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Crystal: What you need to know From Gay Men's Health Crisis What is Crystal? (AKA: Tina, crank, crissy, speed, meth, tweek) hCrystal is an amphetamine - a synthetic stimulant that excites the brain and the central nervous system. Crystal increases the release of dopamine in your body - the chemical that sends pleasure messages to the brain. Crystal is most often found as an odorless off-white or white powder but can also be found in pill, capsule, or crystal form. Why so Popular? hPeople express different reasons for using crystal. Some of the more common ones are: The desire to have lots of sex for a long time with multiple partners. The ability to dance for hours on end. To accomplish dull tasks; for example, users report feeling more energetic and having more fun cleaning their house. To get higher on less; for example, crystal provides a high that lasts much longer than cocaine, so users get "more for the money." To lose sexual inhibitions; for example, to have sex with men if you normally don't, to have aggressive or submissive sex, to bottom. People may use crystal for other reasons that are not so apparent: Loneliness: Some gay men may feel isolated; crystal is often a social experience. The desire to connect with others: Some gay men say it's easier to meet or feel close with other men when on crystal. Body image: Some gay men say that crystal makes you feel good about your body (i.e. dick size, build, weight, etc.). Loss of energy: Some gay men say crystal gives you energy to do it all. Some HIV+ men say crystal makes up for weakness associated with taking HIV medications. Self-esteem: Some gay men say crystal reduces insecurities, giving them confidence. Depression: Feeling sad, empty or incomplete inside is a big reason a person might turn to crystal, or any substance, to change how he is feeling. Gay men are sometimes un-aware that depression is impacting their use of crystal. Methods of Ingestion hThe onset of a crystal high varies depending on how you take it. Users report experiencing different highs from the different methods of ingestion - these different highs can inform your sexual behaviors. Swallowing: Getting high by swallowing crystal in pill form, or by mixing it in liquids. The high sets in about 20 - 30 minutes after ingesting. Snorting: Getting high by inhaling crystal through the nose. The high sets in around 3 to5 minutes after snorting. It goes directly into the veins of your nose. Smoking: Using a pipe (glass or homemade) to get high. It takes 7 - 10 seconds to feel the high. Booty Bump: Inserting it into your anus. It takes 10 - 15 seconds for the high to set in. The lining of the rectum absorbs the drug. Injection: Putting crystal in your veins with a needle. It takes about 15 - 30 seconds for the high to set in and is the most powerful high. What happens? hFor many people, crystal use begins recreationally, enhancing one's sexual experiences and dancing or social activities. However, crystal is extremely addictive, and even for many people who have practiced moderation in many aspects of their lives, crystal often becomes an addiction. hCrystal can elevate your mood, induce euphoria, increase alertness, reduce fatigue, increase energy levels, and suppress appetite. It also increases movement and speech, and can provide a sense of increased power and a desire to be sexual. Many describe it as "feeling invincible and feeling like the life of the party." hComing down from the high ("crashing") includes symptoms of anxiety, irritability, and sometimes severe depression. People who are crashing often experience sweating spells, nausea, paranoia, psychosis and total physical and mental exhaustion causing extended periods of sleep. hOverdosing on crystal can dramatically affect your breathing (breathing may be shallow and short) and in some cases may stop your breathing. Some symptoms of an overdose include severe chest pain, convulsions, and vomiting. Overdose can result in heart attacks, strokes, and death. Long term or heavy use can lead to neurological damage, chronic depression, liver and kidney damage, and other health related problems. Crystal and Sex hSome users who have sex while high on crystal can stay hard and fuck for hours. Others experience what is known as a "crystal dick" or the inability to get hard. Often, men will use crystal in combination with Viagra to get or keep an erection. This can potentially raise your blood-pressure to dangerously