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Poison & Cure: Drug Use Among Gay and Bisexual Men

From ancient aphrodisiacs to chemsex, drugs have long played an intoxicating role in human sexuality.[1] Among gay and bi- men, cultural ties to drug use date back to the origins of contemporary gay communities, where gay bars, clubs, and bathhouses emerged as touchstones of Western gay love and gay life.[2] Of course, things have changed in recent years: bars, clubs, and bathhouses are no longer the hubs they once were, [3] the monolithic narrative about what is means to be gay has crumbled,[4] and the multiplication of gay cultural identities (e.g., bears, twinks, professionals, artists, gaymers) has called into question the relevance of traditional representations of sexuality and gender.[5] Examining the role that drug use continues to play today, qualitative studies have repeatedly explored the rationale for various patterns of drug use – often highlighting their role in social bonding and stress coping.[6] For many, drug use is inextricably “suffused with romantic, emotional, and communal attachments”[7] – illustrating drugs as what the ancient Greeks referred to as “pharmakon:” both ‘poison’ and ‘cure.’[8]

Exploring the complexity of drug use, the Momentum Health Study recently examined how gay and bi- men in Vancouver use various drugs. For the most part gay and bi-guys were pretty straight-laced (no pun intended): 36.7% exhibited only limited drug use and 25.9% exhibited pretty conventional patterns of use (e.g., tobacco, alcohol and marijuana). However, 11.4% exhibited patterns characteristic of sex drug use (e.g., erectile dysfunction drugs, methamphetamine, poppers, and ecstasy), 9.5% exhibited club drug use (e.g., alcohol, ecstasy, cocaine, poppers, and shrooms), 12.1% reported using common street drugs (e.g., opioids), and about 4.5% exhibited polydrug use (e.g., heavy use use of most drugs).

While these patterns are interesting in and of themselves, they also reveal a lot about the folks who fall into these patterns of use. Just a few examples: Street drug use was associated with homelessness, being out of work, and identifying as bi- or straight. Club drug use was associated with being younger and patronage of gay bars. Sex drug use was associated with higher annual income, higher sex drives, and more group sex. Polydrug use was associated with homelessness and selling drugs. In summary, the way gay and bi- men use drugs reflects much more than just how they get high (or don’t, as is the case for most), it tells a story about how people fulfill their sexual, psychological, social, and economic needs. In other words, drug use is much more than what courts and health departments make it out to be. Isn't it about time that our programs, policies, and yes, research, reflect that?

[1] Sandroni, “Aphrodisiacs Past and Present.”

[2] Bérubé, “The History of Gay Bathhouses”; Israelstam and Lambert, “Gay Bars.”

[3] Simon Rosser, West, and Weinmeyer, “Are Gay Communities Dying or Just in Transition?”

[4] Ahmed et al., “Social Norms Related to Combining Drugs and Sex (‘chemsex’) among Gay Men in South London.”

[5] Rowe and Dowsett, “Sex, Love, Friendship, Belonging and Place.”

[6] Ahmed et al., “Social Norms Related to Combining Drugs and Sex (‘chemsex’) among Gay Men in South London”; Weatherburn et al., “Motivations and Values Associated with Combining Sex and Illicit Drugs ('chemsex’) among Gay Men in South London.”

[7] Amaro, “Taking Chances for Love?,” pp. 255.

[8] Hayes and Gilbert, “Historical Milestones and Discoveries That Shaped the Toxicology Sciences.”

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