In the last decade, crystal meth has become not only one of the most popular drugs among men who have sex with men (MSM), but a problem facing gay, lesbian, bisexual and transgender communities across the country, and particularly in Utah. In 2000, the Utah Substance Abuse & Anti-Violence Coordinating Council estimated that the Beehive State takes in meth users for treatment at three times the national average — or 82 per 100,000 people versus 29 per 10,0000 nationwide.
Statistics on how many Utahns use meth, on the other hand, are not only unavailable, but impossible to pin down, said Lynn Beltran, STD/HIV Program Manager of the Salt Lake Valley Health Department whose department often counsels HIV-positive MSM who use meth. The reason, she said, is largely because health officials have no choice but to rely on meth users to report that they use — which many deny.
“Whenever you’re dealing with an issue relying on self-reporting data, it’s never going to be reliable,” she said. “It’s also true as a state and a community that we and our Legislature don’t want to acknowledge this [meth use] is going on. We say these are the throwaway members of society, so we don’t need to talk about it.”
Regardless, Beltran said that meth use is an issue that divides the gay community, often polarizing MSM on lines of those who use and those who do not. It is, she added, also a problem in Utah’s gay club scene.
“Cocaine and meth seem to be like party favors,” agreed Jerry Buie, a gay therapist who primarily counsels MSM. “I think people go into it underestimating the power and addictive quality of meth, and so one time turns out to be this great party time and then they keep resorting back to it. We’ve integrated it into our social scene.”
“If I were to take the three top mental health issues in the gay lesbian community to be dealt with, the first would be substance abuse,” he continued. “I think it’s highly prevalent and very, very problematic and destructive.”
Having Sex With God
Meth, short for methamphetamine, is a powerful stimulant derived from the class of drugs known as amphetamines. As a stimulant, it creates a feeling of energy and euphoria and also speeds up metabolism.
“The biggest percentage of meth users are gay men and housewives who want to lose weight,” said Beltran.
Along with weight loss and increased energy, meth can also increase pleasure during sex. One of Beltran’s clients, she said, described the experience of having sex on meth as “having sex with God. And once you’ve had sex with God, why would you want to go back to the other?”
These qualities make the drug not only popular among people who frequent high-energy environments like clubs, but highly addicting. Given that it’s easy to produce and less expensive than similar drugs like cocaine, it’s also accessible to people of all incomes. But while the price may be less than a lot of street drugs, meth’s side effects are just as strong. In the short term, it can cause dangerous spikes in body temperature, convulsions, hallucinations and paranoia. If used long term, it can destroy vital organs like kidneys and lungs, repress the immune system, and even kill users. The risky sexual behavior that it encourages can also expose users to a number of STDs, including HIV — STDs that then spread at what Beltran calls “sex parties” where the drug is present.
“We know that many HIV-positive men are using [meth] and they’ve developed very strong sex networks,” she said. “A new person [outside that network] will come along and suddenly they’ve got it, and they’ll bring it back to their network which isn’t positive men.”
Meth can also damage more than physical health.
“I had a client who two years previously was making $200,000 a year. When he came into my office after being hooked on meth he was down to $30,000 a year,” recalled Buie. “He’d destroyed his career and lost his savings. He’d done some brain damage and contracted HIV. His life was in a very short period of time was destroyed. I see that story over an over and over again. I see it personally and professionally.”
“People think they can handle it and they can’t,” he continued. “I have never seen a good story come from it.”
Anatomy of a Meth User
But energy and great sex aren’t the only reasons that people — and MSM in particular — get caught up in the drug.
John Bonner, a licensed clinical social worker who counsels meth addicts through Volunteers of America, Utah, said that meth addiction, like addiction to any drug, often has psychological roots.
“They’re self-medicating, and I think it’s a symptom of the real cause which is underlying stress, grief and loss issues, family issues,” he said.
Bonner, who is gay himself, noted that several of the MSM he counsels come from LDS backgrounds. While noting that he did not want to put the blame for meth use squarely on the church’s shoulders, Bonner noted that many MSM who use meth have faced rejection from their Mormon families because of their sexuality. And when these men lose their communities of faith, Bonner said that they often turn to destructive behaviors.
“I see a trend where a lot of gay men who come out from orthodox religious backgrounds, including LDS, often act out in myriad ways,” he said. “They go to excess with substance use and sexual behavior. They don’t have a framework for what healthy development of a gay man looks like, or what [gay] relationships look like because they don’t have a lot of role models for that.”
Worse, Bonner said that many of these men have internalized anti-gay messages from church and media, and believe that being gay means “that you drink, you use drugs, and you shouldn’t expect stability or monogamy.”
