By Peter S. Theodore, Ph.D.

Part 2 of 4

Once isolated to the West Coast, methamphetamine abuse has grown into a national epidemic that impacts many gay and bisexual men. This article, second in the four-part series on methamphetamine, examines the underlying psychosocial and cultural forces that help explain the prevalence of methamphetamine abuse in our communities.

Most simply, people begin using methamphetamine due to its initial pleasurable effects — feeling euphoric, energetic, self-confident and sexually charged. Looking more closely, it’s important to understand that methamphetamine use also commonly helps users avoid psychological pain engendered by a confluence of social and cultural factors.

Growing up with few or no role models in a society that values and normalizes heterosexuality, many gay and bisexual men learn to feel badly about themselves. We can develop feelings of shame, guilt, anxiety and fear about our same-sex desires and actions. Within cultures that equate masculinity with strength, power and respect, many of us end up feeling like outsiders because we fail to meet societal expectations. This can limit our ability to develop pride and self-esteem, which can be particularly difficult for gay and bisexual men of color who often struggle with additional cultural beliefs and demands.

Given these sets of issues, the pleasurable effects of methamphetamine create a powerful yet temporary sense of relief for gay and bisexual male users. For those who feel isolated and lonely when not on meth, the bond felt with other users creates a welcome sense of belonging, identity and community. In such cases, it becomes difficult to imagine letting go of the bonds formed with other meth users.

Several factors within our own communities also contribute to methamphetamine use among gay and bisexual men. For some, the importance attached to physical appearance and sexual performance in our communities lead to body image concerns that can intensify these psychological issues. Many gay and bisexual men in treatment for methamphetamine abuse have stated that using meth makes them feel “sexier,” “hotter,” “better at sex” and “more confident approaching men.” As a result, methamphetamine has become increasingly present in many places where gay and bisexual men meet, socialize and have sex. It’s frequently used at gay bars, dance clubs, circuit parties, bathhouses and sex clubs.

It is very important to note that the relationships between methamphetamine use and sex are quite complex, with many users saying that they don’t know which comes first, their desire to have sex or to use meth. The connection between methamphetamine use and sex is significantly related to high rates of HIV infection and other sexually transmitted infections. These relationships will be examined more fully in the next article.

If you think you might have a problem with meth and you would like to try to stop your meth use, help is available. Help yourself and your community by calling Friends La Brea at (323) 463-7001.