Is crystal meth just another party drug, or is it a clear and present threat
to HIV treatment and prevention in the UK? asks David G Taylor
Crystal, Tina, Crank, Ice, Tweak and Yaba are all innocuous sounding names
for what’s proving to be one of the most noxious drugs to hit gay club
culture yet. Snorted, smoked or injected at dance clubs and sex parties, crystal
meth is blamed for fuelling the current Aids epidemic. It’s also blamed
for the surge of new HIV and sexually trasmitted infections, as well as the
acceleration of HIV-related illnesses in those already infected.
The drug was recently heralded as “a serious challenge in HIV treatment
and prevention” by American journal Clinical Infectious Diseases. Others
go further. HIV resource The Body called it “an epidemic within an epidemic”,
while a hard-hitting US ad campaign pulled no punches with the slogan: ‘Huge
Sale! Buy Crystal - get HIV Free!’
Tweakers
Crystal use has already had serious consequences for the US gay community
and is all too rapidly spreading through the UK. Unlike Desperate Housewives
and denim, crystal meth probably won’t prove one of our better US imports.
If you haven’t run into it yet, crystal (or methamphetamine) is a synthetic
amphetamine that both stimulates and disinhibits. It has been around for a
while, but with new drugs like Viagra overcoming crystal’s tendency
to make you temporarily impotent, despite being horny, it’s never been
more popular.
Meth users experience a feeling of exhilaration, alertness and heightened
sexual desire. Physical effects can range from increased heart rate and body
temperature to memory-loss and mood-swings; to extreme convulsions, erratic
rages and paranoia. They are invariably restless and fidgety which is why
they are commonly known as ‘tweakers’. Although crystal meth doesn’t
seem to be physically addictive, anecdotal evidence points to psychological
addiction.
Visit the US support site, tweaker.org and you will find a litany of personal
accounts from meth users whose recreational dabblings have spiralled out of
control. The problem is so acute that a new ad campaign has just been launched
in San Francisco to raise meth awareness. The campaign ‘Crystal Mess’
carries the shock slogan: ‘Your career took up too much time anyway
- A crystal meth habit can suck up your job, your friends, your home, and
your health in 18 months.’
Hype or reality?
Grainne Whalley, project co-ordinator for Antidotes, explains how meth addiction
can take hold without your realising.
“One problem is the severe comedown, and if you know that the one thing
that will stop withdrawal is to have more, then that’s what you’re
going to do. And from there it all too easily snowballs.” She said they
had one client who had “literally had spent hundreds of thousands of
pounds” on meth.
Exactly how big the problem might become and how quickly it will present isn’t
yet clear. Whalley first became aware of crystal meth back in 1999, doing
outreach work at dance festivals. “At the time we discussed what a potentially
huge problem it could be,” she said.
“I’ve been working at Antidote for less than a year and in that
time we’ve only had about six meth users, but that doesn’t necessarily
represent the number of people still out there with a problem.”
Cold light of day
It’s not just the crystal meth’s addictive qualities that worry
experts, it’s also the way it is used. In the US they call it PNP (Party
‘n Play), in the UK we call it ‘chem sex’ but it means the
same - taking drugs to enhance 1-2-1 or group sex. Crystal meth already has
the ability to disinhibit and increase sexual desire; add other drugs into
the mix any you’ve got real trouble.
“Crystal meth makes you horny but it also makes it difficult for you
to get a hard on,” says Dr Gavin Yamey, senior editor of US medical
journal PLoS Medicine. “That’s why some crystal meth users also
take Viagra. Studies show that by the time you’ve taken both drugs together,
the idea of using a condom for sex has gone out the window. Crystal meth users
are twice as likely as nonusers to have unprotected sex,” he adds.
For Dieter Doneit, 25, an HIV positive man from Edinburgh, an encounter with
crystal at a sex party led to a three-day sex marathon which left him unable
to sleep for five days. He finally collapsed with convulsions and fever.
Dieter, who works for the Life or Meth campaign, said: “The comedown
is an absolute nightmare. It is a thousands times worse than ecstasy. And
if you are HIV positive it wreaks havoc on your immune system.”
He said that for HIV positive people, crystal was sometimes used as the ultimate
release. “Crystal smashes through the inhibition, the hurt. It makes
you feel like superman. Condoms and safer sex is the last thing going through
your head.”
