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Is Ottawa ready to fight Crystal meth use?

Getting ahead of the coming problem

NASTY, NASTY TINA. Crystal meth is said to turn the usually careful sex partner into a cock-mad bottom.

Call it what you will – crank, Tina, crystal meth or even C10H15N – methamphetamine is nasty business. In the major gay centres of North America’s west coast, and more recently in New York and Toronto, some health activists claim a link between the use of crystal meth and rising rates of syphilis and HIV.

Can Ottawa be far behind? We’re a city of over a million people – Canada’s fourth largest urban centre. We have a burgeoning gay scene and we’re just a quick hop from Montreal and a reasonable jaunt from Toronto – two major centres where crystal meth is making inroads on the party scene.

A survey by Capital Xtra found that crystal is here, if not common – yet. Ottawa has a well-deserved reputation for circumspect drug use – we’re discreet, unlike users in cities like Vancouver. Attempts to strike up a conversation about crystal use among customers of two local gay bars met with perhaps predictable results: complete denial of any knowledge coupled with a look of suspicion, or complete denial of any knowledge coupled with a huge knowing grin. End of bar inquiries.

But socially active friends and acquaintances know about nasty Tina’s local shadow. One has seen “kids” using at an after-hours bar. Others, familiar with the ammonia-like odour, claim they’ve smelled it wafting out of a popular gay pub on occasion. Another claims knowledge of a violent incident in a bathhouse involving a patron raging while under the influence. A Toronto friend describes how it is everywhere there, but practically unseen here, while another regular Montreal-goer describes how he sees people from Ottawa regularly using there, but never here. The anecdotes add up to not much: wee glimpses into an apparently still largely marginal drug.

But what about “official” numbers? Do we have any idea just how many people are using crystal meth in Ottawa, let alone in Ottawa’s queer scene? Weeks of phone calls to local agencies trying to find statistics turned up, well, virtually nothing. Either the drug is virtually non-existent here, or even those responsible for tracking it are blind to its presence.

Yvon Lemir, the director of the Addiction And Problem Gambling Services Of Ottawa, says that none of their clients have come forward for treatment for crystal meth addiction. Sure, on occasion crystal has shown up on the inventory of drugs taken by patients. But on the treatment side, there hasn’t yet been any evidence that it’s visible in Ottawa. While the subject has been broached within the organization, they have yet to deal with it directly.

If it’s here, it’s in small numbers so far.

The Canadian Mental Health Association offers an explanation: Because of the illegality of street drugs such as crystal meth, less work is done with them by public agencies than is done with such legal drugs as alcohol or tobacco. Of the studies that are out there, few are broken down municipally. The recent report by the Canadian Centre On Substance Abuse is one example: it only looked at drug use in Canada on a national scale, broken down by province rather than municipality. In a province like Ontario, where you have the mass that is Toronto as its population centre, trying to find any information on the impact of the drug in other regions is difficult.

The City Of Ottawa Public Health Unit offers another explanation: crystal meth users are in and of themselves difficult to track. The city’s needle exchange program has been able to track only a very small number of injection methamphetamine users. Between October, 2004 and April of this year, they had seven service encounters with people who listed crystal meth as their drug of choice. Given that the program sees an estimated 12,000 service contacts in a year, and given that tracking by service encounter means that it may be the same person reporting more than once, the numbers remain extremely small.

But most crystal users prefer to smoke the drug rather than inject it. And smoking is difficult to track and doesn’t get picked up in needle-exchange statistics. As well, many of the people in the needle exchange program may be unaware that while they think they are doing crack, they are in fact using crystal meth. There have been reports of people who list crack as their drug of choice, but the physiological effects actually match those caused by crystal.

So it’s complicated. And that presents a clear challenge for those trying to fathom the extent of crystal use in the Ottawa region. What’s a queer group, hoping to serve its clients or prepare for a possible invasion by the nasty drug, to do? The AIDS Committee Of Ottawa is trying to get ready. Michelle Ball, ACO’s health promotion and education coordinator, feels that not a lot of attention has been paid to the issue of crystal meth in Ottawa. Or, for that matter, that anyone has put any effort into it.

