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Meth is still ravaging the LGBTQ community, we must address the crisis

Queer people at least twice as likely to use drug than straight counterparts

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(Photo by mikeledray/Bigstock)

As the opioid epidemic continues to dominate national news, another urgent crisis is wreaking havoc in communities throughout the United States. Methamphetamine addiction is on the rise, and it’s hitting communities hard, especially the LGBTQ+ community.

November 30 is National Methamphetamine Awareness Day, a poignant time to raise the alarm about the devastating impact of this drug and the reasons behind its growing prevalence within the LGBTQ+ community.

Based on 2020 and 2021 data compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA), sexual minorities (gay, lesbian, or bisexual) adults were at least twice as likely to use stimulants in the past year as their heterosexual counterparts. Gay men were over four times more likely than straight men to have used meth in the past year.

As a mental health counselor and coordinator of the LGBTQ+ program at River Oaks Treatment Center in South Florida, I know firsthand how devastating meth addiction in this marginalized demographic can be. The National Institute on Drug Abuse notes that sexual minorities tend to enter treatment with more severe substance use disorders than those who identify as heterosexual, and I often find this to be the case in our patient population as well. Our LGBTQ+ patients face numerous challenges that may lead to substance use as a means of coping, such as discrimination, stigma, and trauma. 

Our LGBTQ+ patients talk often about feeling their needs and experiences are invalidated by those around them. Constantly feeling unsafe or unable to live as one’s true self at a young age can have a lasting impact on a person’s mental health and is a risk factor for problematic substance use as a tool to manage shame and emotional pain. 

Another complicating factor is that for many queer people, there are few safe spaces, and one of the first ones they encounter is gay bars, where drinking and/or substance use is the norm. Meth is popular in gay nightclubs and parties because it causes euphoria, increases libido, and raises energy, enabling people to party for many hours before crashing. But while use of the drug often begins voluntarily, it quickly becomes compulsive and very difficult to quit. 

The brain quickly learns to link certain people, places, and activities with drug use, triggering uncontrollable cravings. Meth use is ubiquitous in the social circles or “chosen families” of some sexual and gender minorities, making avoiding the drug uniquely difficult. Quitting meth may require them cutting ties and breaking contact with people they’ve come to love and care about deeply.

Our LGBTQ+ patients sometimes express fear they won’t be able to experience sex and other activities in the same way once they quit using meth. Indeed, it can take some time for someone’s brain and body to return to normalcy after quitting. Methamphetamine has a profound effect on dopamine activity, a brain chemical associated with motivation and the urge to repeat pleasurable activities. Over time, this effect can limit someone’s ability to experience pleasure from healthy activities. 

The effects of chronic meth use and withdrawal also complicate the early treatment and recovery process. Intense paranoia — a common long-term effect of meth use — makes it very difficult to trust people, a crucial facet of treatment that is necessary for building relationships with counselors, mentors, and peers. 

Distrust of clinicians and treatment programs is often heightened among LGBTQ+ patients, who often face even more stigma when entering treatment programs and have a distrust of institutions like law enforcement, which they may associate with addiction treatment. To further this point, some of our patients have had bad experiences in the past and worry about treatment being safe for them. Many of our LGBTQ+ patients also have complicated relationships with their families who might otherwise form the foundation of their support network in recovery.

These obstacles highlight the importance of specialized LGBTQ+ addiction treatment programs, in which patients are surrounded by peers who can relate to their experiences. It’s crucial that treatment centers don’t just claim to be accepting of sexual and gender minorities but do the necessary work to make these patients feel safe and welcome, protecting them from harassment and mistreatment from both staff and other patients.

These programs also must work to address common issues that co-occur with addiction among LGBTQ+ patients, such as trauma, emotional turmoil, and interpersonal conflicts. For example, utilizing effective, evidence-based therapeutic approaches, such as dialectical behavior therapy (DBT). 

DBT is among the techniques we use in our programs. Originally developed to treat borderline personality disorder (BPD), DBT has been expanded to treat many mental health disorders that involve emotional dysregulation, which is something we often see among our patients in early recovery from meth addiction. 

