Script for “Crystal Methamphetamine and HIV: The Connection.”

Hi, my name is [PRESENTER NAME]. I’m [PRESENTER ROLE]. Welcome to “Crystal Methamphetamine and HIV: The Connection.” This video will discuss the history of crystal methamphetamine and its impact on the spread of HIV/AIDS.

Crystal methamphetamine, also known as tina, crank, tweak, ice, speed, and glass, among other names, has exploded onto the HIV/AIDS scene with a flurry in the last 5 to 6 years.

First developed in Germany in 1887, it found its way to Japan by 1919 and was used in the United States as a stimulant and appetite suppressant by 1930. It had been legal for many years and was even used to treat depression in the 60’s, but then became illegal in 1970. Bikers used to smuggle it between states in the “crank” case of their motorcycle, thus the name crank.

Over the last twenty years, truckers, students, soccer moms, Midwestern businessmen and women, young junior high and high school girls, gay men, and more recently, South African communities are using crystal methamphetamine for a variety of reasons. Whether used to stay awake on long truck rides, study all night for exams, stay slim, or sex, this drug has permeated all cultures, ages, and sexes. It is estimated that 12 million Americans have tried crystal, with 1.5 million regular users and that number is growing daily. All 50 states have reported finding crystal methamphetamine labs.

No population has seen more damage from this drug than gay men. Because of the effect of a heightened sexual response, gay men have been using crystal methamphetamine for quite a while. It has only been recently that researchers have been able to connect the dots between crystal and an increase in HIV/AIDS cases. A recent study in California showed that 25% of occasional crystal users and 40% of chronic users were HIV positive. In one residential drug treatment center, 86% of the individuals in recovery were infected with HIV.

So, what’s the attraction to crystal? Once ingested, it stimulates the release of a chemical in the brain called dopamine. Dopamine is responsible for the physical “feel good” sensation we get with sex, sleep, eating, and mood. Basically, it is our internal “rewards” mechanism. Individuals on crystal methamphetamine have a heightened sense of self-confidence, ability, and sexual drive. Unfortunately, it is also responsible for the addictions that have destroyed many people’s lives.

In the gay community, a very ugly triad has emerged to perpetuate HIV transmission. With the popularity the Internet and the discovery of Viagra and medications like it, crystal has only added fuel to an already burning blaze. Individuals now have easy access to sex partners via the Internet and can stay awake for days on crystal. Adding Viagra or medications like it to the mix creates a scenario where there is often very aggressive and long lasting sex, usually unprotected because the crystal reduces the sense of responsibility. The result: an increase in HIV transmission among gay men.

The heterosexual crystal methamphetamine community has not been studied as extensively with regards to HIV/AIDS transmission, but common sense would tell us that anytime you have a decrease in inhibition with an increase in sexual desire without feeling responsible to yourself or your partner, HIV/AIDS will probably show up in the mix.

The negative effects of crystal methamphetamine are devastating and often irreversible. They are usually visibly obvious. Here are a few pictures of individuals who have chosen crystal over their health, their career, and their physical appearance. These photographs are mug shots of people who were repeatedly arrested for methamphetamine possession. By looking at the before and after photographs, you can see the effects of using methamphetamine such as the development of sores on the skin and the face. Crystal methamphetamine causes skin infections by a bacterium called MRSA, which is often resistant to most antibiotics. When these infections develop, the methamphetamine user often compulsively picks at them, which worsens and spreads the infection and can lead to permanent scarring.

Other obvious physical changes include an extreme thinness in the face. Methamphetamine suppresses the appetite, so users usually lose weight, often to a very unhealthy extent. It also causes the appearance of accelerated aging. If you are currently using methamphetamine or thinking about it, look at these photographs and ask yourself: do you want to wind up looking like this?

The destruction crystal causes of the teeth can be both unhealthy and downright ugly. Look at these photographs of the mouths of people who have developed a condition known as “meth mouth” as a result of using of crystal methamphetamine. When people use crystal methamphetamine, their teeth can rot away to the gum line as illustrated by these photographs. There are a number of factors that contribute to this outcome. First, methamphetamine reduces saliva production, which can cause oral bacteria to increase up to ten times over normal levels. Second, methamphetamine users often drink sugary sodas to try to counteract their dry mouth, which feeds the bacteria and contributes to further tooth decay. Third, methamphetamine users often fail to brush their teeth regularly and practice good oral hygiene. Fourth, they often compulsively and uncontrollably grind their teeth while using crystal, which causes the teeth to crack. Finally, they may develop severe gum disease as a result of decreased blood flow to the gums caused by crystal. Do you want your teeth to wind up looking like this?

Methamphetamine also causes damage to the brain, liver, kidneys, heart, and bones. The effect on the brain is the most significant with regards to ability deal with life stressors and maintain healthy relationships. Crystal methamphetamine causes irritability, insomnia, aggression, paranoia, depression and psychosis.

So for those individuals who are currently using crystal or thinking about it, ask yourself: “Given all the risks and complications, is it worth it?” If you are using crystal methamphetamine, please tell your doctor and consider entering a treatment program.

No matter who you are, you are a valuable individual, and your life matters as do the lives of those in your community. Take care of yourself and those around you. Make healthy choices that eliminate or reduce your risk of contracting HIV.

This is [PRESENTER NAME].

Script by Becky Kuhn, M.D. of Global Lifeworks.

This script was reviewed for accuracy and approved by Becky Kuhn, M.D. on May 4, 2007.

References:

1) David R. Bangsberg, M.D., M.P.H. "Adherence, Viral Suppression, and Resistance to Antiretroviral Therapy." In Crystal Methamphetamine: A symposium for internists, primary care, and family physicians, psychiatrists, and other healthcare professionals involved in treating patients with addictions. 23 June 2006. Office of Continuing Medical Education, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
2) Michael Campos, Ph.D. and Steven Shoptaw, Ph.D. "Evidence-Based Treatments for Methamphetamine Abuse." In Crystal Methamphetamine: A symposium for internists, primary care, and family physicians, psychiatrists, and other healthcare professionals involved in treating patients with addictions. 23 June 2006. Office of Continuing Medical Education, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Centers for Disease Control and Prevention, “Methamphetamine Use and Risk for HIV/AIDS,” January 2007.

3) Centers for Disease Control and Prevention, “Methamphetamine Use and HIV Risk Behaviors Among Heterosexual Men --- Preliminary Results from Five Northern California Counties, December 2001--November 2003,” 17 March 2006 Morbidity and Mortality Weekly Report Weekly, 55(10);273-277. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5510a2.htm?s_cid=mm5510a2_e
4) Grant Colfax, M.D. and Steven Shoptaw, Ph.D. "The Methamphetamine Epidemic: Implications for HIV Prevention and Treatment." In Crystal Methamphetamine: A symposium for internists, primary care, and family physicians, psychiatrists, and other healthcare professionals involved in treating patients with addictions. 23 June 2006. Office of Continuing Medical Education, Cedars-Sinai Medical Center, Los Angeles, CA 90048.

5) Multnomah County Sheriff’s Office, Portland, Oregon, http://www.facesofmeth.us/
6) METH Awareness and Prevention Project of South Dakota, http://www.mappsd.org/Meth%20Mouth.htm