The AfterMeth: Gay Men Recovering from Crystal Methamphetamine and Chemsex Addiction

23 Jul 2026 · 56 min

0:00

In this two‑part episode of The Aftermath Podcast, host Dallas Bragg first presents a concise review of the latest peer‑reviewed research on chemsex, especially methamphetamine use among men who have sex with men, highlighting the limitations of abstinence‑only models and presenting three evidence‑based “doors” to recovery: (1) contingency management – rewarding negative drug tests, which is supported by 26 of 27 studies, now covered by California’s Medicaid Recovery Incentives Program; (2) reduced‑use or managed‑use approaches, where tapering or structured reduction leads to measurable improvements in cravings, depression, legal problems and quality of life, as shown in large NIH meta‑analyses; and (3) patient‑centered outcomes, where people prioritize stable housing, employment, legal safety and mental health over urine screens. Bragg argues for a spectrum‑based harm‑reduction framework that keeps abstinence as one option but adds these additional doors. The second half is an in‑person interview with Thickums de Longue Cray, a 43‑year‑old former meth user who is currently unhoused in Los Angeles. Thickums recounts a trajectory from a privileged early adult life (two houses, a husband) through family loss, foster‑care background, and a spiral into meth use and eventual homelessness. He describes his attempts at quitting (cold turkey, managed use, marijuana, poppers) and the strategies that helped him stay sober: test strips for fentanyl, keeping videos of past use as a reminder, staying busy with work (Uber driving) and school (near‑completion of an associate’s degree in horticulture), therapy, and self‑acceptance. He explains the resources he accesses: the APLA AIDS Prevention Los Angeles chemsex program (an 8‑week contingency‑management program with gift‑card incentives), SHARP’s case management and medication, the Sunrise Shelter (a reconverted motel with three‑person rooms, regular drug testing, and a six‑month stay limit), and his Instagram page “How to Be Homeless in LA” that maps locations for housing, laundry, showers, and car‑parking options. He also shares practical advice for newly homeless individuals (obtain gym membership for showers, apply for General Relief and food stamps, navigate intake processes). Throughout, Thickums emphasizes self‑love, the importance of basic dignity (showers, haircuts), and systemic gaps such as fragmented service coordination, lack of public restrooms, and the need for more nonprofit action. The episode ends with mutual gratitude and calls to follow Thickums’ Instagram for resources.

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