Methamphetamine Treatment Issues and Considerations among Men Who Have Sex with Men

Article excerpt

Methamphetamine use is epidemic among men who have sex with men (MSM), but treatment has lagged for this group. The author reviews literature concerning use, individual effects of the drug, and treatment for MSM and discusses implications for counselor training, future practice, and research.

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Methamphetamine is an amphetamine-type stimulant whose use has grown epidemic across the United States and many other parts of the world (Maxwell, 2005). Known as "speed," "crank," "chalk," "chandelier," "ice," "quartz," or "redneck cocaine," methamphetamine usually appears as a translucent crystal substance similar in appearance to rock candy or salt (Halkitis, Parsons, & Stirratt, 2001; National Institute on Drug Abuse, 2006; U.S. National Library of Medicine, 2009). In its smoked form, methamphetamine is also referred to as "crystal," "glass," or "tina" (National Institute on Drug Abuse, 2006; U.S. National Library of Medicine, 2009). Although it has been used medicinally to treat obesity, narcolepsy, and attention deficit disorder (Gorman, 1998; U.S. National Library of Medicine, 2009), it is currently listed as a Schedule II drug under federal regulations because of its potential for abuse and likelihood for dependence (Halkitis et al., 2001; National Institute on Drug Abuse, n.d.).

Prevalence and Patterns of Use

Methamphetamine is a highly addictive drug that can be smoked (e.g., by heating on aluminum foil and inhaling the vapor through a pen or straw), injected, inhaled, taken orally, or taken via "booty-bump" (i.e., anal insertion; National Institute on Drug Abuse, 2006; Shoptaw, 2006). Caulkins (2003) noted that the prevalence of methamphetamine abuse is more complex than other drugs, such as cocaine and ecstasy, because of the national variations of patterns of use. Methamphetamine use is widespread within the western regions of the United States, growing in the Midwest, and beginning in the East (Maxwell, 2005), with several larger cities such as Miami (Kurtz, 2005), New York City (Halkitis, Fischgrund, & Parsons, 2005; Halkitis, Green, & Mourgues, 2005; Nanin, Parsons, Bimbi, Grov, & Brown, 2006), and Atlanta (Dew, Elifson, & Sterk, 2007) serving as centers of the eastern front of the epidemic. Methamphetamine use is predicted to continue to grow quickly for a number of years. There is concern that abuse of the substance may reach high levels and the drug will spread into regions that previously had little methamphetamine use (Maxwell, 2005). At the present time, a substantial proportion of the U.S. population resides in areas where methamphetamine is currently unavailable, but as access increases, abuse of the drug may increase considerably (Caulkins, 2003). Much of the difficulty in tracking abuse of this drug has to do with the fact that methamphetamine is readily accessible to a large population because it is cheap and easy to make (Buxton & Dove, 2008; Rawson, Gonzales, & Brethen, 2002; Shoptaw, 2006), and most of the ingredients used to make the drug are available for purchase without a prescription at drug stores and pharmacies (Doweiko, 2009).

Use Among Men Who Have Sex With Men

Counselors and researchers have classified methamphetamine abuse as a growing public health concern in the United States and across the globe. It is also a pressing issue for the population of clients who identify as men who have sex with men (MSM). For the purposes of this article, literatures that explore the experiences of both MSM and gay and bisexual men are reviewed because gay and bisexual men are a subset of the larger MSM population. Methamphetamine use among urban MSM has been classified by researchers as endemic (Shoptaw et al., 2005): More than 11% of gay and bisexual men reported use of the drug within the previous 6 months, 20 times the prevalence for the general population (Substance Abuse Mental Health Services Administration, 2001). …