Nothing about Theresa's Noxzema-fresh face, curvy body, and just-washed auburn hair reveals the hell she put herself through for more than 20 years.
"I know I don't look like it now," Theresa says, sipping an iced chai tea at Willow House, a downtown Phoenix coffee house, "but I did some really bad shit."
She's years past her brief career as a second-grade schoolteacher, when she counted down the hours until she'd get home to do more tweak. That lasted just one semester, before Theresa began dancing at a strip club in central Phoenix, where she graduated from the diet pills she'd been using since she was 14 to smoking the street meth her brother was cooking up.
After grinding poles in Phoenix strip clubs, Theresa scored a contract to work in the South Pacific as a stripper, for $5,000 a week. There, she began smuggling "glass" -- one of a dozen street names for high-grade crystal meth -- back and forth between Guam and the Philippines.
She came back to the Valley, worked as a high-cost hooker for an escort agency, made a couple dozen porno films, and never stopped tweaking.
"I was always high, and I was always having sex," says Theresa, who -- like the other meth users in this story -- asked that her last name not be used. "The two just went hand-in-hand."
Not just sex.
But the kind of uninhibited, disconnected, sometimes violent, and often unprotected sex that tweakers obsess about, hunting for orgasms as they would a gram of meth.
"We've compared meth to cocaine, opiates and alcohol, and have found much more of a connection between sex and meth than those other drugs," says Richard Rawson, a researcher and associate director of the Integrated Substance Abuse Program at the University of California-Los Angeles. "It increases sexual pleasure, it increases sexual activity, and it increases the extreme kinds of high-risk behavior that lead to HIV and other STDs. More so than any other drug."
Theresa is sitting inside a smoke-filled room at the Willow House today with two fellow ex-tweakers, Randy and Robert. The three are here to share a graphic, cautionary tale. Just 20 feet behind the coffee house is a meeting hall, where their 12-step recovery program -- which they prefer remains unnamed so they're not seen as speaking for the group as a whole -- gathers weekly.
The stories pour with the coffee.
As an escort, Theresa says, she once "double-fisted a guy" while high on meth.
She worked in a dominatrix's dungeon, and allowed her clients to hang her upside down with her arms tied behind her back until she passed out. Then they had their way with her.
She liked to smoke meth -- or sometimes "slam" it (intravenously) -- while a trick "fucked me from behind," she says.
And when she wasn't "working," she still needed sex -- from her boyfriends, girlfriends, and from herself.
"I would masturbate for eight hours straight," she says. "I remember once that the dildo I was using got so hot, I had to wear an oven mitt."
But such occasions were rare. There was almost always someone willing to pay for the pleasure.
"I've had sex with over 2,000 men, at least. I can't say exactly how many," she says. "And most of them were unprotected."
Unlike other narcotics -- namely cocaine, universally regarded as the sex drug of the 1970s and '80s -- crystal meth makes women just as horny as men. It turns them into raging sexaholics, just like their male counterparts -- gay and straight -- looking to live out the most deviant of their sexual fantasies.
"Our data shows there's almost a negative reaction to sex among women using cocaine. But with meth, it's very powerful and positive," Rawson says.
Theresa was lucky. She caught herpes, and a bad case of crabs once. But she's never tested positive for gonorrhea, syphilis or HIV.
She's been pregnant, though -- a lot -- but never had kids. Theresa ended up having 12 abortions, and doubts she could ever get pregnant again.
Officials at Planned Parenthood of Central and Northern Arizona estimate that the number of abortions had by meth users has quadrupled in recent years.
"We get these women coming to us for an abortion who can barely get through their appointments because they need to hit the pipe," says Joseph Feldman, Planned Parenthood's director of counseling and education.
And one state employee who works closely with Child Protective Services calls meth a fertility drug. "Meth moms are having baby after baby after baby," she says. (See "Ice, Ice, Baby" for more details about meth moms.)
"The meth moms trade sex for drugs, and contraception and prenatal care are not always the highest priority," says the state employee. "There's a bit of a baby boom among women using meth."
As reports of HIV infections increase in Maricopa County, local health officials say widespread meth use is to blame. The meth problem in the Valley's gay community, where most of Arizona's HIV-positive cases have been reported, has been pervasive for years.
Yet even with more than 40 percent of local HIV patients reporting that they are also meth users -- significant because tweakers are much less likely to use protection, HIV-positive or not -- there's been no significant public health campaign in Maricopa County warning of the dangers of having sex while tweaking.
