Fawcett Chairs SunServe Conference on HIV/AIDS and Seniors

Individuals over the age of 50 represent half of all people living with HIV and they face challenges from both aging and HIV. On Friday, March 31st Dr. Fawcett attended and presented at the 2017 HIV/AIDS Seniors Conference sponsored by SunServe and AIDS United. Serving as conference chair, he assembled a panel of nationally known experts to address issues unique to this population. For example, even if the person is virally repressed, accelerated aging occurs which can lead to cardiological, liver and kidney issues, as well as bone problems. In addition, there are very few resources for psychosocial support of people who are aging with HIV and AIDS.

The conference was open to anyone who self-identified as a senior. While it is easy to assume seniors with HIV are long-term survivors, this is not always the case since seniors represent a significant group of new cases of HIV. The conference consisted of two tracks, one for professionals and one track for the community. Dr. Fawcett opened the conference and participated in panels for care of “body, mind and spirit” as well as a closing panel. That workshop, “The Next Frontier: Building a Collaborative Community of Care” consisted of Fawcett, and other panel members including Mark King, Nelson Vergel, and Bruce Richman. King is an author, HIV/AIDS advocate, long-term survivors of HIV, and two-time GLAAD Media Award nominee for his blog, My Fabulous Disease. King believes his diagnosis is not a tragedy but something to embrace and utilize to make change. Vergel is also a long-term survivor of HIV and the author of two books, Built to Survive and Testosterone: A Man’s Guide. Vergel believes in using testosterone and hormone replacement therapies to prevent AIDS wasting and extending life. Bruce Richman has been living with HIV since 2003 and is the cofounder of Prevention Access Campaign. Richman’s mission is to end the dual epidemics of HIV and HIV-related stigma. Prevention Access Campaign’s message of U=U (Undetectable = Untransmittable) is about getting the word out that people living with HIV on effective treatment cannot transmit HIV, and that there is no shame in being HIV positive.

Over 100 people attended the conference, which was held at the Center for Spiritual Living in Oakland Park, Florida. Conference attendee Dr. Alicia Bosley, staff therapist at SunServe who works with newly diagnosed HIV-positive clients as well as long-term HIV survivors stated, “What a wonderful conference! I was able to connect with professionals in the area and learn new things to apply to my practice with people living with HIV. I was impressed by the insight and clinical knowledge of Dr. Fawcett and the humorous but inspirational anecdotes of Mark King.” The HIV/AIDS and Seniors conference is just the beginning of more conferences like this in the future.

“Lust, Men, Meth” event is standing-room only in Seattle


On February 9, Dr. David Fawcett presented a reading and discussion on reclaiming sex and intimacy after methamphetamine based on his book “Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery” in Seattle.  The event was a held in collaboration with Gay City and was moderated by local Seattle therapist Peter Jabin, M. Div, LMHCA.  Following a 45 minute presentation based on critical information about recovery from the book, Dr. Fawcett led a lively discussion and answered questions from attendees about meth use in the gay community. Over 50 people were in attendance, filling the Calamus Auditorium to standing-room only. The number of participants is an indicator of the intensity of the meth epidemic among gay men nationwide, as well as the need for solutions.  To order a copy of “Lust, Men, and Meth,” or to learn more about the book and Dr. Fawcett’s upcoming appearances, visit david-fawcett.com.

2016 Personal Transformation Intensive Announced

Kris Drumm and David Fawcett have announced their 2016 Personal Transformation Intensive (PTI).  This experiential workshop provides an accepting and supportive environment for the challenge of profound personal growth. The PTI takes place over five weekends—one weekend per month for five months.  Groups start Friday at 6pm and end Sunday around 6pm.

The Personal Transformation Intensive process is designed to break through barriers and accelerate personal growth exponentially. During each weekend participants move beyond traditional cognitive therapy to deeper levels of mind-body awareness.  Modalities include meditation, hypnotherapy, psychodrama, and breathwork. Group size is limited to 10 people, providing a safe space for therapeutic work. The PTI facilitates the release of stored emotions and integrates healing into healthy change and new behaviors.

Space is limited. The first weekend is February 19-21, 2016. For more information contact David at or Kris at .

