Gay crystal methamphetamine abusers: A grounded theory approach to a multifaceted issue

Substance abuse rates in the gay community are significantly higher than in other segments of the population, by some estimates as high as 35%. Although substance abuse appeared to decline in the 1980s in response to the AIDS crisis, drug abuse is once again rising. A new generation of drugs called "party drugs" have become popular with gay men. Among these, crystal methamphetamine, has been singled out as a very addictive and dangerous drug. Crystal methamphetamine, or "crystal," increases sexual libido, impairs judgment, and results in high risk sexual behavior. Increased crystal methamphetamine use concerns public health officials as unprotected sex increases exposure to sexually transmitted diseases, such as HIV, hepatitis, and syphilis. Secondly, gay men may be exposed to stronger strains of HIV that will not respond to medications. In order to understand the experience of gay men who abuse crystal methamphetamine, a small group of men were interviewed. A semi-structured interview and qualitative analysis using grounded theory determined that the men had many motivations for abusing crystal methamphetamine, as well as many factors that contributed to their drug use and life experience. Surprisingly, loneliness and a desire to belong was listed as a factor in crystal methamphetamine use. Also, crystal methamphetamine was used by a majority of subjects as a way to forget about safe sex and manage shame related to sexuality and HIV. Many subjects also felt that exposure to the gay community was related to their crystal methamphetamine use. Finally, many men who were interviewed had been exposed to sexual abuse or a highly sexualized environment before they were comfortable with their identities. Although a causation between early sexual behavior and crystal methamphetamine use cannot be proven, the effects on self-esteem and homophobia support a correlation between early sexual behavior and crystal methamphetamine use.