In late October 2012, just days before Hurricane Sandy hit New York City, Dominic Faison was binging on methamphetamine, or “tina,” as it is more commonly known in New York City queer scenes.

He was hopping from party to party, each attended by gay men gathering for days-long group sex, amplified by use of tina and other substances. “I was doing crystal meth; I was doing the date-rape drug, G; I was doing coke; I was popping viagra; and of course smoking my weed and drinking liquor,” Faison told Filter.

By the second day at one of the parties, “I started feeling the pain on the lower left side of my abdomen,” he said. Something was wrong and he knew he had to leave. “I could barely stand up straight. I thought people were following me. I’m too high and paranoid to tell people that I’m just high and that I’m in pain. I didn’t know what the pain was, but it was unbearable.”

Eventually, Faison made it back to his apartment in the Bronx. He collapsed outside his door. Next thing he knew, he woke up in Lincoln Hospital. After all the wear and tear on his internal organs from chaotic polysubstance use, his appendix had burst.

As a Black gay man, Faison’s experience of emergency hospitalization related to amphetamine use is far from anomalous. According to data obtained by Filter from New York City Health and Hospitals, in 2012 Black men comprised more hospitalizations (3,222 in total) for amphetamine poisoning, dependence and “nondependent abuse” in the city’s public hospitals than did all white people (a total of 3,185 for both men and women).

Health and Hospitals was unable to comment at the time of publication, but their responses will be added as they become available.

Yet use of amphetamine remains associated in the public eye with rural white straight men.

Over the past decade, more amphetamine-related hospitalizations in New York City were for Black people than for any other specified racial group. On a national scale, Native American people have the highest rates. Yet use of amphetamine, and specifically methamphetamine, remains associated in the public eye with rural white straight men.

In 2017, meth use was most concentrated in western states like California and Oregon, as well as states in the middle of the country, like Arkansas and Kentucky. Nationwide, white and Native American people reported the highest rates of lifetime use (6.8 and 16.1 percent, respectively). In contrast, Black people had one of the lowest lifetime use rates (1.2 percent).

The data obtained by Filter is based on diagnosis codes used by clinicians. To be clear, just because a patient receives a diagnosis code for amphetamine “abuse” or poisoning does not necessarily mean that’s why they ended up in the emergency room—though in many cases it is definitely a contributing factor.

But relying on diagnosis codes to gauge crisis-level amphetamine-related health incidents is shaky. This is in part because the symptoms of amphetamine poisoning or related conditions could be diagnosed using other codes that do not specify amphetamines. One emergency room doctor in Montana explained that “there’s 20 or 30 different codes” that could be used “to describe a patient who comes into the ER because of meth,” reported a student journalist from the University of Montana.

This could mean that the number of people going to New York City emergency rooms for amphetamine-related conditions is higher than that reported.

A Community Hit Hard

The assumption that Black people do not use meth has been widespread—even amongst public health researchers. Perry Halkitis, a biostatistics professor at Rutgers University and a leading researcher on meth use amongst Black gay men, once heard another researcher say, “I don’t think it’s going to enter the Black community because African Americans have a different allele structure,” he recalled in a December 2018 interview with Filter.

Halkitis remembers his response: You’re out of your mind. He predicted, and then witnessed, that meth was “an ideal drug for gay men who are marginalized, especially for gay black men who are marginalized because of their race and because of their sexual orientation,” he explained.

Six months before he was hospitalized for his meth-related health emergency, Faison had broken up with his boyfriend and was “pretty much homeless.” Originally from Virginia, he had become isolated: “I [was] struggling to figure me out, up here in New York City, no family or nothing.”

According to Yolo Akili Robinson, executive director of the Black Emotional & Mental Health Collective, “the emotional isolation of Black gay men” is shaped by “patriarchal male socialization, transphobia, homophobia, and racism” and can contribute to their meth use, as he explained in a December 2018 press release for “Blueprint: A Community Response to Crystal Meth Use.”

Gay men of color using meth have been sidelined within a harm reduction movement centered around the opioid-involved overdose crisis.

The amphetamine-related diagnosis data obtained by Filter from New York City hospitals does not account for sexual orientation, so the role of Black gay meth use in driving Black men’s high numbers of hospital admissions is unverifiable. But in 2015 in New York City, Black men who have sex with men (MSM) reported the highest rates of recent meth use by racial group (7 percent), while their white counterparts reported the lowest (4 percent).

The city’s Department of Health and Mental Hygiene does not collect data on amphetamine use, or amphetamine use by race ethnicity group. As a result, they were unable to comment on the broader trends regarding amphetamines and Black New Yorkers—let alone Black queer New Yorkers.

Gay men of color using meth have been sidelined within a harm reduction movement centered around the opioid-involved overdose crisis. The greater occurrence of amphetamine-related health emergencies amongst Black male New Yorkers could be shaped by what the Blueprint describes as the “limited” resources dedicated to “reduc[ing] risk and promot[ing] safe use” within this community.

While risky meth use is left unaddressed until a health emergency arises, gay men of color also face medical providers who are often incompetent regarding their specific experiences.

“The one time I was injected [with meth] where I had the negative reaction and went to the ER, I was waiting with everyone and I was talking to the doctor and told him straight up ‘I injected meth a couple of days ago and I am having this reaction’ and I forget what he said, but he kind of made a joke out of it and was kind of ‘Maybe you should stop using meth,’” a Latino 25-year-old from the West Coast reported in the Blueprint. “And I get that, I understand that, but that comment and attitude is not helping me at all and it is making me feel really stupid right now in front of a lot of people.”

For Akili Robinson, addressing this issue must go beyond fixing medical institutions. “Healing Justice calls on us to recognize that mental health for Black gay men using meth means more than just clinical support, it means community and systemic level support as well,” he said.

“Our efforts to support our community have to advocate for decriminalization, the expansion of care models, and create spaces as well as art that help our communities process the shame and stigma the so called ‘war on drugs’ has created for us. Anything less is only half the healing.”

Photograph of an emergency room; by Wonderlane via Flickr