By Peter S. Theodore, Ph.D.

Methamphetamine is a powerful stimulant used by some gay and bisexual men to experience the intense pleasurable effects (happiness, self-confidence, excitement and sexual arousal) and avoid the aftermath of depression, fatigue and irritability. Many users also turn to meth as a source of connectedness and community only to later experience a disconnection between sex, love and intimacy. This article focuses specifically on the role methamphetamine plays in the sexual lives of its gay and bisexual male users.

Methamphetamine typically changes the sexual experiences of gay and bisexual male users in several ways. Methamphetamine is frequently used in sex clubs, bathhouses, bars and dance clubs—contexts where gay and bisexual men socialize and often meet sex partners. Psychologically, the drug can temporarily reduce anxiety, shame and stigma (common products of internalized homophobia), while increasing confidence and sexual desire. Users commonly report that they feel “sexier,” “charming,” “more attractive” and “sexually desirable” when they are high on meth. Functionally, the drug enhances sexual stimulation, prolongs arousal and delays ejaculation.

As most users say, meth makes sex feel better and last longer. This is especially true for those who combine methamphetamine with erectile dysfunction medication such as Viagra, Levitra or Cialis. The combination of psychological and functional effects described above can motivate users to have lengthy periods of continuous, rough sex that frequently includes unprotected anal intercourse. For some, methamphetamine use facilitates experimentation of new sexual roles—for example, becoming a bottom rather than a top. For many, methamphetamine use broadens one’s sexual activities to include uninhibited behaviors some label as “kinky.” Such behaviors may include group sex, bondage, sadomasochism, fisting or alternating use of dildos and other sex-toys.

Unfortunately, the sexual pleasure experienced while high on methamphetamine can come at a considerable cost. Each of the sexual behaviors described above increases exposure to blood and semen, thereby increasing the likelihood of becoming infected with HIV and other sexually transmitted infections. For many users, the meth/sex connection becomes ritualized. For example, chronic users commonly report that methamphetamine and sex always go together and that they find it difficult to remember what sex was like without meth.

Many gay and bisexual men seeking methamphetamine treatment say that while sex on meth was exciting and intense at first, their sexual lives ultimately grew “out of control”—having sex for days at a time, with multiple partners they did not know and engaging in sexual activities they typically do not practice when not using the drug. For these reasons, sex on meth often leaves behind a trail of shame, embarrassment, humiliation and fear—emotions that can fragment sex, love and intimacy.

The good news is that there is recovery from methamphetamine use. While methamphetamine treatment is compounded by the strong link between meth and sex, treatment options are available. These options will be reviewed in next issue’s column. If you think you might have a problem with meth, and you would like to try to stop your meth use now, remember that help is available. Call Friends La Brea at (323) 463-7001.