David ohmKris

Fawcett Presents Book Reading and Workshop in New York

On December 13, 2015 Dr. Fawcett presented a reading and discussion called “After Meth: Rebuilding Your Life, Intimacy and Sex” to a packed house at the Bureau of General Services Queer Division at the LGBTQ Center in New York.  Based on his book “Lust, Men, and Meth: A Gay Man’s Guide to Sex and Recovery,” Fawcett outlined key points about the physiological and psychological impact of methamphetamine as well as critical skills and tools to promote recovery and healing. After his presentation and reading, Dr. Fawcett had a lively question and answer session with the attendees followed by a reception.


Portions of the workshop are available on video:

“Why I Wrote this Book”

“After Meth Part 1”

“After Meth Part 2”

Dr. Fawcett Receives Prestigious Award

On September 26 David was honored to receive the 2015 Koch Professional of the Year award in recognition of his service to the recovering community. This award was presented in recognition of Broward National Alcohol and Drug Addiction Recovery Month celebrations.

Fawcett accepting this prestigious award.

Fawcett accepting this prestigious award.


Thebody small (4)

This article was originally posted on TheBody.com on David's blog "Riding the Tiger: Life Lessons from an HIV-positive Therapist"

    Public apprehension about recreational drugs, especially those that impact HIV, seems to come in waves that swell with increasing alarm and then peak and fade away, always to be replaced by the next "drug du jour."  Heroin, cocaine, and methamphetamine, each with a well-deserved reputation for putting people at risk for HIV or, if HIV positive, for interfering with their ability to properly manage their health, have all gained notoriety in recent years.   

    While the popularity of various illegal substances rises and falls, alcohol consistently remains the granddaddy of recreational drugs.  New forms of alcoholic drinks began appearing in the 1980s, first with wine coolers and then flavored alcoholic beverages (that's FAB, for short) and energy drinks.  They have gained popularity, especially among youth.    Now, just months after the FDA urged the removal of caffeine from alcoholic drinks such as 4Loko, beverage companies are once again shape-shifting their fruity-tasting concoctions and they're literally bigger than ever: they've been supersized.  The new packaging, still largely targeting young (and often underage) drinkers, features a 23.5 ounce can with a 12% alcohol content.  That's equivalent to four or five beers.   They're cheap, accessible, and highly potent.

    Why is this a concern?  The numbers tell the story.  10.7 million underage youth drink alcohol, and about 70% of those youth binge drink, resulting in harmful physical consequences, poor judgment, lower inhibitions, and an abundance of high risk sexual behaviors.  And the concerns extend beyond youth.  Excessive consumption of alcohol is a significant health concern for everyone, but especially for those at higher risk for, or living with HIV.

    Some speculate that if alcohol were introduced today it would never be legalized.  It is, of course, here to stay.  Because it is so easily available, socially acceptable, relatively cheap, and widespread, it's easy to forget  its risks, which are really worth a second look.   It's not fair, however, to demonize alcohol.  There is little evidence that moderate drinking (described in most literature as one drink per day) impacts persons living with HIV.   Excessive drinking, however, can be destructive for persons living with HIV for a number of reasons.  Here are a few:

Excessive Alcohol Weakens the Immune System

    The physical toll of too much alcohol is expressed in a number of ways.   It taxes the liver, which is already working overtime metabolizing medications.  This situation is made even worse, of course, when someone is also dealing with Hepatitis.  Alcohol also interferes with the body's ability to create white blood cells and is disruptive to other factors necessary for health such as hydration, nutrition, motivation for exercise, and sleep. 

Interactions with medications

    As noted above, alcohol can affect the absorption of medications necessary to fight the virus.  This can result in reduced efficacy, more unanticipated reactions, and alteration of the effects of some drugs.  Alcohol  also results in medication adherence problems due to altered states and inconsistent behavior.

Risky activities

    Speaking of inconsistent behavior, alcohol impacts  reflexes, inhibition, and judgment, which can clearly compromise the health and wellness of the drinker.  This can lead to poor sexual choices and a loss of motivation for safer sex.  Despite that fact that alcohol impairs physiological sexually functioning, people under the influence can still engage in enough risky sex to get them in trouble!


