Reducing the Risk of Meth Use in the Gay Community

Methamphetamine use among gay men may have decreased somewhat since its height in the 1990s, but it is still a major problem among this subset of the LGBTQ community. Treating and reducing use of this dangerous illegal drug remains a priority for a group of people disproportionately affected by drug abuse and addiction. Crystal meth first became popular among gay men in the 1970s, and there is some evidence that meth use is undergoing a resurgence after dropping off during the first decade of the 21st century. Furthermore, meth use—always a serious health risk—may now be more dangerous than ever. Methamphetamine has long been cheap and easy to get because it can produced relatively easily from readily available products. In 2006, the federal government banned pseudoephedrine from over-the-counter products in order to prevent it being used to make meth. However, an unintended consequence has been that more potent and dangerous methamphetamine is being brought into the U.S. from Mexico. It has also become more common for users to inject methamphetamine rather than snort or smoke it, which significantly increases the risk of overdose.

Physical and Behavioral Signs of Meth Use

There are many physical signs that can accompany meth use, some of which are strongly associated with this particular drug. Meth users often exhibit dilated pupils, bloodshot eyes and dark circles. They may have uncontrolled twitching, especially of the eyes, excessive sweating and hair loss. Meth use typically causes weight loss, and long-term meth users may lose a significant amount of weight and appear gaunt. Meth use can significantly impact oral health, causing bad breath, dry mouth, cracked lips and especially the tooth rot and loss known as “meth mouth.” Another classic symptom of meth use is skin sores from scratching and picking, because meth causes the sensation of bugs crawling under the skin. The behavioral signs of meth use can range from short-term intense focus on trivial things to paranoia and psychosis after long-term use. Meth users may exhibit fidgeting, excessive talking, hyperactivity and sleeplessness, followed by periods of sleep that can last several days. Teeth grinding (which also contributes to meth mouth), compulsive behavior, nervousness and short-term memory loss are common. In the long-term, meth use can cause delusions, aggressive behavior, hallucinations and even suicidal behavior.

Reducing the Risk of Contracting HIV While Using Meth

Meth use also comes with an increased risk of HIV, which is already a well-recognized health risk among gay men. Methamphetamine use causes intense sexual desire that can result in risky sexual behavior, and needle sharing among meth users can also put them at greater risk of HIV exposure. People who have become addicted to meth are less likely to seek treatment if they do contract HIV, and often struggle to stick to the prescribed drug regimen when they do seek treatment. While getting users to quit meth entirely is the ultimate goal, a 2014 study from the University of California, San Francisco and the San Francisco AIDS Foundation found that users who focused on reducing their meth use and finding safer ways to get high were also able to reduce the sexual behaviors that put them at high risk for contracting HIV. This approach, known as harm reduction, encourages users to employ strategies to avoid high-risk sex and needle sharing while they are in the process of cutting back their methamphetamine use. Proponents of this approach believe that it is a more practical way to save lives than abstinence-only programs that don’t teach addicts to make safer choices while using the drug, which can leave them highly vulnerable if they relapse.

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