The approach functions to enhance one’s capabilities to regulate emotions, practice mindfulness, improve interpersonal effectiveness, and strengthen distress tolerance before practicing these skills and encouraging patients to apply them in their daily lives. DBT also works to improve a patient’s motivation to track and reduce their dysfunctional behaviors.

On a nationwide level, it will take significant work to disentangle the grip of methamphetamine on the LGBTQ+ community. With the pervasiveness of illicitly manufactured fentanyl — a synthetic opioid that causes overdose in very small doses — in the drug supply, the need for action has never been more immediate.

A large part of this work involves changing the perception of society toward methamphetamine addiction and especially queer people who struggle with this disease. Rather than viewing it as a moral failure, we need to see it for what it truly is: A public health crisis. Much like at the start of the HIV/AIDS epidemic, the disease of addiction is heavily stigmatized and too often, we place blame on those who are impacted rather than taking effective action to curb the crisis. 

In addition to culturally competent addiction treatment, we desperately need more sober, safe spaces for the LGBTQ+ community. Upon exiting treatment, many find themselves on uncertain ground and in desperate need of sober friendships and networks that support their recovery. Substance-free community centers provide a useful model that can be implemented on a larger scale.

While these are trying times, I sincerely believe we can make a profound difference by confronting this issue with compassion and understanding. It will take a multi-faceted approach that involves the cooperation of treatment centers, queer people in recovery, allies, and the broader LGBTQ+ community.

Karah Moody, LMHC, CPP, MCAP, is a counselor and LGBTQ2+ Coordinator at River Oaks Treatment Center, an American Addiction Centers facility.

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Remembering Jesse Jackson

Civil rights icon supported LGBTQ rights, D.C. statehood

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Rev. Jesse Jackson (Washington Blade archive photo by Jim Marks)

There is no question that Jesse Louis Jackson, Sr. had a significant impact on the civil rights movement, Democratic Party politics and D.C.’s struggle for statehood. After I heard of his death, I took some time to reflect on how our lives had intersected although I met him only once in person.

During the 1970s, sickle cell disease was a celebrated cause in the African-American community. Rev. Jackson was in the vanguard of that advocacy because he had the sickle cell trait. My mother had sickle cell disease and I have the trait. I responded to Rev. Jackson’s exhortation to be involved with fighting the disease and was blessed to have worked for seven years at the Howard University Center for Sickle Disease in its community outreach program.

In 1983, the March on Washington for Jobs, Peace & Freedom was held to celebrate the 20th anniversary of the 1963 March on Washington. Local organizing committees called Coalitions of Conscience were formed to get people involved with the march. I attended the first meeting in D.C. and introduced a resolution that the 20th anniversary program held on the National Mall include a speaker representing the LGBT community. The resolution passed unanimously but the response from the chief organizer of the march, Rev. Walter Fauntroy, was that no such speaker would be permitted. Fauntroy was also the District of Columbia delegate to Congress. Three days before the march, four gay men – all D.C. residents, three of whom were Black – went to meet with Del. Fauntroy to discuss his opposition to having a LGBT speaker on the day of the march. He refused to meet with them and had them arrested. I was one of those arrested.

Our arrests made local and national news. While we were in jail, a conference call was held consisting of representatives of most of the major national civil rights leaders in the nation to discuss having an LGBT speaker at the march. Among those on that call were Coretta Scott King, Ralph Abernathy, Mayor Marion Barry, Dorothy Height; Reverends Joseph Lowery, Walter Fauntroy and Jesse Jackson. The decision was made to give three minutes to a speaker representing the LGBT community. The speaker was Audre Lorde, the African-American lesbian writer, poet, professor and civil rights activist. Jesse Jackson’s presence on that call was critical to her being chosen as a speaker.

In 1984, I was a volunteer in the Jesse Jackson for president campaign in his quest for the Democratic Party nomination. I, along with dozens of volunteers, boarded the bus that left from Union Temple Baptist Church to journey to Alabama to campaign for Rev. Jackson in that state’s primary. My involvement with Jackson’s D.C. campaign led me to visit the Players Lounge for the first time in order to get signatures for Jackson’s D.C. presidential delegate slate and to do voter registration.

