When we ask what can we do about unsafe sex and crystal use, I think we should look at the evidence that Peter Staley has presented – his own experience. His honesty and candor have earned him a leadership role in recent efforts to come to terms with methamphetamine, the party drug that is enjoying a revival in New York City.
Mr. Staley attracted attention by using his own money to purchase advertisements warning of the dangers of crystal, but he avoids demonizing the drug and its users.
He found the drug enormously attractive and it provoked a mid-life crisis, but it wasn’t the drug alone that provoked this strong reaction, but, rather, the good sex he had while on the drug. In other words, it was the combination of the drug and the drug setting that made him a binge-user.
His is not a clinician’s view of a patient, but rather his own personal, and valid, observation: “Someone told me inaccurately that crystal was a fun drug to have sex with and no hangover.” Pretty instantly, Mr. Staley got hooked. In a recent conversation, Mr. Staley indicated that he often thought about the “amazing sex I had and wanting to get back.” Despite the enormous attraction, however, Mr. Staley says he never became a daily user.
Mr. Staley’s initiation into the use of crystal illustrates a classic harm reduction warning. Indeed it’s the most basic warning about drug use that was offered by Winifred Rosen and Dr. Andrew T. Weil in their book, “From Chocolate to Morphine.” If a drug rocks your world, and provides a tremendously positive experience – watch out. Your risk of dependence is high. If you want to preserve your positive experience then you need to use in moderation. If you can’t moderate your drug use, you will find that the experience deteriorates and you need to stop.
Mr. Staley’s warnings are most directly aimed at the heavy user. He knows people who control their use of meth, but he wasn’t one of them. According to Mr. Staley, the second time he used the drug, he increased his dosage and smoked it so he could feel its effects faster. He was not a daily user, but a binger, yet in a matter of weeks recognized that he had a problem. “I never went through the denial phase.” Ultimately, Mr. Staley stopped using crystal, but he frequently feels the pull of the drug.
The drug high is only a part of that temptation, Mr. Staley says. The other part is what has become the siren call of the crystal meth underground in which use of the drug becomes requisite in order to have sex. Mr. Staley acknowledges “nobody seemed to ask you your status. It seemed to be assumed that everybody was positive. So there was this underground where you could feel young and sexy again which you had not felt since you seroconverted. You feel 20 years old on this drug.”
The inhibitions felt by HIV-positive people remain a source of sadness and depression for them and it is a problem that should be addressed by enterprising and responsible activists in the community. I would hope we could make it easier for people with HIV to find fulfillment. Most of us have made our peace with safe sex. But the sexual adventurer remains a vital part of the gay community, and it is important to have social structures that work for these persons, both HIV-positive and HIV-negative.
Peter Staley had every reason to believe he could handle crystal as he had handled other drugs in his life. However, he got bad advice from a friend who told him that unlike ecstasy, crystal would give him the high without a long hangover. He used harm reduction techniques while working with his psychiatrist. He kept up his AIDS medications, drank water, took vitamins (B-complex is especially important for crystal users) and purchased smaller amounts of the drug in an effort to reduce use. However, these methods did not lead to controlled use. Therefore, Mr. Staley concluded there was little choice but to abstain. Nevertheless, Mr. Staley made moral choices, such as in his harm reduction phase when he informed partners of his status and used condoms.
People like Peter Staley represent only part of the crystal underground. Gay City News has been chronicling the rise of crystal over the past five years, including studies conducted by CHEST, the Center for HIV/AIDS Educational Studies and Training. In 1999, researchers had no trouble finding crystal users who practiced unsafe sex in New York City. The study group was 52 percent HIV-positive, and only ten percent of the HIV-negative group was bottoming during unsafe sex. Facts like these dictate further research and argue against facile conclusions that the users of crystal are on a suicide mission.
Other recovering addicts like Peter Staley didn’t set out to become addicts, much less die from using crystal. The CHEST study corroborates that many men in the crystal-using group had many sexual partners and were cavalier about the risks of contracting certain sexually transmitted diseases. But these men were much more careful when it came to contracting HIV. Only a small percentage of the negative members of the group ran a high risk of sero-converting by being bareback bottoms.
These kinds of in-depth conclusions form the heart of a harm reduction analysis that often finds out that popular fears aren’t justified and that other dynamics are driving a new set of social behaviors. There is speculation that crystal use is peaking or has peaked. As the community has become aware, the users take steps to avoid the most destructive outcomes.
Self-help groups for crystal users are growing rapidly. Last winter, over 750 people showed up at a community meeting on crystal meth awareness at F.I.T. In the city, Crystal Meth Anonymous meetings have grown from one meeting a week four years ago to over 20 weekly meetings now. The most popular meetings have an attendance of more than 100.
There is no need to turn on the crystal meth users. They are concerned. Paying attention to them and listening to their concerns will do more good then simply venting anger.
