How many gay men are using crystal meth?

Reports using probability sampling in the United States indicate that up to 13% of adult MSM used methamphetamine in the previous 6 months (Celetano et al, 2006). Among MSM aged 15-22 years, 20.1% reported using methamphetamine over a similar period (Thiede et at, 2003).  In a 2000-2001 baseline study of methamphetamine use among MSM, use was at 18% in San Francisco and 7% in New York City (Mansergh, CDC 2006). In 2006 Halkitis reported that use and abuse of methamphetamine by MSM in New York City had risen sharply, reporting on a sample of club drug using MSM he found that 65% indicated that they had used methamphetamine in the past 4 months.  In addition, anecdotal reports indicate that large numbers of MSM are attending the many crystal meth anonymous (CMA) 12 step recovery groups in New York City.  In the overall conclusions of his study on methamphetamine use, sexual behavior and HIV seroconversion (2006) Halkitis indicated that methamphetamine use is endemic to urban gay and bisexual men in cities which are HIV epicenters.

Should crystal meth be a concern for all gay men, including gay men of color?

A number of studies and public health reports have also cited the growing problem of crystal methamphetamine (crystal) use among gay men (NASTAD, 2004; Halkitis, Parsons & Stirratt, 2001; Halkitis, Fischgrund & Parsons, 2005; Halkitis, Shrem & Martin, 2005). Empirical research and drug surveillance data have further indicated that crystal use is a growing problem among MSM of color, particularly Black MSM (Halkitis, Parsons & Wilton, 2003; Reback & Grella, 1999; Semple, Patterson & Grant, 2002; Semple, Zians, Grant & Patterson, 2005).
 
Are gay men of color using crystal?

• Recent studies have showed that crystal is also being used at increasing rates by men of color including Latinos and Black men.
  • Men of color report different issues and/or reasons why they use crystal.  From 2005 to 2007, the Community Based Research (CBR) division of the Institute for Gay Men's Health at Gay Men's Health Crisis (GMHC) conducted research to inform crystal campaigns targeting the general MSM community and MSM of color in NYC.  Interviews identified reasons impacting crystal use which included low self-esteem, curiosity, homophobia, isolation, escapism and other coping mechanisms. Other themes that surfaced from the interviews included: crystal stigma, crystal use across races, crystal in comparison to other drugs, crystal as manageable drug and crystal use consequences.
  • The Latino Commission on AIDS reports that men of color experience more social pressure which impact their likelihood to use crystal meth.  This may be due in part to racism and the longing for a sense of belonging to a group.  The desire to be part of the gay culture, driven by social isolation new immigrants face drives many of these men who have sex with men to succumb to pressure and use meth.
  • A study done of men who use club drugs by Halkitis and Jerome (2007) compares methamphetamine use between Black gay and bisexual men in relation to men of other races. They found that almost half of the Black men (49%) in the sample indicated use of methamphetamine in the 4 months prior to assessment, a proportion somewhat lower than their White counterparts. In terms of frequency and reasons for use, Black methamphetamine users did not differ in any substantive way compared to other races and ethnicities. They concluded by saying that once a drug considered popular only among White gay men, methamphetamine use has been shown to transcend racial and ethnic lines. Because of the synergy that exists between use of the drug, the concentrated levels of HIV in the Black gay population, and the sexual disinhibition engendered with methamphetamine use, this drug presents a potentially mounting public health challenge.

What do gay men of color think about crystal use?

• GMHC research has pointed out that among men of color there are myths and constructions of crystal that inform their views about the drug. One particular finding showed that crystal and crystal use was constructed in largely contradictory and stigmatizing ways. Research participants shared both that crystal is a "White" drug but also reported that people of color are using it. Another finding was that they referred to crystal as a "gay" drug only but also reported that everyone uses it. Research participants referred to crystal users as crack heads, rich, reckless HIV + users.

What are some of the underlying reasons that gay men use crystal meth?

Research shows that crystal meth is used for a variety of reasons for coping with life experiences, both physical and social. At GMHC, we have also conducted research and evaluation projects for our work creating crystal campaigns targeting MSM's.

Some of the emergent themes from the research that impact the use of crystal meth are:

• low self-esteem
• curiosity
• homophobia/stigma
• isolation
• escapism
• coping mechanism

Why would these underlying reasons influence the use of crystal meth?

Due to the drug's euphoric and stimulant effects, many crystal users say the drug provides an escape from stress, depression, alienation, and loneliness.

Many men report a greater facility in social settings which provide them a great sense of community. In a culture where the strong focus on physical appearance and sexual performance can be destructive of men's self-esteem, intimate relationships, and the enjoyment of a wide range of life activities, many men report that, initially, crystal helps them to feel more attractive, sexually desirable, and socially connected.

Gay men and MSM also report that the drug helps them cope with the homophobia and prejudice they experience in everyday life. In the case of HIV-positive gay men, crystal meth is used as a way to avoid the stress and pressures associated with dealing with their illness and the stigma of having HIV.

Crystal meth's ability to heighten the senses and increase stamina cannot be underestimated — and its use in conjunction with sexual activity serves, for many gay men, as a means of coping with feelings of isolation and loneliness and other psychological stressors. Using crystal meth gay men can "leave" reality and indulge in pleasurable experiences, such as dancing, partying and sex.