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Crystal Meth and AIDS
Sep 6, 2007

hey dr, i have aids and use crystal meth(smoke it).It makes me feel very good and takes away alot of my pains and anxietys as well as I can accomplish many things.I wanted to know what are your personal views on smoking meth to help cope with AIDS????

Response from Dr. Frascino

Hi,

Smoking meth to cope with AIDS is a bad idea for many reasons. See below. I urge you to talk to your AIDS specialist if you need help with pain and/or anxiety control. There are many much safer modalities to help with these symptoms!

Good luck.

Dr. Bob

The Horrors of Crystal Meth

By Ross Slotten, M.D.

September 20, 2004

In the last few years, the abuse of crystal methamphetamine (also known as crystal, meth, tina or speed) has gotten out of control in the U.S. gay community. One reason this is so alarming is that the abuse of crystal meth contributes to the spread of HIV infection. Crystal meth is similar to pure amphetamine and ephedrine. It is easy to get, costs less than cocaine and is highly addictive. Crystal meth can be smoked, injected, snorted and swallowed.

Like all amphetamines, crystal meth causes large amounts of dopamine to be released in the brain. Dopamine is a chemical that improves mood, increases self-confidence and strength and heightens sex drive. Unlike other amphetamines, crystal meth works mainly on the brain, causing fewer side effects on other parts of the body (such as rapid heart rate and shortness of breath).

The problem with frequent use is that people need larger amounts to get high. At higher doses, side effects on other parts of the body become more obvious. At very high doses, usually taken by accident, people can develop brain-damaging fevers, stroke-producing high blood pressure, heart attacks and massive damage to muscle tissue that can lead to kidney failure and death.

Long-term use changes the chemical balance of the brain and can cause a mental illness called psychosis. In the psychotic state, hallucinations are common. People may believe they are infested with parasites, which they see crawling from their nails or out of their skin. They come to the doctor's office with sores caused by picking and scratching. If the drug is not stopped at this point, the person may wind up in the psychiatric ward unable to take care of him or herself.

Long-term users of crystal meth experience withdrawal when they stop the drug. Withdrawal symptoms include fatigue, depressed mood, loss of pleasurable feelings and suicidal thoughts. These symptoms may never go away, even if the person never uses crystal meth again.

One of the worst effects of crystal meth is that users often have unprotected sex when they are high. This puts people at risk for new HIV infections. Even people who already have HIV can get reinfected with a drug-resistant strain of HIV or contract another sexually-transmitted disease.

In addition, crystal meth may interact with HIV medications. There is one report of a person taking a protease inhibitor who died of a crystal meth overdose because of a drug interaction.

Successful treatment of crystal meth addiction is difficult because most people start using again. Nevertheless, it's worth seeking counseling rather than trying to stop the drug on your own. Most cities have drug addiction treatment programs.

Your best bet is not to start using crystal meth in the first place. But if you have, seek help to kick the habit. Call the National Clearinghouse for Alcohol and Drug Information at 800-729-6686 for treatment programs in your area.

Ross Slotten is a family physician in Chicago who has specialized in the treatment of HIV+ people for 20 years.

Living With Crystal Meth

By Eddie Young

March/April 2005

Alter the chemical make-up of ephedrine, add just the right amount of drain cleaner, battery acid and antifreeze, toss in assorted other easy-bake compounds, and you have the recipe for crystal meth. Bon appétit. I had heard rumors about the ingredients, but didn't care. It looked clear and pure enough, especially after the first hit. I had also heard (from another addict) that an Australian study had shown that regular crystal use would lower the amount of HIV virus in the body. It's amazing how much an addict -- no matter how educated -- is willing to suspend disbelief to indulge his habit. Though I knew it wasn't true, the excuse was convenient and compelling. But some things were absolutely certain: crystal made me feel good, made sex fabulous, and put me on somebody's A-list. All it took was a harmless bump up my nose ... at first.

