. "Finally, I surrendered. I realized I couldn't do it on my own and I needed help from the people who love me and a lot of structure to keep me from picking up [the pipe]."

Meth addiction zaps our support networks to ash, leaving us alienated and alone. If we want to kick tina to the curb, we need to find support and strength in our friends and in our community. We need to reach out to our family, chosen or given, and the people who've been there for us before. Just like in the last great epidemic, it was the community that helped us back from the brink and to make sense of the horror, and it will be the community who helps us now.