The Ins and Outs of Gay Sex (41 page)

This class of drugs includes barbiturates and the all-popular benzodiazepines, with Valium and Xanax the poster children.
Although many hypnotics are not illegal and often are obtained by prescription, their abuse potential is great.
Men approach multiple doctors for prescriptions and sell them to friends.
An internist may give you a script not knowing that your psychiatrist has as well.

Hypnotics work by affecting the GABA system of the brain, which controls three functions:
sedation, anxiety, and the prevention of seizures.
Thus the drug you take dissolves your troubles, leaving you calm and free of inhibition.
In high doses, hypnotics put you to sleep, slur your speech, or occasionally make you violent (especially in combination with other drugs).
Although most commonly taken in tablet form, liquid preparations for injection are also prevalent.
The half-life of these drugs (length of time they hang around in your body) varies greatly.
Valium has
one of the longest half-lives, while Xanax has one of the shortest.
These medications are highly addictive.
Withdrawal from them can produce nausea, tremors, irritability, seizures, hallucinations, rapid pulse, and high blood pressure.
Flumazenil (Romazicon) is an antidote for overdose.

K, or Special K, as it is sometimes called, is another potent hypnotic that is actually a disassociative anesthetic used frequently in surgery.
So how does that fit in with your night on the dance floor?
K, or ketamine, as it is known in the medical community, makes your brain feel disconnected from the rest of your body.
Some men find this quite pleasurable—as if they are floating above their body looking down—but for others it is a disturbing kind of high bordering on feeling psychotic.
Take too much and you’re catatonic and ready for surgery—or at least the hospital.
Although sold in a liquid form that can be injected, most often K is boiled down to a powder residue and then snorted or swallowed.
Sexually, K can make it seem like the guy fucking you without the condom is fucking someone else, and you’re just there to watch.
I warn you:
If HIV is passed, it will be
you
who gets it, not the guy floating above you.
Doctors worry about the potential for serious yet still unidentified side effects from prolonged K abuse (including personality changes).

GHB is another abused hypnotic, but potentially it is far more dangerous than the others because there is very little difference between the amount you need to feel high and the amount that puts you into a coma.
In other words, there is little margin for error between enough and too much—especially if you’re mixing it with other depressants, like alcohol or Valium.
Because GHB is a clear liquid, most men mix it with water and swig it on the dance floor.
For some reason, people perceive anything clear as harmless, and you never know how much drug you’re getting when you drink up.
Combine all this with the fact that
you can easily overdose on GHB and you’re courting an extremely dangerous situation.

Poppers, or amyl nitrite, are the most commonly abused of the vasodilators.
They produce their high by expanding blood vessels so that your heart races as your blood pressure drops—you swoon, get dizzy, the room spins—like “almost” fainting.
Although your rush lasts only moments, it comes as your heart struggles to keep blood flowing to your brain.
Amyl nitrite is sold as a liquid, but you inhale the fumes to get high.
These fumes are quite flammable, so beware of smoking and doing poppers at the same time.
The liquid itself can burn the skin around your nose.
In men with heart trouble or blocked arteries, poppers can lower blood pressure to the point where the brain and heart can’t get enough oxygen.
Recently deaths occurred in men who combined poppers with Viagra.
Both drugs dilate blood vessels, and, together, they can drop blood pressure to lethal levels.
Headaches are another bad side effect of poppers—especially with repeated use, as men try to maintain the fleeting high they get from each sniff.

Synthesized from poppies, opium became man’s first narcotic, used widely not only for its unparalleled euphoria but also because it eliminated pain.
Morphine, heroin, Dilaudid, and Codeine are natural drugs made from poppies; most others, including Demerol, Darvon, Percocet, and Percodan, are synthetic.
The list of synthetic narcotics is endless, and varies by strength as well as the substance they are combined with.
(Percocet contains Tylenol, while Percodan contains aspirin.
) Heroin, like all narcotics, is highly
addicting.
Some gay men believe that if you snort a narcotic it is not as addicting—wrong!
!
!
These drugs are just as addicting whether swallowed, injected, smoked, or snorted.
Once addicted to heroin, people find it is so nearly impossible to break free that therapy often centers on control (methadone) rather than kicking the habit.

In addition to producing euphoria, narcotics deaden pain, diminish libido, and depress your respiratory and heart function.
In high doses, narcotics will stop your breathing (an overdose).
Narcotics are vital in providing pain relief after injury, surgery, and many other debilitating conditions, such as cancer.
If you suffer from a chronic pain problem, keep in mind the addictive potential of narcotics and the fact that tolerance builds with prolonged use.
Consider using alternative medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), which are highly effective and not habit forming.
If you require narcotic pain medication but your supply outlasts your need, throw away any extra pills.
Keeping drugs around only entices you or others to abuse them for that little pick-me-up.
It’s easy to convince yourself that your muscle ache requires Percocet when Tylenol would do just fine.
If a loved one has severe pain from incurable cancer, don’t be afraid to give narcotics, because pain control is essential and the addictive potential doesn’t really matter.

