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 burst on to the HIV/AIDS scene in recent years. 

Crystal methamphetamine was first developed in Germany in 1887. It was in Japan by 1919, and it was used in the United States to keep people awake and reduce their appetite by 1930. It was legal for many years, and it was even used to treat depression in the 1960s, but it became illegal in the United States in 1970. Motorcycle riders used to smuggle it in the “crank” case of their motorcycle, so it got the slang name crank in English. 

Over the last twenty years, truckers, students, housewives, businessmen and businesswomen, young junior high and high school girls, gay men, and more recently, South African communities have been using crystal methamphetamine for a variety of reasons. Some people use it to stay awake on long truck rides. Others use it to study all night for exams, stay slim, or for sex.This drug has spread into all cultures and age groups and both genders. It is estimated that 12 million Americans have tried crystal, that there are 1.5 million regular users in the U.S., and that the number of regular users is growing daily. All 50 states have reported finding labs for making crystal methamphetamine. 

No population has seen more damage from this drug than gay men. Because crystal methamphetamine initially heightens sexual response, gay men have been using it for quite a while. It has only been recently that researchers have seen the connection between crystal methamphetamine and an increase in HIV/AIDS cases. A recent study in California showed that one in four occasional crystal methamphetamine users and four in ten chronic users were HIV positive. In one residential drug treatment center for gay men, more than 17 out of every 20 people in recovery were infected with HIV. 

So, why are people attractied to crystal methamphetamine? 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 “reward” mechanism. People on crystal methamphetamine fell more self-confident and able and initially have an increased sex drive. Unfortunately, crystal methamphetamine also causes the addictions that have destroyed many people’s lives. 

In the gay community, Internet sex sites, crystal methamphetamine, and medications like Viagra are combining to spread HIV. With the popularity the Internet and the discovery of Viagra and medications like it, crystal methamphetamine has only added fuel to an already burning blaze. People can now easily find sex partners using the Internet and can stay awake for days on crystal methamphetamine. Adding Viagra or medications like it creates a scenario where there is often very aggressive and long lasting sex, usually unprotected because the crystal methamphetamine reduces the sense of responsibility. The result has been an increase in HIV transmission among gay men. 

The heterosexual crystal methamphetamine community has not been studied as much with regards to HIV/AIDS transmission, but common sense tells us that anytime you have a decrease the sense of responsibility and increase sexual desire, the risk of HIV transmission will probably be increased.

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 methamphetamine 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 reduces 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 methamphetamine 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. Several things cause this result. 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 stress and maintain healthy relationships. Crystal methamphetamine causes irritability, insomnia, aggression, paranoia, depression and psychosis. 

So if you are currently using crystal methamphetamine 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].

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

This script was reviewed for accuracy and approved by Becky Kuhn, M.D. on July 30, 2011.

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.
3) Centers for Disease Control and Prevention, “Methamphetamine Use and Risk for HIV/AIDS,” January 2007. http://www.cdc.gov/hiv/resources/factsheets/meth.htm Accessed 30 July 2011.
4) 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
5) 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.
6) Multnomah County Sheriff’s Office, Portland, Oregon, http://www.facesofmeth.us/
7) "Meth Mouth." METH Awareness and Prevention Project of South Dakota, http://www.mappsd.org/Meth%20Mouth.htm
8) "Meth Mouth" photos courtesy Brett H. Kessler, DDS.
9) Steven Shoptaw and Cathy J. Reback. "Associations between Methamphetamine Use
and HIV among Men Who Have Sex with Men: A Model for Guiding Public Policy." Journal of Urban Health: Bulletin of the New York Academy of Medicine doi:10.1007/s11524-006-9119-5

NOTES TO TRANSLATORS:
1) "Crystal methamphetamine, also known as tina, crank, tweak, ice, speed, and glass, among other names, has burst on to the HIV/AIDS scene in recent  years." Find out what the standard term in your language is for crystal methamphetamine and use that term consistently throughout the translation. If you can identify "slang" terms for crystal methamphetamine in your language, include those terms from your own language after "also known as." If you can't identify any slang terms for crystal methamphetamine, delete the phrase ", also known as tina, crank, tweak, ice, speed, and glass, among other names, " from your translation.
2) If "crank" (or a translation or equivalent of "crank") is used as a slang term for crystal methamphetamine in your language, include the sentence "Motorcycle riders used to smuggle it in the “crank” case of their motorcycle, so it got the slang name crank in English." Otherwise delete this sentence from your translation.