The Role of Sex (Eros and Thanatos; Complexities of Speed and Sex)

The Role of Sex(Eros and Thanatos; Complexities of Speed and Sex) PAUL SIMONS YALE UNIVERSITY, SCHOOL OF MEDICINE, DEPT. OF PSYCHIATRY, HARM REDUCTION UNIT MARIA G. MESSINA, PHD MICHAEL C. CLATTS, PHD LLOYD A. GOLDSAMT, PHD INSTITUTE FOR INTERNATIONAL RESEARCH ON YOUTH AT RISK NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC. 71 WEST 23RD STREET NEW YORK, NY paul.simons@yale.edu

ACKNOWLEDGEMENTS • “HIV Risk Among MSM Speed Injectors” • NIH R01 DA152231 • Project Officer Dr. Elizabeth Lambert • All the men who were interviewed

Purpose • To examine a number of problem statements in light of the work of several post-modern/critical theorists (Foucault, Marcuse, Deleuze and Guattari) in order to situate and observe sexual desire and the public health as they confront each other over the issues of methamphetamine use and sexuality among MSM. To conjecture as to the reasons for the seeming ineffectiveness of interventions among this population and to recommend a line of movement towards interventions based on harm reduction, non-abstinence, or anti-abstinence principles, techniques and messages.

Problem Statement 1 • “The impact of methamphetamine on daily functioning is less well studied, although it is known that abusers of the drug have impaired decision-making abilities. These could potentially affect treatment and relapse prevention efforts, as well as things like money management and driving performance.” • Dr. Terry Jernigan of the HIV Neurobehavioral Research Center of the University of California-San Diego (NIH News, August 2005)

Problem Statement 2 • “Because of the heightened sex drive and feelings of invincibility that crystal meth causes in users, the potential for unprotected sex, and HIV infection, increases dramatically. One of the ironic side effects of crystal meth is that while it increases libido. It also causes impotence, leading many men to become “bottoms” in anal sex acts... One recent study indicates that MSM in New York City and who use crystal meth are 2.9 times more likely to contract HIV through receptive anal intercourse the MSM who do not use the drug.” • New York AIDS Coalition Position Paper: The Crystal Methamphetamine Epidemic and Its Impact on HIV/AIDS Prevention and Treatment.

Problem Statement 3 • "We've had ecstasy, pot, acid--but this is the crack of the gay community." Jason Riggs, spokesman STOP AIDS Project, San Francisco (23 January, 2005, Pittsburgh Post-Gazette, Lisa Richardson and Lee Romney)

Problem Statement 4 • " The curse of methamphetamine, also called speed, crank, tina, and tweak, is not unique to the gay male community. As addictive as crack, more powerful than ecstasy and cheaper than cocaine, methamphetamine has become the leading demon in drug treatment programs nationwide." (23 January, 2005, Pittsburgh Post-Gazette, Lisa Richardson and Lee Romney)

Problem Statement 5 • Resp: If I’m going to splurge or binge, it’s going to be a fun time, one or two nights. You ride it high and then you let it go. The binge was one night…I had it [sex] non-stop the whole binge. It was sexual arousal for the whole experience.

Problem Statement 6 • Resp: The last binge I bought a ‘teener of speed and I started doing 50 cent shots. • Q: What does that mean? • Resp: Half gram shots, half gram at a time. That was unbelievably fun. But I did too much and I couldn’t move after a while and I got paralyzed from it. • Q: Did you plan it? • Resp: I knew what I was doing. I knew I was going to get it from the Aryan Brotherhood and I was getting a ‘teener of it. I knew I was going to be alone to do it. I planned it so nobody would be around and my lover would be away.

Problem Statement 7 • Resp: That was a week from that, we bought a little over a quarter, so it wasn’t like a binge. Me and my sexual partner used that for uh, you know to enhance the sex. • Q: So was it planned? • Resp: Yes it was planned and he was thinking about planning it again. I don’t know, people really like what it does for their sex life. • Q: How has speed impacted your sex life? • Resp: Oh, uh it’s a new world actually, I don’t know. There’s more stamina, there’s more sensitivity, there’s more feeling. It just seems more deeper for some reason, I don’t know.

