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I came of age as a gay man in Greenwich Village during the late 1980s when the AIDS epidemic was raging. I watched my friends and lovers die left and right. At the peak of the crisis, I was attending a funeral every other weekend. Elected officials all across the country turned a blind eye as tens of thousands of young people died.
After a decades-long fight for solutions, H.I.V. is manageable today thanks to preventive medicine like PrEP; medications that reduce the viral loads of H.I.V.-positive people; and a better understanding of how to manage the virus. H.I.V. went from an inevitable death sentence to a manageable chronic disease. But it took far too many deaths to get there.
Today, the gay community is facing another crisis that we’re not talking about and that elected officials are once again ignoring. Scores of gay men are addicted to crystal methamphetamine. The drug, which can change the chemical composition of the brain in chronic users, is extremely addictive. And just like during the AIDS epidemic of the 1980s and 90s, resources are paltry, government support is virtually nonexistent and an aura of denial surrounds the crisis.
Gay men are more likely to try meth than straight men. One explanation for this could be that gay men struggle with acceptance in ways straight men don’t have to. Growing up gay, and being forced to keep that a secret for fear of family rejection or neighborhood bullying can create huge insecurities and issues with intimacy.
My best friend was rejected by his family for being gay and beaten in the streets of his hometown in Mexico. He had to flee to the United States for refuge. As he grew older, he became more and more desperate to belong to a community. He sought out men on gay apps, and ended up falling for a handsome young man who was addicted to meth. He fostered my friend’s addiction. The initial drug use was about acceptance and remaining relevant in an overly sexualized culture. Now, despite recent interventions by me and other people, my friend is overcome by the daily ritual of obtaining and using crystal meth. He’s a different person than the one I’ve known for over 25 years.
There are many stories like this. The truth is, using meth can create a twisted sense of camaraderie among users.
Hookup apps like Grindr make finding meth — as well as men to use it with — fast and easy. Users sprinkle capital Ts, referring to meth’s street name, Tina, or diamond emojis throughout bios and usernames. Meeting a stranger from the internet for the first time is stressful for anyone — especially for someone who might struggle to form deep connections. Using meth can create an instant, false sense of intimacy and trust, allowing a cheap escape from the problems of our daily lives. In the moment, it seems euphoric; the drug is associated with enhanced sexual pleasure, after all. In reality, it’s ruining countless lives.
There are many underlying reasons gay men start using meth in the first place — and those reasons must be addressed.
It’s an unfortunate reality that certain insidious practices and beliefs are upheld within gay male culture that put all of us in danger of adopting risky behaviors. We put intense pressure on each other to be thin, hot and have a lot of sex. Plus, while society is significantly more accepting than it was even 10 years ago, many gay men still struggle with discrimination, violence and our own internalized homophobia, which means drugs can be an escape for many. And meth use greatly increases the risk of getting H.I.V. and other sexually transmitted diseases.
This isn’t a new issue. I’ve watched gay men suffer from meth addiction for over 20 years — and it’s only getting worse. One of my closest friends started using the drug a couple of years ago. Previously a successful businessman, he has now lost his friends, family and his business. He spends his days searching for meth. Ten years ago, I lost a partner to crystal addiction. He relapsed after two years of sobriety and eventually died on the street.
No one in the gay community is immune to the impact of crystal meth addiction. If we want to continue growing as a community, we must immediately provide funding and support for gay men who are addicted.
At the network of community health centers I lead in South Los Angeles, the overwhelming majority of patients we treat in our substance abuse programs are addicted to crystal meth. Because meth addiction disproportionately affects gay men, it hasn’t risen to the level of priority and intervention of other addictions.
Elected officials, gay leaders, health care centers and community centers must develop funding and programming to respond to this crisis. Universities and research institutions must begin intervention studies that can inform community-based practice.
Countless gay men suffer from this crippling addiction — and we cannot lose even more of our family members. It’s time to talk openly about the crisis so we can organize the will and the resources we need to address it.
Jim Mangia is the president and chief executive of St. John’s Well Child and Family Center.
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