The unseen face of meth use

I met Courtney a few months after continually seeing the same question on Grindr profiles: "Do you PnP?" The phrase was ubiquitous on the geosocial networking app for men who have sex with men. I had no clue what the acronym meant, so I looked it up and found an entire Wikipedia page devoted to Party and Play, defined as a "phenomenon and subculture of recreational drug users who engage in sexual activities." It went on to say that PnP is usually associated with gay men who use crystal meth.

While I was producing several LGBT-themed short documentaries in grad school, sources kept bringing up the omnipresence of meth use in New York City's gay scene. "It is the gay man's drug because you can have sex for hours, even days, and never feel judged for it," one source told me.

According to a study cited by the Centers for Disease Control and Prevention, meth use is nine times higher for gay men than for the general population.

In the 1990s and early 2000s, meth became the most widely used illicit drug among urban gay men. "Early characterizations of the meth problem in the gay community depicted the party boy or the middle-class white man as the prototype of the meth user," says Dr. Perry Halkitis, professor of applied psychology, global public health, and medicine at New York University.

Public health campaigns in the early 2000s targeted white gay meth users as a way of combating the AIDS epidemic. This, Halkitis believes, created a stigma among middle- and upper-class white gay men and pushed the drug underground in the gay community. And while Halkitis says meth use is still common among all subsets of the gay population, a recent study of his found meth now disproportionately affects HIV-positive and African-American gay men.

After weeks of chatting online with many men and attending a Crystal Meth Anonymous meeting at New York's LGBT Community Center, where 38 gay male ex-meth users shared their recovery stories, I still couldn't find a current user who was willing to share his story on camera.

And in spite of the apparent omnipresence of meth use, it wasn't a surprise that nobody was jumping at the opportunity, given the stigma associated with the drug.

Then Courtney called. From the get-go, he was game to participate, telling me he wanted to be a voice for gay African-American youth. "It's something that needs to be addressed in the community and the world," he says.

Courtney, in his apartment. (Spencer Macnaughton)

As an HIV-positive, African-American gay man on government assistance, Courtney fits Halkitis's profile for the prototypical meth user. But Courtney says he hasn't found any form of treatment that has helped. And while he can't think of a formula that will help users like him get clean, he does suggest a place to start. "Maybe focus groups where users, researchers, and doctors collaborate and share their knowledge of the drug will help start a conversation where we can brainstorm more effective treatments," he says.

While meth addiction in the gay community has received little media attention in the past 10 years, it is currently seeing a resurgence. In light of this, Halkitis hopes the Department of Health will do more to target the problem in the African-American gay community. "Imposing white middle-class paradigms to the treatment approach is not going to work. We need to start understanding why men like Courtney are drawn to the drug," he says. "Understanding the motivations for substance use will direct us on how to help individuals. One size does not fit all."

Courtney is currently being forced out of his apartment because he is not allowed to have his dog in the building. Because of this, he says, he continues to use. "It's been depressing. And my [meth] use is kind of an outlet for that."

Courtney says he will get sober one day.