Script for "Crystal Methamphetamine and HIV: The Connection."

Hi, my name is [PRESENTER NAME]. I'm [PRESENTER ROLE]. Welcome to "Crystal 
Methamphetamine and HIV: The Connection." This video will discuss the history of 
crystal methamphetamine and its impact on the spread of HIV/AIDS.

Crystal methamphetamine, also known as tina, crank, tweak, ice, speed, and glass, among 
other names, has exploded onto the HIV/AIDS scene with a flurry in the last 5 to 6 years. 

First developed in Germany in 1887, it found its way to Japan by 1919 and was used in the 
United States as a stimulant and appetite suppressant by 1930. It had been legal for many 
years and was even used to treat depression in the 60's, but then became illegal in 1970. 
Bikers used to smuggle it between states in the "crank" case of their motorcycle, thus the 
name crank. 

Over the last twenty years, truckers, students, soccer moms, Midwestern businessmen and 
women, young junior high and high school girls, gay men, and more recently, South 
African communities are using crystal methamphetamine for a variety of reasons. Whether 
used to stay awake on long truck rides, study all night for exams, stay slim, or sex, this 
drug has permeated all cultures, ages, and sexes. It is estimated that 12 million Americans 
have tried crystal, with 1.5 million regular users and that number is growing daily. All 50 
states have reported finding crystal methamphetamine labs. 

No population has seen more damage from this drug than gay men. Because of the effect of 
a heightened sexual response, gay men have been using crystal methamphetamine for quite 
a while. It has only been recently that researchers have been able to connect the dots 
between crystal and an increase in HIV/AIDS cases. A recent study in California showed 
that 25% of occasional crystal users and 40% of chronic users were HIV positive. In one 
residential drug treatment center, 86% of the individuals in recovery were infected with 
HIV. 

So, what's the attraction to crystal? Once ingested, it stimulates the release of a chemical in 
the brain called dopamine. Dopamine is responsible for the physical "feel good" sensation 
we get with sex, sleep, eating, and mood. Basically, it is our internal "rewards" mechanism. 
Individuals on crystal methamphetamine have a heightened sense of self-confidence, ability, 
and sexual drive. Unfortunately, it is also responsible for the addictions that have destroyed 
many people's lives. 

In the gay community, a very ugly triad has emerged to perpetuate HIV transmission. With 
the popularity the Internet and the discovery of Viagra and medications like it, crystal has 
only added fuel to an already burning blaze. Individuals now have easy access to sex 
partners via the Internet and can stay awake for days on crystal. Adding Viagra or 
medications like it to the mix creates a scenario where there is often very aggressive and 
long lasting sex, usually unprotected because the crystal reduces the sense of responsibility. 
The result: an increase in HIV transmission among gay men. 

The heterosexual crystal methamphetamine community has not been studied as extensively 
with regards to HIV/AIDS transmission, but common sense would tell us that anytime you 
have a decrease in inhibition with an increase in sexual desire without feeling responsible to 
yourself or your partner, HIV/AIDS will probably show up in the mix.

The negative effects of crystal methamphetamine are devastating and often irreversible. 
They are usually visibly obvious. Here are a few pictures of individuals who have chosen 
crystal over their health, their career, and their physical appearance. These photographs are 
mug shots of people who were repeatedly arrested for methamphetamine possession. By 
looking at the before and after photographs, you can see the effects of using 
methamphetamine such as the development of sores on the skin and the face. Crystal 
methamphetamine causes skin infections by a bacterium called MRSA, which is often 
resistant to most antibiotics. When these infections develop, the methamphetamine user 
often compulsively picks at them, which worsens and spreads the infection and can lead to 
permanent scarring. 

Other obvious physical changes include an extreme thinness in the face. Methamphetamine 
suppresses the appetite, so users usually lose weight, often to a very unhealthy extent. It 
also causes the appearance of accelerated aging. If you are currently using 
methamphetamine or thinking about it, look at these photographs and ask yourself: do you 
want to wind up looking like this? 

