Emily Nerland
Graduate Student
USC Annenberg School for Communication

Brian Wilmoth had resorted to turning tricks on Santa Monica Boulevard to make enough money for Tina.

Tina ruled his life. Tina was his everything. Only Tina wasn't a person. Tina was crystal meth.

Then, one day, everything changed.

Wilmoth was chasing down a $20 bill that had been thrown at him. As he reached down into the gutter to collect his payment, a picture flashed in his mind. The picture was of a smiling, soft baby boy. It is the kind of picture one would get at the local department store, often posed and stiff yet this child was completely comfortable in that moment. That child was Wilmoth.

"I could see that picture clearly in my mind and I thought 'How does that kid end up here?'" said Wilmoth. "There is no reason that chubby little baby should be doing this."

Wilmoth calls it his moment of clarity. It wasn't when he had lost almost all of his friends to AIDS. It wasn't when he isolated himself from any family or friends that were still alive. Wilmoth said he had lost everything and in the process he had lost himself

The only thing Wilmoth had going for him was he was HIV positive—not negative—positive. He could get the drugs and the treatment he needed because he had HIV. Only then would the government would pay for it.

He quit 20 years ago, and has been sober for 10 years straight. He works at the Rainbow Bridge Community Services, a residential rehabilitation center that treats mostly gay men from West Hollywood dealing with meth addiction, and lives on HIV disability.

But not every road leads to recovery. Often it does not.

What happens to those who are HIV negative? What do they do?

In America in 2006, there were 149,415 admissions to treatment with methamphetamine identified as the primary substance of abuse, according to methresources.gov. The Drug Enforcement Administration (DEA) reported 6,090 methamphetamine-related arrests during 2005. This is up from 5,893 in 2004 and 6,055 in 2003.

Numbers are on the rise everywhere, but in West Hollywood there are other compounding issues and problems that make it a more complex issue to solve, David Giugni, the social services program supervisor for West Hollywood, said.

Meth use is 11 times more common in gay men than the general population, according to a Los Angeles Times article. Forty-six percent of the gay community still believes it is socially acceptable to do meth, Wilmoth said.

Part of meth's popularity is due to its accessibility. It is made with chemicals that can be obtained through legal means with directions just a Google search away. It may go by many street names, like crack, tweak, and Tina, but there are more variations to exactly what each dose incorporates than there are names.

Sometimes drain cleaner is added to create a "better" high, according to methresrouces.gov. There are dangers in making the drug, such as houses that have been known to explode, but those dangers are only second to taking it.

There are many side effects to using, including irreversible physical and psychological consequences, the ultimate being death. Not only are users putting their lives at danger by putting themselves at risk for an overdose, but they are also in danger of catching and transferring diseases, like AIDS though either intravenous or unprotected sex.

"A common use of meth with gay men is to elevate sexual experiences" , said West Hollywood Council Deputy Hernan Molina. These experiences can take place at sex clubs or meetings put together over the Internet through MSM sites that explicitly mention meth use.

Federally, the government is mainly invested in a "war against drugs," with the focus being on punishing the distributors rather than rehabilitating the users. This approach has not affected the growth of the drug and so on March 14, 2008, $11 million was invested in the California Department of Alcohol and Drug Programs to start a campaign aimed at gay meth use. The program was called "Me not Meth."

The funding was cut in October, which Wilmoth said was just a money matter and had nothing to do with its efficacy.

"It had a big effect and it was educating people and getting them involved," said Wilmoth. "It got people knocking on doors but the facilities were not set up and we were not prepared for the response. We didn't have the beds to help and if you don't take them then and there, you lose them."

West Hollywood, which has been disproportionately affected by the drug because of its large gay community, has set up its own programs to combat the problem.

West Hollywood is a small city covering 1.9 square miles. In the last three years, the city has put money into an HIV Prevention Providers Collaborative, Giugni said.

The money, which comes from a general fund, goes towards a prevention social marketing campaign for substance abuse and prevention. The focus is on meth.

Last year $75,000 was budgeted for this program. Before 2003, there was $230,000 allotted to a similar prevention task force to combat the AIDS epidemic that the city was facing.

But the budget cuts to these city run programs is not because of a lack of need for it.

