At Terrence Higgins Trust we often see men who are in two minds about their drink or drug use. For some reason they no longer feel completely in control. Some have toyed with crystal meth and GHB – the drugs which grab the headlines. But it’s actually people who have problems with ketamine, cannabis, cocaine and alcohol that we mostly see.

Most men who contact the service are in their late 20’s to early 40s. Some have been using one drug or another for most of their adult lives and functioning (or not) under the influence has become normal. The most important early step is for the person themselves to establish why they feel they have a problem. It’s not for us to decide this.

We tend to see men when they’re asking questions like:

• Isn’t there more to life? Why can’t I break this cycle?
• How come my friends can control their drinking or drug-taking but I struggle with mine?
• Is there another gay life besides the scene?
• If I make changes, what will fill the emptiness left behind?

After years spent doing the same thing you might be left asking if it’s time for a change. Wondering how to make that change can be a stumbling block. For some men their first, and maybe only, experience of gay life is the bright lights and sexual playground of the scene. It can seem hard to imagine alternatives which can also seem uninteresting.

You may not have explored the alternatives and they’re difficult to imagine if you feel controlled by a habit that’s getting hard to kick. A social life which revolves around the gay scene, and friends who don’t understand the problem , can just add to the shame and guilt you might be feeling when you are isolated and unhappy.

Sexual issues often go hand-in-hand with escalating drug and alcohol problems, which can haave a big knock-on effect. It can be useful to look at worries about drink or drugs in the wider context, including how they impact on jobs, relationships and health. Drugs or drink might also be helping to block things out that you would rather not face up to, such as feelings about being gay, family and childhood issues, getting older or dealing with HIV.

If facing life ‘clean’ is unknown, frightening territory, you might feel scared that if you ask for help you’ll be told to give up the booze or pharmaceuticals. Our services aren’t about “just say no” clichés. They provide safe, non-judgemental and supportive spaces to explore drinking or drug taking with someone who knows the score. Then it’s up to you to decide whether the next step is cutting down, getting more control over how much you use, or stopping completely.

You don't need to come to our services knowing what your problem is. Many of us use substances in a controlled way that feels manageable. But many don’t.  When your substance has a negative, overwhelming impact on other areas of your life, it’s only a matter of time before the skunk hits the fan. When it does, we’ll be there.

Terrence Higgins Trust provides counselling and groupwork services or you may like to see a Health Trainer. Call THT Direct on 0808 802 1221 to find out which services are available in your area.

This article was last reviewed on: 28/10/11
Date due for next review: 28/10/13