Overview
Harm Reduction Coalition partnered with BEAM (Black Emotional & Mental Health) Collective and the Counter Narrative Project (CNP) to learn more about crystal methamphetamine use among Black and Latino men who have sex with men (MSM) — including why they are using crystal meth, unmet health and social needs, and suggestions for resources and tools to stay healthy and safe. The information in this report includes two primary sources: (a) survey data from social service and health providers across the country, and (b) narratives from Black and Latino MSM who use crystal meth. In April 2018, we conducted an online survey of 182 providers across 24 states, including health educators, medical assistants, social workers, program directors, and clinicians. The survey data provided us with a background of how informed they are about crystal meth use among Black and Latino MSM, how confident they are in discussing crystal meth use and risks, and what resources and tools would be useful to support their level of awareness and ability to have these discussions. The narratives from Black and Latino MSM who use crystal meth come from focus groups that were conducted online. Questions were developed after we analyzed the findings from the survey data to better understand the experiences of crystal meth use, talking to providers, where they seek information and resources, and what would be useful in a future toolkit. Next, we’ll discuss what we learned about why and how Black and Latino MSM use crystal meth.
What is Crystal Methamphetamine?
Crystal methamphetamine (meth) is a synthetic illicit stimulant that affects the central nervous system (CNS) and has a crystalline-like appearance. It can act as an upper to make people feel more awake, active, sensitive, and sexual. People can use crystal meth a variety of ways, including injecting, snorting, smoking, and booty-bumping (i.e. administered in the rectum) and risks are related to the route of administration, experience and tolerance of the drug, and any co-occurring health conditions. Like other drugs, these risks are compounded by social determinants of health, including access to resources, housing, healthcare, social networks, and other aspects related to the person’s sociocultural identities.
What Crystal Meth Use Looks Like Among Black & Latino Men Who Have Sex with Men (MSM)
Why Are People Using Crystal Meth?
One word: sex. Black and Latino MSM overwhelmingly described crystal meth use as a tool to enhance a sexual experience and to promote connection and intimacy. Similar to what we knew before about crystal meth use in white MSM communities, it is used in the context of what we call “chemsex” or “Party and Play” or “parTy” which is using drugs during sex to enhance or improve the experience, releasing inhibition and having fun.
“When I was using [crystal meth], I used it for sex. If I wasn’t having sex there wasn’t a reason for me to use it.” — Black, South (Age 32)
Where and When Are People Using Crystal Meth?
There are a variety of places and contexts where people may be using crystal meth, and they’re all tied to having sex. Whether it’s at a house party with other people to a one-to-one encounter, Black and Latino MSM connect with each other in online spaces (such as hook-up sites like Grindr, Jackd, Scruff, and online forums) to meet up. A culture of sharing indicators — including phrases like “mild to wild” or “blowing clouds” or “do you parTy?,” or use of emojis such as diamonds and clouds — to communicate interest in engaging in crystal meth use during sex.
“You can see it subtly on Grindr profiles or other online profiles: the phrase ‘mild to wild’ is a very good indicator that the person uses meth or is in the scene or diamond emojis (?), those are another good indicator the person is into meth.” — Latino, West Coast (Age 25)
How Are People Using Crystal Meth?
We heard that people use crystal meth in a variety of ways, and that for people who injected crystal meth there were a few key components to doing it safely. First, in group or oneon-one situations, someone may inject someone else if they aren’t able to do it themselves and are referred to as the “administrators.” We also heard that the most accessible and reliable source of syringes was from drug dealers and large chain pharmacies or “hood pharmacies” which gatekeep less around safer injection supplies.
What Are the Perceived Risks of Using Crystal Meth?
We usually talk a lot about health risks when we think about drug use, and safety is synonymous with harm reduction practices that reduce these health risks. However, we learned that the top priority risks for Black and Latino MSM were social risks, including, but not limited to:
Looks and appearance. We heard that people had heard from others how meth was impacting their physical appearance (e.g. teeth, weight, sudden weight loss, skin, looking ill) and the impact that has on their social standing.
