hiv meds

HIV Meds and Party Drugs

Before thinking about the relationship between HIV meds and party drugs, some of you will probably need a crash course in how HIV makes its living in the human body. The virus cannot reproduce by itself-it needs a host cell to do this. The virus begins its reproductive process by binding to a cell in the body. It has a particular affinity for T4-cells-part of the body's immune system. When binding occurs, the virus fuses to the cell's outer wall, opens a hole in the cell, and releases its own contents into the host cell. These contents-enzymes and something called RNA-trick the healthy cell into producing more copies of the virus. Effectively, the virus hijacks a healthy cell's reproduction facilities to produce more copies of the virus. Part of a cells reproduction process involves the production of proteins and enzymes-think of the proteins as the building blocks of cells and enzymes as the tools used in this building process (enzymes help break molecules down into smaller pieces). One of these enzymes is protease, which acts as a kind of scissors used in cutting protein molecules into the different shapes needed to build various parts of the cell's structure. In a cell infected with HIV, the healthy cell is tricked into using protease to produce new HIV viruses rather than new versions of the healthy cell or material the health cell might need to sustain itself. Protease inhibitors block the production of this enzyme-in effect, damaging one of the tools needed to produce more viral cells (www.aidsmeds.com; www.tthhivclinic.comm). In effect, without one of the stolen tools necessary to reproduce itself, the virus is kept in check.

When it comes to HIV meds-particulalarly protease inhibitors-and party drugs, the thing to be concerned about is metabolism. Metabolism is the body's mechanism for processing anything you put in your body-food, drink, prescription, and recreational drugs. The liver plays a central role in the metabolism process-although there are other metabolic pathways. There are two things to think about here: The first is that as a drug makes its way through your body, your metabolic system gradually reduces the drugs potency by transforming it into other chemicals that are eventually excreted through respiration or digestion. There are cases, however, where your metabolism can actually increase the effect-and the toxicity-of a drug. This is particularly the case when there is more than one drug in your body at the same time. In cases where there are multiple drugs in your body, your metabolic system is so busy looking after one drug that it neglects to look after the second drug. If you are on protease inhibitors, you have at least two drugs in your body at the same time. This could cause changes in either of the drug's effects-and it is difficult to predict which drug will become stronger or weaker. If you are on HIV meds, err on the side of caution: take less of the recreational drug.

The second thing to keep in mind is that much of your metabolic system depends on various enzymes to do the work of breaking down drug molecules-remember enzymes are a kind of tool used to break chemicals down into their constituent parts. Protease inhibitors suppress the production of the same enzymes that your body uses to metabolize ecstasy and crystal (Harrington et al. 1999). What this means is that if you are taking HIV medication-particularly protease inhibitors-your body has fewer of the chemicals (the enzymes) it needs to break down any recreational drug you might have taken. In practical terms, you may increase the potency and toxicity-"elevated levels and an enhanced effect"-of your party drugs to dangerous levels (Harrington et al. 1999: 2223). There have been a few deaths and overdoses attributed to the combination of protease inhibitors and party drugs-particularly ecstasy (Henry and Hill 1998). Protease inhibitors will also affect pot, special K, GHB, Viagra, and benzodiazapines (sedatives like Valium and anything with a generic name that ends with "-pam") in the same manner. Ask your physician about this stuff if you feel comfortable doing so. If you don't feel comfortable talking to your physician about this, have a look at the following chart (link here) and the following link (www.ashm.org.au) for more detailed information.

The short of it is that while on HIV meds, the potency of recreational drugs has a very real potential to increase-you may end up getting high faster and longer than while not on HIV medication. If you are going to consume drugs while on HIV meds, consider reducing the dose of your recreational drugs-particularly if you are on HIV meds for the first time, or returning to your HIV meds after a drug holiday. We do not recommend skipping or reducing your HIV meds. If you think you might need to be tested for HIV we recommend STDAware.com for STD testing.

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