There certainly hasn't been an effort like that made in other major metropolitan cities like New York, Chicago, Boston, or San Francisco, where city leaders and nonprofit agencies are pre-emptively targeting gay men before they use meth for the first time. The Stop AIDS Project credits a series of public health awareness campaigns coordinated in part by the agency for a nearly 50 percent drop in meth use among gay and bisexual men in San Francisco.
That's not the case in Phoenix, where health officials admit they've done little, if anything, to address what a huge problem meth and sex present.
"It just hasn't been on our radar screen," says Bruce Porter, the HIV/AIDS coordinator for the Arizona Department of Health Services. "Should it have been? Absolutely."
That's an understatement, according to Steven Varnadore, an investigator in Maricopa County's Department of Public Health, who administers HIV tests at local gay bathhouses.
"We're dropping grains of sand to fill up a hole," says Varnadore, a former "recreational" meth user. "And it's enormous."
For the sex-addicted tweakers, if they manage to be sober long enough to get into recovery and therapy -- like Theresa, Randy and Robert -- there is a lifetime of sexual reprogramming, somehow learning to disassociate sex from the act of using meth.
"I know I'm not gay," says Randy, who once so obsessively sought "to get a nut" while high on meth that he had unprotected sex with a transsexual while his girlfriend waited for him at home. "I've never seen some guy's hairy ass and said, 'Oh, I gotta have that.' I'm not dealing with my sexual identity.
"My biggest problem," says Randy, "is that I don't know how to have a healthy sex life."
Crystal meth has an almost instant attraction to dopamine receptors -- commonly referred to as the human brain's "pleasure system" -- more so than other narcotics, according to Brough Stewart, the chemical dependency program director for Banner Behavioral Health in Scottsdale.
"It's a euphoric drug," says Stewart. "It allows us to work more, to eat less, but most often to have more sex."
"If you talk to the users," says Richard Rawson, the UCLA researcher, "meth becomes sex. It actually stimulates the same part of the brain [the dopamine receptors] that controls sexual arousal. The chemistry of sexual arousal and the chemistry of meth become the same. That's why it's so uniquely different from these other drugs we associate with sex."
Which explains why Don Sherrard, who supervises the Phoenix Police Department unit that focuses on searching out and shutting down meth labs, finds "stacks and stacks" of porn at almost every meth house he busts.
"When these guys aren't cooking up the meth or tweaking, they're masturbating or having sex with multiple partners," Sherrard says. "There's pornography everywhere. Sex toys everywhere. These people have contraptions hooked up all over the bedroom."
Robert, one of the ex-tweakers now in recovery, is familiar with what happens in a meth lab.
He says he was once referred to simply as "The Doorman," guarding local meth labs run by biker gangs, protecting both the house and the cooks inside from cops and psychotic tweakers alike. But for willing teenage "sex toys," there was plenty of meth, if not access inside the meth house, for the price of orally satisfying The Doorman.
Robert wasn't initially into meth for the sex. He was only in the seventh grade when he was first exposed to it, weighing cocaine for a friend who happened to have a pocket full of "white crosses."
But over the years, working for biker gangs like "The Dozen" and "The Spartans," he was exposed to more women -- more women looking for drugs.
"You wanted meth? You had to go through me," Robert says. "So I had all these little 18- and 19-year-old sex toys at my feet."
Robert and a fellow tweaker buddy decided it wasn't enough to have their way with young girls who were totally uninhibited on meth; they wanted to film it. They bought a stolen professional-grade video camera, recruited the girls, and then spent hours at a time choreographing the scenes, like big-shot porn directors in the San Fernando Valley.
"I remember we stressed about the cum shot, the 'money shot,' for so long," Robert says -- typical, obsessive tweaker behavior. Eventually, they finished the film, and ended up selling it to a small-time subsidiary of a larger porn distributor for about $7,500.
"They started out with a $10,000 offer," Robert says. "But then they came out to see us, saw that our faces were sunken in and how skinny we were, and they lowballed us down to, like, $6,000. We had to struggle just to get the price we did."
Randy, now a beer-bellied process server also in recovery, never made his own porn. But he did do things he wouldn't have done had he not been on meth.
There are some things about that hot summer night that Randy remembers vividly: He left his job as a car salesman to meet up with some fellow tweakers at a house party, he says, as Robert and Theresa nod, almost fondly remembering what those days were like. At the tweaker party, Randy would sell some meth, and smoke a little, too.
"Beyond that, all I remember is that I needed to fuck. I was just looking for a receptacle to put my dick in," Randy says. "Pretty much everyone I had sex with was just a receptacle."