Addiction is progressive and fatal.

I tested HIV positive in November 1992, after waking up one morning blind in one eye. What few people know is that I had been using cocaine for about three years at that time and was just coming off a binge. Full-blown AIDS, shingles, presumptive toxoplasmosis and optic neuropathy were diagnosed in a matter of days.

How did I get to that point, and why wasn't that the end of my addictive behavior? Complete answers are too complex for this article, implicating everything from a dysfunctional family and childhood, to homophobia, to internalized shame about being HIV-positive (if not my own shame, then the shame that others projected onto me), to my own physiology. But the distilled answer is this: I felt lonely, I wanted to escape, and I desperately needed to feel that I belonged -- somewhere, anywhere. Add to that the drive of my inner addict -- the obsession to use, and the compulsion to use more. After I took that first drug or drink, I had to have another and another. The nature of addiction is that one is too many and a thousand never enough.

Early on, I refused to consider that I had a problem, much less that I was an addict. Addicts were "those" people, not me. They are not board presidents and band leaders, law school graduates and community activists. I had only missed a few committee meetings over the years, didn't lose my house or car and kept a healthy amount of money in the bank. I was only a binge user -- getting high only after finding and blocking off a long weekend on my calendar, or maybe rescheduling a meeting here or there to create a long weekend, or maybe just doing a little less meth on a two-day weekend so that I could be sure to eat before Monday. Or maybe using on the occasional weeknight, but taking a sleeping pill to make sure I got enough rest. I couldn't see a problem. Addicts use every day, I told myself. Anyway, meth was a relatively recent phenomenon for me.

The reality was that as my addiction progressed, I was online almost every day, hunting for party and play (PnP) men. I would plan trips out of town just so that I would not use on a given weekend. Looking back, it's clear that I wanted out; I just didn't know how to get out. A close friend accused me of being a tweaker. He said that I had changed, that I never called him. He told me that I no longer spent time with him and that I was short-tempered, even belligerent, on the phone. I was indignant and denied every word of this truth. OK, so maybe I chose the escape route of alcohol and drugs when my former partner was diagnosed with cancer. Maybe I never made it across the street to a friend's pool after 16 invitations one summer because I was busy, busy, busy cruising online, snorting and smoking meth. And maybe I had convinced myself to sell my house and move to a condo because I just didn't have time to mow the lawn. And maybe I was hanging out at my dealer's place several nights a week, spending more money on meth than I was on food, and driving my car when high, and allowing groups of strangers into my home and into my bed. And maybe I engaged in other acts of incomprehensible demoralization that I now find difficult to even consider. And yes, maybe nothing came before the supply run to the dealer, as I always prudently planned ahead so that I would have enough for the next binge. And OK, so I stopped looking people in the eye. Who would want to look at me, anyway? Given another day or so of using, I would have slammed crystal into my veins with a needle. I had already planned it. The real horror is that this all seemed normal.

After that first bump of meth, during an online hookup, I was cured of any other addictions. Crystal made me confident, even fearless -- something alcohol and cocaine could never do. I felt validated through meth-infused sex. A few hours of illusory intimacy was better than days of emptiness. Instead of always being the best little boy in the world, I could run, if only for a few hours at a time, with the fast crowd -- the fabulous people.

But none of that was real. The reality is that I neglected and abused my body, not wanting to eat, unable to sleep for days at a time. I lost weight and exposed myself to other sexually transmitted diseases. I so weakened my immune system that I developed Kaposi's sarcoma. I became paranoid, skeptical, mistrustful and isolated. I felt hopeless and full of despair, and came to rely more on meth to escape feelings of worthlessness. I was caught in the vicious cycle of addiction.

If you think you may have a problem with crystal meth, you probably do have a problem with crystal meth.