Hernan Molina, deputy to Councilman John Duran, said the spending is at the discretion of council but there are limited resources. The money comes from a general fund from property and sales tax and is already spread thin. It also has to service housing, nutrition for seniors and education. Substance abuse is still a priority though.

While the city of Hollywood does not provide a health clinic like other cities like Santa Monica, it does give money to support the various different rehab clinics primarily dedicated to meth addiction and HIV counseling.

Two of the most prominent places are Rainbow Bridge Community Service and Van Ness Recovery House. Both are in house treatment facilities that provide housing, food and treatment for recovering addicts.

The majority of the clientele are gay males from West Hollywood. They are also almost all homeless but Wilmoth said they weren't always that way. Many of his residents once had great careers as TV producers, and movie executives, but had lost everything because of the drug.

In his experience, having a residential recovery house is imperative to this population because of the circumstances of living on the street. Without having 24-hour support, they are left vulnerable with an abundance of temptation and a lack of tools to fight them with. Out patient treatment would be impossible.

Gennaro Moore, a substance abuse councilor at Van Ness Recovery House, said that the residents of Van Ness are there because, "They are either ordered there by a court or are homeless and looking for a place to stay," but they accept everyone with welcoming arms.

"It doesn't matter how they get here," Moore said. "Just so long as they get here."

As an openly HIV positive as well as openly in recovery (not from meth), Mayor John Duran is very active in the recovery community, regardless of the substance. "With meth being the current drug of choice, giving funds and attention to attacking the problem isn't only a good idea, it is a necessary one", said Duran..

"It is really something that has been brewing for the last 4-5 years and we can't just put our heads in the sand," said Duran. "At first the county was reluctant, but as problems come out in the open through conversation, we make progress, like getting a clean needle exchange to reduce the transmission of HIV."

Meth's impact on the community is beginning to resemble the AIDS epidemic of the 80s, said Jimmy Palmieri, an official on the Lesbian & Gay Advisory Board also the founder of The Tweakers Project.

"For the first time in a decade there are new infections on the rise," said Palmieri. "It looks just like AIDS again. It has really hit us hard."

The medical community in the different clinics around West Hollywood has found a connection between meth use and HIV transmission.

Giugni said the clinics requested that the subjects fill out a questionnaire while waiting for their HIV test. In these surveys, it was found that over half of those who tested HIV positive had used meth. That is not to say that everyone who does meth is HIV positive, or that not using meth will keep one negative, but it does suggest a strong correlation between the two. Giugni also said that the transmission can occur from both intravenous drug use, as well as unprotected sex.

The main focus of the Rainbow Bridge Community Services is to have its HIV negative clients stay negative, Wilmoth said. In the last nine months, of the patients who have left, one hundred percent have stayed HIV negative.

This is difficult for different recovery centers to do because there is no federal funding for those seeking treatment who are HIV negative.

"Clinics find themselves getting tests back and saying 'Oh, its too bad you are not [HIV] positive," Wilmoth said. "That's horrible."

Palmieri also acknowledges the discrepancy.

"There seems to be more alternatives for you if you are HIV positive, but you will then have other issues to deal with," Palmieri said. " To be HIV negative, finding recovery services can be more difficult."

The issue with a lack of funding for HIV negative individuals is that if they are unable to get treatment, they don't stay negative long.

"There are people we see come in negative and then we see them come back the next year and they are positive," Moore said. "It just the nature of the drug. There is a very high risk factor for transmission."

Wilmoth said the cost to the government for the full 90 days of treatment ranges from $17,000 to $20,000. It costs $400,000 to $600,000 over 20 years to treat someone who is HIV positive. But now people are contracting the disease earlier and living longer so it ends up costing more.

"HIV is costing healthcare and lives," Wilmoth said. "Right now the government is not seeing the long-term solution, they just see the short-term."

Both Wilmoth and Moore said that their houses wouldn't turn down anybody regardless of whether they are HIV positive or negative, but Moore said there are only so many beds and so they have a waiting list.

While they don't turn down those seeking treatment, somehow the client, who often has nothing, has to pay. Sometimes it is subsided through the government, other times through West Hollywood, and recently there have been other sources of financial support.

Wilmoth said that recently at his facility, the HIV positive residents recognized how difficult it was for those who were HIV negative to get the help they needed.

