A report by the Gay and Lesbian Medical Association has called into question the common belief that crystal meth addiction is untreatable.

Titled “Breaking the Grip: Treating Crystal Methamphetamine Addiction Among Gay and Bisexual Men,” the report virtually debunks the widely held perception by health care professionals that crystal meth addicts are a lost cause. Released on Nov. 30 in conjunction with National Methamphetamine Awareness Day, the report provides guidance for health care providers, emphasizing the importance of tailor-made treatment regimens that assess the needs of gay and bisexual men, a demographic 10 times more likely to use crystal meth than the general population, according to the study.

The report’s findings were extracted from strategically recruited focus groups in five American cities thought to have widespread meth use among gay men. The makeup of the groups consisted of health care providers experienced in treating gay men for meth addiction, clinical researchers and health policy experts. Additional information was derived from salient scientific literature on the subject.

While the intractability of crystal meth addiction is noted throughout the study, it also suggests that dependence on the manmade substance is not insurmountable, given the optimal environment. Unfortunately, barriers to achieving abstinence from the drug are numerous, beginning with the misconceptions of both clinicians and the general populace. “Many people believe gay men use methamphetamine for sex, when in fact individuals vary greatly in the antecedents and frequency of use, the situations surrounding use and motivations for using,” the study found.

Such social externalities as homophobia, fear, stigma and public discourse maligning the “lifestyles” of gay men are all factors found to contribute to what the study calls “psychosocial pressures” potentially leading to meth use. Focus groups also found that gay men are often drawn to the escapism of the drug, using meth as a coping mechanism for depression and anxiety about becoming physically unattractive due to aging. They highlighted the allure of meth for HIV-positive gay men as allowing them to embark on “drug holidays to escape feelings about having a chronic illness.”

A consensus among the focus groups was that the need for culturally competent health care professionals, aware of the nuances and conditions unique to meth use among gay and bisexual men, are vital in providing effective treatment.

Jim Zians, Ph.D., project manager for The Edge Research Project in San Diego, agreed with the study, citing the lack of early breast cancer detection in the ’80s as analogous. “Just like in the 1980s when there was a realization that one of the reasons why women were not getting early detection for breast cancer was because male doctors were uncomfortable teaching about breast exams and emphasizing the need for regular mammograms, when they trained the doctors to get comfortable with this, they made a lot of progress,” Zians said.

The focus groups discussed “anecdotal reports of staff in some substance abuse treatment facilities refusing to permit clients to discuss their sexual practices,” and criticized that “not only is this culturally incompetent care to gay men, but it also prevents sex, one of the most common and powerful triggers for relapse, from ever being addressed and dealt with therapeutically.”

One of the many conclusions drawn upon in the study is that meth addiction can be overcome if “triggers” are discussed openly, equipping the addict with the tools necessary to combat urges to relapse.

There is no one surefire method to treating the multifaceted problem of meth addiction. Rather, a combination of approaches like cognitive behavioral therapy, motivational interviewing and contingency management have proven highly effective when tailored directly to the needs of gay and bisexual men, according to the study.

“We’re one of the first projects to conduct motivational interviewing with gay men in a longitudinal study around methamphetamine and safe sex, so we’re proud of that,” Zians said, speaking to the local progress of The Edge Research Project. “We used cognitive behavioral therapy, borrowing from the social learning theory, to help with skill building, reframing attitudes, thinking about health and the role of past behaviors.”

Contingency management or “pee for pay” has yielded positive results in other studies nationwide. “Some of the tailored curricula around the country have been experimenting with contingency management and I think that’s exciting,” Zians said.

Although no pharmacological solutions to the problem of meth addiction exist, a slew of medications are used to help with the physiological and psychological effects of withdrawal. Included are sedatives such as Desyrel and antidepressants like Provigil and Valium to ease intense dysphoria. According to Zians, “The best therapy would be a combination of cognitive behavioral counseling and medication treatment.”

On a broader scope, the focus groups faulted the media for reinforcing society’s negative views of gay men by associating “methamphetamine with reckless sexual behavior, while excluding the role of low self-esteem, depression and internalized homophobia, as well as external social pressures, such as discrimination and rejection by families.”

The study is replete with helpful suggestions about cultural competence and sensitivity, the development of pharmacological antidotes to reduce the fear of pain during withdrawal and creating more effective prevention campaigns. For more information about the study, visit www.glma.org/breakingthegrip. Those seeking help for meth addiction can visit www.thecentersd.org/methinfo.php.