Jackson did not win the Democratic presidential nomination in either his 1984 or 1988 campaigns. But his efforts along with Congresswoman Shirley Chisolm’s and Rev. Al Sharpton’s presidential campaigns paved the way for Barack Obama’s historic nomination and victory for president in 2008.

In 1990, Jesse Jackson was elected to be one of D.C.’s United States Senators or what is known as a “shadow senator.” He made it clear that D.C.’s struggle for statehood is not just a political issue but a salient civil and human rights issue. His involvement helped make D.C. statehood a national issue.

I cannot remember the exact year that I finally met Jesse Jackson in person but it was around the turn of the millennium. There was an event taking place in the Panorama Room at Our Lady of Perpetual Help Roman Catholic Church. Rev. Jackson was standing alone on the hill taking in the breathtaking view of D.C. I walked over, introduced myself and  thanked him for what he had done for the D.C. statehood, LGBT rights, and the Democratic Party. Even though he was a major celebrity he gave me a hug as if we were longtime friends. It was a brief conversation but we both agreed to keep praying for a cure for sickle cell disease. That hope is still being kept alive.


Philip Pannell is a longtime Ward 8 community activist. Reach him at [email protected].

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‘Are you on PrEP?’

Md. lawmakers considering bill to expand access to medication

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From left, FreeState Justice Executive Director Phillip Westry and Maryland state Del. Ashanti Martinez (D-Prince George's County) (Courtesy photos)

When we’re out with friends, we ask a question that sometimes surprises people: Are you on PrEP?

PrEP is a medication that reduces the risk of getting HIV by about 99 percent when taken as prescribed. We’re both on it. And we both talk about it openly because too many people in our communities still haven’t heard of it, can’t access it, or have been made to feel like asking for it says something about who they are.

It doesn’t. Taking PrEP is about taking control of your health. It’s that simple.

But getting there wasn’t simple for either of us. Our paths to PrEP looked different.

Del. Martinez learned this firsthand. When he asked his primary care doctor about PrEP, the response wasn’t medical — it was judgment. Instead of a prescription, he got a lecture. He had to leave Maryland entirely and go to Whitman-Walker in D.C. just to get basic preventive care. He serves on the Health Committee and sits on the public health subcommittee. Even he couldn’t access HIV prevention in his own state. That reality was soul-crushing, not just for him, but because he immediately thought about every person in his community who doesn’t have the resources to find another way.

Phillip came to PrEP through his work at FreeState Justice, where he was learning about HIV transmission rates and the gap in PrEP access for queer people of color. Black Marylanders account for 65 percent of new HIV diagnoses but only about 35 percent of PrEP users. Latino Marylanders account for nearly 19 percent of new diagnoses but fewer than 8 percent of PrEP users.

Seeing those numbers, he had to ask himself why he wasn’t on it. When he walked into Chase Brexton’s HIV Prevention clinic in Baltimore, the experience was easy and affirming, exactly what it should be for everyone. No judgment, just care. That’s the kind of experience every Marylander deserves.

A proposed bill would make it the standard in Maryland. HB 1114 would let people walk into their neighborhood pharmacy and access PrEP without waiting months for a doctor’s appointment, remove insurance barriers that slow things down, and connect them to ongoing care. 

Our stories are not unusual. When we talk to friends about PrEP — and we do, regularly — we hear the same things. People who didn’t know about it. People who tried and gave up. People who assumed it wasn’t for them. People who couldn’t afford it or couldn’t find a provider. There’s still misinformation out there, and there’s still stigma. Among women in Maryland, most new HIV diagnoses come from heterosexual contact, but PrEP is still rarely part of the conversation from their doctors.

When we talk to our friends about PrEP, we lead with honesty. Here’s what it does, here’s what it costs, here’s where to go. We talk about the different options: daily pills or long-acting shots. Generic options are available, and in many cases, free. If you’re sexually active, it might be right for you. It’s not a morality question. It’s a health question.

We try to make it feel approachable, because it should be. We answer every question, because sometimes we’re the first person someone has had this conversation with. It’s a conversation between people who trust each other. And it works, but it can only go so far when the system itself is still in the way.