“Why aren’t we being proactive?” Ball asks. “Why aren’t we looking at this, addressing it, learning from other big cities, and putting into place some educational and support resources?” She hopes that we can look forward to some kind of educational outreach in bars, bathhouses – all over the community, for that matter – in order to let people know the correlations between meth use and the transmission of sexually transmitted diseases.

The Ottawa Gay Men’s Wellness Initiative is also taking a look at the issues surrounding crystal meth. Kevin Muise is putting together a plan. The GMWI co-chair has been studying the literature review conducted by the AIDS bureau of the provincial ministry of health and long-term care. After attending a province-wide meeting in Toronto to discuss crystal meth use in the gay community and strategies to address it, he returned with some troubling revelations.

According to the studies cited in the review, there are four main reasons why gay and bisexual men in North America start using crystal meth: to get more energy, to feel more attractive, to enhance sexual pleasure and to feel more self-confident. But the fun comes at a high price.

“Gay men who use crystal meth are four times more likely than non-users to have unprotected anal intercourse with a partner who is known to be HIV-positive,” Muise cites from the studies. “Crystal meth use is also associated with higher risk of unprotected anal intercourse with HIV-negative partners and partners of unknown status.”

But the data isn’t as black-and-white as it may sound. “We don’t know to what extent one is causing the other,” Muise points out. “We see a statistical link between crystal meth use and increased rates of HIV – both of them are happening at the same time. We know that there is some link between crystal meth use and some of the higher-risk behaviours, but we don’t have any research that indicates what is causing what.”

The actual extent of Tina use in the gay community is still open to debate. And while some US anti-drug activists are loudly proclaiming it’s causing another burst of HIV transmission, others suggest the threat is largely an invention of media hype, another attempt to over-simplify and stigmatize the gay community’s party culture. Take Matt Lovick, the co-chair of Vancouver’s Gay Men’s Crystal Meth Working Group. Crystal is “certainly not something we need to panic about; it’s just another drug,” Lovick told Xtra West in March. “When people get hysterical about crystal meth, judgement starts happening. The hysteria is more damaging to the gay community than crystal meth.”

Lovick cites a lack of information linking crystal meth usage to the rise in HIV rates and foresees an impact where the hysteria of meth usage creates a division between “good gays and bad gays.”

In gathering their own local anecdotal evidence of impact on the community, GMWI has heard that a few months ago crystal meth wasn’t as readily available in Ottawa as it was in Toronto or Montreal, but it is now. They have also heard that in Ottawa the drug is used primarily at private sex parties and mainly smoked rather than ingested or injected. But that’s anecdotal evidence. They have also heard warnings from Toronto that crystal meth is being added to ecstasy in many cases.

But facts matter more than rumours. Facts are needed to ensure the community knows the true extent of the drug’s use, to plan for effective and properly targetted campaigns, and to avoid a counter-productive over-reaction. GMWI hopes to start gathering concrete data as part of their collaboration with the national Public Health Agency on a large-scale study of gay men’s behaviour across Canada. Ottawa is a pilot site. The study’s focus is on high-risk sexual behaviour for HIV and other STIs, and includes illicit drug use. The study will have questions specifically on the use of crystal meth.

Ottawa was chosen as one of the first cities for the study because the rate of HIV in our local gay community is one of the fastest growing in Canada. Somewhere between 1 percent and 1.5 percent of the gay men in this city sero-convert every year, according to the research of Dr Robert Remis.

Whatever the long-term solutions, for now the city of Ottawa is hoping to reach those who smoke the drug. The needle exchange program needs expanding with a “safer inhalation equipment” campaign, says coordinator Paul Lavigne.

“With this initiative, we are offering something to reach out to the population that may be putting themselves at risk through smoking crystal meth, just like the smoking of crack,” says Lavigne. “The advantage that we have at Ottawa Public Health is that we’ll be able to reach the people because they have a reason to come to us for our services, just like the needle exchange. By being in contact with them, we can do some of the education, the prevention, the medical care and the referral to social and health services in town, including drug treatment services.”

Crystal may not be a big issue in Ottawa yet, and the gay community may so far be largely unaffected by it, but Lavigne and Lovick agree that we need to get ready. “I don’t think it’s a question of if; I think it’s a question of when,” warns Lavigne.