    Alcohol is a central nervous system depressant which directly affects mood.  It can be misused to numb feelings of sadness, anger, and fear, and can quickly become a crutch on which people depend to avoid uncomfortable emotions.  Persons living with HIV are at greater risk for addictions of all kinds, and it is incumbent on anyone who is HIV positive to be vigilant about their alcohol consumption. 

"I'm recovering from drugs and alcohol isn't my problem!"

    I have patients in recovery from amphetamines who question why they need to abstain from alcohol.  Many proclaim their dislike of an alcohol high: slow and sluggish. They prefer the perceived clarity of amphetamines and see no reason why they can't indulge in a beer or glass of wine with their friends.  After all, they say, alcohol isn't the problem, it's meth (or cocaine).  Unfortunately many discover that a few beers in the bar with friends reduces their ability to resist the impulse to use their drug of choice (such as cocaine and meth) and their resilience and sometimes their recovery crumbles after a few drinks.

    Despite the numerous risks, excessive alcohol consumption remains a common problem that requires routine monitoring.  Most people won't volunteer this information unless specifically asked, and even then their responses may be less reliable until a level of trust is established.  There are quick screening tools for alcohol such as the MAST (Michigan Alcohol Screening Test) that are effective and easy to administer.  Of course it is dangerous for a heavy drinker to just stop using alcohol, but with proper medical supervision there is no reason for excessive drinking to jeopardize anyone's health.


Thebody small (4)

This article was originally posted on TheBody.com on David's blog "Riding the Tiger: Life Lessons from an HIV-positive Therapist"

    Even the bed sheet touching my skin was intolerable.  The sharp pain was centered in my toes and had kept me sleepless for three nights in a row.  It was the worst neuropathy I had ever experienced and I was near despair.  My only relief was to lower my feet and sit up in a chair trying to sleep.  That was my situation last year when, for some unknown reason, my neuropathic pain suddenly escalated.  Over the years I had been relatively lucky.  I had become accustomed to numb and tingly feet but I had rarely experienced such severe discomfort.  Only on one other occasion, when I broke a toe, had the nerves in my feet rebelled with excruciating stinging which had lasted for months. 

    I am still uncertain what caused the severe flare up last year, but at that time I needed pain medication.  My physician prescribed it until the pain receded.  The medications blunted the discomfort but hardly stopped it, and had the undesirable effect of making me feel muddled and out of sorts.  I tried other things as well, such as lidocaine patches, but they proved no match for my raging nerves.  Thankfully, after several weeks, the pain faded as quickly as it came.  I was relieved yet unnerved by the severity of the discomfort and the mixed blessing of the pain medications. 

    I share this experience to convey that I understand the disabling effects of severe pain and our complicated relationship with the medications that control it.   We may need these drugs at times, but they can quickly and all too easily create other significant problems.  There is a constant temptation to use them, as well as recreational drugs, to self-medicate both our physical and emotional discomfort. 

    While I choose not to use mood altering substances in my own life, I am no hero when there is a medical condition causing disabling pain.  I have had patients who were in recovery from substance abuse and who had a particularly difficult time wrestling with the issue of prescribed pain medications.  I totally respect the desire to remain clean from mood altering substances, indeed, much of my work is toward that end.  But suffering extreme pain is not healthy for our bodies or our emotions; living in pain is not heroic.  Anyone in this situation needs to find a manageable balance between controlling their discomfort and avoiding the potential damage that these medications can inflict.  

    This isn't a decision that should be made in isolation.  The experience of pain is subjective and it is extremely easy to drift into self-delusion about the need for these medications.  They can quickly become the focus of nearly every waking moment: making sure there is a supply, obsessing about the next dose, and becoming exquisitely sensitive to anticipation anxiety that the pain will worsen or return.  Psychology begins to impact our decisions as much as physiological processes themselves.

    So what is someone living with HIV and experiencing significant pain supposed to do?  My recommendation is to be as informed as possible and work with your physician, and possibly a pain management specialist, to control the pain in the safest possible way. 

    It has been my experience that some physicians treating HIV dispense potentially problem-causing medications such as opiates (hydrocodone, oxycodone) and benzodiazepines (Valium, Xanax) entirely too freely.  I see the results in my office when my patients add addiction to their existing problems.   In south Florida many HIV docs are now referring all such cases to pain management specialists.  This has mixed results: they often offer a better range of pain control options but the patient has yet another specialist to include in their already crowded calendar of medical appointments.  

