Crystal Meth and Gay Men
Treatment Curbs Methamphetamine Abuse Among Gay and Bisexual Men Research Findings
Vol. 20, No. 4 (March 2006)
By Lori Whitten, NIDA NOTES Staff Writer
Behavioral therapy can help gay and bisexual men (GBM) reduce methamphetamine abuse and risky sexual behaviors and sustain these gains for 1 year, NIDA-funded researchers report. By the end of a 16-week trial of four different behavioral therapies, study participants’ stimulant-positive urine samples fell 31 percent, and their number of past-month sexual partners fell more than 50 percent—outcomes that regressed little at the followup visits. Symptoms of depression also improved.
Benefits of Behavioral Therapy Persist Up to One Year
Although all interventions were effective, participants who received contingency management (CM), cognitive-behavioral therapy (CBT) and CM, or culturally tailored Gay CBT (GCBT) submitted fewer stimulant-positive urine samples during treatment, compared with those in standard CBT.
Dr. Steven Shoptaw and colleagues at the University of California, Los Angeles and the Friends Research Institute recruited 263 methamphetamine-addicted GBM throughout Los Angeles County, particularly in Hollywood, where HIV prevalence is especially high. Of these, 162 completed the requirements for entering the treatment phase of the study, which were to attend six assessments and participate in at least two of four group sessions on abstinence skills during a 2-week “baseline period.” Men who met the requirements reported less severity and shorter duration of methamphetamine abuse than those who did not, despite having abused methamphetamine for 5 years and having spent $293 on the drug in the past month, on average. Half had engaged in unprotected anal intercourse (UAI) with someone other than their primary partner in the past month, and 84 percent of these men linked the behavior to methamphetamine abuse. Most participants (73 percent) reported symptoms of depression, with about 30 percent describing these as moderate to severe.
The researchers randomly assigned each patient to one of four behavioral therapies: cognitive-behavioral therapy (CBT), contingency management (CM), CBT+CM, or Gay CBT (GCBT). In CBT, participants analyzed situations and emotions linked with relapse, practiced ways to manage craving and thoughts about drug abuse, and discussed healthy behaviors in group sessions. In CM, participants received vouchers redeemable for groceries, transportation, and clothing if they submitted stimulant-negative urine samples. GCBT addressed standard CBT issues—including relapse, craving, and healthy behaviors—using specific examples from gay cultural events and environments. For example, they compared the experience of owning up to a drug problem with the experience of acknowledging sexual orientation by “coming out.” All four interventions were offered three times a week for 4 months.
