We Are Not OK
"There are gay people on TV and we can get married in Massachusetts; aren't things getting better?"
"No, honey, not if you still want to kill yourself."
The gay community is not just in the midst of a crystal meth epidemic. Rather, it faces a far larger spiritual crisis that is never acknowledged and, through its secrecy, grows daily.
To get better, we must start to say that we are not OK.
Some of our problems are self-inflicted but others are a direct result of America oppressing, demonizing, and isolating gay people. The very serious effects of oppression on gay people have been long apparentthose of us living on the West Coast know that crystal meth has been steadily killing gay men for years. Historically, gay people have had significantly higher addiction rates than those found in the straight world. In short, too many of us have been torching our lives for decades now with coke, Special K, GHB, poppers, and even good old alcohol. But the real story is not told in the media, because that would require straight people to take responsibility for the harm they have caused us.
On the other hand, it would be far too easy to say that gay people have simply been victims of the dominant society. Like many other gay men, I have lived in a state of crisis for my entire adult life and have even found pleasure in the sense of purpose these crises instill. While the '80s and early '90s were a devastating time for me, I briefly shared a sense of purpose with other gay people during the marches, fundraisers, and funerals. But by 1994, I had lost my lover of 10 years and burned out on the intensity of activism. Alone again, I found solace in alcohol and drugs, including crystal meth. Had I looked deeper, I would have seen that I had always felt self-destructive and isolated, even from other gay people. I believe many young gay men still feel that way.
I began working at the Van Ness Recovery House in Los Angeles to research a book on crystal meth. The book is now written, but I'm still working there because, for the first time since the days of ACT UP, I feel a sense of connection with other gay people. The overwhelming majority of the residents I deal with on a daily basis are gay men (there are also a few transgenders, lesbians, and even the occasional straight person) who have lost everything to drugs (most frequently crystal meth) and alcohol. Nearly all of them are HIV-positive as a direct result of their drug use, but many of them will die from addiction long before HIV can kill them.
There will always be another drug
photo: Robin Nelson/ZUMA Press
It would be wonderful to think that catchy graphics and free condoms would prevent other gay people from addiction and HIV infection. However, having witnessed the amount of work it takes for one person to see that he is killing himself with drugs and alcoholone person who has already hit bottomI know that we are beyond the place where any traditional prevention campaign will be effective.
One of the questions I most frequently ask residents is "What is it that you wanted to do sexually that you could only do when you were high?" You might suppose that the answer would be an array of sex acts so extreme and kinky as to be unimaginable. And for some this is true. However, for most, their fantasy is no more than to get fucked and to connect with another man. Albeit in all the wrong places and all the wrong ways, these guys are basically looking for love.
We sometimes forget the difficulty of what we are asking gay men to do. In a world where many of them face an uncertain future, in a country where they are the most hated minority, in a time when they are acceptable only as part of television minstrel shows, we have asked gay men to value themselves enough to talk honestly about sex and to make loving, ethical decisions.
Far from forgetting about HIV, gay men have come to believe that it is the baseline of their existence. While it is true that young gay men may not fully understand the horrific side effects of HIV medications, older gay men (the median age for new infections is around 40) do. These men have simply become used to death as a normal part of daily life. On some level, they see it as inevitable and warranted. And, if that reality becomes too scary, an array of drugs is available to numb the feelings.
Making matters worse, most HIV prevention campaigns targeted at crystal meth users are ridiculously shallow. The government has actively participated in the deaths of gay men by prohibiting funding from being used to disseminate the graphic sexual information needed to make informed decisions. For example, most gay men do not know that crystal use can cause sores and abrasions in their mouths, transforming a generally low-risk behavior like oral sex into a high-risk behavior. Many meth users are also under the impression that they cannot ejaculate while they are high. But if this were true, we would not be seeing continuing high rates of seroconversion for gay men using crystal.
Peter Staley is someone I worked with in ACT UP who is now also in recovery from crystal meth addiction. Using his own money to produce a much discussed series of posters about meth use, Staley helped spark the current wave of interest about meth addiction in New York. However, even he says that he hasn't heard about anything that's working. "I'm very pessimistic about prevention campaigns," he says. "I personally don't believe that prevention campaigns change behavior. Gay men talking to gay men can change behavior."
Crystal Meth Anonymous (CMA) started in California but has become a huge force in New York's gay community. The problem is that "the program" is designed to help those who have already done enough damage to realize that they are addicts and need help. Based on the principle of "attraction not promotion," it was never intended to be a prevention campaign.
Staley correctly identifies changing "community norms" as a first step in dealing with the immediate problem of crystal use. He hopes to make crystal use analogous to heroin usesomething so extreme as to be unacceptable. This type of campaign is called "environmental prevention" and has been pioneered in the fight against alcoholism by organizations such as the Marin Institute in California. The organization's brochure explains: "Remember when smoking was allowed on airplanes? Today, the airline smoking ban not only reduces exposure to second-hand smoke but also promotes nonsmoking as a social norm.
This is an example of environmental preventionchange policies, settings, and community conditions to support healthy behavior and discourage high-risk, unhealthy behavior."
There are some problems with environmental prevention. First, if used in a simplistic way, it can lead to judgmental sexual repression that is anathema to gay culture. Second,the approach does not help those who have already entered into active addiction. So the question remains, how to create a healthier environment in the gay community.
Personally, I found that I began to make healthier sexual decisions when I connected to gay history with pride rather than shame. As a young man, my view of gay history was that the '70s were a time of self-indulgence that led directly to AIDS. Only during the research for my book, Beyond Shame, did I begin to understand that my history as a gay man was part of a larger continuum of revolutionary change that included civil rights and feminism. While history may not seem like a particularly easy sell, it can be presented in an entertaining way as an alternative to the generally superficial films, television, and literature now being produced for gay audiences.
The gay community already has organizations that do the hard work of bringing men of different generations together to form the rich connections that yield true pride rather than just visibility. In the past, the leather and alternative-sex scene made sure that older men mentored younger into the community. Many of these "elders" died, but there is no reason that mentoring could not exist again, in both sexual and nonsexual settings, to provide gay youth with aspirational examples of long and happy lives.
In a less sexual realm, churches such as the Metropolitan Community Church and Agape have created spaces where gay people can seek spiritual growth. Not as well-known but incredibly powerful movements include the Body Electric, where gay men learn to be less superficial in seeing sexual worth in one another. Coming out of the gay faerie movement, the Gay Men's Medicine Circle continues to create rituals that encourage spiritual growth. These organizations and their rituals may seem like quaint reminders of a more innocent time. However, they are vital models for the kind of programs that might actually change the tone of gay life in America.
Finally, it seems necessary to say something about the idea of gay marriage (and its presumed result, monogamy) as a solution for combating self-hatred. Gay marriage may indeed be a source of pride and healing for those who aspire to it. However, marriage alone has not solved the problems of straight people, so I see no reason to view it as a panacea for self-destructive behaviors in the gay community. Indeed, gay marriage may make things worse as it will lead us to believe the battle against homophobia has been won. It also carries the risk of creating a hierarchical gay community divided between those who choose monogamy and those who prefer other arrangements.
Our instinct is to deal with the immediate crisis, and we have little choice but to deal with crystal meth now that it has become so widespread. But let's remember that, ultimately, crystal addiction is just one symptom of a larger disorder. There will always be another drug. The solution, unfortunately, is not a better prevention campaign. It's an inside job. Let's make this our last crisis.
Patrick Moore is a writer and producer in Los Angeles. Kensington Press will publish his memoir of crystal meth addiction next year.
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