September 18, 2008
Call 1-800-367-2437 or visit AIDSHotline.org for a referral to a community group near you that provides more information or services for gay and other men who have sex with men who use methamphetamine.
Methamphetamine is a stimulant that affects the central nervous system. Commonly known as "crystal," "speed," "meth," or "Tina", it is a white or off-white, odorless, bitter-tasting crystalline powder that easily dissolves in water. Meth provides the user with sustained energy and a general sense of well-being. Along with increasing alertness and wakefulness, it masks the body's need for food, water, or rest. It mirrors the body's natural "fight or flight" response, a reaction that slows digestion and increases alertness and concentration. Meth can be snorted or smoked as is or dissolved in water and drunk or injected. The effects can last from 6 to 12 hours or more, depending on the individual's tolerance and the dosage. With sufficient quantity of speed or use over time, a state of high agitation can develop along with extreme emotions and intense paranoia. These can sometimes lead to violent behavior.
Methamphetamine, like cocaine, is a "psychostimulant" that increases the amount of at least three important brain chemicals called neurotransmitters: dopamine, serotonin and norepinephrine. As a result, methamphetamine can elevate your mood, induce euphoria, increase alertness, reduce fatigue, increase energy, decrease appetite, increase movement and speech, and provide a sense of increased personal power and prowess. This is the high you feel -- you instantly become the "life of the party". And, unlike the high from cocaine which is brief, the effect of meth lasts for six to 12 hours or more depending on how much you do.
Unfortunately, there's also a down side. The same process produces increased blood pressure, heart rate and sweating, it can cause anxiety, irritability, insomnia, paranoia, and psychosis. In addition, once the high wears off, mental and physical exhaustion set in often with a deep depression that sometimes includes thoughts of suicide.
Methamphetamine causes long lasting changes in brain chemistry, particularly in the neurotransmitter systems of your brain. Notably, these brain chemistry changes seem to impact cognitive abilities such as memory, judgment, reasoning, and verbal learning. And these changes do not reverse themselves quickly. Current research indicates that it takes many months away from the drug before your brain begins to heal. Other long term effects are often frequent bouts of drug craving, frequent agitating dreams of using crystal or frequent frustrating dreams of being unable to use. These also fade over time, but this takes many months away from the drug as well.
Common indicators that someone is "tweaking" or using meth include grinding teeth, obsessive picking of the face or body, hallucinations (auditory or visual), euphoria, extreme energy, no sleep for 2-3 days, dramatic weight loss, paranoia, and aggressive behavior.
Yes, one can fatally overdose from use of methamphetamine. Increased heart rate, increased blood pressure, and vascular constriction affect many organ systems, causing heart problems, stroke, and acute kidney failure. They usually result in direct toxic effects, followed by multiple organ failure. Death from a methamphetamine overdose is associated with the rapid onset of kidney failure and collapse of the circulatory system. A large percentage of patients who die usually have symptoms of coma, shock, inability to pass and secrete urine, and muscle twitching.
Other complications associated with methamphetamine intoxication include pulmonary edema, hypoglycemia, intracerebral hemorrhage, hyperthermia, hypertension, confusion, delirium and hyperactivity.
The most common way to produce meth is a quick-cook process that requires only a few hours. The main ingredients used to make speed are ephedrine and pseudoephedrine.
The process used to produce meth is potentially explosive, highly toxic, and results in highly toxic byproducts in addition to the drug. Meth is often produced in large, rural areas because ample open space is needed due to frequent explosions, a typical consequence of meth production. Because crystal is an illicit substance manufactured in makeshift labs by people who do not have training in organic chemistry, it often contains harmful chemicals and heavy metals as contaminants. In addition, to increase their profit, many unscrupulous dealers will cut the meth with any number of substances, some benign and some quite toxic.
"Crashing" from meth often entails severe anergia, or lack of energy, and massive anhedonia, a sustained lack of motivation to perform normal tasks and inability to experience pleasure. The severity and duration of these symptoms vary depending on the amount of drug you've used and how long you've been doing it. Common symptoms include loss of energy, depression, fearfulness, wanting to sleep a lot or difficulty in sleeping, shaking, nausea, palpitations, sweating, hyperventilation, increased appetite, irritability and drug craving. These symptoms can last from days to weeks after you stop using methamphetamine. Some of these symptoms can sometimes be alleviated with medications.
There is no direct connection between the use of crystal meth and sex. As a stimulant, however, meth stimulates your libido as well as anything else. And crystal can increase your self confidence and lower your inhibitions. It also enhances sensation. If one uses crystal in a sexually charged situation, the effect will be heightened. Because of this, people mistakenly believe that crystal caused the sexual feelings. It is indeed a very potent mixture. For many people, sex under the influence of meth rapidly leads to an incredibly strong association between the two which is hard to break. One without the other becomes inconceivable.
The association between meth and HIV transmission is related to 1) the tendency of many people to engage in unprotected and uninhibited sex while under the influence of meth and 2) the risks associated with injection drug use for those who shoot speed. In terms of sexual transmission, many people when high on crystal do not use condoms and may have sex with many different sex partners during a speed run. And even if they do use condoms, the lengthy and rougher sex that often happens results in a much higher likelihood that the condom will break. Additionally, some men who have receptive anal sex while on speed are less sensitive to pain responses and may be inclined to have more aggressive sex for longer periods where injury is more likely to occur and the risk of HIV infection is increased.
There is also a high risk for transmitting Hepatitis B and C for many of the reasons mentioned above. Like HIV, Hepatitis B can be transmitted through unprotected sex or through sharing of syringes and injection supplies. Hepatitis C is mostly transmitted through blood to blood contact, usually by sharing syringes or other injection equipment.
The risks of HIV and Hepatitis B and C transmission for those who shoot crystal are the same as with any injection drug use. Any sharing of syringes or the various items used in preparing to inject the drug can pass these viruses. For more information on safe injection, the tweaker.org website is a great reference.
Further increasing the likelihood of HIV transmission among crystal users is the fact that gay men who use meth have a much higher rate of HIV prevalence than gay men who do not use speed. Different studies have found that gay men who use methamphetamine are two to four times more likely to be infected with HIV.
For people infected with HIV, even occasional use of crystal can lead to a lapse in taking HIV medications, weight loss and vitamin depletion. With crystal, you can stay awake for days. Sleep, however, is essential to maintaining the immune system. Lack of sleep and poor nutrient intake aside, crystal use itself causes a drop in CD4 cells and NK cells, and recent research suggests that crystal takes a major toll on people who are immunocompromised.
Check out www.tweaker.org. This is a comprehensive website dedicated to educating people about crystal meth, as well as providing a forum for people to communicate and share their experiences with the drug.
The website for the NEON project in Seattle, WA, www.crystalneon.org, has health and safety tips and an on-line 'zine for gay and bisexual men who use crystal meth.