We have the medical tools to virtually end new HIV transmissions. What we need now are the policies to make sure everyone can reach them. At a time when the future of federal HIV prevention programs is under attack, Maryland has both the opportunity and the responsibility to lead.

We’re asking our friends to take charge of their health. We’re asking Maryland to make it possible.

If PrEP sounds right for you, talk to your provider. If you know someone who could benefit, share what you know. And if you want to see Maryland get this right, tell your legislators to support HB 1114.

State Del. Ashanti Martinez represents District 22 in Prince George’s County in the Maryland House of Delegates, where he serves as Majority Whip and sits on the Health Committee. Phillip Westry is the executive director of FreeState Justice, Maryland’s statewide LGBTQ+ advocacy organization.

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A dream: Democrats focus on candidates who can win

Defeating every Republican has to be the goal in 2026, 2028

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(Washington Blade photo by Michael Key)

I know this is just a dream, but I am a dreamer and continue to hope Democrats can get beyond Black or white, gay or straight, man or woman; to look at who can win in 2026, and then in 2028. It’s often said each election is the most consequential in our lifetime. The next two actually are. 

The reality is without change; we face losing our democracy. We have a racist, sexist, homophobic, lying felon, in the White House. He has a Cabinet of vile incompetents, and a cadre of fascist advisers, controlling our government. They threaten our freedoms, and even our health. They think the military is theirs to use at will, without restrictions. Again, my dream for elections in 2026 and 2028, is we put our personal desires aside, for the good of the nation.

Everyone is being hurt by Trump. Black women being fired in huge numbers. Transgender people literally having their lives threatened. The LGBTQ community facing new threats. Civil rights are being undermined, and the Latino community across the country is targeted. Women are losing the right to control their bodies. Our voting rights are being threatened, and all this is happening with the consent of the Republican sycophants in Congress who are either in complete agreement with the felon, or threatened into submission by him, and his fascist cohorts. This is what we are facing in the next two election cycles as we try to take back our country. As the opposition party, we must first take back Congress in 2026. If we succeed, we must replicate that success as we work to reclaim the White House in 2028. 

I believe we must all be represented in our elected officials. For years I felt comfortable looking at the equality issue in choosing a candidate, as even in the worst-case scenarios, when losing meant the election of the likes of a Richard Nixon or Ronald Reagan, I never believed my country’s existence was threatened. They, and others like them, may have been vile, but none professed wanting to be king. They didn’t go to court seeking full immunity for anything they did and getting it from judges they appointed. 

I am a proud gay man but will not automatically vote for an LGBTQ candidate in the next elections. In 2024, I worked hard, and proudly, to see two strong Black women elected to the United States Senate. In the 2008 primary I was proud to stand with Hillary Clinton, then support Barack Obama when he won the nomination. In 2016, I again stood with Hillary. In 2020, I proudly supported Kamala Harris as vice president and then supported her for president in 2024. 

Today, I am looking at the next two election cycles differently. I have written the only way to win back my country is to look at which Democrat can win in a particular race. I will support a Democrat committed to voting for the Democratic leadership in the House and the Senate, and in their state legislature, even if they don’t support fully everything I want. Because when Democrats win the leadership, they set the agenda. The Democratic platform has been about the same for many years. It stands for equality in every area. Have we accomplished all we stand for, clearly NO. Have we made progress, clearly YES. 

In these upcoming elections each Democrat may win their race with a different set of issues at the forefront. I have suggested in the morning they go to the diners in their district, and in the evening to the bars, to find out what people are talking about, and concerned about. Then respond to that by running on those issues. If there is a primary, demand each candidate pledge to fully support the winner. Think about what is said about Democrats and Republicans, “Democrats fall in love; Republicans fall in line.” Well in the next two election cycles, Democrats need to fall in line with every Democrat on the ballot in the general election willing to say, “if elected I will vote for, and support, the Democratic leadership.” 

If we don’t commit to doing that in the next two election cycles, we may actually not have future elections. It is the only way we can stop the felon, and his fascist government, from winning. Defeating every Republican in 2026 and 2028, has to be the goal for all who care about our country, and moving on to the next 250 years. Not winning is not an option.  


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

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