Randy met eyes with a black-haired girl across the room once he finished getting high. She needed a ride home, and Randy, although he had a girlfriend at the time, needed "to get a nut."
"He was hot, man!" Randy recalls. "I thought he was a girl; everyone thought he was a girl."
Until the girl pulled down her pants and showed Randy she was only a girl in spirit.
"I can't really say what was going on in my head, but it wasn't enough for me to stop myself from getting what I wanted," Randy says. "He looked enough like a girl for me to fuck. So I did."
Scott is an HIV-positive tweaker. He's in recovery with Robert, Theresa and Randy, but he relapsed back in September, going on a monthlong meth and sex binge.
He hangs out at the Willow House, too, and goes to the same 12-step meetings.
"I had sex with as many as 20 different guys in that one month," Scott says, taking a long drag of an American Spirit, gazing out the window of the Willow House on a breezy Saturday afternoon. "I have no idea exactly how many men. I was high every time."
Steven Varnadore says he deals with new HIV patients like Scott all the time. As a communicable-disease investigator with the county's health department, Varnadore's job is to contact every sex partner new patients can identify. (The new patients are required to inform Varnadore and the county to be eligible for HIV treatment.)
Varnadore spends most of his time sifting through lists as many as 300 names long of former sex partners who might have been exposed to HIV.
"And I'd say that, easily, better than 50 percent of them are meth users," he says.
The figure sounds high, but not far off from a June 2005 assessment of Phoenix's HIV-positive population, funded by a federal grant, that says almost 44 percent have used crystal meth. Of those referred to in the report as MSMs (men having sex with men) and HIV-positive, 40 percent said they were users.
What's worse, according to Mark Kezios, the director of HIV services for Pueblo Family Physicians, a clinic in central Phoenix that caters to lower-income patients, is that those same HIV-positive, meth-using patients are still having unprotected sex.
"They just don't care, it seems, what happens to them or to the people they're having sex with," Kezios says.
Scott says it's not that he doesn't care; after all, he tells every prospective sex partner that he's HIV-positive (and has been since 1993).
"At that point, it's up to them whether or not they want to have sex with me," he says.
Problem is, they tend to make that fateful decision high on "Tina," meth's most common nickname in the gay community.
The easiest way to score meth is by visiting a gay chat room online, Scott says. In fact, his most recent relapse occurred after a late-night cruise on the Web.
"It's easy," he says. "Some guys advertise that they'll just leave their apartment door open, you can come in, slam some meth, fuck them, and then leave."
On sites like gay.com and men4sexnow.com, users publish profiles that advertise "PnP," an acronym for "party and play," a.k.a. tweak and sex. But it's becoming more difficult to get hook-ups on some sites, like manhunt.net, which edits all references to "PnP" and even the word "party" out of users' profiles.
Frustrated, a gay tweaker might head out to any of Phoenix's gay dance clubs, where it's easy to spot the "circuit boys," who travel in packs with supplies of meth, Ecstasy, and poppers from party to party.
The circuit boys will usually wait around until closing time to organize a very exclusive after-hours party where a dozen or more gay men will gather to snort or slam meth, and then begin having unprotected sex, often in groups.
If they don't find their way into a meth party, there's always a gay bathhouse. At the bathhouses, men wait inside their private rooms as horny tweakers search for prospective partners and dance music pumps through the PA system.
Patrick Kelly, the owner of The Chute (a central Phoenix bathhouse) and a member of the Phoenix City Council's crystal meth task force spearheaded by councilmen Tom Simplot and Dave Siebert, knows his bathhouse is a tweaker haven. But, he says, he's done everything he can to eliminate its presence, posting anti-meth signs, kicking out drug users, and keeping a three-ring binder of more than 200 names of those who've been 86'ed.
"I'm so tired of people blaming me for their HIV and their drug addictions. I'm not the one responsible for that," Kelly says. "I'm not the reason they got AIDS or hooked on meth. It's their own behavior. There's only so much policing I can do."
Local law enforcement officials, like Phoenix police meth-lab supervisor Sherrard, know that meth is a huge problem in the gay community, and, he says, they know where to find it. But, he admits, police are doing little to address it. Sherrard tells New Times that police don't want to be seen as "bashing the gay community" by targeting gay bathhouses or dance clubs. "That's the last thing we need," he says, "to be seen as if we're harassing gays."
"I think the biggest reason we don't bust the gay community," says Detective Matt Shay, who works with Sherrard in Phoenix PD's Drug Enforcement Bureau, "is that the gay community pretty much keeps it to themselves."
