POZlife

POZLife: Life from the Infected and Effected point of veiw.

Of Mice and Meth

Posted by pozlife on May 11, 2007

 By: Christopher Murray

10/26/2006

As crystal methamphetamine continues its destructive inroads into the gay male community, the frequency of relapse remains a major concern.
Meth, while not clearly physiologically addictive, is intensely psychologically so. This drug-by dint of its extraordinarily powerful, long-lasting high and its association with already psychically-charged behaviors, most particularly sex-manages to deeply lodge itself in a user’s memory and also in his sense of self. Combine that with brain changes that actually lower users’ ability to resist picking up again-known to mental health professionals as “impulse control”-and the frequency of relapse starts to make some sense. 

Consider Jefferson, a 32-year-old designer. He used meth for two years, introduced to it by a casual sex partner. It felt great, and while he didn’t go looking for the drug, when it came his way, he enjoyed the super-charge it gave to his time in the sack. All his inhibitions about anal sex disappeared, he immediately found a deeply pleasurable sex groove, and even explored kinky scenes he had never considered before.
After six months or so, his use progressed to binges almost every weekend and he was buying his own supply. He knew he was playing with fire, but had never in his life felt so sexually alive and engaged.
“I thought I could handle it,” he said recently. “It was a trade-off. I was risking addiction, I knew that, but I was exploring sex without all these hang ups. It was really important to me and liberating.”
Before long, Jefferson grew more concerned about the potential for transmission of STDs. He was also missing Mondays at work. His boss didn’t know why he had become so unreliable, and friends were expressing concern that he had fallen off the face of the earth. Jefferson recognized things were going too far. He knew people whose journey with meth had gotten ugly, giving them HIV and emptying bank accounts, excising friends and jobs from their lives.
He didn’t want that to happen to him. So, he started going to Crystal Meth Anonymous meetings.
Jefferson racked up 18 days clean, and relapsed over a three-day weekend. He got another 15 days sober, had a big deadline at work, and, after meeting it, relapsed again.
“I didn’t actually think I was that addicted,” he said. “It was scaring the pants off me. I couldn’t seem to leave it alone.”
Eventually, Jefferson’s relapses got farther and farther apart. He now has been off meth for seven months and is feeling much more secure in his path away from the drug.
A recent major study throws a lot of light on Jefferson’s experiences. Researchers at Oregon Health and Science University announced research last week that indicates that stress may be a major trigger for relapse with meth. The study, conducted on mice, went like this: Scientists fed the furry little creatures meth by giving them a tiny lever to push to get the drug, then took their supply away. Of course, for a while, the mice kept hitting the lever to get more drug, but eventually recognized their source had dried up and stopped.
Then the researchers introduced stress into the mice’s lives by way of a metabolic compound that induces hypoglycemia-a critical shortfall in blood sugar that deprives the body of the energy needed to carry out essential functions and is a powerful stressor in humans, too. Those mice went wild hitting the lever again and again, clearly responding to the stress by trying to go back to their old meth-using behavior.
Now gay men are not mice. But what’s key in understanding this study is first recognizing the potential impact of stress on meth users’ tendency to relapse, and second, digging deeper to assess the particular kinds of stress that gay men face.
Ilan Meyer, a psychologist at Columbia and visiting scholar this year at the Russell Sage Foundation, a leading social science research center, studies the concept of minority stress, the premise of which is that in the case of gay men and lesbians, existing in a heterosexist society leads to greater levels of pressure based on being part of a stigmatized group. Chronic stress, which can combine that stigma with other factors including the ongoing threat that AIDS poses and a history of sexual abuse, among others, has the strong potential to create health pathologies including depression and drug abuse.
Meth use, Meyer says, may be a way, a coping mechanism for gay men to create circles of safety in which to escape the constant pressures-often not fully recognized, if at all-experienced from minority stress.
“For many gay men who use meth, it gives them access to a bonding mechanism,” he says, “where they can create a little environment where they feel free and protected.”
Meyer takes pains to distinguish between physiological kinds of stress, like what the mice were exposed to, and social stress, which his model is concerned with.
“I think gay men have in some ways forgotten how to think about the impact of homophobia,” he argues. “We’ve come so far in so many ways, but I still know people who aren’t out to their parents, or who still experience tensions at work around not bringing a girlfriend or wife to the business dinner. These circumstances are stressful and doing drugs is one response to this stress.”
A new book, “Overcoming Crystal Meth,” by New York-based psychiatrist Steven Lee, attempts to put the whole meth situation in context. Lee describes the drug’s impact on people’s bodies and why it can take such a toll. He also explores the vicious cycle of relapse, noting, “The ambivalence and temptation to use crystal will always be a part of you, to some extent.”
Lee compares addiction to an escalator going down.
“You are standing in the middle of the addiction escalator and if you don’t move your feet, the rolling staircase will take you lower and lower, to the depths that addiction takes you,” he writes.
Steven Lee and Ilan Meyer agree that accessing a new kind of bonding, strong social supports like those found in Crystal Meth Anonymous and other group counseling, can go a long way toward helping gay men counter the effects of minority stress and not get stuck on the down escalator.
For Jefferson, moving away from meth meant readjusting to his own challenges in being a sexually active gay man.
“Now that I’m clean, I need to learn how to have sex again, without meth,” he said. “I need to be able to deal with my loneliness, and make decisions about how I get close to other guys that don’t send me back to meth.”
Christopher Murray, LMSW, is a therapist in private practice in New York City.

Source: GayCityNews – Of Mice and Meth

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