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Drugs and HIV

As most drugs are illegal substances, little research has been done as to the interaction between drugs and anti-HIV substances. Research is extra difficult as the quality of cocaine, ketamine or speed is inconsistent because of added adulterants. Nowadays we know from experience that some anti-HIV substances and drugs increase or decrease the separate effects. This may be dangerous as it may influence the level of the daily dose of HIV medication. This may result in nasty side-effects or becoming resistant to medication. Especially protease treatments may enhance the effects of some drugs which increases the risk of overdose. Check if you get protease treatment. Nowadays other mixed treatments are possible. After all, the effects of taking drugs are that your sense of time may be different. You may forget to take your medication or take it too late. Stay adherent even when under the influence of drugs.

A list of known side-effects:

Alcohol. The use of alcohol increases the risk of pancreatitis and neuropathy. The same applies to the mix with anti-HIV drugs like ddl (didadosine) and d4T (stavodine) which is even more dangerous. Alcohol will increase the abacavir level in the blood. This effect appears to be relatively mild with small doses of alcohol.

Benzos. Many ant-HIV drugs increase the effects of benzos. Especially the mix with protease inhibitors enhance the effects of muscle relaxation, drowsiness and sleepiness. This effect is very strong with ritonavir.

Cannabis. Up till now the interaction between cannabis and anti-HIV drugs has not been proven. There are indications that the degradation of THC – the main active substance of cannabis- decreases when you use protease inhibitors. In this way the effect of cannabis is enhanced and you will be more sensitive to being stoned and suffer anxiety and panic attacks.

Cocaine. Various small-scale surveys show that there is little interaction between cocaine and anti-HIV drugs, though daily use of coke weakens the immune system. The development of the HIV-virus increases.

Crystal meth. American surveys show regular use of crystal meth weakens the immune system and enhances the development of the virus. Recovery from HIV-related complaints will not be as fast and the benefit from HIV treatment will not be as positive. Take good care when you take protease inhibitors. These increase the risk of a meth overdose. The adverse applies to efavirenz and nevirapine. Crystal will be degraded faster when you take this mix.

Erection pills. When you use protease inhibitors the level of active substances of erection pills may be higher than usual. The risk of side effects such as splitting head aches and a sharp lowering of the blood pressure, may be increased. We advise you not to take more than half the dose (25 milligrams) maximum once every 48 hours.

GHB. Ritonavir and other strong protease inhibitors (cobicistat) probably increase the GHB level in the blood. The effects of the drug are more intense and the risk of an overdose increases. GBL use is even more dangerous as the concentration of the drug is higher and it is more difficult to dose.

Heroin. Some anti-HIV drugs increase the degradation of the heroin. The drug effects will wear off faster, you will feel dope sick sooner and the result may be that you will take another dose of brown.

Ketamine. Frequent use of Ketamine may counteract the effects of some anti-HIV drugs. Protease inhibitors like ritonavir or NNRTIs raise the level of Ketamine in the blood as the drug takes longer to wear off. This mix increases the effect of ketamine and the risks of unwanted side-effects (K-hole).

LSD. Protease inhibitors may slow down the degradation of LSD. Always take a lower dose of LSD to prevent a trip that is too intense. As LSD takes a long time to wear off (eight to twelve hours) adherence to treatments is low.

Poppers. The mix of poppers and erection pills may cause a dangerous decrease of the blood pressure. Avoid this mix when you use protease inhibitors, as it lowers the blood pressure even more.

Speed. Ritonavir increases as it were the amphetamine level. Avoid speed when you use a mix of protease inhibitors, e.g. ritonavir. The degradation of speed will slow down and the risk of an overdose will increase. Frequent use of speed may cause weight loss and malnutrition. The body will have more trouble suppressing the HIV virus.

Ecstasy. Especially the mix of ecstasy and ritonavir is risky. This protease inhibitor slows down the degradation of ecstasy, which causes the concentration to increase to twice or three times as high. This increases the risk of an overdose. Ecstasy slows down the absorbation of HIV treatment in the body, which increases the risk of negative side-effects.

Safe(r) use

  • Be open and honest about your (measure of) drugs use when visiting the internist or HIV consultant.
  • When you start with your HIV treatment, move on to a different combination of medicines or change the dosage of ant-HIV medicines, restrict the use of other drugs the first two weeks. In this way your body can get used to the (new) HIV treatment. If you have side effects in the beginning, you will know this is because of the anti-HIV treatment and not because of the mix with other drugs.
  • Are you on anti-HIV medication and do you want to take drugs, always start with a low dose.
  • Drugs will influence your sense of time and this may cause you to forget your medication or forget to take it in time. Your therapy compliance should not be affected, even if drugged.
  • Some drugs suppress the appetite, which is not convenient when having to take anti-HIV drugs with a meal.
  • You can have the concentration in your blood tested of almost any anti-HIV treatment, even if you use other drugs. They test the active substances of an anti-HIV drug in the blood. The correct dose of anti-HIV drugs can be determined in this way. If the concentration in your blood is too high, you risk side effects. If the concentration is too low, the treatment may be less effective.

Links for drug users

  • apexx.nl: Young people’s experiences with drug use and sex.
  • bluelight.org: Comprehensive Australian information and forum about drugs, drug mixes and possible risks.
  • drugsinfoteam.nl: Extensive question and answer site about drug use, effects and risks.
  • drugsforum.nl: Online discussion forum for users containing questions, experiences and tips.
  • drugs-test.nl: National list of  drugs test centres for a free and anonymous drugs test.
  • jellinek.nl: Information on drugs, effects and addiction.
  • mantotman.nl: Informative website about sex and health for homosexual and bi-sexual men. Also about drug use effects on sex.
  • trimbos.nl: Information on drugs also by telephone.
  • tweaker.org: Neutral American information and forum site about crystal meth.
  • unitydrugs.nl: Extensive information about kinds of drugs, effects and possible risks.

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"Before I start working and using I always eat something. That way I have more energy and I can my focus."