Crystal, Tina. Meth. No matter what you call it, South Florida’s methamphetamine epidemic continues to wreak havoc on the lives of gay men. According to the Florida Department of Children and Families, methamphetamine deaths in the state rose 28 percent from 2013 to 2014, and 89 percent since 2011. 


While these data represent the entire population, other surveys confirm the grip of meth among gay men. The National HIV Behavioral Surveillance Study found that meth use among gay New Yorkers has more than doubled in three years. Similar findings are reported for Los Angeles and San Francisco’s gay communities. And therapists and private treatment centers report more gay men slamming (injecting) meth, a particularly alarming matter since Miami-Dade and Broward consistently lead the nation in new HIV infections.

Among gay men, meth is the most criminalized and least-understood drug, utilized primarily for sexual enhancement. But too many underestimate its danger or feel that they will escape its destruction, even though their peers could not. Moreover, meth users experience public stigma that impedes their recovery. In my new book, “Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery,” I combine 20 years of therapy sessions with meth-using clients with personal research to document this drug’s impact. The result is an effective roadmap to both physical recovery and healthy sex with intimacy. To end this epidemic, we first need to clarify meth misconceptions. 

1.) Meth recovery is impossible. 

Many gay men believe that, once addicted, escaping meth’s grasp is unattainable. Yet thousands in recovery, as well as addictions professionals, know better. Fortunately, with better current information, treatment opportunities, and support resources in the community, gay men now have the tools they need to get past meth. Increasing numbers of treatment programs serve meth-using gay men, and Crystal Meth Anonymous meetings in most urban areas are filled to capacity. Yes, getting clean involves relapses along the way to abstinence, but harm reduction strategies such as needle-exchange, education, and outreach are available. The recent lifting of the Federal ban on needle exchange will save lives.

2.) “Meth addiction couldn’t happen to me!”

Not every gay man uses meth. But for those who ingest it consistently, it can be ruinous. My clients initially believed they were fully capable of controlling this drug. They felt they could handle meth several times a year at circuit parties. Indeed, some could. Despite their best efforts, many increased their meth use to the point that their lives were dominated by binges which lasted for days – and then additional days needed for recovery. Jobs were lost, health and relationships destroyed. Nor is meth use restricted to young gay men. This year I had my first meth client in his seventies. 

3.) Meth damages sexuality permanently.

Meth deeply harms sexual functioning by quickly fusing intense, sexual desire with your intoxicated state. Users who stop using commonly experience post-meth fallout: a lack of sexual desire, problems with sexual functioning, and a belief that sex without meth is boring. This is not a permanent condition, but it requires altering your rituals connected to sex, dispensing with “meth-sex” habits, and no longer using pornography that you enjoyed while on meth. Sex without meth (or other drugs) may be frightening for gay men, yet sex and intimacy after meth is possible. In “Lust, Men, and Meth,” I document how, through brutally honest self-examination, you can fully reclaim sex and intimacy after meth. Some proven tactics for recovery are cognitive behavioral therapy, mindfulness, meditation, and group processes.

4.) Meth allows gay men to connect better.

Most gay men seek meaningful bonds with other gay men. Having been stigmatized and shamed, we search for the safety and intimacy of relationships. While many of these connections are sexual, we also strive for authentic friendship and a supportive community. Connections on meth may seem intensified, but are actually self-destructive, exploitative, and degrading. They erode healthy relationships, leaving the user without partners, friends or social support when the drugs run out.

5.) Calling out the dangers of meth only stigmatizes users. 

Meth is “the HIV of this generation.” That’s how a nationally-known addictions specialist accurately described this growing problem. Yet the shame and stigma associated with meth has smothered any frank and open talk about this epidemic. The truth is this: Meth destroys careers, friendships, lives, and relationships. Publicly discussing the dangers of meth shows compassion, not criticism. As I note in “Lust, Men, and Meth,” “it’s not the person who is bad or shameful; it’s a very nasty drug that hijacks sexual desire and clear thinking, often with disastrous personal consequences.” Let’s support each other with compassion and truth to move past this epidemic.

Dr. David Fawcett, a Fort Lauderdale-based psychotherapist is nationally-recognized in mental health and drug treatment. He is the author of the new book Lust, Men and Meth: A Gay Man’s Guide to Sex and Recovery (Healing Path Press). Learn more at