high levels which can take you steps closer to an overdose or give you a really long lasting hard-on that can permanently damage the muscles and tendons in your dick. hThe inability to get a hard-on can often lead someone who usually tops to bottoming. And in whichever position, some guys report dispensing with using a condom from the start. Remember: unprotected anal sex is the leading cause of HIV transmission. If you are HIV positive If you are HIV positive, you should know that Crystal speeds up the rate of HIV replication. Crystal reduces the effectiveness of HIV meds (HAART). Some protease inhibitors like Amprenavir (Agenerase) increase the amount of amphetamine in your blood stream, putting you at risk for an overdose. The lifestyle connected to crystal use can exhaust your immune system and affect your ability to take medications as prescribed. Using crystal may affect your decisions. You may decide not to use condoms. If you have sex without a condom, you are likely to transmit the virus to your partner(s). These findings make it even more important for you to take better care of yourself and to reconsider your use of crystal. If you are HIV negative: Research has connected the rise of HIV infection rates amongst gay men to crystal use Crystal is known to impair judgment and can lead to unsafe sex... and HIV. Crystal is known to reduce inhibitions allowing men to engage in rough sex, or bottom. Crystal can complicate your decisions on condom use These findings make it even more important for you to take better care of yourself and to reconsider your use of crystal Safer Sex Tips Stay mindful of your sexual limits. Identify ways to ensure you use a condom. Tops need condoms too. Protect yourself. Topping without a condom still holds significant risk for HIV transmission. Remember to reapply lube frequently to prevent the condom from drying out and to prevent the lining of your rectum from tearing, both of which increase the risk of HIV transmission. Condoms wear out. Change the condom during extended fuck sessions. Pull your dick out regularly and check if the condom is still intact. Lube keeps condoms from breaking. Discuss your HIV status with your sex partners. Use plenty of lube when masturbating for extended periods of time as your dick may chafe or scratch. When having oral sex for extended periods of time, check the condition of your mouth - you might not notice whether your mouth is chafed or sore. Drink water throughout the night. Check your partner(s') dick for sores or scratches. Remember Sexually Transmitted Infections increase the chance of HIV transmission. Health Concerns to Remember Crystal is highly addictive. Use may change from snorting to smoking or slamming - or from using socially to using alone. Binging postpones the end of the party but will make the crash worse. Tolerance develops quickly. You will need more and more crystal to get high. Crystal will decrease your desire for food. Crystal will impact your perceived need for sleep. Crystal can cause exhaustion and dehydration. It can lead to depression and cause temporary psychosis. Agitation and anxiety are common when using crystal. Overdose is a very real and present danger. How to Care for Your Body If you are going to use, you ought to use extreme caution and limit how much you take. Listen to what your body is telling you. Drink water and cranberry juice to keep hydrated. EAT. Don't assume you didn't get enough. The more you use the less burning you will feel in your nose and the less intense you may feel. If you don't feel it right away, wait. Avoid caffeine, soda, and energy drinks. Sleep, take naps. Allow your body to recover. Don't overdo it. Don't hesitate to get help. If you have questions, whether you are just thinking about using, occasionally using, or find yourself using more often, you can get answers. See resources below. If you are injecting (slamming) crystal: Use a new syringe and new equipment every time you inject. Don't share needles. Sharing needles can lead to HIV, Hepatitis C and B. Clean injection sites with alcohol pads before injecting. If alcohol pads are not available, clean the injection site with warm soap and water. It will not be as effective as alcohol. Change injection sites to avoid collapsed veins and abscesses. Access needle exchange programs. For information on exchange locations, visit the website of the Harm Reduction Coalition at www.harmreduction.org. In Washington DC, call PreventionWorks at 202.588.5580.

