Meth. Speed. Ice. Crank. What do you think of when you hear one of methamphetamine’s many nicknames? You might first conjure images of a rural town plagued with poverty, or an urban cityscape where shady exchanges go on in back alleyways, unseen amidst the bustle of the metropolis. Rather than a place, perhaps you think of the after-effects: scabby, sore-stricken skin, gaunt faces, a mouth full of missing teeth and overtaken by decay. Whatever comes to mind, it likely isn’t the thought of the vibrant gay community. However, that’s precisely what’s been going on—and it’s been going on for decades.

Drug Use In The Gay Community: How Does Meth Fit Into the Picture?

Numerous studies conducted over the past few decades have shown that sexual minorities have much higher rates of substance abuse and addiction than the general population, and across all drug categories: alcohol, tobacco, marijuana, prescription painkillers, as well as illicit drugs. A study conducted in the United Kingdom found that gay men and women used drugs three times more frequently than that of their heterosexual counterparts. 

Unfortunately, this isn’t a surprising trend. As a historically marginalized group that continues to face discrimination and persecution today; these findings align with the phenomenon known as minority stress. These groups, such as LGTBQ men and women, consistently have higher levels of stress and are far more likely to turn to substance abuse. But the frequency of drug use only paints part of the picture. The types of drugs favored by the gay community are also distinct from that of the general population. It is here in the drug preferences that provide the biggest insight as to why meth holds such sway over the gay community. 

Stemming from the powerful influence of the gay nightclub scene, the drugs of choice are what have come to be known as “club drugs”, a group of psychoactive stimulants known for enhancing energy and sexual experiences. The drugs included in this informal classification include cocaine, ketamine, MDMA (ecstasy), amyl nitrite (poppers), LSD, shrooms, amphetamines (like Adderall), and not least of all methamphetamine

Of these drugs, meth is one that finds itself a frequent target of abuse. Why meth in particular? While its popularity can be partially attributed to the fact that many club drugs first passed through the walls of gay nightclubs and bars before crossing over into mainstream (cocaine, ketamine, and MDMA were all relatively unheard of before there were adopted by the gay clubbing scene) the most influential reason for their staying power is a specific and somewhat sordid purpose within the microcosm of the gay nightclubbing scene. 

Gay Meth Use: Who’s Using It & How 

Meth abuse has long been a rampant and destructive force in the gay community, but particularly—and almost exclusively—among gay men. The National Survey on Drug Use and Health reported that their meth use is more than 4 times higher than that of straight men (there seems to be little to no use amongst gay women). A big part of this discrepancy is due to troubling behavior known as chemsex.

What Is Chemsex?

A term that originated in the sex networking apps for gay men, chemsex is the use of methamphetamine, mephedrone, GHB, ketamine, or sometimes a combination of these, during sex—with meth being the particular favorite. The act itself can be a multi-day event and involve multiple people. These psychoactive stimulants are favored as sexual disinhibitors that help to prolong or intensify the sexual experience. One study looked at the behavior of men who used a chemsex drug. Nearly 75% of participants say it was involved with sexual acts (chemsex), showing the strong correlation of drugs like meth being used for this specific act, rather than simply being a recreational drug of choice. 

Although the number of individuals who participate in these acts represents a very small subset of gay men (only 6% reported participating in chemsex in the past year from that same study), these numbers highlight that the small few of chemsex participants are doing so at an alarming rate. Widely available and easily discoverable via social media, these drug-addled gay sex parties are a hotbed for transmission of HIV as well as hepatitis. In fact, meth is directly associated as the biggest contributor to the spread of HIV among the gay community.

Aside from the multiple immediate potential dangers of intravenous drug use are the risks of drug use itself. Addiction and overdose are alarmingly common in these circles. A 2015 documentary of the act’s namesake followed the tumultuous highs and lows of those who partake in this underground sex scene, showcasing this subculture’s dark and often dangerous side. In the UK where the phenomenon now has been studied much more thoroughly, chemsex was linked to one death every 12 days. 

Chemsex, Meth & Addiction

On its own, methamphetamine is one of the most addictive drugs out there. Unlike other stimulants, it has a much longer half-life, which means it remains in the brain and body for longer. Frequent use can quickly result in a toxic level of buildup (and overdose). One of the reasons meth is so addictive is that unlike other stimulants such as cocaine which merely blocks the reuptake of dopamine (the culprit of euphoric sensations), meth both blocks dopamine’s reuptake and increases the amount of dopamine released. 

The same mechanisms that cause chemsex to result in heightened sexual pleasure, confidence, and duration are powerful enough to override the brain’s reward center. When paired with sex, another act that can elicit a powerful response of the brain’s reward system, it’s a recipe for overstimulation that can quickly result in tolerance and dependence. As such, chemsex participants engage in riskier sexual acts more often and put themselves at an increased risk. Studies also show that the types of people who participate in chemsex are naturally more prone to risky behavior in general. 

Specialized Meth Addiction Treatment

While chemsex drugs are available and used far beyond the fringes of gay nightclub culture (where many of today’s club drugs first entered the scene), several of them, such as meth, have remained relatively niche and a consistent presence within LGBTQ social circles. The specific sexual acts associated with gay meth use can complicate the already complex nature of addiction. As such, new, specialized treatments are being developed to better address the needs of this unique behavioral disorder. 

But even as chemsex addiction treatment is developed and refined, it’s crucial to emphasize that there is no safe level of methamphetamine use. It’s possible to cause addiction within the first try, and the association of drugs with any sexual act has the potential to amplify the addictive nature of a drug. The risk of addiction and HIV transmission is incredibly harmful to an already vulnerable community. Although this act is only undertaken by a small subset, their acts can have repercussions that affect the greater LGBTQ community as a whole.