Gay Peoples Chronicle

Page 10

AIDS, DRINK & DRUGS

Sacramento--The roots of chemical dependency run deep into and throughout the AIDS epidemic, according to psychotherapist Ellen Ratner, who addressed a conference of California AIDS organizations meeting here.

A study in the Wall Street Journal reported that over 70% of AIDS patients have a history of drug abuse.

"The study is suspect," said Ratner, "but the point is valid. A large number of the people with AIDS in my practice are recovering from addiction to alcohol or other drugs. There's a real need for reliable data on how many chemically dependent people come down with AIDS. The urgent issue, though, is not to analyze history but to change it."

Ratner, who directs the clinical program at a new facility that only treats addicted gay people, offered several reasons chemical dependency has such an impact on the AIDS epidemic.

"It's speculative, but many researchers think there's a link between the immune response itself and drinking and drugging. We know that excessive substance abuse can make you generally run down, and affect the liver, heart, and bones, but is there a link beyond that? Our medical advisor, Dr. Mel Pohl, tells me fascinating research is going on into the links be tween opiate receptors and immune response, but I think the jury is still out."

For people who are already immune-compromised, the denial of alcoholism or drug addiction puts their whole health in jeopardy. The chemical dependency itself

is a block' to well-being, and behavior under the influence of chemicals may bring on further health hazards.

High Risks Linked to Addiction According to Ratner, the link between chemical dependency and high risk behavior is definite, and important to all gay men. Most chemicals do reduce inhibitions, and a person under the influence of alcohol, cocaine, or a narcotic is more likely to engage in sexual activi-

vies that transmit body fluids.

"All the good reasons to wear a condom or to stay with low risk playing suddenly seems a lot less important than the urges of the moment," she said. "And that's life-threatening behavior when 50% of the men in major cities may be infectious for LAV [the presumed AIDS virus]."

Barbara Faltz of San Francisco General Hospital reported that 9% of the gay men in her city were responsible for over 40% of the unsafe sex taking place. Expers said indications were that this 9% was likely to include many substance abus-

ers.

Good Sex is Sober Sex "A

lot of people just can't have sober sex," Ratner pointed out. Many have been brought up to believe that sex is dirty and shameful and they have been told that's ten times as true for gay sex. "They can't do it unless they're stoned and that means sex is always something you did when you were not responsible or aware. It reinforces internalized homophobia and it makes for irresponsible, uncaring sex even between lovers."

At Pride Institute where Ratner is in charge of treatment programs, patients are told that decisions about whom to have sex with .nd what to do with them are

"...AIDS cannot be contained unless the epidemic of

chemical dependency in the gay community is.

contained."

On the controversial question of compulsive sexuality Ratner says she is unsure whether this really qualifies as addiction.

"But there's some interesting research--mostly among straight women--suggesting that people can become addicted to having sex with new partners. And I firmly believe that it is the process of mood change that people get addicted to. It doesn't matter what the mood is. A large number of different partners produces that kind of series of stimulations from anticipation to excitement to intense pleasure and even to revulsion."

Ratner suggested there is a great deal of truth to the old country-western song, "All the girls get prettier at closing time."

"You're just more likely to find someone irresistible who, when you're sober, would turn out to be really quite easy to resist. You know what I mean if you ever woke up and said, 'I know he or she didn't look like that last night.

IN

personal; but that it's inpossible to make informed, rational decisions when you are drunk or high.

"It's a problem for many of our patients, male and female. But for gay men, these are life and death decisions and throughout our month-long program we stress sazfe sex over and over, Ratner said.

Epidemic of Drinking and Drugging

The audience of California AIDS educators heard speaker after speaker say that AIDS cannot be contained unless the epidemic of chemical dependency in the gay community is contained. Over 30% of gay men and lesbians have problems with alcohol or drugs, according to recent studies.

"That's 30% who will forget all the posters and pamphlets and video spots after one drink, one snort, or one joint too many. Getting off is just going to be more urgent than all the rational Considerations in the world," Ratner said.

She noted that many recovering gay people also have

August 1986

preexisting sexual issues. "Over 70% of our patients at Pride were sexually abused by an adult before the age of 15. There seems to be a powerful tie--in gay and straight people--between these experiences and chemical dependency as adults. Many of the women I see are victims of incest."

Pride Institute was founded because research and anecdotal experience indicated that many gay people fail in conventional therapy programs. It is the first inpatient program exclusively for gay men and lesbians. An integral part of the recovery process is feeling free to discuss relationships and needs. Most heterosexual establishments simply do not allow that freedom, even those with special interest meetings for gay clients.

"When everyone else in the group is talking about marriage and kids, it's tough to talk about meeting people in bars or making a same-sex relationship work,' Ratner said.

Gay Pride Key to Recovery

The Institute's program fouses on gay culture, gay behavior and gay achievements. It aims to build gay pride and to teach sober behavior in a gay environment. Ratner and her colleagues have started a nationwide list of referrals and resources.

People with substance abuse problems or their friends or lovers can get more information on treatment by calling 1 800-54PRIDE. The call is toll-free

Pride Institute professionals can provide the names of local therapists, gay-sensitive AA groups, details on other communitybased resources and informȧtion on residential programs. All records are kept strictly confidential and data on sexual orientation is never released without a patient's consent.

In-patient therapy has a distinct edge over community based programs, according to Ratner. The recovery process involves close monitoring: a resocialization process that gets the patient used to life without substance abuse, providing sober--and preferably gay--role models. "It's much easier to do all of that in a closed environment, Ratner said.

[This month's Healthwise column did not arrive. We substituted another article about AIDS.]

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