12 Steps From Tweaker.org hMethamphetamine abusers are the hardest to treat of all drug addicts, often in extreme denial of their problem and resistant to any form of intervention. hIf the abuser fails to face up to his addiction or concedes that he has a problem, he may have to hit rock-bottom before choosing to commence the process of recovery. Otherwise, his uncontrollable abuse of crystal will eventually destroy him. Often, the abuser's helplessness will force him to awaken to his situation and seek medical help, comprising CBT (cognitive behavioural therapy), MET (motivational enhancement therapy), or via a 12-Step recovery and support program like Alcoholics / Narcotics Anonymous and Crystal Meth Anonymous (CMA), which has a 100-strong network of regular, informal meetings across North America. hCMA boasts one of the greatest success rates of any organisation specialising in the rehabilitation of crystal meth abusers, embracing a spiritual approach which encourages members to confront their problem head -on by surrendering to a higher power and empowering themselves as a means to overcoming their addiction / state of powerlessness. CMA isn't suitable for all; the requirement for the addict to place his faith in a higher power can be alienating and disconcerting to those with a fractured belief system and those in conflict with such a concept, and some can find their craving triggered at meetings where members graphically recount their meth using experiences. hThe path to recovery varies from person to person. The severe effects of withdrawal - suicidal depression, irritability, fearfulness, loss of energy, insomnia, palpitations, sweating, hyperventilation - can last several weeks, but the wall (craving period) continues for around six-eight months for casual users and up to two-three years for hardened abusers. Because there is no methadone-like bridge to sobriety for crystal addicts, the relapse rate is very high - 94% according to a recent University of California study - and a full return to sobriety can take anything up to several years. hIn an effort to expand treatment options and develop a "silver bullet", The National Institute on Drug Abuse (NIDA) has set up a program to develop pharmacological approaches to meth addiction, with around a dozen compounds already used in other areas of medicine in various stages of clinical trials. These include: Calcium-channel blockers, which treat high blood pressure and may inhibit the excessive release of neurotransmitters, thereby reducing the "reward" of using methamphetamine The anti-nausea drug Zofran, which has been shown to work against relapse in alcoholics Tyrosine, an amino acid that's a precursor of dopamine and may increase production of the neurotransmitter Wellbutrin and other antidepressant medications, currently being studied for their potential to reduce relapse based on their ability to boost levels of neurotransmitters associated with pleasure hScientists also plan to test medications that may be able to reverse some of the neurological damage and cognitive impairment caused by methamphetamine. One of the most promising, Selegiline, is used to treat some symptoms of Parkinson's disease - itself a severe mental condition associated with the progressive loss of dopamine - and has neuroprotective properties that can reduce HIV-related cognitive deficits. Studies on vitamin E, which is thought to boost natural protective chemicals in the brain, are also planned. hNIDA is also developing an antidote for use in meth overdose situations, which would literally drain meth out of the tissues, thereby decreasing concentrations of the drug in the body, reducing the duration of the high and some of the adverse effects. However, such a treatment is still years away from being tested on people. Meanwhile, scientists at The Scripps Research Institute have found evidence in laboratory studies that the immune system may be able to recognise methamphetamine and boost tolerance to the drug through an unusual vaccine-like mechanism, a finding that could lead to new treatments for those addicted to the drug. Crystal Meth Anonymous Meetings in Washington DC Monday 8:30pm "Meth Busters" at the Triangle Club, 2030 P St., N.W., Washington, DC, three blocks from the Dupont Circle Metro Station (upstairs from Lustre Cleaners) the club phone number is 202-659-8641. Open, N/S, Chips (Alternating Speaker / Step Mtg.) Wednesday 8:30pm "Mid-Week No Tweak" Relapse Prevention at the Triangle Club, 2030 P St., N.W., Washington, DC, three blocks from the Dupont Circle Metro Station (upstairs from Lustre Cleaners) the club phone number is 202-659-8641. Email Contact - Closed Discussion, N/S, Relapse Prevention Thursday 8:45pm - 9:45pm "Ice & Tina Turners" - Relationships, Sex and Intimacy (closed) Triangle Club, 2030 P St., N.W., Washington, DC. three blocks from the Dupont Circle Metro Station (upstairs from Lustre Cleaners) the club phone number is 202-659-8641. Friday 8:30pm "Tweak-enders" at the Triangle Club, 2030 P St., N.W., Washington, DC, three blocks from the Dupont Circle Metro Station (upstairs from Lustre Cleaners) the club phone number is 202-659-8641. Open, N/S, Chips, Speaker / Topic mtg. Saturday 7:00pm (Starts Dec 6th 2003) - Open, N/S, Speaker / Traditions mtg. - Dupont Circle Club, 1623 Connecticut Ave., NW, Washington, DC, one block from the Dupont Circle Metro Station Q Street Exit (upstairs from Melody Records) the club phone number is 202-234-7837.