Also known as crystal, crystal meth, ice, tina, crank, or yaba, methamphetamine is a synthetic form of amphetamine, a stimulant drug.

Crystal meth has been popular on the US gay scene for over a decade.

As regards the UK, research suggests that only a small proportion of gay men use the drug.

However, much higher levels of methamphetamine use have been recorded in HIV-positive gay men. These men often use other drugs as well.

Methamphetamine is a 'Class A' drug. This means that conviction for dealing can have a maximum prison sentence of life and/or an unlimited fine. Conviction for possession can mean a maximum prison sentence of two years, an unlimited fine or both.

Methamphetamine can be bought as a pill, as a powder to be snorted through the nose or injected, or in a crystal form – ice – which is smoked in a pipe.

Methamphetamine brings on a rapid feeling of exhilaration, a perceived sharpening of focus and heightened sexual desire.

Smoking crystals of methamphetamine causes a rise in body temperature, an increased heart rate and rapid breathing.

Paranoia, short-term memory loss, rages and mood swings have been recorded.

There is anecdotal evidence that use of methamphetamine can cause people to become ill because of HIV more quickly than they would have otherwise, to take more time to recover from infections, and to respond less well to HIV treatment. However, some people believe that this has a lot to do with users of the drug not taking their HIV treatment and other medication properly.

Rapid falls in CD4 cell counts have been observed in methamphetamine users. However, as many users of methamphetamine have difficulty sleeping and/or eating properly, there may be lifestyle factors involved in the quicker disease progression noted in some users.

Psychological dependence on the drug has also been reported, although it does not seem to cause physical addiction.

Taking large amounts of the drug can cause convulsions, problems with blood circulation, inability to breathe, coma and death. However, deaths have also been reported in people who have taken only small doses.

In the US, concerns have been raised about a link between the use of methamphetamine by gay men and unprotected sex, particularly when used in conjunction with drugs to treat erectile dysfunction, such as Viagra  and Cialis.

It has been reported that the protease inhibitor, ritonavir, increases levels of methamphetamine to possibly dangerous levels. Methamphetamine is metabolised by the body using the same mechanism as ritonavir. Doctors believe that inhaling poppers may make the interaction worse.

The use of any drug can interfere with normal sleeping patterns, affect appetite and interrupt routines. Some people have found that this is particularly the case with methamphetamine, and if you are using the drug, it makes sense to consider how it might affect your adherence to your HIV medication. The drug has also been linked with an increased likelihood of having unprotected sex, so plan how you’re going to manage this.

If you are worried about your use of methamphetamine or any other drug, then talk to a member of your healthcare team, who may be able to offer practical advice or refer you to somebody who can offer specialist advice and support.

NAM reminds readers that the use of methamphetamine is illegal in the UK. This factsheet has been written with UK law in mind, and the drug’s legal status may be different in other countries.