Windy City Times' exploration into crystal use in Chicago continues with part two of our profile of Christopher, a 36-year-old gay man now in recovery from addiction. Christopher described crystal as the substance which 'brought him to his knees' and forced him to admit his drug dependency. In our first installment, Christopher told Windy City Times how he transformed from a college student with a taste for marijuana and alcohol into first a cocaine user and eventually, a crystal addict in the North Halsted bars. When we left off, Christopher was in his mid-20s, working as a bartender, and regularly indulging in crystal runs with his bar buddies.
Christopher continued using crystal until he says he was 'no longer employable. I was a bartender. I became a bartender because part of the job description was being a drunk. I felt my drinking and drug use would be tolerated, even encouraged, there. But I got so out of control that even in an environment where intoxication was de rigeur, I was considered too far gone. I was fired from one gay bar after another. Finally I was without a job for three or four months, I was about to lose my apartment, then one of my friends overdosed and died ... he was the last person I could relate to, because drugs were his whole life too. I didn't know what to do, where to go, where to turn. I began to realize that I could no longer put noun and verb together into a coherent sentence. I couldn't focus on an idea, because my drug use had so clouded my thinking. I recall vividly, on more than one occasion, having what I thought was a lucid conversation and getting such a bizarre reaction from the person I was talking to—they hadn't understood a word I said because I was blathering on nonsensically, but to my ears, I made all the sense in the world. I had been using crystal regularly for two years by then. I was already an addictive personality and had abused many drugs, but crystal was what finally broke me.'
Like one of the subjects of a Jan. 10, 2004 New York Times piece documenting crystal use among the predominantly white gay men of New York City's downtown bathhouse scene, Christopher believes that he became HIV-positive around the time he started using crystal. He calls himself 'promiscuous' and says that his risky sexual behavior ran parallel to his drug abuse. 'My inhibitions were nonexistent. I believe I had a death wish during those years, so contracting HIV was not really a concern for me then. To be honest, I think in a way I wanted it all to end. In the late '80s and early '90s, people died of HIV—it was still a death sentence. It was episodic in some bars to browse through the latest issue of whatever gay newspaper—one in particular was pretty much nothing more than a giant obituary page —and it became fashionable to go through the obituaries and say, 'oh, I knew him, I knew him and him, oh, she was a real slut.' For me, it became desirable for me to actually BE on that list, because it would define my gayness, and I could die a martyr to the community. Plus, it would be a dramatic way to go.'
Christopher doesn't believe that crystal leads all of its users into reckless promiscuity, but he does believe that unsafe sex practices are a 'result' of the drug's effects. 'Crystal makes you horny. I used to spend 12 hours in the bathhouse on crystal, having sex. I'd get kicked out of one bathhouse, because of their time limit, and drive right over to the next bathhouse. When they kicked me out I'd go back to the first bathhouse again.'
In Christopher's opinion, crystal abuse is a 'growing problem' in Chicago. 'We are a much stronger gay urban frontrunner than is recognized by the mainstream media. I believe Chicago's drug use is easily on a par with New York and LA, and I think we surpass San Francisco, Atlanta, and Toronto. And most of the gay men who use drugs, use crystal, and crystal has a terrible relapse rate. If you compare an alcoholic to a crystal meth addict, in my experience for every hundred alcoholics who turn their lives around, only ten crystal meth addicts are able to do the same. I think much of that is because in order to break addiction you have to understand your own motivations for using, and I don't know if as many meth addicts do that as alcoholics.'
Christopher thinks that gay men in their late 20s to early 40s are typically more reckless with crystal than their younger counterparts. 'Gay men in their 20s and even their teens are just beginning to experiment with drugs, and they're learning from the experiences of my generation. I see more and more young gay men not doing drugs, not involving themselves in the bar scene, embracing monogamy. They see guys my age destroying themselves and they don't want that. Once you get into your upper 30s and 40s, you start really crashing if you're living the crystal lifestyle. The lucky ones get clean. Some are lost, and God only knows where they'll end up.'
Christopher, like many people struggling with drug and alcohol abuse, found an alternative to drugs in the teachings of the 12 steps, more colloquially known as the 'Anonymous' family of fellowships. Overeaters Anonymous, Narcotics Anonymous, Crystal Meth Anonymous, and Debtors Anonymous are just a few examples of the seemingly innumerable self-help programs based on the same principles of overcoming addictions, originally popularized by the first such fellowship, Alcoholics Anonymous or 'AA'. In the 80-plus years since AA first appeared in the U.S., 12-step philosophy has come to dominate—and, according to its critics, monopolize—the treatment of addictions. Anecdotal evidence suggests that virtually all inpatient detoxification programs in the U.S. utilize its methodology, and court-mandated alcohol and drug diversion programs also rely predominantly on the 12-step model.
Yet there is great debate as to the actual efficacy of the 12-step method, which reportedly has never permitted an objective study of its results and requires belief in a God-like entity (referred to as a 'Higher Power'), advocates a medically unproven insistence that addiction is a physical disease rather than a behavioral problem, and encourages what some critics have called 'cult-like' deference to the 12-step program. Newcomers to 12-step meetings are frequently told that the program is the 'only way' to stop using drugs or alcohol, and a frequent admonishment heard in meetings is that failing to surrender one's life and self-will to a God-like entity (the 'Higher Power,' ostensibly any concept, person, or even object of the person's choice to whom the neophyte is encouraged to 'pray' for strength and guidance) will result in 'jails, institutions, or death.'
