This article is the second of a four-part series on meth in the gay and bi community. Read parts 1, 3 and 4.
Meth has gotten an outsized reputation as the “scourge of the gay community” even though far more people have been harmed by alcohol, prescription drugs and other illegal substances. So we decided to compare the harmfulness of meth to other legal and illegal drugs, explore why the community at large has focused on it as a “gay problem” and the unexpected ways that focus affects our community. This article seeks not to encourage meth use nor to deny its harmful impact for some, but rather to explore the ways our current attitudes towards the drug disable honest discussions around it.
Alcohol (and many other drugs) are far more addictive and socially harmful than meth
In 2010, roughly 17 drug experts with the U.K.-based Independent Scientific Committee on Drugs (ISCD) ranked the harm of 20 different drugs based on 19 different criteria, including nine related to self-harm (like a drug’s impact on a person’s mental and physical health) and seven related to societal harms (like a drug’s impact impact on crime, healthcare, families and international conflicts).
In terms of overall harmfulness, alcohol, heroin and crack cocaine all ranked higher than meth: Alcohol had a score of 72, heroin scored 55 and crack 54 — meth scored 33 points. By their measure, alcohol causes almost twice as much overall harm than meth and caused 23 times more social harms than meth, primarily in terms of economic damage, family problems, crimes committed under the influence and injury to others.
Regardless, meth outranked alcohol and almost every other drug (besides heroine and crack) in terms of self-harmfulness, particularly in its impact on one’s own mental health, loss of personal relationships and financial difficulties. And it still inflicts other social harms, albeit in ways that the ISCD may not have taken into account (we’ll discuss them below).
A Dutch replication of the ISCD study ranked each drug’s addictiveness between zero (least addictive) and three (most addictive). While individual genetics and life experiences determine one’s propensity towards addiction, in these studies drug experts most considered the neurochemical and withdrawal effects that contribute to a drug’s addictive qualities. The Dutch study ranked meth as the fifth most addictive drug with a score of 2.24. Heroin ranked first (2.89) followed crack (2.82) and nicotine (2.82) and then methadone (2.62). Alcohol and cocaine followed meth with equal scores of 2.13.
People abuse other drugs far more regularly than meth. A 2002 global study by the World Health Organization (WHO) found that 2 billion people worldwide drink alcohol, 1.3 billion use tobacco and 185 million use illegal drugs like meth. Even among those illegal drugs, the WHO ranked meth as the fifth most used out of six. People are far more likely to use alcohol and tobacco because of their widespread legality, accessibility, affordability and accepted social use.
A 2015 study of illegal drug use by the U.S. Substance Abuse and Mental Health Services Administration showed that while 900,000 people had tried meth in 2015, twice as many had misused prescription stimulants, prescription tranquilizers or crack cocaine, and four times as many had misused prescription painkillers. Approximately 155 times as many had used alcohol.
As a result, these other drugs kill far more people than meth. The WHO says that illegal drugs (including meth) contribute to a combined 0.4% of all deaths worldwide whereas alcohol contributes to 3.2% and tobacco to 8.8%. A U.S. government study of drug deaths during 2014 showed that heroin caused 10,863 deaths, cocaine caused 5,856 and meth caused 3,728 — overall, meth ranked as the eighth most deadly illegal drug that year.
And while the Centers for Disease Control (CDC) say that alcohol poisoning only kills approximately 2,200 people annually, the CDC also estimates that alcohol-related illnesses kill 88,000 people annually and an additional 9,967 die from alcohol-related driving fatalities. Comparatively, a U.S. study of drug and alcohol related deaths from 1995 to 2013 showed that 15% of all fatal car accidents involved alcohol while only 2.53% involved stimulants, like meth.
So if meth is harming a smaller number of people, why is the gay community so focused on it?
People perceive illegal drugs as more harmful than legal ones but these studies above prove that simply isn’t true. In fact, because people equate legality with harmfulness, criminalizing a drug sends incorrect messages about its addictiveness and lethality. As a result, legal substances like alcohol and prescription drugs remain widely accessible and socially sanctioned (or even encouraged), factors which actively encourage their abuse. Furthermore, public perception of the danger of illegal drugs encourages legislators and the judicial system to punish their use far more harshly.
Gay and bi men especially focus on the harms of meth use, for three reasons, says Craig Sloane, a clinical social worker, substance abuse counselor, sex addiction therapist and educator in New York City who is also a board member of the National Association of LGBT Addiction Professionals and their Allies (NALGAP).
First, meth’s association with sex makes it much “sexier” drug to discuss. Secondly, its effects on the body and psyche reveal themselves much more quickly and visibly than other drugs.
Thirdly, a lot of research links meth use with HIV. Studies have shown that meth use increases one’s chances of HIV transmission (up to three times more than non-meth users) and accelerates HIV progression in the body, primarily because of its wear on the body’s immune system. For gay and bi men traumatized by the HIV epidemic (both its lethality and the way conservatives have used it to stigmatize gay and bi men), they harbor a special hatred towards meth and its continued contributions to both HIV and conservative homophobia.
