Jordan Duran sat down to coffee downstairs from his office at Gay City Health Project on Capitol Hill. His calm presence and sweet smile reveal little of the horror this 26-year-old has put his mind, body and spirit through.
Just a few years ago, Duran wandered the streets outside Gay City a skeletal form of his current self. Homeless, sick and estranged from his family, he would look away from passers-by, including some of his current colleagues — all the while completely loaded on crystal meth.
“In my brief moments of clarity I knew my life was supposed to be better than this,” Duran said. “Growing up I had so many dreams … but I completely lost myself.”
Meth use among gay men has been a pervasive problem for decades, particularly in the western United States. Here in King County, about 10 percent of gay and bisexual men used crystal meth in a given year, according to data from Public Health — Seattle & King County. These rates are twice as high in men under the age of 30.
And gay men who use meth are among the highest risk for contracting HIV, according to local studies, perhaps because of the drug’s libido-boosting effect or the lack of inhibitions and invincibility people feel when using.
Local organizations have been reaching out to meth users in the gay community, hoping to pave their path to recovery by offering counseling, support groups and other resources.
“While meth affects everyone because its so highly addictive, it’s a particular problem for those in the LGBTQ (lesbian, gay, bisexual, transgender and questioning) community,” said Arnold Martin, who works for project NEON, a program for gay and bisexual men struggling with meth use.
“The shame of being gay and an outcast, the low self-esteem … the drug allows you to not feel, to not care; it knocks down the barrier around self-esteem.”
Party drugs
By the time Duran was 5, he knew he was different from other boys in his hometown of Puyallup.
In high school, he threw himself into religion and saw a therapist who specialized in reversing homosexuality. He had strained relationships at home.
His senior year he came out about his homosexuality. After graduation he moved in with an older man in Seattle who introduced him to the standard party drugs — ecstasy, ketamine and GHB — and then methamphetamine, or crystal meth.
“From the first time I took meth I was hooked,” Duran said. “It was about escaping from who I was, and meth was the perfect drug to wash it all away.”
Like many stimulants, meth increases the release of dopamine, a brain chemical associated with pleasure and euphoria. But where stimulants like cocaine pass through the body within an hour or two, meth persists, causing a slow and steady rush that can last 12 hours or more.
But the euphoria offered by meth is deceptive — the toxicity of the drug damages and changes brain chemistry, sometimes permanently.
In the short term, all that dopamine causes heart rate, blood pressure and body temperature to soar. In the long term, high levels of dopamine destroy parts of the brain, sending users into bouts of violence, dementia, psychosis and paranoia while damaging memory and emotional capacity.
The drug eliminates the need to sleep, exacerbating mental dysfunction, and suppresses appetite, leading to rapid weight loss. Disinterest in self-care can lead to a host of physical problems, including dental damage.
“Even in patients who have been clean for years and years, we see neurological damage and permanent changes to the brain,” said Chet Robachinski, psychiatric director at Bailey Boushay House, a Seattle facility dedicated to caring for people living with AIDS. “It’s one of the horrible side effects of crystal.”
On Duran’s 21st birthday, after a night of drinking, he sought out crystal meth. He also picked up a stranger. That night, they had sex without a condom.
A few weeks later Duran fell horribly ill with classic signs of a primary HIV infection. His entire body ached, and he came down with a staph infection.
“Every time I test a meth user I feel afraid for them in the pit of my stomach,” said Joshua O’Neal, who conducts HIV-testing research at the STD Clinic/ Public Health-Seattle & King County at Harborview.
Three-quarters of all the men who test positive for HIV at the STD clinic have used meth, he said, adding, “When you feel invincible, you don’t care about using a condom.”
After Duran tested positive, he began using meth more frequently. By the time he was 23, Duran was using 20 times every day. He migrated between odd jobs, apartments and partners until he ended up on the street. In addition to unsafe sex, he wasn’t caring for himself and had frequent outbreaks of staph and MRSA.
He also had acquired syphilis, but because he didn’t seek out medical care the infection spread to his brain, causing unbearable bouts of disorientation.
When he finally went to the doctor, he was seen by a petite older woman who resembled his grandmother. She asked if he was using meth.
“She told me if I kept using I would die within six months either from an overdose or the HIV,” he said. “Up until that point I was afraid of living, but suddenly I was afraid of dying.”
The reasons that gay men use meth are diverse.
Some say the drug empowered them or allowed them to temporarily ignore the stigma of being gay. One former meth addict said he began using in the 1980s, as a means to cope with watching his friends passing away from AIDS.
But others said they never touched crystal meth until they contracted HIV. The drug helped stifle feelings of hopelessness, boosted their energy and allowed them to have sex without thinking about the virus.
“Gay men use meth for the same reasons that we use any other drug; it kills the pain,” said Tony Radovich, one of the founders of Strength Over Speed, a peer-based meth-addiction-recovery support group.
When Duran left the doctor’s office he went immediately with a friend to an Alcoholics Anonymous meeting. Through the help of local organizations, like Seattle Counseling Services, Duran began his path to recovery.
“Quitting the drugs wasn’t the hard part,” Duran said. “Feeling my emotions was the hard part.”
Along the way he reconnected with family and made new friends, some who had also gone through recovery. He got on antiretroviral drugs, and within weeks his viral load was undetectable. He now works for Gay City Health Project, a community-based HIV-prevention program.
Duran has been sober for 2 ½ years
“Being gay and growing up feeling different, drugs were a good fit for me,” Duran said. “But I believe in people’s ability to change.”
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