“Saved my life”: Program for people using meth improves health and gives hope
Tina, Crystal, Glass, Ice, Meth… we know it by many different names, and we know it’s all around us in San Francisco.
Methamphetamine is a stimulant drug that’s use has increased each year in San Francisco in many communities. People in the LGBTQ+ community, in particular, have a history at the intersection of meth and sex that can lead to a variety of negative health outcomes such as HIV, hepatitis, mental health issues, overdose and more. While some can manage the use of meth in their lives, others seek options in changing their relationship with its use.
People who want to explore stopping using, reducing their use, or decreasing the negative effects that meth can cause are finding success through San Francisco AIDS Foundation’s PROP program.
“The PROP program saved my life and gave me the hope I needed to succeed,” said one participant, who was interviewed as part of a recent evaluation of the program.
Another participant said that they “love the volunteers, and [have] a feeling of family. Zero shame is what makes all the difference in the world.”
Based on a strategy called “contingency management,” PROP is a 12-week program where participants meet three time a week for social support and substance use counseling. People in the program can opt to take urine drug screens at each visit, and earn financial incentives after each test that comes back non-reactive.
“People can earn incentives for having non-reactive screens, but there’s no penalty for people who have reactive screens or who opt not to take a screen,” said Rick Andrews, associate director of contingency management at SFAF. “We don’t require abstinence, and there’s no judgement from staff or volunteers. People are allowed to have all kinds of goals, which we support. Every time someone comes to a group, it’s an opportunity for them to explore how best to make changes, and we provide people with the information and peer support they may need to reach the goals that they set for themselves.”
“Still showing up even when I was high made me feel safe and kept me coming back,” said one participant. “Having a non-judgmental group of people made me feel comfortable no matter what shape I was in.”
“The freedom to stop in when it worked for me with no pressure about being perfect, I could follow at my own pace,” said another participant.
A recent evaluation of the program, with a sample of people who completed the program 6 – 12 months previously, found that the majority of participants reduced their stimulant use. On a scale ranging from 6 (very heavy use) to 1 (no use), the average use of speed/meth fell from 4.79 before PROP to 1.86 after PROP. Across all people included in the study, there was an average 3.79 months of abstinence from meth reported after completing PROP. About half of participants, 47%, said they were confident in their ability to not use meth if they are triggered.
There were other health benefits that people who completed the program reported, with the majority saying that their mental and physical health improved. People living with HIV in the program experienced improvements in HIV-related measures, including 91% who reported they were taking HIV medications very often as prescribed. All HIV-negative participants were taking PrEP, a medication that prevents HIV infection.
Some people who completed the interviews continued to use meth after PROP, and many reported changing some things related to how they use to reduce the harm that can come from meth use. For instance, people were more likely to report doing things like eating enough and drinking enough water when using meth, and less likely to report using meth during sex, binging meth use, and injecting meth after PROP.
The social support provided by PROP is at the heart of the program, and its benefits were evident in the feedback received from participants. Improvements in mental health measures were dramatic: On a scale from 1 (very poor) to 5 (very good), satisfaction with quality of life rose from an average of 2.07 before PROP, to 4.00 after PROP. A rating of mental health rose from 1.64 to 3.71.
One participant said that PROP groups gave them a place to talk about the pain of stigma and judgement that can come from non-meth users. Being able to share these experiences with staff and other group participants allowed them to reduce some of stress from being stigmatized. More than half of people interviewed (64%) said that PROP helped them to create a sense of community among their peers, and 43% said they “strongly agreed” with having someone they could count on when they were having issues related to stimulants.
“PROP is great. After years of use I finally have a program that is accepting and understanding and for me a successful way to meet my needs,” said one participant.
Find out how to join PROP by contacting Rick Andrews at email@example.com.