But the seemingly outsized focus on meth as a scourge of the gay and bisexual community backfires in at least three ways: Foremost, it minimizes the more widespread harms that other drugs have on our overall health, leaving those drugs under-discussed, under-researched and under-treated. Alcohol and other drugs contribute to HIV transmission as well for example, but alcohol users get blamed far less often for the HIV epidemic.
Second, people disparage meth and its users in the hopes that it will discourage others from using it. These messages include public service announcements that focus on horror stories of rape, jail, sexually transmitted infections and “meth mouth.” But these messages also have the dual effect of shaming current users and compelling them to use meth in secret and to remain silent in discussions of how meth affects our lives. Some recreational users use meth occasionally rather than compulsively and remain in high functioning lives and careers, but because it’s so widely regarded as evil, these experiences get excluded from public debates as naive, selfish and dangerous.
“[Meth users] are ousted from their own inner circle because of stigma,” Sloane says.
“I think that we love to try to scare others into comporting their behavior to our moral expectations, and horror stories are a great way to do it,” says Wes Parks, a licensed professional and national certified counselor specializing in LGBTQ mental health with a background in forensic psychology that has put him in close contact with drug users in state jails and mental facilities.
“We see it with drugs. We see it with religion. We see it with sex,” Parks continues. “I think a better approach is genuine education combined with open and honest dialogue free of stigma and judgment.”
How the gay community’s stigmatization of meth actually harms users and non-users alike
Although the ISCD study said that meth harms individual users far more than the greater community, their ranking incorporated data directly linking drug use to social problems while ignoring the more subtle ways that drugs can hurt a community’s political standing and internal strength.
“Many gay men can’t understand how other gay men could do this to themselves, making it a moral issue rather than a medical one,” says David Fawcett, a substance abuse expert, certified sex therapist, clinical psychotherapist specializing in gay men’s health and the author of Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery. “This rift, on top of others, like the viral divide of HIV, greatly undermines the strength of our community.”
David Stuart agrees with Fawcett. Stuart is manager of the ChemSex support services at 56 Dean Street in England, creator of the European ChemSex Forum and founder of the Dean Street Wellbeing program, a series of artistic community events that encourage discussions about sexual health, well-being and community. He adds that the gay and bi community’s differing responses to the HIV epidemic and the meth epidemic have been discouraging.
“I don’t want to over-romanticize it, because it was a difficult time,” Stuart says, “but in 1985, when someone was dying of AIDS in a hospital bed, another gay guy who never met him ever, would march down the streets demanding for his right to medicine. That’s community. Chemsex [which includes meth use] is not eliciting the same kind of community response.”
When a guy develops paranoia or dies as a result of meth use, Stuart says, gay men don’t rush to help him. Instead, he says, “We see his best friend stepping over [him] saying, ‘Oh, she can’t handle her drugs. She’s too high again.'”
“What we see in the press is people vilifying it, demonizing gay men who use drugs as if there’s those of us that let us down in our gay community. ‘Those filthy sluts that do chem.’ And us, we’re the good guys who don’t do that, as if they got nothing to do with each other, as if we’re not all one community,” Stuart says. “We have a choice to support each other and to be kinder online, empathizing why people are medicating their way through their sex lives. Empathizing why so many of us have adopted chems into our lives as a tool to manage our sex lives. We should be empathizing with this, understanding it, talking about it kindly rather than villifying each other in a ‘them and us’ situation.”
Sloane also believes that perceptions and some media coverage about meth use among gay and bi men perpetuate stereotypes of gay men as crystal meth-using sex addicts, stereotypes that influence public opinion and affect gay human rights in the voting booth and legislature. It’s impossible to study or measure the effect of one on the other, he adds, but he says these gay and bi men are convinced of a correlation between meth use and public opinion of the gay and bi community.
However, he acknowledges that meth’s impact on our community remains complicated and double-edged. The large number of men who have become HIV-positive under the influence of meth over the last 20 years have created a new wave of shame, guilt and secrecy, he says, but they have also helped create recovery communities in the gay male world that have been amazingly healing and transformative for so many.
When Crystal Meth Anonymous (CMA) first started in New York City, he says, it was four people in a guy’s living room – gay guys who were trying to get sober in Alcoholics Anonymous but who felt like meth addiction had its own intricacies different from alcoholism. “They felt they could relate better and have a better chance of recovering if they had their own group,” he says. “Today there are dozens of meetings with hundreds and hundreds of recovering gay men in community and mutual support.”
“Many of my clients have reported that if they hadn’t become meth addicts they don’t believe they would have found the community that is so life affirming for them today,” he adds. “So it is a bit of a paradox. In some ways crystal meth addiction has ravaged the urban gay male communities and in other ways recovery from meth addiction has brought it together.”