“The basis of optimism is sheer terror.”
“The Picture of Dorian Gray”
Recently, I co-facilitated a support group for HIV-positive gay men about crystal methamphetamine. The group’s discussions led to some surprising suggestions about why positive men may use meth and the role it might play not just in the pursuit of pleasure but also in the amelioration of psychic pain.
I started the group because, while meth and other drug use has been implicated in a new wave of HIV infections among gay men, as a social worker and therapist, I wanted to provide a place for men already infected with HIV to discuss what partying with tina has meant specifically in their lives.
What was apparent from the first meeting was that the guys wanted to talk about the drug, not the disease. At least initially, HIV didn’t resonate as the main topic, even among those recently infected. It was as if problems with crystal trumped what in many ways is becoming a more manageable long-term health condition. Perhaps that is overstating the case, but it was clear that crystal was the most immediate concern for the group members. In fact, they were pretty freaked out by their experiences with meth.
Something else that became clear quickly was that in each man’s experience, crystal use was a highly compartmentalized activity and firmly linked with sexual activity. This may seem like a no-brainer to some who are reading this, but it’s worth considering. Each person in the group had a specific place, usually a little box or secret hiding place to store their drug—that is, if they could stop snorting or slamming before all the drug, or all their available cash, was gone. A very specific set of circumstances acted as the metaphorical key to open the tina box. In some cases, it was the desire for a particular kind of sex, or sexual scene, in others a concatenation of emotional forces—too much stress, not enough structured time, depression, triggered low self-esteem, elation, boredom, the desire for celebration.
When groups of gay men talk about tina, everyone discusses two things—how incredible the sex is (whether it’s group fisting or endless online masturbation) and how horrible the crash is. In fact, most group members cited the crash and attendant repercussions from extended use—fatigue, depression, dehydration, sores, highly resistant infections, never mind the impacts on immune and brain function—as a major motivator to quit using. Most of the men identified the crash or come-down period being as long in duration and intensity as the high—in fact, really a part of the intensity of the high, only its shadow side.
One of the most poignant and revealing insights for the group was the possibility that the crash was not only the unavoidable downside of tina’s fabled high, but maybe part of the package that the men on some level craved. This seems counter-intuitive at first. Who would want to suffer an agonizing inability to sleep, aural hallucinations that make you think the neighbors are talking about you just outside your door or morbid thoughts of paranoia and Kafkaesque malaise?
Well, what if as an HIV infected gay man—having dealt with layers and layers of pain, denial, worry, mourning and frustration, and having experienced the slowly roasting traumas of coming out in a homophobic society, enduring the fear that sex would kill, watching friends sicken and die, facing addiction to alcohol and other drugs, dealing with onerous and sometimes dangerous side effects of medication and waiting for the seeming inevitability of disability, penury and death—a tina-induced downer was one of the only ways you could process all that crap? What if the God-awful come-down was in some fashion an attempt to come to terms with the pain of their lives?
Certainly using a destructive drug like crystal as a tool to grapple with unresolved negative emotions is an ill-advised and dangerous self-therapeutic technique. Most people are forced to rein in their powerful emotions, whether euphoric or dismal. Many peoples’ drug use is an attempt to sort out or solve some problem or pain. Maybe tina allows—yes—some carnal Dionysian pig sex, but also a great big boo hoo fabulous pity party.
A lot of these men have a lot to cry about.
Being a positive gay man on tina is in many ways like being Oscar Wilde’s Dorian Gray—an artist who becomes a monster by trying to live out an endless adolescent fantasy. Crystal somehow encapsulates the flat abs porn star sensibility and the sagging troll’s love of his own misery and dejection in one fell swoop. The support group was a place to consider such blended identities and the HIVers’ wierd experience of being young and old at the same time.
The group went back and forth about whether or not the crash was part of what they unconsciously wanted with crystal meth. But they did acknowledge that their lives were replete with anxieties that in their sober lives they struggled mightily to keep the lid on and control. Perhaps tina’s magic is that once the Pandora’s box is opened, one can just let the demons dance around.
At the end of the day, the group came to an agreement that their coming together to talk about these questions, as messy, painful and convoluted as it could be, was the key to a different sort of lock that hopefully opened the door to a new corridor of options. Certainly this group of men was exhausted by the dangerous cycle of illicit drug dependency, unsafe sexual encounters and that devastatingly dark crash. As one group member said, “When you get high on crystal, you always know exactly what is going to happen.” That repetition is tina’s promise and its curse.
Christopher Murray, MSW, is project coordinator of the LGBT SmokeFree Project and a therapist in the mental health program at the Lesbian, Gay, Bisexual & Transgender Community Center, on the board of Honoring Our Journey, a gay men’s spiritual wellness organization, and the vice president of Body Positive’s Board of Directors. He will be co-facilitating a new Body Positive support group for HIV-positive gay men about crystal methamphetamine starting on February 11. For more information on that group, call Body Positive at 212-566-7333.