“Crystal meth it kinda messed me up … I’m a very attractive male, so at the end of the day it’s like when your friends take notice, when your friends actually take notice of what you actually look like, what your face actually looks like, the marks on your face, your face looks dried out, you look sick, you look hungry, you’re sweaty, your teeth start to look bad … I mean it definitely changes your appearance.” — Black, South (Age 32)
“You might look hungry, you might have been up for three or four days, it shows on you, it shows on your face … I know with me, my family members were like ‘well, you’re losing weight,” and I was like wow … one of my key thing is feed your drug, eat and drink. If you’re doing drugs, make sure you eat, make sure you drink water. That’s the main thing, but crystal meth, it kind surpasses all that because it has you on one track really, you don’t really focus on what you need to focus on.” — Black, South (Age 38)
Not being able to enjoy sex. We heard that sex was more wild and pleasurable, without inhibition and ability to connect with someone, and without crystal meth, they didn’t enjoy it as much.
“It is hard for people because they don’t have the same sex as if they were sober. They not even have access to the same people if they were using the drug or to the same spaces either. It is not even just meth. People use GHB or other variations of that drug to enhance their sex. It is a whole world on its own too and that is the big allure too. I realized wow my sex is going to turn really pland if I am not using this or I am not with these people.” — Latino, West Coast (Age 25)
Situational risk. We heard from nearly everyone that they had shown up to a situation where they were going to use crystal meth and have sex that was different than their expectations, feeling a loss of control over the siituation or uncertainty about how much they could trust the person or people around them.
“Always try to maintain control … don’t go to any place you’re not familiar with. You can’t trust everybody, but you can trust yourself so if it doesn’t sound right, just don’t do it. I’ve gone places with no ID, no wallet, just the stuff I needed to make sure no one robs me for anything … And I always watch, even though I might not pay attention totally 100%. I’m always watching people and I make sure that if I’m somewhere and someone is like ‘Let me invite these people,’ and sometimes it’s like imma invite one person and then they bring five people with them … What I always tell people is don’t show up to places already high … and with meth, it’s not like ecstasy … you know what you’re doing, you just don’t want to control it.” — Black, South (Age 38)
Loss of control in the moment. Feeling an inability to manage emotions, including anger, to experiencing paranoia, hallucinations, and panic attacks when using.
“I have a temper when I’m sober, so [when using meth] the smallest thing will make me explode.” — Black, South (Age 32)
“[Before I started using] I wish I would have known that you may feel shit, but nothing’s really fucking there, like you may feel shit crawling on you, and I messed up … messed up my body [from scratching] for this damn drug.” — Black, South (Age 32)
“If you’re paranoid, you’re probably going to be super paranoid.” — Black, South (Age 38)
Loss of stability. Ongoing drug use could potentially lead to losing a job, housing, social relationships, and general community networks and ties.
“I have seen men, who look outwardly successful and use it and seen how they lose everything (their house, their jobs, their security) due to their use … It is a really slippery slope and I have seen so many guys get lost and lose everything that I think it is way too much of a risk.” — Latino, West Coast (Age 25)
Health risks. While secondary to the social risks, we did hear that people had experienced injection-related infections and for people who were HIV positive that there was some concern crystal meth impacted the efficacy of their medication and, in turn, their viral loads.
[Someone tried to administer it and they did not do it right] “I think it got stuck in my system … I did not fully feel it after two days, I started having a panic attack. I started having swelling of arms and I had a panic attack. I took myself to the ER, and they just told me to put a hot compress on it and to ‘stop using.’ After a while the symptoms went away on their own.” — Latino, West Coast (Age 25)
“It’s made me more wild and there are times where I question myself and I wonder, ‘wow I would not have had those experiences, these sexual experiences, if I wasn’t doing this, if I wasn’t using meth.’ It makes men want to have sex more and with more people.” — Latino, West Coast (Age 25)