Fighting Stigma: A Former College Professor Opens Up about Meth Use
Stigma is a complex social issue and one that has wide-reaching and detrimental effects on health, safety and wellness. People who use drugs may be stigmatized in a way that leads them to conceal their use and prevents them from accessing beneficial health care, social or substance use services—increasing their vulnerability to infectious diseases and other harms.
Ahead of World AIDS Day, BETA explores the difficult issue of stigma, drug use and HIV with a personal look at one man’s relationship to crystal meth.
Tim Pursell, PhD, keeps a closely cropped beard and wears angular dark-framed glasses and a dark blazer, blending in with many other middle-aged men in San Francisco. The 48-year old former European history college professor self-identifies as a kinky gay man with a “few mental health issues.” He also describes himself as a crystal meth addict.
“I’m a highly-educated, articulate tweaker,” he said.
The reason he’s OK bringing his substance use to light? To help combat the stigma that can swirl around substance use—especially meth.
Stigma associated with drug use can make people who use substances feel social rejection, discrimination or somehow “lesser than.” The problem with stigma attached to substance use is that it can create a social context where people who use substances do not, or cannot, reach out for the help and care that they need—increasing the harms that can come to people who use drugs.
“There’s stigma around using drugs in our society, but if you use meth—especially if you inject it—you’re at the bottom of the barrel. I think it’s about fear. People assume that if you inject meth you have terrible teeth and that you’re crazy. They have this stereotypical image of what a meth user looks like in their head, and that’s not always the case.”
Pursell first started using meth nearly 20 years ago. In graduate school, meth helped him escape the stress and burden of everyday life. Suffering from depression at the time, the rush meth brought made him feel happy. It made sex better by helping him overcome inhibitions he had in the bedroom.
Most of the time, he felt in control of his use. He bought his own product and would use in the safety of his own home. Pursell would occasionally stop using for periods of time to make sure he was still in control.
During the time he was with his partner, he stopped using altogether. “We had such a loving relationship—it was the kind most people dream of. But he didn’t want me to use, so I stopped for the six years we were together.”
Pursell moved to San Francisco with his partner and they shared a full and happy life together, one that began to break down when his partner developed health complications related to HIV. When he got sick, and died suddenly, Pursell fell apart. Isolated from the support of family and close friends, Pursell turned back to meth.
“As he died, the cravings came back. I was disgusted with myself. But I gave in to the cravings as my life eroded. I was numb with grief. Meth made me feel something. I felt optimism. I was still sad and grieving, but I was able to function.”
When he started revealing to friends and family that he was using—snorting and injecting—meth, he found people were uncomfortable, afraid to help and judgmental about what he was going through. “All of the sympathy I got for losing my mother and my partner went away—I felt ostracized,” he said.
Once, he admitted to using injection drugs when he wound up in the emergency room. “I could tell that the level of care changed. Respect just disappeared. It is interesting to be a highly educated, upper-middle class white male and just see all that privilege go out the window because of (intravenous) drugs. Having that privilege was stripped away—particularly perceptions about my general respectability and honesty—was thought provoking. It made me angry, not for myself, but for everyone who is treated in that way.”
So Pursell talks openly about his drug use and isn’t afraid to show his face because he realizes that others can’t—or won’t—broach the subject. “This is a position of strength for me. You can’t call me a junkie. Because I admit it.”
As soon as he started injecting meth, Pursell decided to seek out services at the Stonewall Project, the substance use program of San Francisco AIDS Foundation. He said the outpatient, harm reduction model made sense to him. Through Stonewall groups and counseling sessions, Pursell explored substance use management and learned harm reduction strategies to care for his veins and overall health. With staff and fellow Stonewall clients, Pursell spoke about his substance use in connection with his grief for his partner.
Pursell continued to use meth, and for a time, experimented with other substances. He hated crack and decided to stop using heroin because he feared the withdrawal symptoms. The first time he got hepatitis C, he cleared it without treatment. He contracted it again, and is now taking medication for it. In 2014, he contracted and tested positive for HIV. He says getting HIV was “absolutely” connected to his use.
“I was open to the risk,” he said simply. “I had been negative for a long time and was having sex with guys who were positive. Even when I was using drugs, I wouldn’t say I was self-destructive—more self-defiant.”
Pursell started to worry about his use when the psychosis began. He began hearing voices and having vivid visual hallucinations. “It was hard to know what was happening around me sometimes. It was a nightmare. I got to the point where I couldn’t trust my own memory.” That’s when he started to think about making bigger changes to his use.
Financial concerns forced Pursell out of his San Francisco apartment last year. The day he was forced to leave—without many of his belongings—was the day he got a call about an opening at a drug treatment center. He stayed for 90 days—the longest stretch of sobriety he’d had in a long time.
After leaving the inpatient facility, he was granted a room in a transitional housing facility, where he is living now. These days, he focuses on other parts of his life that bring him joy—playing the organ and harpsichord, writing short stories and poems and connecting to the Catholic faith. He continues to attend support groups and counseling sessions through Stonewall.
“I still say that I’m doing substance use management, but right now I’m abstinent from drugs because that’s what reduces the harm in my life. I can’t say that I won’t ever use again. This isn’t a story that goes from bad – ‘I used drugs’—to good, ‘when I quit using drugs.’ This is my life. There are times when meth was helpful to me and times when it wasn’t. It’s wonderfully complicated.”
Harm reduction-based counseling, treatment and support services for gay men, transgender men and other men who have sex with men who would like to change their drug and/or alcohol use are available through The Stonewall Project—a program of San Francisco AIDS Foundation.
Learn how you can make a difference in fighting substance use, HIV and PrEP stigma in your own community with these tips from San Francisco AIDS Foundation staff.