The sun had begun to rise, and Matt could see the first flickers of light creeping around the curtains hanging on the motel room's windows. He'd been awake for days.
It must have been a Monday, because the paranoia and hallucinations had set in – blurry shadow people moving in the corners of his eyes, tricks of a tired mind. Friday evenings that lasted until Tuesday morning were routine. Matt had set his work schedule as a waiter that way, four days off in a row.
Enough time to get high.
By then, 2017, he'd been injecting methamphetamine intravenously – "slamming" – for about a year. It didn't matter where or with whom. He'd drift from motel to motel, at times lingering on the streets. He'd get high with doctors who'd shoot up before shifts, or with lawyers. He'd use dating apps to advertise as a prostitute, to bridge the gap between one high and the next. His customers always had what he needed.
By Monday, he'd feel depleted – physically, mentally, sexually. Tuesday would come, as would a small hit to get through the day, and Matt would find himself crying in the bathroom at work. He hated himself. He loved the high.
"Growing up gay, you already feel outcast by society, and this drug makes you feel like you're the most important person, that you're the hottest thing," Matt says. (He asked that his last name be withheld out of concern that his addiction could make employers wary of hiring him.) "There's an illusion behind it, that you just use it for sex. So it doesn't seem harmful. But the effects it had on my life – I lost everything."
Although the nation fixates on the opioid crisis that claimed nearly 49,000 American lives in 2017, meth is making a comeback.
In 2011, meth was the eighth-most common cause of overdose death in the U.S., according to the Centers for Disease Control and Prevention, claiming 1,887 lives, 4.6 percent of all overdose fatalities. By 2016, meth was the fourth-most common cause of overdose deaths, causing 10 percent of overdose death – 6,762 fatalities.
In Florida, according to the Florida Department of Law Enforcement, the drug killed 327 people in 2016. That's a 109 percent increase from the number of people meth killed in 2015, 156 – itself a 77 percent increase from the number of meth-related fatalities in 2014, 88.
From January to June 2017, according to the FDLE's most recent data, meth caused 213 more deaths in the state. That's on pace for a 30 percent increase from the previous year's tally, and a nearly 400 percent increase since the 2014 report.
It gets worse.
Amphetamine is a metabolite of methamphetamine, meaning meth breaks down to an amphetamine once inside the body. It's also meth's narcotic parent. So if you add all amphetamine deaths to the toll, it rises significantly: 526 deaths in 2016, up from 243 in 2015, up from 67 in 2014.
The Florida Department of Health in Orange County doesn't track meth abuse, but the Sheriff's Office says it has seen a sharp rise in meth-related arrests in recent years, from just 43 in 2012 to 87 in 2016 to 212 last year.
It's no secret who's most at risk. In 2015, the National Survey on Drug Use and Health found that adults defined as "sexual minority" – i.e., LGBTQ individuals – were more than twice as likely as heterosexual adults to have used an illicit drug in the past year. More specifically, gay men use meth at roughly twice the rate of the general population, according to data from the U.S. Department of Health and Human Services.
David Fawcett, a Fort Lauderdale-based sex therapist and the author of Lust, Men, and Meth: A Gay Man's Guide to Sex and Recovery, says the problem goes beyond just gay men. Trans and bisexual men across all ethnic groups are also at risk.
"What I started to recognize is that it's men who have sex with men," Fawcett says. "It's most certainly a problem – and I would say if it's not a crisis, it's bordering on a crisis. The reason that resonates with some people and doesn't with others, I think, is because it's a small portion of the [LGBTQ] community."