LOS ANGELES -- It was the kind of town hall meeting that could, perhaps, only be held in West Hollywood.
"We're going to talk about sex," City Councilman John Duran warned the crowd, feigning surprise.
Behind the scenes a few minutes earlier, one of the panelists, a drag queen in a sparkling halter top, had asked him how much swearing was appropriate, given the topic. (Try to avoid F-bombs, Duran advised.)
But what they were talking about, in such a colorful way, could not be more serious.
The topic at the packed town hall Wednesday night was a growing crisis, especially in the LGBTQ community, that health experts say is not talked about enough: "chemsex," or using drugs like methamphetamine, cocaine and MDMA to enhance sexual activity and lower inhibitions.
Also called "party and play," chemsex has become pervasive on online dating apps like Adam4Adam, Scruff and Grindr, where people use constantly changing code words and emojis to show they want to use or buy drugs and have sex, said Jimmy Palmieri, founder of the Tweakers Project, a support group for people struggling with crystal meth addiction.
"I don't think there's anyone in West Hollywood that hasn't been touched, somehow, some way, by meth," Palmieri said.
In West Hollywood, methamphetamine was involved in 47 deaths between 2015 and 2018, and meth-related hospitalizations have steadily ticked upward for the last decade, according to the Los Angeles County Department of Public Health.
The event follows the overdose deaths of two black gay men in the West Hollywood apartment of Democratic donor Ed Buck, who was accused last fall of injecting fatal doses of crystal methamphetamine into victims for his own sexual gratification.
"For far too long, I think, meth has been overlooked as a public health crisis," said Dr. Lello Tesema, an associate medical director at the L.A. County Department of Public Health Division of Substance Abuse Prevention and Control.
While it does not have the same national attention as the opioid crisis, methamphetamine in the Los Angeles area "is actually incredibly prevalent and incredibly dangerous," she said.
The town hall came at a time when, city leaders say, there is a critical shortage of spaces in West Hollywood that can and will accommodate addiction recovery groups. Currently, the fate of a run-down log cabin on Robertson Boulevard that hosts some two dozen sobriety meetings each week is up in the air. Beverly Hills owns the lot on which it sits and wants it gone; West Hollywood officials are trying to lease it to keep the meetings going.
Town hall panelist Jason De Puy, a drag queen, said the problem is rarely discussed openly. There are "influencers on Instagram with a hundred thousand followers, and they're doing crystal meth on the side, and no one understands or even knows that and everyone's scared to talk about it," he said.
De Puy, who has been sober for eight years, said that, like many young gay men who come to West Hollywood, he had not been taught about gay sex and was ashamed by it. He was introduced to crystal meth at a bathhouse, and it seemed to make intimacy easier and more euphoric.
The addiction quickly took over his life. He was homeless for a spell before moving into an apartment filled with cockroaches, fleas and bedbugs.
"Meth and sex kept me from having to deal with life," De Puy said.
"When I got sober, I had to learn how to have sex again because I was used to this seedy, dangerous, risky sex. ... You can go to the orgies, honey. You can go to the bathhouse. You can do this stuff sober," De Puy said.
In recent surveys of nearly 1,600 people in West Hollywood, more than 70% of respondents that meth use at community events, bars and clubs is a "pressing issue" for the city, according to the Safe West Hollywood Community Coalition.
The coalition and city employees recently have begun going to major events like LA Pride and West Hollywood's Halloween Carnaval to hand out free naloxone, a medication that can reverse drug overdoses, as well as condoms and testing strips to determine whether recreational drugs are laced with fentanyl.
According to the Centers for Disease Control and Prevention, the contamination of illicit drugs such as methamphetamine with fentanyl -- a synthetic opioid 50 times more potent than heroin -- is a growing public health concern. Often, users are unaware that it has been added.
"People don't even realize they're doing fentanyl," Duran said. "We're seeing a lot of people in our community who just thought they were going to party and not waking up the next day.
"When you throw in sexuality, oppression, shame, stigma, HIV, meth and then add fentanyl in the mix, it's a deadly combination."
The town hall panelists said that one of the tragedies of chemsex is that it often stems from loneliness and LGBTQ people's shame around their sexuality or gender identity. Tesema said that in a world increasingly connected by technology, "we're in a crisis of loneliness."
The questions from the audience reflected that: "Can you talk about how this ties in with mental health and self-esteem and suicide prevention?" "How can I get people to rally around this issue?"
Melissa McCracken, a chemsex counselor for Breathe Life Healing Center in West Hollywood, said people "lose self intimacy" when in the throes of drug addiction and that meth use "disables empathy, which is one of the tragic casualties."
"Giving yourself the space and the time to actually connect with another person is difficult, but it's not impossible," she said.
Tesema noted that people often become depressed when they relapse after trying to stop using meth, even though relapse is "not only common but an expected process in recovery."
In the lobby afterward, where naloxone and fenantyl-testing strips were being handed out, a 31-year-old man said the town hall was a nice change of pace from the crystal meth and alcohol addiction recovery meetings he attends.
The man, who asked that his name not be used because he was in recovery, said he works as a property manager for a 187-unit building in Westwood and has had to call authorities twice recently because of tenants overdosing on heroin.
Sobriety meetings are peer-to-peer, he said. Seeing issues like chemsex and meth use be discussed bluntly by experts, in a city council chamber, gave him hope that they would get more attention, he said.
"To see that the city is behind it is amazing," he said. "It elevates it, for sure."
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