"[The HIV positive residents] didn't even know how good they had it," Wilmoth said. "And without any prompting or even our knowledge, they got together and held a yard sale to raise money for the [HIV negative residents.] That was so amazing to see."

The Rehabilitation Process

It is shortsightedness on the part of the government that there is no treatment, both physically and mentally, for HIV negative addicts so they don't become HIV positive and thereby even more burdensome on the healthcare system.

While part of the road to recovery consists of the moral support and structure that an in-house rehab facility can provide, often there are either pre-existing or post-occurring psychological problems that is the cause or result of meth use.

Post-using psychological problems can both be temporary and permanent. When using, Wilmoth said the addicts can go into what is called a "crystal meth psychosis." As you sober out the illness can go away, but sometimes it does not. The amount of toxins going into the body can permanently affect the brain.

There are also the issues that cause gay men to use.

"Why gay men use is much different than straight people," Wilmoth said. "Their problems are deeper than the drug."

Those active in helping the gay community, like Palmieri, say that gay men are forced to deal with different prejudices their whole lives that many others do not always encounter. Many gay men were not raised with a sense of community but meth can fill that void.

"Meth is a tribal drug and it comes with its own community," Palmieri said. "When it comes to gay men and meth, there has always been a fertile ground for it. There is a social hatred against gays. We think we are accepted but we many times are not."

Wilmoth said that at Rainbow Bridge they have found they need to address those issues. He has set up classes that teach gay history and gay culture.

"They need to know its ok to be gay," Wilmoth said. "If they have no sense of history, they have no sense of themselves. It normalizes being gay."

On top of the history and culture classes, Rainbow Bridge offers body image work, hypnotherapy and a community service group.

Van Ness uses the foundation of the 12-Step program and HIV counseling. Over the last four years, Moore said the focus has changed from old-fashioned scare tactics to harm reduction.

"We realize they have been doing it this way for most of their lives and they aren't going to change all of a sudden," Moore said. "We need to meet them where they are at and only then will they think about the possibility of changing their behaviors."

But neither Rainbow Bridge nor Van Ness has 24-hour on site psychologists, due to a lack of funding.

At Van Ness, Moore said the turnover rate is about one person every 10 months, and only about one person every year goes through the program successfully. He attributes the lack of money and support for in depth recovery for psychological issues as one of the main reason for relapses.

"The relapse rate of meth users can be up to 94 percent" , Palmieri said, stressing the unattainable satisfaction that comes from taking the drug.

"Once an addict, always an addict," Palmieri said. " You never recover completely. It is just an interruption of the illness, like remission from cancer, when you are in recovery. Every day of not using is an extraordinary thing."

While Palmieri insists that meth use can almost always be traced back to low self-esteem, he also acknowledges that not everyone who is gay uses, or everyone that tries meth becomes addicted.

"Addiction is a disease," said Palmieri. "People don't choose to be addicts, there is something more there.., something pre-set in their brain. Any one of them could be any one of us."

Dealing with deep rooted psychological issues could be one of the biggest components to ones recovery, but often recovering addicts cannot get that help.

Moore said that their clients are referred to psychologists often, but since they do not have any on staff the client needs to leave the treatment center for help.

"But most of them don't have cars, they don't even have homes," Moore said. "That is the gap where many people get lost."

"It is the governments inability to contribute to that psychological help that is the missing key to stopping the cyclical nature of meth use" , Moore said.

One of Moore's sponsees sticks out in his mind as an example of how treatment is lacking and professional psychological treatment has to be supported for both HIV positive and negative individuals.

As Native American, male-to-female transgender meth user, Moore's sponsee had a difficult time fitting into the social constructs of society. "She worked as a prostitute before she came in for help, just as many transgenders do because they often have a hard time integrating into regular jobs", Moore said. "She was able to find funding to receive treatment but because of her HIV negative status she did not get full psychological treatment. She went through the rehabilitation process successfully and after she worked as a staff member at Van Ness and then moved downtown to work. Once downtown, she relapsed and now is HIV positive."

"This cycle is common," Moore said, "and it shouldn't have to be."

"If you don't deal with one issue, you aren't dealing with all of them," Moore said. "They may not be using but the cycle gets perpetuated by the feeling of not being good enough. We need to deal with those issues."