Peter Staley is someone I worked with in ACT UP who is now also in recovery from crystal meth addiction. Using his own money to produce a much discussed series of posters about meth use, Staley helped spark the current wave of interest about meth addiction in New York. However, even he says that he hasn't heard about anything that's working. "I'm very pessimistic about prevention campaigns," he says. "I personally don't believe that prevention campaigns change behavior. Gay men talking to gay men can change behavior."

Crystal Meth Anonymous (CMA) started in California but has become a huge force in New York's gay community. The problem is that "the program" is designed to help those who have already done enough damage to realize that they are addicts and need help. Based on the principle of "attraction not promotion," it was never intended to be a prevention campaign.

Staley correctly identifies changing "community norms" as a first step in dealing with the immediate problem of crystal use. He hopes to make crystal use analogous to heroin use—something so extreme as to be unacceptable. This type of campaign is called "environmental prevention" and has been pioneered in the fight against alcoholism by organizations such as the Marin Institute in California. The organization's brochure explains: "Remember when smoking was allowed on airplanes? Today, the airline smoking ban not only reduces exposure to second-hand smoke but also promotes nonsmoking as a social norm.

This is an example of environmental prevention—change policies, settings, and community conditions to support healthy behavior and discourage high-risk, unhealthy behavior."

There are some problems with environmental prevention. First, if used in a simplistic way, it can lead to judgmental sexual repression that is anathema to gay culture. Second,the approach does not help those who have already entered into active addiction. So the question remains, how to create a healthier environment in the gay community.

Personally, I found that I began to make healthier sexual decisions when I connected to gay history with pride rather than shame. As a young man, my view of gay history was that the '70s were a time of self-indulgence that led directly to AIDS. Only during the research for my book, Beyond Shame, did I begin to understand that my history as a gay man was part of a larger continuum of revolutionary change that included civil rights and feminism. While history may not seem like a particularly easy sell, it can be presented in an entertaining way as an alternative to the generally superficial films, television, and literature now being produced for gay audiences.

The gay community already has organizations that do the hard work of bringing men of different generations together to form the rich connections that yield true pride rather than just visibility. In the past, the leather and alternative-sex scene made sure that older men mentored younger into the community. Many of these "elders" died, but there is no reason that mentoring could not exist again, in both sexual and nonsexual settings, to provide gay youth with aspirational examples of long and happy lives.

In a less sexual realm, churches such as the Metropolitan Community Church and Agape have created spaces where gay people can seek spiritual growth. Not as well-known but incredibly powerful movements include the Body Electric, where gay men learn to be less superficial in seeing sexual worth in one another. Coming out of the gay faerie movement, the Gay Men's Medicine Circle continues to create rituals that encourage spiritual growth. These organizations and their rituals may seem like quaint reminders of a more innocent time. However, they are vital models for the kind of programs that might actually change the tone of gay life in America.

Finally, it seems necessary to say something about the idea of gay marriage (and its presumed result, monogamy) as a solution for combating self-hatred. Gay marriage may indeed be a source of pride and healing for those who aspire to it. However, marriage alone has not solved the problems of straight people, so I see no reason to view it as a panacea for self-destructive behaviors in the gay community. Indeed, gay marriage may make things worse as it will lead us to believe the battle against homophobia has been won. It also carries the risk of creating a hierarchical gay community divided between those who choose monogamy and those who prefer other arrangements.

Our instinct is to deal with the immediate crisis, and we have little choice but to deal with crystal meth now that it has become so widespread. But let's remember that, ultimately, crystal addiction is just one symptom of a larger disorder. There will always be another drug. The solution, unfortunately, is not a better prevention campaign. It's an inside job. Let's make this our last crisis.

Patrick Moore is a writer and producer in Los Angeles. Kensington Press will publish his memoir of crystal meth addiction next year.