“The common denominator is I don’t know who I am and this drug helps me feel accepted,” Buie agreed.
Although MSM make up the bulk of meth users visiting Utah’s clinics, Bonner pointed out that he sees “a significant number of women” in therapy — many of whom are lesbian and bisexual. These users, he said, are more likely to get into meth because of relationships than an interest in sex and partying.
“Often times, early on they got into a relationship with a male who introduced them [to meth]. Then they got hooked and their addiction was perpetuated outside the context of that relationship,” he said. He added that women who get into relationships with female meth users can find themselves picking up the habit, too.
Bonner has also counseled transgender women who inject meth. One of these clients, he said, has faced “significant discrimination” because of her gender identity and worries about being able to “pass” as female. And fears about facing anti-gay and anti-trans discrimination and violence aren’t the only things queer meth users have in common.
“I don’t wish to stereotype or over-generalize, but I do see with queer female clients as well as with MSM [that] there’s often an abuse history — particularly a sexual abuse history,” said Bonner. Often, he added, clients have also experienced emotional, verbal and physical abuse as well as exposure to substance abuse by family members during childhood.
Meth use can also be a coping mechanism for any number of mental illnesses, including clinical depression, a symptom of which is often substance abuse.
For years, Utah has led the nation in mental health diagnoses. In 2008, a study by Mental Health America ranked Utah as number one in the country in cases of diagnosed depression.
“In Utah, in general [mental illness] is not something that’s talked about openly enough,” said Bonner, noting that Utahns are also more likely to abuse prescription drugs than residents of many other states. “I think it’s a state that’s often overmedicated, and that’s something we don’t like to discuss.”
“If I were a betting person I’d definitely say yes, there is a correlation between mental illness diagnoses and meth use,” said Beltran.
Kicking the Habit
Although meth is highly addictive, it isn’t as hard on the body or as hard to give up as drugs like heroin, which often require medical assistance to quit. The difficulty many users have in giving it up, said Beltran, has more to do with psychological addiction than physical dependence.
“I think with meth use they get addicted to the lifestyle and the sex activity that seems to accompany the meth use,” said Beltran. “They can recognize that it puts them at risk for HIV and other issues, but many of my clients say they can’t get away from [meth] because even if they try to, the guys’ll pull them back into it.”
“Yes, yes and yes,” said Buie, when asked if meth users had a high relapse rate. “In our community it’s highly socialized, so [one’s] circle of friends are doing it, the club kids are doing it, it’s everywhere” to the extent that giving up the drug means giving up socializing.
“For a lot of people, there’s a sense of isolation and loneliness,” he explained. “[They] know who [they] are at the club and parties, but without those circles [they] have to reinvent [themselves] and that takes a lot of energy.” For this reason, Buie said that he supports group therapy for meth users as well as other forms of therapy that can help them seek “healthier socialization.”
Still, even a good therapist and a supportive social circle aren’t enough.
“Unless something has happened to them in their life to force them to make the change, they often don’t,” said Beltran. “They may go to the first meeting and they’re done, or they may not show up. It has to come from them, and most are aware of the options.”
And right now, the options for treatment — especially programs that receive public funds — are swamped. And some, like the Utah AIDS Foundation’s short-lived Utah Tweaker project, are long gone.
“[Salt Lake County] has poured a lot of money into trying to effect change, but the resources can’t seem to keep up with the demand,” Beltran continued. “So if today I felt like I was ready to take the step, if I had to wait a week to talk to someone, by the time that week rolls around I might be back using in someone’s garage.”
“I think we’ve almost come to an acceptance now that it’s just rampant,” she added.
Ultimately, said Buie, the only way to stop meth use in Utah’s gay, lesbian, bisexual and transgender community is for the community to stop treating the drug as acceptable.
“I don’t think collectively that we have been willing to embrace more profound stories of who and what we are, so we settle for this club existence and this really superficial way of existing that leaves a lot of permission for drug use,” he said.
“I would love for our Pride events to really focus on what it means to have Pride in who we are,” he continued. “But even [the Utah Pride Festival] is a big beer party, if you think about it. Everything is centered around going to the clubs and having that beer garden, and I think on many levels we’re communicating permission to not take care of ourselves in that way.”
And while meth programs are strapped for funds and staff, Buie insisted that a change in attitude will go a lot further than dollars in saving lives.
“It’s about having dialogue on issues that are relevant to our lives,” he said. “But we seem to have this reluctance to talk, and that reinforces these narratives of ‘poor me, I’m a victim.’”
But the good news, said Beltran, is that SLVHS and other health organizations can give referrals for meth addiction treatment for those who want to quit.
“It’s never too late to change,” she said. “It’s worth stopping.”