And, in the gay community, meth is such a touchy subject, according to Steve Schimmel, an advertising manager for Echo magazine, Phoenix's most-circulated gay publication. Earlier this year, Echo ran a tongue-in-cheek anti-meth ad in consecutive issues, paid for by an AIDS-advocacy Web site based in New York.
The ad said:
"Buy crystal, get HIV for free."
"I'm sure we offended plenty of people," Schimmel says. "But you know what? I don't care. This is a huge problem. We need to get in people's faces."
A similar tactic worked in San Francisco, according to Jason Riggs, spokesman for the Stop AIDS Project there. The organization, in conjunction with a citywide effort modeled after other public health campaigns in Chicago, Boston and New York, began a series of similar efforts that included anti-meth posters and meth-and-HIV seminars after a Stop AIDS study in 2004 showed that 18 percent of San Francisco's gay and bisexual population were current meth users.
Just a year later, in the midst of the Stop AIDS "Crystal Clear" poster campaign, a survey of 4,200 gay and bisexual men showed that the number of those using meth had decreased to 10 percent.
Riggs says that his organization has been pre-emptively targeting gay men who are at the "highest risk" of using meth, before they actually do.
"We can't worry about the men who are already addicted to meth," Riggs says. "We have to let the treatment and recovery programs deal with them."
Bruce Porter, the state's HIV coordinator, says that, despite the agency's failure to address the dire public health concerns that arise from the combination of unprotected sex and meth use, it's only a matter of time before public funds are devoted to some type of educational awareness campaign.
But until that happens, Scott says meth will continue to ravage the gay community.
"Meth has set us back 10 to 20 years," he says. "We want gay marriage? We have no idea what commitment is."
Theresa's content, she says, even though she knows it's unlikely she'll ever be able to have children because of the dozen abortions she had as a meth addict.
"I'm getting older anyway," she says. "I think it's too late for me even if I could get pregnant."
Feldman, the counselor for Planned Parenthood of Central and Northern Arizona, says he sees women like Theresa with increased frequency.
"We had a young lady come in about six months ago who had already had three kids taken into foster care," Feldman says. "She came in and had the procedure started. We put the cervical dilators into her cervix [a procedure required for pregnancies past the first trimester] and asked her to come back the next day.
"Well, she had been smoking all morning when she came back. We tried to manage her, to keep her in the clinic long enough for her vital signs to return to normal for surgery. But when we tried to get her undressed for the doctor, she refused. Her brain wasn't working right because she was all meth'ed up. So we convinced her that the dilators had to come out. She called me about two weeks later and asked if we would still see her, and I said no. That's a very rare occurrence, but given her drug history, we didn't figure the risk to ourselves was appropriate."
It's a risk that's not going away. Far from it.
"About four years ago, we would have gone a month without seeing a meth user come to us for an abortion," Feldman says. "Now, we're lucky if we go a week."
Randy, the ex-tweaker now in recovery and working as a process server, hasn't had sex since he got clean two and a half years ago. He's had opportunities, he says, although he hasn't really been dating. Instead, he's focused on playing it straight as a process server, going to his 12-step meetings and getting closer to God.
"It hasn't been as difficult as you might think," he says. "I'm really working hard on my program. I'm trying to learn how to be friends with women.
"And besides, I've still got my hand!"
Sex has a way of kick-starting a meth relapse, according to Carol Ross, a licensed counselor who works with alcohol and drug addicts and specializes in sex addiction and trauma at Sierra Tucson, a high-end treatment center in the Sonoran Desert just north of Tucson.
"All those addictions need to be treated," says Ross, who's been at Sierra Tucson for 17 years, "because what tends to happen is that the patient will relapse because of other issues. They tend not to be able to disassociate the sex from methamphetamine use."
Ralph Earle, a sex-addiction expert who runs Psychological Counseling Services in Scottsdale, agrees.
"Patients will say that the only time they act out on their sex addiction is when it's in combination with crystal meth. The two of them go together. When they're sober, they're much more careful than when they use meth and cross that line into inappropriate sexual behavior.
"The meth user who is also a sex addict is either incredibly, highly motivated to make a change or there's nothing we can do in therapy," Earle says. "There has to be a reason the patient has enough motivation to come to us. They have to hit the bottom."
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Randy did just that on that summer night long ago.
Now, Randy wants what Theresa has. She's in a committed, monogamous relationship, and is learning what is and isn't "appropriate sexual behavior" on a daily basis.
"What I want sex to be is a communion," Randy says. "I worry that I'll never feel an emotional attachment again.
"I worry that sex will be just," he pauses, "nothing."