What sparkles, feels like fine sand, and makes you "trip the night fantastic?" Speculate no more. It's New York's latest party: favor crystal meth, also nicknamed tina, crank, chalk, chandelier, ice, quartz and redneck cocaine. About five years ago crystal began gusting slowly into Manhattan from the Western and Midwestern US, where it has been popular among gay and bisexual men and straight blue-collar men and women for decades. The early gusts were harbingers of a gathering storm as crystal is furiously becoming one of gay New York's most popular and dangerous party and play drugs.

In New York City, the drug has manifested itself greatly among gay and bisexual men regardless of race or ethnicity. Our preliminary work at the Center for HIV/AIDS Educational Studies and Training (CHEST) shows that among 324 self-identified drug users, 64 percent report at least one incident of meth use in the prior year, and of these 36 percent are HIV-positive. Further, meth is slowing finding its way into the club culture of young straight youth. The writing is on the wall for an enormous crystal epidemic. And because of its hyper-sexual qualities, the drug will certainly intersect with the transmission of HIV.

What Is Crystal Meth?

"Better living through chemistry?" Think again. Crystal is a rocky substance manufactured by combining over-the-the counter cold and asthma remedies with toxic chemicals, which is then crushed into a fine powder. Let's face it, the folks who cook your crystal aren't FDA-approved pharmacists; they're more like storybook witches huddled over a cauldron stewing a poisonous brew. Among the ingredients are anhydrous ammonia, a liquid fertilizer so corrosive it burns the skin; red phosphorous, iodine, drain cleaner, battery acid, lye, lantern fuel and anti-freeze. Now does that sound like something a witch might want you want to inject into your veins, inhale or snort into your lungs or stick up your ass to be absorbed like gelatin? This substance is easily made in mom and pop shops, in kitchens and make-shift labs. In fact, in California last year up to 1,000 toddlers became addicted to crystal due to the chemical residues landing on the floors of their parents' homes on which they crawled.

Like many other club drugs such as ecstasy, ketamine, and GHB which have been widely associated with dance clubs, parties, and raves, crystal is also to be found among users moving to the pounding rhythms of the dance floor. Why not? Meth is speed which can keep you dancing for hours, feeling energetic, powerful, and sexual all at the same time. But meth is not just a drug used at these venues. Studies indicate use is as common in people's homes, at the homes of friends, at sex parties, bars, and bathhouses. And users of crystal tend to associate with other users thus creating an "underground network." "Where's Tina?" or "where did Tina go?" can be commonly heard among users at a club who are in search of the substance.

Why would anyone eat, smoke, snort or inject such a toxic powder? The answer is simple. Crystal can make you feel exuberant, "on top of the world," like you "can do anything." Crystal users report that the drug increases their feelings of self-esteem, confidence and sexual desire. The downsides (and there are downsides to every party and play drug) can be disastrous. The crystal high which makes you feel invincible, doesn't actually make you invincible (surprise), and men whose libido the drug shifts into overdrive often wind up having lots of unprotected and uninhibited sex when they are zooming around on crystal.

Crystal and Sex

While crystal enhances one's sex drive, it can also make it difficult to stay hard (a "crystal dick"), a condition that causes many men to become, "instant bottoms." So for HIV-negative men, the biggest risk of crystal's high is becoming HIV-infected. However, nowadays "crystal dick" is a thing of the past. Studies conducted at CHEST, which is a New York University-Hunter College collaborative behavioral research center, indicate that many men who use crystal combine it with Viagra, thus allowing them to overcome their inability to obtain an erection while high. Investigators in San Francisco learned that the men who used crystal meth were significantly more likely to have unprotected intercourse than men who did not. The crystal users were about 3 times more likely to become HIV-infected through unprotected sex than men who did not use crystal. At CHEST through our work on Project TINA, a study of crystal methamphetamine users, and Project BUMPS, a study of club drug use among gay men, those reporting the use of crystal were much more likely to practice both unprotected insertive and receptive anal sex when high at much higher rates then when not high.

Dangers Ahead

The dangers of meth use do not stem from the use of the substance in isolation. Preliminary data from project BUMPS indicate that 30 percent of users mix it with cocaine, 35 percent with ecstasy, 44 percent with ketamine, and 45 percent with alcohol. Add to this mix the use of antivirals by HIV-positive men and you create a formulary that is bound to have profound effects on both physical and psychological health.

Dangerous physical side effects of crystal meth users are increased heart rate, blood pressure, and the constriction of veins and arteries in one's entire circulatory system. These effects can cause stroke, heart attack and irreversible damage to blood vessels. Men who inject crystal, which is often the preferred route of administration for highly addicted individuals, are also vulnerable to pericarditis, a potentially deadly bacterial infection of the heart caused by unsanitary injection practices. Crystal meth can also over-excite your central nervous system to the point where you feel paranoid, fearful and anxious. Heavy users can experience psychotic episodes, medical jargon for losing touch with reality. Studies of the brain also demonstrate an enormous impact of methamphetamine on brain functioning, which in some cases of heavy use may lead to the development of Parkinson's-like symptoms.

Men and women who take HIV medications are especially vulnerable to crystal's dangerous side effects because many HIV medications can cause crystal to be absorbed in the body two or three times faster than in someone not taking HIV medications. So the one bump you snort unwittingly becomes three, three bumps becomes six and so on. Crystal also wrecks havoc on your medication-taking schedules. If you decide to stop your medications for the night because you don't want it to interact with the crystal your taking, or you forget to take your medications because you're so blasted you can't remember to, then you are setting yourself up to develop medication-resistant virus. Finally, like HIV, which may wreak havoc on the brain, methamphetamine also may add to the deterioration and functioning of this organ.

Those who are both HIV-negative and -positive also should think about the possibility that they can transmit or become infected with a drug-resistant virus. Whether you are positive or newly infected, if your HIV resists antiviral medications then your treatment options become limited.

Helping Crystal Users

Because crystal meth is so new in New York, drug treatment agencies often do not have experience in recognizing the addiction or treating it, and so many people with crystal meth problems may find it difficult to find appropriate help. GMHC's SUCE program and the Lesbian, Gay, Bisexual and Transgender Community Center's Project Connect are good places to start, as are any of the increasing number of twelve-stop programs that have emerged throughout the city.

Many substance use experts and researchers in the LGBT community believe strongly that in order to help men deal with crystal meth use problems that they must recognize the importance and power of crystal's ability to lift men's self-esteem, confidence and sexual satisfaction. For many men, crystal is the answer to a long dry spell of isolation, anxiety and sexual boredom. Substance use professions need to learn how to help men attain these same benefits without risking their lives on crystal.

Perry N. Halkitis, Ph.D. is Assistant Professor at New York University and Co-Director of CHEST. Paul Galatowitsch is the Director of Community relations & Outreach at CHEST. For further information about Project Bumps, call 212 206-7919 x 303.