Miss Tina (gay slang for the drug crystal meth). PNP (short for party-n-play, meaning to do crystal and have sex). Blowing clouds (code for smoking crystal). Or simply a cryptic, out-of-place capital "T" sprinkled throughout hookup app profiles.
All those terms were put on the table Thursday November 29 at Harlem's Schomburg Center for Research in Black Culture. At a public forum organized by ACT UP New York, an array of public health experts, researchers, and community activists took the stage to discuss ways to combat inroads that the powerfully addictive stimulant crystal meth has made among gay men and trans women of color in New York City in recent years. (Some of the forum can be watched here.)
Before an audience of about 75 to 100 people, TheBody senior editor Kenyon Farrow moderated as participants discussed meth's exhilarating highs -- and then devastating lows. "I first started partying [slang for using meth during sex] in D.C. with a couple in 2012," said panelist Jacen Zhu, an openly HIV-positive adult film star who now speaks out against meth under the hashtag #TakedownTina. "That first high was amazing. But over time, I saw more people of color wanting to use meth -- even 19-year-olds. At first, you feel like you're finally part of a community. But then I realized that wasn't the community I wanted to be a part of."
Tracking that same frightening trend among his gay friends of color, Brooklyn filmmaker Micheal Rice, also a panelist, was moved to make the documentary parTy boi, which TheBody interviewed him about last year. Rice said that he has been touring in and out of the U.S. the past several months with the film, which graphically depicts gay men of color talking about their meth use, often while using and having sex. The film, which was screened at the forum, is not yet watchable on a streaming platform.
"Friends were losing weight and calling me in a paranoid state," said Rice. "I thought to myself, 'What is this thing taking over my community?'" He, like others on the panel, noted that crystal meth had been thought of as a "gay white men's" drug for so many years that the substance's explosion in gay communities of color had taken many advocates by surprise.
Much of the evening was devoted to counseling and treatment options currently available for, and tailored to, gay/bi men and trans women of color in New York City. Among them is Re-Charge, a joint effort from the HIV/AIDS agencies GMHC and Housing Works. Re-Charge offers free individual and group counseling, as well as connection to health services and treatment for both HIV-positive and HIV-negative clients, from screening for sexually transmitted infections to PrEP (the HIV prevention drug Truvada [FTC/tenofovir disoproxil fumarate). The program uses a harm-reduction model, meaning that it helps people reach their own health and wellness goals -- while abstinence can be the goal, it is not required for participation.
On the panel was Re-Charge counselor (and self-disclosed recovering meth addict) Clifton Brown, who said that the first thing he asks of incoming clients is to name their goals or dreams. "A lot of these young people stopped dreaming and died inside, maybe because of an HIV diagnosis or because of loss among family or friends," he said. "The opposite of addiction isn't just sobriety -- it's connection."
A second panel took a more clinical look at meth and current patterns of use, the science behind addiction and recovery, and the current best options for treatment, including pharmaceutical options that may be used in conjunction with some kind of support group or therapy. Demetre Daskalakis, M.D., M.P.H., New York City's deputy health commissioner for disease control, talked about how a health department report of rising crystal use in recent years -- especially among gay men of color -- plus an assessment that not enough community agencies were offering harm-reduction-based treatment services, led to the city partnering with GMHC and Housing Works to start Re-Charge. The program, started in February 2017, now has 179 participants, he said.
He said that most Re-Charge clients were gay/bi men under 40 who were unemployed and below the poverty line, many unstably housed, with 27% of them black and 31% Latinx. Most, he said, were classified as "severe" users (one to six times a week) and tended often to use the drug GHB alongside meth, with HIV-positive clients more likely to inject meth than smoke or snort it.
David Fawcett, Ph.D., LCSW, a therapist, contributor to TheBody, and author of the book Lust, Men and Meth: A Gay Man's Guide to Sex and Recovery, talked about strategies for gay men in recovery from meth struggling to untangle the drug from their experience of sex and intimacy, as the brain tends to fuse the drug with those things, often making it hard to enjoy them once the drug has been left behind. Fawcett documented research showing that meth floods the brain with dopamine -- the body's natural "feel-good" chemical -- at levels several times that sparked by food, sex, or even cocaine, but then damages the brain's ability to make the chemical naturally, sometimes for months or years before it returns to baseline. This is why, he said, recovery from meth must be seen as a long process that takes time and patience. He suggested that gay men trying to kick meth also take a break from sex, porn, and online hookup sites -- all things that the brain has likely interwoven with the drug.
Echoing Brown, he also urged social support of any sort, 12-step-based or otherwise, for recovering users. "We have an epidemic of loneliness in the LGBTQ community," he said.
Gabriel Torres, M.D., a researcher who has also written for TheBody about his experiences kicking meth after years of use, then talked about current trials underway, including a combination of the drugs Wellbutrin (bupropion hydrochloride) and naltrexone, exploring the use of pharmaceuticals to ease meth recovery and decrease the risk of relapse. (Such options are detailed here). "There's no pharmaceutical magic bullet to treat meth, but there's some evidence that certain drugs can help alleviate cravings," he said.
Questions were taken from the audience. Among the most provocative was one asking, "When do we disconnect from people [who are using]?" Tia Carter, a panelist and community activist, replied, "There is a limit [to how much we can be there for addicted friends]. We have to take care of ourselves first."
But Brown, who admitted that his best friend cut him off when he was using, said, "I disagree. You have to be in it for the long haul."
"Loving on each other is so important," added Rice.