If you’ve had a problem with drug abuse in the past (even if it’s alcohol), you probably have what is termed an addictive personality.
If at some future point you require pain medication, help yourself by admitting your problem to your doctor.
Ask for a NSAID-type medication.
If it isn’t strong enough you may require narcotics, and there is nothing wrong with that.
Don’t be embarrassed by your past problem, and ask your doctor for a narcotic to get you through a period of terrible pain.
Medications serve a valuable purpose when used properly.
To safeguard against addiction,
request a limited supply and throw away any extra the moment you can switch to something milder.

The name may sound dangerous, a class of drugs you would never try, until you remember that marijuana is actually a hallucinogen.
LSD and mescaline are certainly far more potent, but all of these drugs are capable of producing hallucinations.
Marijuana in low doses causes a high similar to what you’d expect after a few drinks of alcohol, but if you smoke a lot, hallucinations similar to those from LSD are possible.
Although your auditory acuity is said to increase with marijuana and other hallucinogens, true auditory hallucinations are rare.
Most men describe visual alterations in both form and color.
If marijuana is smoked, the high begins within minutes and lasts for two to three hours.
When you eat marijuana, onset is more gradual, but because 50 percent of the active drug is destroyed by smoking, you get a much greater high from eating the same amount of grass.
Tolerance to hallucinogens builds rapidly with repeated abuse.
Blood or urine tests detect evidence of marijuana use for as long as two weeks.
Remember this if your job mandates drug screening.
Medically, marijuana stimulates your appetite, is a strong anti-emetic (keeps you from vomiting), and is effective in treating certain forms of glaucoma.
Although activists are campaigning to change laws, marijuana is still illegal in this country.

I glanced at my patient’s intake sheet and saw nothing to explain his visit.
I treated his lover for years, but never him.
“From the looks of everything you seem fine,” I said.
“Is this a routine checkup?”

He shook his head.
“I’m fine.
It’s about Bill.”

I shifted in my seat.
I never like to discuss one patient with another—even if they’re lovers.
“Then maybe we need to discuss this with Bill too.”

“He doesn’t believe he’s got a drug problem.
He said I’m exaggerating.
Trust me, I’m not exaggerating.
He’ll listen to you.
I know he will.”

“Look, I’m here for you both, but don’t be so sure he’ll listen to me.”
I looked at my calendar.
“Can you get him to come in tomorrow?”

“No, we’re flying to Miami.
It’s the White Party.”

Not everyone who drinks or uses drugs has a problem.
In fact, most don’t.
There clearly is a biological and possibly even genetic basis to addiction.
And for those in relationships, drug dependency is not an individual problem; it is a couples problem with the nondependent partner playing an integral role.
Any solution to a partner’s drug problem becomes a couples solution, with both men taking active roles.

No one wants to believe he has a drug problem.
We all try to explain and rationalize it away—anything to keep from facing the truth.
Partners do the same thing.
They never want to believe their lover is addicted.
If you’ve got a drug problem, expect to hear about it from friends long before you recognize it in yourself.
If someone tells you he suspects you have a problem, listen.
He’s probably right.

If friends remark that your personality has changed, it’s probably from drugs.
It can begin as episodic outbursts when you had always been even-tempered.
Little problems you could have laughed off in the past suddenly take on paramount importance.
Every struggle becomes a do-or-die battle.
You fight with everyone and break old friendships.
Watch for other erratic behaviors, including interrupted sleep and spending sprees.

Depression is another very common symptom of a drug problem.
It is especially common after a period of prolonged drug use while your brain struggles to replenish vital chemicals.
You may not get out of bed—except to go party some more.
You miss work and other critical appointments—but always have a good excuse.
And it was never your fault; someone else is always to blame.

You may also notice physical symptoms of your growing drug troubles.
Weight loss or weight gain are common, as are frequent headaches.
Check your arms and legs.
Are they covered with unexplained bruises?
You probably got them when you fell down, stoned out of your mind.
Watch your blood pressure, because it can fluctuate with drug use.

Now take a hard look at when you use drugs.
Try to keep track of patterns.
Are you using drugs every day, spending more and more money to get high?
Once you take that first hit, do you have trouble saying no?
If the answers are yes, get help.
When you go over your list of times you got high, try to remember the reason.
People with drug dependency always find excuses to explain why they got high.
Maybe your day was too hard and you needed to unwind.
Maybe you were owed.
Or your day was great and you wanted to celebrate.
No, you
deserved
to celebrate.
Some men need drugs to relax, while others need them to sleep.
When you hear your reasons and they all sound too familiar, get help.

Last, look at your own family.
If a parent or other close relative had a problem, you may have one too.
Most people with drug dependency can easily point to a relative with the same trouble.
Our parents taught us well, and if they taught us about alcohol and other drug dependencies, it may be impossible to avoid those same pitfalls—especially when our genes pull us in that direction.

If your partner has a drug problem, you must share the burden.
Many psychologists use the term “enabler” to describe
a person who helps his partner, often subconsciously, maintain a pattern of destructive drug use.
You may handle drugs and alcohol fine and enjoy getting high.
You do a little coke after work and your partner does a little coke.
He willingly accompanies you to every circuit party and does every drug you do.
But he’s got a problem, and your drug use perpetuates his.