Deep into my addiction, a former party buddy ran up to me one day and whispered in my ear that he had entered recovery and had been clean for a few months. He planted a new seed in my mind. I saw him a couple of weeks later and knew that I had to find the courage to ask about his new life. As a wise man once said, "Courage is the first of human qualities, because it is the quality that guarantees all the others." My friend said that with a little bit of willingness and an open mind, I, too, could find hope for a different way of living. I considered the possibility that I may have a problem.

We drove together to my first 12-step meeting, where I found recovering crystal meth addicts talking about what using did to their minds, bodies, careers and relationships. They talked about how they got and stayed clean and how they are living their lives today. I realize now that I am not the eternally unique outsider as I had so selfishly believed. I now know that I am more like other people than different. I've also learned that I am only as sick as my secrets. To stay sober, I must let people know who I am, warts and all. As people get to know me, I no longer feel lonely and want to escape. The vicious cycle is broken. Crystal meth addiction is progressive and fatal, but today I know that there is a solution. Today, I carry the message and not the mess.

To talk with someone who can help, please call the Georgia CMA Help Line at (404) 454-3637. This 24-hour help line is staffed by volunteers who are in recovery. If you get voice mail, please leave a message and someone will return your call as quickly as possible. Note that this line offers the support of one addict helping another and cannot answer your medical or legal questions. If you are infected with or affected by HIV, a "Positively No Speeding" recovery group meets every Thursday at 7:00 p.m. at the AIDS Survival Project offices. Call the help line or visit www.atlantacma.org for more information.

Eddie Young is a board member and immediate past president of AIDS Survival Project.

Living With[out] Crystal Meth Addicts were "those" people, not me

By Eddie Young

July/August 2005

Alter the chemical make-up of ephedrine, add just the right amount of drain cleaner, battery acid, and antifreeze, toss in assorted other easy-bake compounds, and you have the recipe for crystal meth. Bon appétit.

I had heard rumors about the ingredients, but didn't care. It looked clear and pure enough, especially after the first hit. I had also heard (from another addict) that an Australian study had shown that regular crystal use would lower the amount of HIV in the body. It's amazing how much an addict-no matter how educated-is willing to suspend disbelief to indulge his habit. Though I knew it wasn't true, the excuse was convenient and compelling. But some things were absolutely certain: crystal made me feel good, made sex fabulous, and put me on somebody's A-list. All it took was a harmless bump up my nose ... at first.

I tested HIV-positive in November 1992, after waking up one morning blind in one eye. What few people know is that I had been using cocaine for about three years at that time and was just coming off a binge. Full-blown AIDS, shingles, presumptive toxoplasmosis, and optic neuropathy were diagnosed in a matter of days. I was put on a separate drug regimen for each of those conditions, which meant at least a couple of handfuls of pills a couple of times a day. I was farmed out to an eye specialist and was poked and prodded by an assortment of other interested doctors, becoming a guinea pig of sorts. Apparently, mine was the first presentation of toxo so affecting the optic nerve in the Atlanta area, and created quite the buzz. The names of all of the prescribed meds are gone from memory, but the panic, fear, and sense of impending death are very much with me today. On the up side, I stabilized with treatment, began attending HIV support group meetings and, in partnership with my physician, chose to stop the antiretroviral meds until circumstances dictated otherwise.

I also stopped using cocaine cold turkey-for about three months. The consequences of using were such that I thought I would never want to use again. But addicts are great forgetters. True to form, I quickly forgot those consequences, and began to romanticize the drugged-out past. The party started again at the 1993 March on Washington for LGBT Equality. I ended up missing most of the March, but made it to many of the parties. So much for gay pride. Cocaine never took complete hold again, but I certainly gave myself permission to binge occasionally, and to dive headfirst back into alcohol, which had been my first drug of choice.