Most informal assessments of 12-step programs suggest that fewer than 10% of its adherents achieve long-term sobriety; some undocumented accounts state that as many as 40% of first-time visitors to a 12-step meeting never return.
And while there is no data available to refute or confirm these anecdotal numbers, there are studies which suggest that while 12-step programs are a good option for some people, they are by no means the only way to quit using drugs or alcohol.
According to a March 1990 article in American Health Magazine, 'people are about ten times as likely to (stop using drugs or alcohol) on their own as with the help of doctors, therapists, or self-help groups.' And according to a study published online in the March 2000 edition of NIDA (National Institute of Drug Abuse), when 128 crack addicts were divided into two groups, with one group receiving cognitive-behavioral therapy and the second attending 12-step meetings, the group receiving cognitive-behavioral therapy was more likely to remain drug abstinent for four consecutive weeks than the 12-step group.
Another piece of evidence emerged as a result of this study. According to the authors: 'In the (cognitive-behavioral) group, patients who scored high on a test of abstract reasoning were more likely to achieve a 4-week abstinence than those with low scores. In the 12-step group, the opposite was found: those who scored low on the abstract reasoning test were more likely to achieve sustained abstinence. In addition, in the 12-step group, but not the (cognitive-behavioral) group, patients with high scores on a scale measuring religious motivation were significantly more likely than their peers with low scores to achieve four weeks of continuous abstinence.' The conclusion seems to be that depending upon the individual drug abuser's personality and beliefs, different modes of treatment are more likely to be effective.
Competing drug and alcohol treatment paradigms have arisen for those substance abusers who do not feel comfortable with the 12-step model. One of these, SMART Recovery, practices REBT (Rational Emotional Behavior Therapy, popularized by psychologist Albert Ellis in the 1950s and today a widely accepted therapeutic technique used to treat such conditions as depression and obsessive-compulsive disorder) to help eradicate dysfunctional behavior patterns, including addiction. According to its Web site at www.smartrecovery.org, the objective of the SMART program is 'to support individuals who have chosen to abstain, or are considering abstinence from any type of addictive behaviors (substances or activities), by teaching how to change self-defeating thinking, emotions, and actions; and to work towards long-term satisfactions and quality of life.'
It subscribes to neither the addiction-as-disease model, nor the spirituality, promulgated by 12-step programs; SMART believes that 'labeling' drug abusers as both diseased and powerless to a God-like entity is disempowering and harmful. While SMART appeals to drug abusers who are not spiritually inclined, its critics point out that the organization provides little support to its members other than providing the REBT framework in which the drug abuser is expected to work essentially independently until their addiction is defeated. Some current and former drug users feel that a strong community, such as the kind found in 12-step programs, is essential for many people to achieve sobriety.
Like the 12-step programs, SMART Recovery advocates complete abstinence from drugs. Other programs posit the idea that using drugs or alcohol in moderation is possible and in some cases, preferable to abstinence. Moderation Management (see their Web site at www.moderation.org) is one organization taking such a position, though their Web site is careful to point out that its program is not appropriate for 'the small ... population of seriously (drug and alcohol) dependent' persons and suggests that individuals who are not able to successfully moderate their drug or alcohol intake within 30 days consider an abstinence program instead.
Like SMART, Moderation Management criticizes 12-step groups for its spiritual roots and addiction-as-disease stance. According to its Web site: 'Nine out of ten problem drinkers/(drug users) today actively and purposefully avoid traditional treatment approaches. This is because they know that most traditional programs will label them as 'alcoholic'/('addict'), probably force attendance at 12-step and abstinence-based meetings, and prescribe lifetime abstinence as the only acceptable change in drinking/(using) ... traditional approaches that are based on the disease model of alcohol/(drug) dependence and its reliance on the concept of powerlessness can be particularly counterproductive for women and minorities, who often already feel like victims and powerless.' The Moderation Management Web site states that approximately 30% of its members ultimately choose an abstinence program such as SMART or the 12 steps.
A unique resource for gay men struggling with crystal use is the Web site www.tweaker.org, an independent information clearinghouse based in San Francisco containing a motherlode of resources specific to the gay community. The site's 'tips for party boys' section includes helpful hints for using crystal safely and responsibly, and other parts of the site include detailed descriptions of the drug's pharmacology and effects on each major body system; checklists for determining whether one has a problem with crystal, HIV resources, listings of gay-positive 12-step recovery meetings, message boards, links to other gay-positive online crystal resources and personal 'crystal war stories' from gay men worldwide, some of which advocate abstinence and others claiming that crystal use can be moderated.
While tweaker.org takes a non-judgmental position vis-a-vis crystal use, it encourages visitors who believe they may have a problem with crystal to seek help. From the Web site: 'Remember crystal is very addictive! If you are having trouble moderating your use or quitting click the GET HELP button located on any page of the Web site, or call 鷟) 502-1999. We can help you manage your use, set limits for yourself or help you quit altogether.'
What does the future hold for crystal's influence in the Chicago gay scene? In Christopher's opinion, 'Boys will always be boys. Boys will go to the bathhouse and have sex, and some kind of drug, whether crystal or something else, will be there too. The key is to educate. Steamworks in particular is doing a great job of educating and protecting the community. They're one of the best things Chicago has going. (Steamworks) will try to keep drug dealers out of their establishment, they do a lot of (drug) searches and sponsor free HIV testing. Other clubs, and organizations, should follow suit. Telling gay men not to have sex and not to do drugs will not work. Drugs and sex have been around since forever, and I don't think they're going to go away anytime soon.'
See www.WindyCityMediaGroup.com for part one of this series, May 26, 2004 WCT..