For decades, the LGBTQ+ community has downplayed the role of crystal meth in the community, but a researcher from Kentucky is hoping to bring a big solution to the table.


Anthony Lanni was drawn to the strength of the gay community he found while living in New York City. The city was proud, lively, and full of parties — nothing like the New Jersey suburb where he was raised. But behind it all, he discovered a culture of addiction and shame.

“I only knew one other gay guy at the time, and he was addicted to crystal meth,” Lanni said. “At the time, it didn’t really interest me though.”

It wasn’t until he was 27 when he moved abroad to Australia and was five years abstinent from alcohol that he started regularly using crystal meth.

“I had five years sober, but it was just really easy,” Lanni said.

In Australia, where supervised injection sites are legal, Lanni said he felt it was easier to skip smoking crystal meth and inject it instead. So he did. Once he moved back to the United States, Lanni moved in with someone who sold drugs in Fort Lauderdale. He said he’ll always remember the moment he knew he would develop an addiction.

“My dealer had packed this syringe so full, and I looked and said ‘I can’t do that. I will die if I inject that,’ but he said ‘Trust me,’ so I did,” Lanni said.

He said at that moment, despite being aware all of the negative consequences, he accepted his addiction to crystal meth.

“Right now, most rehabs don’t even know what to do with meth users. When I was in rehab ... they didn’t seem to know what to do with me.”

— Anthony Lanni, Person in recovery

Chem sex and crystal meth

Today, the relationship between the LGBTQ+ community and crystal meth, which is the purest form of methamphetamine, is largely supported by one trend: chem sex.

Chem sex, or “party and play,” is a sexual encounter when one or all involved are under the influence of drugs. It had a stronghold on the LGBTQ+ community in the 80s and 90s, but in Philadelphia, it seemingly went underground for the past two decades. However, according to Marshall Siegel, the front desk coordinator at the William Way LGBTQ+ Community Center, it’s still a problem in the community.

“No one really talks about it, but it’s still a problem in the party scene here,” Siegel said.

While using crystal meth, many people report experiencing heightened sex-drives and delayed ejaculation, making it the first choice for those interested in chem sex.

On Grindr, a dating app for the LGBTQ+ community, a user might not realize what he’s being asked when others ask about Tina, T, or PnP nicknames for crystal meth but the subculture is still present in the community, Lanni said.

“If I wanted crystal meth, I could download Grindr… and get it right now,” Lanni said.

Lanni’s experience is not uncommon for members of the LGBTQ+ community. Sexual minorities experience higher rates of substance misuse and substance use disorders, and according to the Substance Abuse and Mental Health Administration, 4.1 percent of gay men have used methamphetamine in the past year compared with .9 percent of straight men. Not only that, but according to the Centers for Disease Control, male crystal meth users who have sex with men are twice as likely to report having contracted a sexually transmitted disease compared to men who have sex without using the drug.

“We see that men who abuse crystal meth often engage in unsafe sex, many times with multiple partners,” said John Edwards, director of Mazzoni Center’s Recovery Empowerment and Community Health program. “When a person is high, he usually does not talk with his partners about safe sex. Meth many times will lead a person to make choices that they would not [make] if sober.”

“When a person is high, he usually does not talk with his partners about safe sex. Meth many times will lead a person to make choices that they would not [make] if sober.”

— John Edwards, Mazzoni Center

Meth-induced psychosis

One of the most common side effects of consistent crystal meth use is methamphetamine-induced psychosis, a reaction that occurs in about 40 percent of people who use methamphetamine. Meth-induced psychosis can lead to a variety of symptoms including paranoia, delusions, violence, and agitation.

“With consistent use of meth, you sometimes don’t sleep for days at a time,” Lanni said. “That’s not good for anyone.”

Lanni said that just last week, a friend of his was admitted to the hospital after he unplugged all of his electronics. His friend was convinced that the government was out to get him.

According to Lanni, meth-induced psychosis further complicates seeking treatment for addiction, as many doctors opt to treat the hallucinations instead of the root cause, which is crystal meth use.

“Right now, most rehabs don’t even know what to do with meth users,” Lanni said. “When I was in rehab, I was with about twenty other guys, but I was the only one who used crystal meth, and they didn’t seem to know what to do with me.”

Lanni hopes that medical professionals can find a clear procedure to implement during rehabilitation.

