Tina tackled?

By now everyone has heard about the problem of crystal meth use in Toronto’s gay scene. But questions remain about just how bad it is and what should be done about it.

“The coverage on this issue has been incredible, and not necessarily in a positive way,” says Nick Boyce, the Gay Men’s Harm Reduction coordinator for the AIDS Committee Of Toronto (ACT). “We’re seeing headlines like ‘One Hit And You’re Hooked’ and ‘Lifetime Addiction,’ which simply isn’t true.”

Boyce was one of five panelists at a community discussion held Mar 22 at Buddies In Bad Times Theatre titled “What’s Up With Tina?” The event was organized by the Toronto Gay/Bisexual Men’s Crystal Meth Task Force.

Formed in February 2005, the taskforce was created with representatives from 13 community agencies including ACT, Toronto Public Health, the provincial AIDS Bureau and Gay Guide Toronto, as well as bathhouse management, meth users, nonusers and ex-users. In 2005 the taskforce received $130,000 from Health Canada to facilitate a coordinated response from community agencies toward queer men’s meth use and to spread information including harm reduction tactics. That money runs out at the end of March.

Boyce notes that the election of the federal Conservatives to a minority government last year was cause for concern for the taskforce.

“There’s been a shift at the federal level in the drug strategy,” he says. “They’ve taken harm reduction out of the mix and shifted their focus to justice. I think we’re going to see a shift to a US-style approach to dealing with drug use.”

That shift is already affecting the taskforce; the funding it received in 2005 is no longer available because of cuts made by the Conservatives. In order to keep the program going, the taskforce will be looking to the City Of Toronto for help, as well seeking out other sources of funding.

In 2006 the taskforce conducted a survey of men who have sex with men; the survey was repeated in 2007. Tim Guimond, a fourth-year resident in psychiatry at U of T who helped develop the survey, says they found no significant increase in meth usage from one year to the next.

One of the major concerns about meth use is that it will lead to an increase in HIV rates by affecting meth users’ choices about safer sex practices. However the survey reported no significant increase in overall HIV rates from one year to the next. It did note that for meth users, the rate of HIV infection is slightly higher and that more men who were using meth did not know their HIV status.

Jim Cullen, a PhD candidate at U of T researching meth addition, has found that while meth addiction can be difficult to treat, it’s no more challenging than treating addiction to other stimulants, such as cocaine — a finding that has some experts arguing that meth-specific treatment programs aren’t necessary. Cullen says he isn’t ready to agree or disagree with that hypothesis until more research is done.

Cullen says treatment programs which reward good behaviour, rather than punishing bad behaviour are more successful.

“We think of the person being treated in metaphorical terms as a chair and the leg is meth,” he says. “If we remove the leg, we have to replace it with something, otherwise the chair will fall over.”

He pointed to programs in the US where users undergoing treatment receive vouchers for things like clothing, food or entertainment in exchange for clean urine samples or meeting harm reduction goals.

Shaun Proulx, editor of Gay Guide Toronto and regular Xtra contributor, was one of the taskforce members to attend an international conference on meth use in Salt Lake City last August. There, he encountered the work of psychologist David Schwartz who is examining the role of sexuality in the treatment of meth addiction.

“He couldn’t overemphasize that if we ignore sexuality in recovery we’re in a lot of trouble,” says Proulx. “He went on to say that success is met by recognizing and learning about your deepest sexual self.”

Rehab programs traditionally take a very sex-negative approach to treatment. In some cases, users who are caught masturbating or with sex toys while in rehab are reprimanded, which Schwartz says is highly counterproductive.

For many queer men who use meth as part of sex, the drug is thought to be deeply connected to their ability to express their sexuality, by allowing a freedom from judgment about themselves and their sexual desires. Panelists stressed that it’s a necessary part of recovery for users to learn how to express their sexuality without the use of the drug, if treatment is to be successful.

“It’s up to the gay community to be a leader, if not the leader in educating and guiding stakeholders by sharing our stories,” says Proulx. “We need to continue to be there as a community because those who would be in charge of taking care of us are still working to understand us.”