Suicide Tuesday: Gay Men and the Crystal Meth Scare
by Duncan Osborne
Carroll & Graf. 158 pages, $13.95
PNP BB Bttm Boy Needing PNP HUNG Top to host this morning—24 (castro / upper market) I have been partying the last 4 days and I am looking for 1 more hot FUCK to pound my hole and keep me getting higher and higher. I have some supplies left, but if you have some to share that would be great. I am a HUGE uninhibited raw nasty bttm pig that likes it all… and especially like taking hot thick loads up my ass and then having another guy use the cum from the 1st guy as lube… Me: 24 yrs old, 5’8, 160 lbs with a hair cub like body, 8 inch cut thick cock, and a nice open hole that loves to have cocks, cum, toys and other things in it.
— From craigslist San Francisco (7/26/06)
“PNP,” the abbreviation for “party and play,” is not about dancing but doing drugs and having sex—in this case, being a “BB Bttm” or “bareback bottom.” In metropolitan gay enclaves like San Francisco, New York, and Los Angeles, the most popular party drug is crystal methamphetamine, which in numerous studies has been linked to huge increases in risky sex among gay men. The above Web cruiser is every HIV prevention worker’s nightmare scenario. In Suicide Tuesday: Gay Men and the Crystal Meth Scare, Duncan Osborne suggests that this has become the dominant narrative in the popular and gay press, perhaps even among HIV researchers.
Methamphetamine, popularly known as “crystal,” “speed,” “ice,” “crystal meth,” “tweek,” “crank,” and “Tina,” was first synthesized in 1919 by a Japanese pharmacologist. Amphetamine was prescribed in the 1930’s to treat post-nasal drip and asthma, and was used more extensively on the battlefield during World War II to stimulate wakefulness and improve attention. It increases activity, decreases appetite, and provokes a sense of euphoria. Researchers from the 1930’s through the 1970’s promoted amphetamines almost as a panacea for a wide range of medical and psychiatric disorders. Various types of amphetamine salts are the active ingredients in stimulant medications (for example, Adderall and Dexedrine) primarily used to treat Attention Deficit/Hyperactivity Disorder and narcolepsy.
Stimulant abuse probably began in the 1930’s with pharmaceutical amphetamines. Amphetamine can be swallowed, smoked, snorted, injected, or taken anally (“booty bumping”). After the initial, pleasurable rush, the high lasts six to eight hours. A hit can cost as little as three dollars, so it is much cheaper and longer-lasting than cocaine. Tolerance develops rapidly, which can lead to a cycle of binges and drug withdrawal crashes with irritable or depressed mood, anxiety, fatigue, and drug craving (“feening”)—the “suicide Tuesday” phenomenon in Osborne’s title. In particularly vulnerable individuals or in large doses, amphetamines can cause heart attacks, stroke, hyperthermia, and extreme agitation or psychosis that’s almost indistinguishable from mania or schizophrenia. Long-term abuse can lead to severe weight loss, chronic hallucinations, and paranoia, as well as cognitive impairment. Psychological symptoms can persist for months or years after drug use is ended. In animal models, meth can lead to death of nerve cells that produce the neurotransmitter dopamine.
Federal regulations to control its production began in the 1950’s, and by the 1960’s the U.S. Food and Drug Administration estimated that half of the manufactured amphetamines were being diverted to non-medical use. Laws regulating the production, distribution, prescription, and use of amphetamines grew increasingly stringent in the 1960’s till they were made a Schedule II controlled substance in 1971, just one step below completely illicit drugs with no permissible medical use. Illicit use of meth has grown widely: the 2000 National Household Survey on Drug Abuse estimated that 8.8 million people (four percent of the U.S. population) had tried meth at some time. Its widespread use began in cities on the West Coast, but it has become increasingly available in rural areas, especially in the Midwest and South.
Crystal has had a particular appeal in the gay male community. As a stimulant, it helps fuel long nights of partying and sex. It is also widely seen as a stimulant of libido that heightens erotic pleasure. Dozens of studies have found an association between crystal and both increased numbers of sexual partners and risky sex. New York City’s Gay Men’s Health Crisis (GMHC) has argued that crystal lowers sexual inhibitions and encourages men to be bottoms in anal sex or to engage in aggressive sex. As with the abuse of all recreational drugs and alcohol, crystal can lead to impaired judgment. Some public health researchers have pointed out that the combination of increased numbers of partners and unsafe sex is the disastrous combination for an escalation in HIV transmission among gay men.
A cursory survey of craigslist entries, however, will reveal that the PNP seeker is in the minority and has provoked a backlash. Far more cyber cruisers specify “No PNP!” and safe sex compared to those looking for BB PNP. Osborne’s point is clearly on target: a wave of uncontrolled crystal abuse and unsafe sex is not inundating the gay community. Community meetings and articles in the gay press are leading to consciousness-raising along with institutional and individual resistance to crystal abuse and associated risky sex. Crystal Meth Anonymous groups have sprung up across the country, and HIV service agencies have all targeted the problem of crystal. However, as Osborne points out, an ongoing challenge to HIV prevention is reaching those who are not closely tied to the gay community, notably teens and young men, people of color, and rural populations. Furthermore, while crystal abuse is certainly a serious problem by itself and in association with risky sex, other club drugs (GHB, cocaine, ecstasy, etc.) and old-fashioned alcohol are also major contributors to morbidity and HIV transmission.
I commend Osborne’s effort to be level-headed and to criticize the media’s sensationalization of the “crystal epidemic.” He devotes a lot of space to a review of the HIV epidemic in general and political conflicts in the gay community’s response. This has been covered by many other writers, but it’s a good summary for those unaware of the ideological clashes between sexual radicals pushing for self-regulation and those who would prioritize public health even at the cost of government regulation of gay sex. I only have one quibble with Osborne’s work. Often his rhetorical approach to achieving balance is to juxtapose extreme arguments. In the introduction he claims that “it should surprise no one that much of what is said or written about meth is wrong.” He ridicules some of the media reports about the “crystal epidemic” and its toxic effects on individuals and society. He criticizes the gay press and HIV prevention groups for putting too much energy into the problem of crystal abuse, but later criticizes them for not doing enough. On balance, however, Osborne’s concerns are warranted: crystal is a serious problem in the gay male community, albeit just one element of a complex of factors leading to the transmission of HIV, including other drugs, alcohol, and psychological stressors.
Vernon Rosario, a resident in psychiatry at UCLA, is author of The Erotic Imagination: French Histories of Perversity.
