男同志藥癮減少傷害團體之實踐經驗

Practical Experiences of Gay Recreational Drugs Anonymous Harm Reduction Groups

男同志族群中的成癮藥物使用者，相較於非同志藥物使用者，往往承受了雙重的汙名與壓力。根據筆者實務觀察，台灣男同志近年所使用的藥物以安非他命、GHB、K他命為主。本文以2016年以來所帶領的娛樂性藥物減少傷害團體進行經驗整理，團體共辦理5梯次30場次，參與人數共16人，其中有8位穩定參與至少一梯次以上。觀察發現安全的敘說環境可以舒緩成員對於此一議題的壓力，但團體前需透過個別會談，確認其精神狀態是否適合參與。罪惡感是團體歷程中重要的討論議題，象徵著成員與藥物、性愛、以及愛滋感染者身份間的心結。此外，此一團體基於減少傷害觀點，並預防成員因復發所產生的強大罪惡感而放棄努力。最後，男同志娛樂性藥物使用族群有著自己獨特的文化脈絡與生態，領導者須檢視自己對於多元性傾向與藥物使用的態度，隨時反思自己的價值觀。

Gays who use recreational drugs often suffer from double stigma and stress compared to non-gay drug users. According to the authors' observation in practice, the drugs used by Taiwanese gays in recent years are shifting to meth-amphetamines (crystal meth), GHB and Ketamine. This article is based on the observation from our experiences of 30 recreational drug harm reduction group sessions (5 series) during 2016. The total number of participants is 16 and 8 of them had a stable attendance in at least one series. We have observed that a setting which invokes a sense of security for narratives can decrease the stress of members who have problems with drugs. But the pre-group individual interview is necessary to tell whether or not one's mental state is stable enough for the group. The sense of guilt is an important topic that appears every now and then in the group process and symbolizes the complex relationship between members and their stories with drugs, sex, and HIV. In addition, the groups were based on harm reduction perspective and aimed to help members from giving up their efforts due to the strong guilt of relapse. Finally, gays who use drugs have their unique cultural context. Group leaders are urged to examine constantly their attitudes toward and values on sexual diversity and drug use.