    If one is referred to such a specialist it is extremely important to inquire about their credentials, which should include a board certification.   There are many pain clinics that operate simply as pill mills feeding a large supply of opiates that end up in the hands of addicts.   The city where I live (Fort Lauderdale) has the sad reputation of being the capital of such pill mills with visitors coming from as far away as Ohio to get pain meds in bulk.  Fortunately, recent joint efforts by law enforcement and the medical community have resulted in a great reduction of such clinics.

    Besides working closely with their physician (and perhaps a pain specialist) there are some other things people need to know about pain meds and the risks of self-medication.  Here are a few:

Potential for Addiction

    "A doctor prescribed it!"  It is the responsibility of every patient to take an active role in making medical decisions.  As I noted above, some docs are all too happy to overprescribe.  Others succumb to the pleas (and yes, sometimes manipulation) of their patients demanding pain meds.  Whether prescribed or obtained on the street, opiates have a high potential for addiction.  For that reason, their merits need to be carefully balanced with their consequences.

    Across the country we are seeing a vast increase in the amount of prescribed opiates and a cross-over effect to heroin.  Many people who have become physiologically addicted move to heroin when doctors refuse to renew their prescriptions.  In other cases, prescription drugs, which are considered "safer" than street drugs, are sometimes illegally obtained for pain relief as well as for recreational use.  All of this increased used of opiates has resulted in a dramatic rise in the amount of  hospital admissions and in the stunning fact that, in the US, prescription drugs now account for more overdose deaths than street drugs.

Drug Interactions

    Some opiates, particularly methadone, interact with HIV medications in powerful ways.  Because both are processed by the same metabolic system in the liver (CYP-450), some antiretrovirals can cause a significant reduction in blood levels of drugs such as methadone.  This can actually precipitate withdrawal symptoms long before another scheduled dose.  In one study Efavirenz (Sustiva) created the need for a 50% increase of methadone to prevent withdrawal.  In another, Norvir reduced heroin levels by as much as 50%, increasing the likelihood for overdose.  Kaletra can also cause methadone levels to become subtherapeutic.  On the other hand, the levels of some HIV drugs, such as didanosine and stavudine, were significantly reduced when used with methadone.  Such a reduction can lead to drug resistance.  Alternatives to methadone, such as Suboxone, appear to have less interactive potential with HIV medications.  Ultimately it is essential to be honest with your physician about all the drugs you are taking – both prescription and recreational – even if they're for purposes of self-medication.  It could save your life. 

What about marijuana?

    The medical use of marijuana is a major topic of discussion in nearly every community in the United States.  Research shows that THC compounds do have a therapeutic effect for both pain management and for mitigation of other symptoms and side-effects.  The down side is that sustained use of marijuana can create psychological dependence and marijuana smoke contains more toxins than cigarette smoke.  Additionally, the dosage of THC ingested by smoking marijuana is inconsistent.  Speak with your physician about the possibility of synthetic THC which addresses some of these issues.

What about emotional pain?

    Living with HIV is a difficult experience that creates abundant opportunities for anxiety, depression, hopelessness, and numerous other negative emotions.  It is tempting to numb these feelings with the use of mood-altering drugs, both prescribed and recreational.  Unfortunately this only compounds the problems by driving uncomfortable feelings not to resolution but underground, impacting overall mental and physical health, and often adding addiction to the mix.

     I believe that everyone living with AIDS requires not only antiretroviral medications to remain healthy but daily emotional care as well.  This can take the form of meditation, relaxation, connecting with others, quiet time to soothe nerves, recreation to shift attention, and an endless list of other activities that restore our balance.  When we experience excessive physical pain we should consult with our medical providers to select the best course.  At other times, investing in healthy alternatives is the best form of self medication.

David Fawcett Receives Who’s Who in Florida Prevention Award

David Fawcett PhD, LCSW, has been honored with the "Who's Who in Florida Prevention Award" in recognition of his leadership in both substance abuse and HIV/AIDS prevention.   The Florida Office of Drug Control named individuals recognized for their leadership at the annual statewide Prevention in Florida Conference in Orlando in early October.  This award acknowledges the accomplishments and dedication of individuals and groups within Florida’s prevention community.  Dr. Fawcett's nomination specifically recognized a decade of leadership working to strengthen individuals and families, especially within the LGBT community.