How did I get to that point, and why wasn't that initial AIDS diagnosis the end of my addictive behavior? I had, after all, been given a sort of second chance at life. Complete answers are too complex for this article, implicating everything from a dysfunctional family and childhood, to homophobia, to internalized shame about being HIV-positive (if not my own shame, then the shame that others projected onto me), to my own physiology. Perhaps, in twisted thoughts of death, I just wanted to go out with a bang. But the distilled answer is this: I felt lonely, I wanted to escape, and I desperately needed to feel that I belonged-somewhere, anywhere. Add to that the drive of my inner addict-the obsession to use, and the compulsion to use more. After I took that first drug or drink, I had to have another and another. The nature of addiction is that one is too many and a thousand never enough.

Early on, I refused to consider that I had a problem, much less that I was an addict. Addicts were "those" people, not me. They are not board presidents and band leaders, law school graduates and community activists. I had only missed a few committee meetings over the years, didn't lose my house or car and kept a healthy amount of money in the bank. I was only a binge user-getting high only after finding and blocking off a long weekend on my calendar. Or, maybe I'd reschedule a meeting here or there to create a long weekend, or maybe I'd just do a little less meth on a two-day weekend so that I could be sure to eat before Monday. Or maybe I would use on the occasional weeknight, but take a sleeping pill to make sure I got enough rest. I couldn't see a problem. Addicts use every day, I told myself. Anyway, meth was a relatively recent phenomenon for me. I had abused alcohol since college days in the early 80's, and then added cocaine at the end of that decade. With time, though, I moved on to sample X and the other letters of the drug alphabet, finally adding crystal in early 2002.

The reality was that as my addiction progressed, I was online almost every day, hunting for party-and-play (PnP) men. I would plan trips out of town just so that I would not use on a given weekend. Looking back, it's clear that I wanted out; I just didn't know how to get out. A close friend accused me of being a tweaker. He said that I had changed, that I never called him. He told me that I no longer spent time with him and that I was short-tempered, even belligerent, on the phone.

I was indignant and denied every word of this truth. Okay, so maybe I chose the escape route of alcohol and drugs when my former partner was diagnosed with cancer. Maybe I never made it across the street to a friend's pool after 16 invitations one summer because I was busy, busy, busy cruising online, snorting and smoking meth. And maybe I had convinced myself to sell my house and move to a condo because I just didn't have time to mow the lawn. And maybe I was hanging out at my dealer's place several nights a week, spending more money on meth than I was on food, and driving my car when high, and allowing groups of strangers into my home and into my bed. And maybe I engaged in other acts of incomprehensible demoralization that I now find difficult to even consider. And yes, maybe nothing came before the supply run to the dealer, as I always prudently planned ahead so that I would have enough for the next binge. And okay, so I stopped looking people in the eye. Who would want to look at me, anyway? Given another day or so of using, I would have slammed crystal into my veins with a needle. I had already planned it. The real horror is that this all seemed normal.

After that first bump of meth, during an online hookup, I never wanted to go back. Crystal made me confident, even fearless-something alcohol and cocaine could never do. I felt validated through meth-infused sex. A few hours of illusory intimacy were better than days of emptiness. Instead of always being the best little boy in the world, I could run, if only for a few hours at a time, with the fast crowd-the fabulous people.

But none of that was real. Quickly after that first bump, I began to neglect and abuse my body, not wanting to eat, unable to sleep for days at a time. I so weakened my immune system that I simultaneously developed Kaposi's sarcoma as this latest addiction took hold. I lost weight and exposed myself to other sexually transmitted diseases, including hep B and, eventually, syphilis-which brought with it the personal humiliation of partner notification. Remember that shortly after my 1992 HIV diagnosis and before finding meth-a span of 10 years-I had not been on any HIV medications. But the KS diagnosis was the writing on the wall. I immediately started on HAART [highly active antiretroviral therapy], enduring severe anemia before finding the right drug combo. The treatment cured the KS, but I remain on an ever-evolving drug cocktail. I've yet to achieve an undetectable viral load. And the scar on my stomach from the KS biopsy will never disappear. Still, I didn't enter recovery for more than two years after first using crystal. In the meantime, I tried to stick to my dosing schedule, but inevitably at the end of a month some bottles would have a few more pills than others. The worst moments were when, within minutes of taking a dose, I could not remember whether I had in fact taken that dose. Under-dosing and over-dosing were common. My doctor always asked about adherence and I always lied. Life was still an unbroken circle of using and denial.