The destruction crystal causes of the teeth can be both unhealthy and downright ugly. Look 
at these photographs of the mouths of people who have developed a condition known as 
"meth mouth" as a result of using of crystal methamphetamine. When people use crystal 
methamphetamine, their teeth can rot away to the gum line as illustrated by these 
photographs. There are a number of factors that contribute to this outcome. First, 
methamphetamine reduces saliva production, which can cause oral bacteria to increase up to 
ten times over normal levels. Second, methamphetamine users often drink sugary sodas to 
try to counteract their dry mouth, which feeds the bacteria and contributes to further tooth 
decay. Third, methamphetamine users often fail to brush their teeth regularly and practice 
good oral hygiene. Fourth, they often compulsively and uncontrollably grind their teeth 
while using crystal, which causes the teeth to crack. Finally, they may develop severe gum 
disease as a result of decreased blood flow to the gums caused by crystal. Do you want 
your teeth to wind up looking like this?

Methamphetamine also causes damage to the brain, liver, kidneys, heart, and bones. The 
effect on the brain is the most significant with regards to ability deal with life stressors and 
maintain healthy relationships. Crystal methamphetamine causes irritability, insomnia, 
aggression, paranoia, depression and psychosis. 

So for those individuals who are currently using crystal or thinking about it, ask yourself: 
"Given all the risks and complications, is it worth it?" If you are using crystal 
methamphetamine, please tell your doctor and consider entering a treatment program.

No matter who you are, you are a valuable individual, and your life matters as do the lives 
of those in your community. Take care of yourself and those around you. Make healthy 
choices that eliminate or reduce your risk of contracting HIV.

This is [PRESENTER NAME].


Script by Becky Kuhn, M.D. of Global Lifeworks.

This script was reviewed for accuracy and approved by Becky Kuhn, M.D. on May 4, 2007.

References:
1) David R. Bangsberg, M.D., M.P.H. "Adherence, Viral Suppression, and Resistance to 
Antiretroviral Therapy."  In Crystal Methamphetamine: A symposium for internists, 
primary care, and family physicians, psychiatrists, and other healthcare professionals 
involved in treating patients with addictions. 23 June 2006. Office of Continuing Medical 
Education, Cedars-Sinai Medical Center, Los Angeles, CA 90048. 
2) Michael Campos, Ph.D. and Steven Shoptaw, Ph.D. "Evidence-Based Treatments for 
Methamphetamine Abuse." In Crystal Methamphetamine: A symposium for internists, 
primary care, and family physicians, psychiatrists, and other healthcare professionals 
involved in treating patients with addictions. 23 June 2006. Office of Continuing Medical 
Education, Cedars-Sinai Medical Center, Los Angeles, CA 90048. 
Centers for Disease Control and Prevention, "Methamphetamine Use and Risk for 
HIV/AIDS," January 2007.
3) Centers for Disease Control and Prevention, "Methamphetamine Use and HIV Risk 
Behaviors Among Heterosexual Men --- Preliminary Results from Five Northern 
California Counties, December 2001--November 2003," 17 March 2006 Morbidity and 
Mortality Weekly Report Weekly, 55(10);273-277. 
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5510a2.htm?s_cid=mm5510a2_e 
4) Grant Colfax, M.D. and Steven Shoptaw, Ph.D. "The Methamphetamine Epidemic: 
Implications for HIV Prevention and Treatment."  In Crystal Methamphetamine: A 
symposium for internists, primary care, and family physicians, psychiatrists, and other 
healthcare professionals involved in treating patients with addictions. 23 June 2006. Office 
of Continuing Medical Education, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
5) Multnomah County Sheriff's Office, Portland, Oregon, http://www.facesofmeth.us/ 
6) METH Awareness and Prevention Project of South Dakota, 
http://www.mappsd.org/Meth%20Mouth.htm