Crystal clear danger

Observations on HIV (1)

The UK's clubbing scene has a new drug. More addictive than crack cocaine or heroin, crystal meth creates a high that can last for days. Gary Leigh, a clubber who has taken the drug twice, says: "Every inhibition falls away - you feel almost like God. Cocaine is just a quick rush, but crystal meth goes on for hours and hours."

But as Leigh now knows, crystal meth, which is associated with reckless sexual marathons, has led to havoc among gay men in America. He has set up a website (www.lifeormeth.org) that spells out the dangers in graphic detail. I quote Chris, who took crystal meth for the first time at a party, and then took part in a 12-hour sex session with eight different men. "I would never have unsafe sex," he writes. "That night I had unsafe sex with at least three guys I know were HIV-positive. Just one bump of tina [crystal meth] is all it takes, and you want more and more."

In the US, the National Institute on Drug Abuse sees crystal meth as the nation's fastest-growing drug threat. According to the British charity Drug-Scope, "it is still fairly rare in the UK" and the government lists it only as a Class B drug. Yet David, who works with HIV-positive patients in the NHS (and therefore does not want his full name used), says: "Even over the past few months, usage has become much more prevalent. It's all over the gay websites - men are actually talking about injecting it, which previously was anathema."

Leigh says the problem could easily be nipped in the bud. But club owners are more worried about gamma hydroxybutyrate (GHB), a depressant causing big problems among clubbers. Crystal, says Leigh, "is creeping in the back door".

Otherwise called tina, ice, krank or glass, the chemical name for crystal meth is methamphetamine, a more powerful version of amphetamine. It can be smoked, snorted, injected, or taken orally. Synthesised in Japan in 1919, it was widely used in the Second World War to keep soldiers awake for long periods of fighting. Because its highs are so long-lasting, the lows are correspondingly severe, and in extreme cases can lead to paranoia, hallucinations and suicide.

The New York singer/songwriter Rufus Wainwright has reported: "I went blind at one point. I was constantly sweating. By the end, I couldn't go an hour without weeping." A court in Canada heard last year how an addict climbed on to a roof in order to take a meat cleaver to imaginary people.

These are extreme reactions, but there is another danger. When a man was recently diagnosed in New York suffering from a strain of Aids resistant to most treatments, one doctor was quick to point a finger at his lifestyle. To date he is an isolated case, but Dr James Braun of the US Physicians' Research Network said: "This was a disaster waiting to happen, particularly in communities where safer sex is not practised regularly and in light of people using drugs like crystal meth."

Will Nutland, head of gay men's health promotion at the Terrence Higgins Trust, says it has never been conclusively shown that there is a correlation between crystal meth and the rise of HIV and other sexually transmitted diseases. "However, we are definitely seeing a trickle of men with HIV using crystal meth, and this is creating problems. They're failing to take medication properly, they're not sleeping well, and as a result they're aggravating their condition."

And David says: "We reckon that Britain is about four to five years behind America, but finally there's a glimmer of awareness. There is clinical evidence that not only does it impair medication for people who are HIV-positive, but it also destroys the immune system all on its own. If you're addicted, it can be a death sentence."