I often wonder whether anything would have been different had I disclosed my addiction to my doctor while still using. The real question is whether, as an active user, I was capable of that kind of honesty when I otherwise lived in a world replete with denial. In a "could have, should have" sense, disclosure might have meant avoiding KS, STIs [sexually transmitted infections], and the need to begin antiretroviral therapy. For me, though, honesty could only come when the pain became great enough.

If you think you may have a problem with crystal meth, you probably do have a problem with crystal meth.

Deep into my addiction, I became paranoid, skeptical, mistrustful and isolated. I felt hopeless and full of despair, and came to rely more on meth to escape feelings of not belonging, of shame, and of worthlessness. I was caught in the vicious cycle of addiction. I was also at my personal bottom-that point which all addicts hope to reach, before dying, when we're ready to try something different. In March 2004, a former party buddy ran up to me and whispered in my ear that he had entered recovery and had been clean for a few months. He planted a new seed in my mind. I saw him a couple of weeks later and knew that I had to find the courage to ask about his new life. As a wise man once said, "Courage is the first of human qualities, because it is the quality that guarantees all the others." My friend said that with a little bit of willingness and an open mind, I, too, could find hope for a different way of living. I considered the possibility that I may have a problem.

We drove together to my first 12-step meeting, where I found recovering crystal meth addicts talking about what using did to their minds, bodies, careers and relationships. They talked about how they got and stayed clean and how they are living their lives today. I realize now that I am not the eternally unique outsider as I had so selfishly believed. I now know that I am more like other people than different. I've also learned that I am only as sick as my secrets. To stay sober, I must let people know who I am, warts and all. As people get to know me, I no longer feel lonely and want to escape. The vicious cycle is broken. Crystal meth addiction is progressive and fatal, but today I know that there is a solution. Today, I carry the message and not the mess.

Eddie Young is a board member and immediate past president of AIDS Survival Project in Atlanta, Georgia. He expanded this perspective from his article published in the March/April 2005 issue of AIDS Survival Project's newsletter, Survival News.

This is Bonnie Goldman, editorial director of The Body. I'd like to welcome you to This Month in HIV. Today we're going to look at the intersection of methamphetamine and HIV. Many researchers are discovering that methamphetamine use is causing the rate of HIV to triple in some communities. However, meth use isn't just a problem because it's an HIV risk factor. Meth use has also become a major issue among people who already have HIV. Research suggests a growing number of HIV-positive people in the United States are using or addicted to meth. One community that has been particularly hard hit by this drug is the gay community, and we will be talking about this with today's panelists.

In terms of meth's effect on HIV and HIV medications, there are far more questions than answers at this point. However, meth use -- just like any other drug addiction -- can cause people to neglect their HIV medications and their general health, possibly causing drug resistance and accelerating HIV progression.

So how do we, in the HIV community, begin to address the meth epidemic? What do we need to know? We brought together three people to help shed some light on this topic.

Our first guest is Luciano Colonna. Luciano is the executive director of the Harm Reduction Project, which co-sponsored the 1st National Conference on Methamphetamine, HIV, and Hepatitis. Welcome, Luciano.

Luciano Colonna: Thank you.

Our next guest is Phil Hendricks, coordinator of the Crystal Meth Program at AIDS Project Los Angeles. The program provides counseling and support for crystal meth users and their friends, lovers and family members. Phil specializes in risk reduction education for high-risk gay and bisexual men. Welcome, Phil.

Phil Hendricks: Thank you.