Problem Statement 8 • Q: Describe to me the high. • Resp: Well okay um, when you first do the high there some excitement to it, it’s going to intensify your horniness, so you look forward to that situation. That you’re going to make your horniness ten times stronger…there’s kind of like a ritual involved in it. So the ritual is like you hooked up with someone so you know there’s going to be some fun. And then if this someone happened to have porno and they say yeah so that makes it a little bit more exciting. So there’s going to be some porno. And what I mean by porno is a video tape. And then depending on which way we’re going to do it, whether we’re going to use the needle or going to smoke it. Sometimes depending on that way we’re going to do it can make the excitement more exciting.

Problem Statement 9 • Resp: Injecting is much more intense, much more intense. Sometimes it’s briefer. It’s more of a physical, more of a sexual. I feel more sexual when I inject it than if I smoke it.

Excursis I: Michel Foucault • The History of Sexuality Volume 1: The Introduction (Vintage Books, New York, 1990)

Excursis I: Foucault • "Four figures emerged from this preoccupation with sex throughout the nineteenth century- four privileged objects of knowledge, which were also targets and anchorage points for the ventures of knowledge, the hysterical woman, the masturbating child, the Malthusian couple and the perverse adult." (p.105)

Excursis I: Foucault • "There is not on one side a discourse of power and on the other side a discourse that runs counter to it. In short it is a question of orienting ourselves to a conception of power which replaces the privilege of law with the viewpoint of the [military] objective, the privilege of the prohibition with the viewpoint of tactical efficacy, the privilege of sovereignty with the analysis of a multiple and mobile field of force relations...because it is one of the essential traits of Western societies that the force relationships which for a long time had found expression in war… gradually became invested in the order of political power." (p102)

Excursis II: Marcuse • Eros and Civilization: A Philosophical Inquiry into Freud (Beacon Press, Boston, 1966)

Excursis II: Marcuse • "Being is essentially the striving for pleasure...And the 'struggle for existence' is originally a struggle for pleasure; culture begins with the collective implementation of this aim. Later, however, the struggle for existence is organized in the interest of domination: the erotic basis of culture is transformed." (p. 125)

Excursis II: Marcuse • "...while any form of the reality principle demands a considerable degree and scope of repressive control over the instincts, the specific historical institutions of the reality principle and the specific interests of domination introduce additional controls over and above those indispensable for civilized human association. These additional controls arising from the specific institutions of domination are what we denote as surplus-repression." (p.37)

Excursis II: Marcuse • "The pleasure principle was dethroned not only because it militated against progress in civilization but also because it militated against a civilization whose progress perpetuates domination and toil. Freud seems to acknowledge this fact when he compares the attitude of civilization toward sexuality with that of a tribe or a section of the population ' which has gained the upper hand and is exploiting the rest to its own advantage. Fear of a revolt among the oppressed then becomes a motive for even stricter regulations.'"(p. 40)

Excursis II: Marcuse • "In a repressive civilization death itself becomes an instrument of repression. Whether death is feared as constant threat, or glorified as supreme sacrifice, or accepted as fate, the education for consent to death introduces an element of surrender into life from the beginning - surrender and submission. It stifles 'utopian' efforts. The powers that be have a deep affinity for death; death is a token of unfreedom, of defeat.“ (p. 236)

Excursis III: Gilles Deleuze and Felix Guattari • Anti-Oedipus: Capitalism and Schizophrenia (University of Minnesota Press, Minnesota, 1983)

Excursis III: Gilles Deleuze and Felix Guattari • "We maintain that the social field is immediately invested by desire, and that libido has no need of any mediation or sublimation...There is only desire and the social, and nothing else [italics theirs]. (p. 29)

Conclusion • "In this struggle reason and instinct could unite. Under conditions of a truly human existence the difference between succumbing to a disease at the age of ten, thirty, fifty or seventy, and dying a 'natural' death after a fulfilled life, may well be a difference worth fighting for with all instinctual energy. Not those who die, but those who die before they must and want to die, those who die in agony and pain, are the great indictment against civilization. Their death arouses the painful awareness that it was unnecessary, that it could be otherwise. It takes all the institutions and values of a repressive order to pacify the bad conscience of this guilt.“ Marcuse, Eros and Civilization (p. 236)

The Role of Sex (Eros and Thanatos; Complexities of Speed and Sex)