Dr. Fawcett has worked on a number of community projects, including serving as Chair of the South Florida Methamphetamine Task Force, which fostered community partnerships to address the methamphetamine crisis through training of professionals and creation of an infrastructure for prevention and treatment.  He was a founder of Meth and Men South Florida, a program of Sunserve, which continues to provide sliding-scale individual and group therapy for substance abuse within the LGBT community.  He also serves on the Board of Governors of the Broward County Commission on Substance Abuse; the Clinical Advisory Board of Sunserve; and recently was Program Co-Chair of the 2010 National Gay Men's Health Summit, a five-day event that drew nearly 500 people from around the nation to address concerns related to the health and wellness of gay men. 

Dr. Fawcett frequently makes presentations on topics of HIV and substance abuse both locally and nationally, most recently at the US Conference on AIDS.  He has been in private practice and created and now facilitates the "Connections" group for gay men at Fusion, a drop-in center funded by the Broward County Health Department.  The weekly "Connections" group is open to all and provides a rare opportunity for gay men to discuss a variety of topics, including body image, self-esteem, intimacy, relationship skills, stress reduction, and many more.  

Living Longer by Living With Purpose

    Purpose Some years ago a friend of mine sold his successful veterinary practice in the midwest, bought a van, and headed to California to pursue his lifelong dream of writing music.  People no doubt thought he had lost his mind, or at least regressed from being a responsible adult to a frivolous adolescent searching for himself.   Years later, he has had some success with his music, but most of all, he has experienced the thrilling notion that he followed his heart.

    Not all of us, of course, have the opportunity to drop out of our lives and begin anew, but we all certainly have the chance to discover what gives our life meaning and follow it to our best ability.  The daily satisfaction is enormous, and so are the health benefits.  A study at Rush University Medical Center in Chicago found that people who followed their life’s purpose were only about half as likely to die over the follow-up period as compared to people who expressed less sense of purpose.   These findings have been replicated in other studies: following your dreams is a protective factor for your health.

For many of us, identifying our personal mission, goals, and objectives is not an easy task.  There are many helpful resources, one of which is Martha Beck’s Finding Your Own North Star.  She outlines several steps that are useful in identifying and following through on living your dreams.

    The first step is articulating what is important to you.  Many experts recommend sitting down without distraction and writing freely about questions such as what makes you smile; what activities cause you to lose track of time; what do people ask you for help with; or what would you regret not fully doing, being, or having in your life.    It will take time and numerous lists before a convergence of themes appears, but it will.  These are your core desires.

    Once you have a notion of your own purpose, it’s important to compare it to how you live your life.   Many of us have unconscious beliefs about ourselves that hold us back – these need to be identified and repaired.  For example, a client of mine had a childhood learning disability that affected his performance in school   He not only had trouble studying, he also believed (and was told) that he wasn’t as smart as others and would never be able to succeed in school.   As an adult he wanted to become a nurse, which required college courses in biology and chemistry.  He took a chance and enrolled, asked for help where he needed it to overcome his learning problems and develop good study habits, and became an “A” student.  He realized his core belief about his intelligence and learning was wrong.

    A second critical step is to compare what life offers you with your own mission and objectives.  The opportunities we accept must align with our goals.  Without the guidance of our life’s purpose in making choices about which to pursue and which to let go, we can become frustrated, disillusioned, or simply burn out. 

    With practice it becomes increasingly easy to know when we our activities resonate with our life’s purpose.  Nurturing our intuition can be a corrective force when we temporarily get off track from the real source of satisfaction and health: cultivating and living our dreams.

David Fawcett, PhD, LCSW

This article first appeared in Out in the News, Volume 3, Issue
21 (April-May 2010), a publication of the Broward County Health
Department, S-Men Campaign for a Safer, Healthier Community.

Crystal Meth Intervention: the Spoof (NSFW)

For anyone who has ever seen the show Intervention on cable and who is familiar with crystal meth, this is hysterical.