Our final guest is Mark King. Mark has been living with HIV since 1985. He has been an AIDS activist, writer and community organization leader since the early 1980s in Los Angeles. He advocates for prevention education and addresses other critical issues for people living with HIV. Mark is an award winning writer, and several of his articles are available at The Body. [Click here to read his articles on The Body.] Mark also has been recovering from an addiction to methamphetamine for the last four years. However, during his recovery, he has had relapses. He has now been clean for more than 30 days. Welcome, Mark.

Mark King: Thank you, Bonnie.

Mark, I wanted to start with you. Can you tell us how you became involved with crystal and why you found it so addictive?

Mark King: Wow. Sure. It's kind of two-fold. One is: My personal experience as somebody who used recreational drugs. Much like many people in the gay community, I certainly had drug abuse problems in the 1980s with cocaine, but what happened for me, I believe, in the 1990s is my work in HIV as a community person was kind of coming to a close and I was exhausted and I was -- this may sound like a bit of rationalization here -- but I was emotionally looking for a way out, I was looking for some sort of escape. At about that time, meth was really taking hold on the party scene. Whereas previously it was other recreational drugs, crystal meth was starting to creep into that scene as well as onto the dance floor, etc.

What year was this?

Image from "Methamphetamine Abuse and Addiction," a research report from the U.S. National Institute on Drug Abuse. To view PDF of publication, click here. Click on image to enlarge. Mark King: This was 1995. The mid-90s, 1995, 1996. Protease inhibitors were coming along in 1996 or so. We all felt as if we were getting a second wind, that we were -- maybe I wasn't going to die soon after all. I don't know ... Again, I don't want it to sound like a rationalization, but the emotional sigh of relief that I was feeling in the mid- to late-1990s allowed my underlying drug addiction tendencies to start searching out for some sort of escape. I found that on the dance floor and I found that by becoming more sexually active.

What happened is probably a route that a lot of gay men see. Crystal meth use didn't stay on the dance floor. It came over into my sexual life, into my friends, into my home. Over the course of several years, it pretty much took it's time, but certainly by 2001 and 2002, I was an actively, regularly-using crystal meth addict who had gone from snorting it to smoking it to injecting it.

Where was this taking place, in Atlanta?

Mark King: In Atlanta and after my move, in Fort Lauderdale, Fla. Really when I moved to Fort Lauderdale and I left the AIDS community work behind -- I needed to go somewhere where nobody knew me and people stopped questioning me about my AIDS work, where I could just be a drug addict. Because by that time the real insanity of drug abuse, and the way it affects your thinking and priorities had set in. I wanted to be in Florida where nobody knew me, where I could be free to have all of the sex, unprotected by the way, and drugs that I wanted.

How prevalent was meth in Fort Lauderdale?

Mark King: Absolutely prevalent. You're talking to a drug addict who was seeking it out, but I think that even those who have a more objective view -- probably your other panelists -- would probably agree that it had really taken root. If you were a single, sexually active gay man, the chances that you had done meth, or at least been around those who were ... I only knew people who were doing crystal meth. Socially and sexually, those were the only people that I sought out. Crystal meth and sex were synonymous to me, so I wouldn't pursue one without the other.

Tell me about the sexual identity part. Why was that so attractive to you?

Mark King: I think it was attractive to me: A) Because I had been repressing my sexuality for so long, so much during the AIDS crisis. We were scared to have sex for a while and then we were being so extremely cautious about sex for so long. I wanted to escape that. I wanted to escape the boundaries of all of that. I don't say that was good thinking [laughs], in any respect. But again this became a lot of my drug addict thinking, "Get me away from all of those restrictions. Let me just run free."