“Family members of people facing addiction will call and email me to get updates, and I wish I could have better news to tell them. Clearly, in the animal models, things are looking stellar. I’m excited for the day that I can finally tell them it’s ready.”

— Dr. Linda Dwoskin, University of Kentucky

A serendipitous solution

In the mid-90s, Dr. Linda Dwoskin and her team of 20 researchers were developing a drug to assist those struggling with nicotine dependence when they stumbled upon a new use for their compound.

Dwoskin’s research, which is funded by a co-op research grant from the National Institute on Drug Abuse, is centered around a molecule found in the lobelia plant, a compound known as lobeline. Lobeline’s success in treating nicotine dependence was limited, but Dwoskin realized it had more success as a treatment for methamphetamine dependence and addiction.

“It was very serendipitous,” Dwoskin said. “We didn’t stop pursuing the treatment for nicotine, but made sure to add this new possibility to our priorities.”

According to Dwoskin, when a person uses methamphetamines, the drug interacts with the dopamine terminals and neurotransmitters. The methamphetamines overwhelm the blood and override natural processes, increasing the dopamine to give the person a euphoric high.

Lobeline blocks the action at the dopamine terminals, so if a person used methamphetamines, they wouldn’t feel the euphoric high, which reduces their desire for the drug, Dwoskin said.

To this day, no medication has been released to help treat methamphetamine use disorder, but several medications have been developed for the treatment of opioid use disorder, such as methadone, buprenorphine, and naltrexone, which Dwoskin said work similarly to lobeline.

Dwoskin and her team, based at the Universities of Kentucky and Arkansas, have modified the lobeline molecule hundreds of times trying to find the most effective treatment. Her team has repeatedly come close to finding the perfect compound, only to then run into roadblocks.

“It’s exciting and frustrating at the same time,” Dwoskin said. “It’s exciting to find something, but it’s deflating that there’s some other issue. But that’s the way that drug discovery is it’s an oscillating emotional rollercoaster.”

The most recent roadblock they’ve faced is the size of an effective dosage. In its latest and most successful form called JPC-077, the lobeline compound looks promising when tested, but is too large of a dose to be administered orally. This sent Dwoskin and her team back to the lab to find a smaller dose that would still show positive results.

“We’ve been able to increase the bioavailability from 3 to 40 percent,” Dwoskin said. “But we’ve struggled as we make it more compact, there was a diminished effect with the transporters.”

As her research developed, Dwoskin said her emotional investment in the cause did as well.

“It is a lot of pressure,” she said. “Family members of people facing addiction will call and email me to get updates, and I wish I could have better news to tell them. Clearly, in the animal models, things are looking stellar. I’m excited for the day that I can finally tell them it’s ready.”

“In our community, we treat crystal meth as just something we use with sex, undermining it as a super devastating drug,”

— Anthony Lanni, Person in recovery

Crystal Meth Anonymous

While researchers like Dwoskin seek solutions to methamphetamine addiction and dependence, many people who struggle with methamphetamine use disorder rely on Crystal Meth Anonymous, an abstinence-based 12-step support group, to enter and maintain their recoveries.

Across the state, there are only four organized Crystal Meth Anonymous groups: one meets twice each week in Titusville, one meets once a week in Harrisburg, another meets once a week in Pittsburgh, and one group meets every night of the week in Philadelphia at the William Way LGBTQ+ Center in Center City.

The meetings at the William Way Center, which last an hour, rotate between different formats every night. Formats include speakers, literature-focused, 12-step-focused, sex and healthy relationships, and beginners’ topics. During the meetings, attendees take turns speaking in for five minutes intervals, led by the meeting’s chair — a volunteer.

Halfway through the meeting, general discussion is paused to collect donations, award chips for varying lengths of sobriety, and discuss any announcements. When the meeting comes to a close, any attendees willing to be a sponsor raise their hands. A sponsor is a person in recovery who offers support and guidance to another member of CMA, including taking that person through the steps. The chair then asks if anyone needs to confess a “burning desire”, which is a desire so strong that if it isn’t confessed then, the person believes they will use again.

But aside from creating better treatment options tailored to people with methamphetamine use disorder, Lanni said a cultural shift in the LGBTQ+ community is needed.

“In our community, we treat crystal meth as just something we use with sex, undermining it as a super devastating drug,” Lanni said.