Crystal Meth Use and Treatment Options for Black, Latinx Gay and Bi Men: The Focus of Nov. 29 Forum in NYC
The evening of Nov. 29 at the Schomburg Center for Research in Black Culture in New York City, an array of LGBTQ doctors and activists (including TheBody senior editor Kenyon Farrow and contributing writer David Fawcett, Ph.D., LCSW) will take part in ParTy boi, Meth & Health, a forum organized by ACT UP's Crystal Meth Working Group to provide more information about the party drug's effects on the brain and treatment options for reducing or stopping use. The forum is aimed primarily at gay and bisexual men of color, whose meth use in New York City has increased dramatically in recent years, according to anecdotal accounts from many experts and activists. It will feature a screening of parTy boi: black diamonds in ice castles, a highly graphic documentary about meth use in New York's gay black community made by Micheal Rice. (We wrote about him and the doc last year.)
The forum will also highlight group treatment programs such as GMHC and Housing Works' Re-Charge and the LGBT Center's outpatient recovery program, which exist as alternatives or additions to the more traditional, abstinence-focused 12-step approach of Crystal Meth Anonymous (CMA). And the forum will highlight studies of pharmaceutical treatments to treat or alleviate meth withdrawal.
We talked with Marcelo Maia, an openly HIV-positive member of ACT UP NY’s Meth Working Group, about what else to expect from the forum, which goes from 4 p.m. to 10 p.m. and is free and open to all. (Register here.)
Tim Murphy: Hi Marcelo. Thanks for talking with us! So how did the forum come to be?
Marcelo Maia: This whole thing started in 2016, when the social worker and psychotherapist David Fawcett came to the LGBT Center to talk about his book Lust, Men and Meth: A Gay Man's Guide to Sex and Recovery. He blew us away with the amount of information he had, telling us that there was no FDA-approved treatment for meth in the U.S., even though the drug has been around since World War II. There's nothing like a nicotine patch to help alleviate the cravings when you're trying to stop using. The hallucinogenic drug ibogaine is used in some countries, but it's illegal in the United States. Meth releases an explosion of dopamine in the brain, and because with gay men the drug is often introduced during sex, the two things become linked to the point where often people don't know if they're getting together for sex or for the drug.
So the following week, I created the ACT UP Meth Working Group to raise awareness about meth and how it affects people -- where they can go to get help. With meth, you're really embarking on a voyage where you don't know how it's going to end. We're not trying to criticize people for doing it or even trying to make people stop. We have a harm-reduction approach, and we've been greatly aided by Demetre Daskalakis, M.D., M.P.H., who is the best thing that's ever happened to New York's department of health. He helped start the GMHC/Housing Works Re-Charge program. I've been to a couple of the group meetings. It's mostly young black and Latinx men there, who are the focus of this forum, too, and who also are the most at risk for HIV. We're not trying to be sex-negative, but there is an established relationship between meth use and HIV risk.
TM: What are unique issues for gay men of color using or trying to reduce use of meth?
MM: The quality of care and prevention is often impacted by racism. Just starting with getting help, going to a place where you don't see yourself represented. That's a barrier. It can even play out in terms of how the receptionist treats you.
TM: Why do you think that 12-step programs like CMA are not enough?
MM: I've never been to a CMA meeting, but something that says you should abstain from a substance that maybe you feel like you can't live without -- that's a huge hurdle for people, stopping cold turkey. A harm-reduction approach like at Re-Charge is a much softer transition, where people can come in at the stage they want to be at and continue getting help. They open up, come to a few meetings, get a one-on-one counselor to design a personal program with. They might decide to try to do meth just once a month, or to stop injecting it and smoke it instead. The idea is to reduce risk or harm. Ideally, of course, the idea is to help people stay [away] from it, but not in a radical setting where, if you fall off the wagon, you have to go back to the beginning, Day Zero. That puts a lot of extra pressure on people who are already psychologically fragile from the drug in terms of challenges with work, housing, health care, family and friend relationships.
TM: What do you hope will come out of this forum?
MM: Giving people information. People may have used for a long time but still don't have a very good idea about the effect it's having on their brains. Again, it's not about criticizing anyone for their habits. Hopefully, people who've never even heard of meth will come, so they'll understand what family members and friends are going through. Researcher Gabriel Torres is going to talk a bit about what Columbia University is doing in terms of studying pharmaceutical treatment approaches.
TM: You said in the promo material for the forum that meth use "grows like mushrooms in the shadow of the opioid epidemic." What do you mean?
MM: Meth use doesn't cause the high number of overdose deaths that opioids do, but according to an article in The Lancet, it actually accounts for 11% of them. I call it the crystal elephant in the bedroom that nobody is talking about. The point is to raise awareness about the issue and not just let it sit there.