Crystal meth, one of its attractions is that it has a reputation for unleashing wild abandon in terms of your sexuality. It has the reputation of keeping you up for days. People go on marathon sex binges when they are using crystal meth that can go on for days and days, partially because it keeps you awake, partially because I think there's a group psychology going on in that community that it's a sex drug. Whether or not it actually does that in your brain, I'm not qualified to say, but it certainly has that reputation. It sort of gives you that feeling that you are sexually invincible. You just go on and on and on and put yourself in increasingly high-risk situations. So high risk that barebacking is the baseline activity. I don't recall in the last several years of my active drug using condoms ever being discussed or present. They were a complete non-issue and beyond that sharing needles, coming inside another person, all of those, as high risk as you can get. As a matter of fact, I believe for me at least, and certainly for drug addicts that I know, the fetishing of the drug and the fetishing of the virus itself and the risks that you are taking are very much a part of that culture.

When you say fetishing, what do you mean specifically?

Mark King: What I mean is the fact that my sexual fantasies and those of the people that I was hanging around with were inseparable from our use of the drug. For the last several years, I never did crystal meth unless I was naked, for instance. It wasn't something I was doing on dance floors. I long ago abandoned going to night clubs. If I went out at all it was to a sex club, where I would be doing crystal meth. So there is a fetish involved where you are meeting up with another drug addict and the subject of crystal meth and how we are going to do it -- "Do you have needles?" -- those sorts of topics, were as sexually exciting as speaking of any particular sex act we could name. They were, again, completely synonymous.

Phil, does this sound very familiar to you in terms of your work at APLA [AIDS Project Los Angeles]?

A version of this advertisement first appeared on phone booths in the Chelsea neighborhood of New York City in January, 2004. They were designed by local AIDS activists in response to meth's impact on the spread of HIV among gay and bisexual men. Phil Hendricks: It's definitely one of the sub-categories of crystal users. The mainstream gay population that picks up crystal on the dance floors and bathhouses and sex clubs, they are definitely the highest risk population that we are trying to reach.

We see all kinds of different populations, from different ethnicities to different socio-economic classes, also getting involved in crystal. It really seems to be hitting everybody regardless of who they are.

People interact with the drug differently. People who are sharing needles and having high-risk sex are definitely one of our target populations that we are trying to work with and minimize the risk. There are also people using it for work. There are people using it for creative outlet. People using it for managing being homeless. There are all kinds of different reasons people use it. It's not solely sexual for all the people we are seeing.

How addictive is it? Can you just use it once or twice or three times, like alcohol?

Phil Hendricks: Well, with addiction, the definition of addiction implies that it is someone using a substance multiple times. There are a lot of campaigns out that say that you cannot even risk using it once. But [using meth] once kind of opens the doors and lets people realize what crystal can do. Addiction is built around repetition of something over and over.

As far as on the scale of drugs, it's probably in the same class as cocaine, but it's not as severe as alcohol or heroin. Both of those have potentially fatal detoxes, whereas the cravings for crystal will last for a long, long period of time. The mental addiction and the physical addiction aren't as severe as some other drugs. But it's very drawing and very addictive for a large percentage of people, above most other drugs.

Luciano, we had talked about this last week when I contacted you. You were telling me that methamphetamine is the number one drug in the world in terms of abuse.

Luciano Colonna: I'd really like to comment on what Phil just said. It was really nice to hear his response to the question.

As far as seizures go and treatment goes, after cannabis, yes, amphetamine, methamphetamine is the most used drug in the world.

I'd like to comment on its use in the gay community. I think there's a lot of hyperbole in the media around its use in the gay community. It's certainly a bad drug, meaning that it causes a lot of bad things, certainly. We just heard that. It causes a lot of damage, especially after you use it for a while. And I think it causes a lot of pleasure for people who use it. However, it also causes a lot of damage because it's not only used alone. It's often used in conjunction with other drugs, and in the gay community it's also often used in conjunction with alcohol. I think individuals in the MSM [men who have sex with men] community should look at the role that alcohol plays in the gay community, continues to play in the gay community, along with methamphetamine and the impact it has on HIV, meaning alcohol. I think we should discuss that more. When we look at methamphetamine, methamphetamine use is actually declining. Meth is not the most abused drug within the MSM community. Alcohol is actually the most abused drug.



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