It was also a ‘ticking time bomb’ for which drug agencies were
ill-prepared.
“It’s getting cheaper. Here in Scotland it costs about £200
a gramme but in London prices have dropped from £160 to £140.”
Phil Henshaw, a leading clinical psychologist in HIV/sexual health at the
Royal London Hospital, admits his medical team has “limited information”
about crystal meth as yet, but he said drugs like E, coke and ketamine were
associated with condom-less sex. “Any psychotropic substance is likely
to impact on the users’ judgements of risk,” he said, “even
disinhibiting them enough to permit practices deemed risky in the cold light
of day.”
As one HIV negative user on the tweaker.org support website put it: “All
I remember is craving more and more unsafe sex, more drugs. At times, I was
able to play with over 10 guys in a 48-hour period, of course it was all unsafe.
There was one time I even told this hot man I was positive - just to have
sex with him. How insane is that?”
Meth and HIV
There is evidence that meth users may be twice as likely as non-users to be
HIV positive, according to Dr Yamey. They’re also more at risk of STDs.
“A study of the recent outbreaks of syphilis in gay men in the UK found
that the men who contracted syphilis were more likely to have taken party
drugs, including Viagra and amphetamines like crystal meth,” says Dr
Yamey.
“Meanwhile a recent study in America found that men who have sex with
men, who used both crystal meth and Viagra, were six times more likely to
pick up syphilis than men who didn’t use either drug.”
Dr Yamey is also concerned about the “risky” practice of mixing
drugs like Viagra with crystal meth. “Crystal meth is an amphetamine
drug, and like all amphetamines it can increase your heart rate, increase
your blood pressure, raise your body temperature and cause seizures. Viagra
dilates your blood vessels, and the overall stress on your heart from combining
these drugs can put a dangerous strain on your heart, increasing your risk
of having a heart attack or stroke.”
For those who are HIV positive, it’s thought meth use carries other
health risks. Doctors are concerned that crystal meth’s interaction
with HAART could result in an accidental meth overdose.
“Four years ago it was reported that the protease inhibitor, ritonavir,
could increase levels of methamphetamine to potentially fatal levels, and
taking poppers at the same time can make things worse” said Robert Fieldhouse,
PN’s HIV treatments editor.
However, for most, the real danger of meth use might be simpler than that.
“For those with a compromised immune system, meth is bad news,”
says Grainne Whalley. “With most party drugs the damage is lessened
by the mere fact that you come down off them after a few hours. So the damage
to your body is lessened by their short duration. With meth the effects are
long-lasting. On a meth binge you can be up for days,” she explains.
“Apart from the damage meth can do to your liver and kidneys, if you’re
not eating and sleeping, you’re depriving your body of the two basic
things that you need to stay healthy.”
HIV positive meth users become ill more quickly than they would have otherwise,
take longer to recover from infections and respond poorly to HIV treatments.
It has been linked to the depletion of CD4 cell counts and the acceleration
of HIV-related dementia. There is speculation that this might be due to users
simply not eating and sleeping, together with poor adherence to HIV medications.
The truth is we just don’t know yet. However, the connection between
crystal meth, self-neglect and the progression of HIV is a major concern.
USEFUL WEBSITES
www.lifeormeth.com
www.lifeormeth.org
www.plosmedicine.org
www.thebody.com
www.thehungerford.org
www.tweaker.org
www.hepCuk.info www.ukcoalition.org
UKC is looking for five community volunteers to conduct research into recreational drug use, particularly crystal meth, among gay men. No previous experience is necessary as training will be given. If interested contact Robert Fieldhouse on 020 7564 2121 or email rfieldhouse@ukcolition.org
UK methamphetamine is illegal in the UK. It’s categorized as a ‘class B’ drug that carries a maximum jail sentence of five years for possession and 14 years for dealing.
A Californian study involving 68 gay men seeking
treatment for meth dependence found 61 per cent
were HIV positive, that they were more likely to have
an STD. Most admitted to having unprotected sex with
multiple partners.
A study involving FIV (the feline equivalent of HIV)
found that meth increased the ability of FIV to
multiply and mutate 15-fold.
back to top of page
