An increased use of club drugs -- crystal (methamphetamine), ecstasy (MDMA), GHB and Special K (ketamine) -- has been seen among young gay men. The trend is particularly troublesome because, as studies have shown, these drugs lead to unsafe sex and the spread of HIV.

Club drugs are taking a toll throughout the United States. In fact, a recent rise in nationwide emergency room overdoses prompted the Gay and Lesbian Medical Association (GLMA) to call for more research to find a solution.

What the Research Shows
Research by Dr. Perry Halkitis, a researcher at New York University, shows that of all drugs leading to unsafe sex, the riskiest are the club drugs. Alarmingly, 59 percent of the men in one of Dr. Halkitis' studies were using club drugs.

Club drug usage varies by serostatus, says Halkitis, based upon his research. He found that 46 percent of HIV-positive men use crystal meth during sex as a means of loosing their inhibitions, whereas less than 30 percent of HIV-negative men use the drug during sex. Regardless of serostatus, however, club drugs play a significant role in unsafe sexual behavior.

Men who use club drugs but who don’t engage in unsafe sex are putting their health at risk in other ways. Crystal meth, on its own, is highly addictive. It can wreak havoc on neurological and circulatory systems and can lead to strokes and heart attacks. Those who take antiretroviral medications and club drugs may reduce the effectiveness of their meds or unintentionally disrupt their antiretroviral regimen. "It is very likely that a person who is high on club drugs is going to miss a dose of their meds," Dr. Halkitis explains.

Dr. Halkitis points to some regional differences among club drug users. "Clearly San Francisco is a meth place, cocaine and GHB are more New York." Ecstasy remains more prevalent on the West Coast, but regardless of the specific drug and city, the sexual risk-taking problems are similar throughout the US, says Halkitis.

At one time, the club drug dilemma was isolated to California. But crystal meth has "inched its way" through the Midwest and has "finally made its way to the East Coast," Dr. Halkitis explains. "The problem with club drugs is only just beginning in New York City," says Dr. Halkitis.

Viagra and Club Drugs
The increase in club drug usage has coincided with the popularity of the legal, erectile dyfunction drug, Viagra (sildenafil citrate). Some men use Viagra to offset what’s known as ‘Crystal Dick’ -- when users feel a sexual high, but can’t get hard. In combination, crystal meth provides a state of sexual excitement and Viagra provides the ability to have sex all night long. Dr. Halkitis says the combination, nicknamed ‘trail mix’ when snorted, is the "most dangerous in terms of sexual risk-taking and HIV because they are creating the most risky sex."

What about experimentation?
Many gay men might find themselves experimenting with these harmful club drugs while out on the scene. But habitual use is where the damage lies, Halkitis says. "If somebody needs these drugs to socialize or to function, there’s a problem." Even so, it only takes one episode of unsafe sex to transmit or acquire HIV.

It’s also important to remember that an introduction to drugs can lead to a permanent relationship, depending on the person. Describing men he called "sensation seekers," Dr. Halkitis says, "I believe that there are personality characteristics that drive people into certain environments that exalt sexuality or drug use." An escapist mentality sometimes plays a role, too. "You want to escape because you have so much internalized homophobia," says Halkitis. Perhaps this helps explain why the gay community is so hard hit by club drug use.

Dr. Halkitis would like to see more places for gay men to socialize that don’t involve sex, drugs and alcohol. He suggests community events and fundraisers.

Help is out there for those who have begun to slip into unsafe sexual behavior as a result of a problem with club drugs. Many gay and lesbian community centers offer counseling or can suggest places that do. The Pride Institute, a mental health organization with several locations, offers counseling to gays and lesbians who are drug-addicted.

Indeed, a lot more work is needed to stop club drug use from becoming even a bigger health epidemic. Funky clothes and great music may be cool, but in light of the risks, club drugs are definitely not.

Resources
If you or someone you know is worried about the dangers of club drugs, log onto the Gay Men's Health Crisis (GMHC) site or look to your local AIDS service organization for information. The website for the Centers for Disease Control and Prevention (CDC) has a whole section devoted to club drugs. Dr. Halkitis recommends the site run by the National Institute on Drug Abuse, which funds research in this area.

Updated: Thursday, 19 October 2000