Street drugs and HIV medications
If you’re living with HIV and are on combination therapy, you already have constant levels of prescription drugs in your system. Adding street drugs to this carries risks. Because your body is processing your HIV meds it can’t process street drugs as easily as a person who is not on HIV meds. As your liver tries to deal with both your HIV drugs and any chems you’ve taken, there can be a build up of street drugs.
Imagine a road of traffic trying to join a road that’s already busy – traffic has to slow down and a jam can start to build. This is like what happens as street drugs reach a liver that’s already dealing with HIV meds. It can cause higher levels of street drugs in someone’s system, which, if unlucky, can reach overdose levels. This has killed a few people.
Which combos are riskiest?
The risk is biggest when the body, in particular the liver, uses the same processes to deal with a street drug that it uses to handle an HIV med. For example, the liver uses the same processes to deal with many street drugs as it does to handles protease inhibitors such as Ritonavir, Kaletra and Darunavir. On the other hand, the body deals with cocaine and HIV drugs using different processes, which is why there are no dangerous interactions between the two.
Here are the most common and potentially dangerous interactions.
| Drug combinations | Possible interactions |
|---|---|
| Protease inhibitors + acid, ecstasy, GHB, GBL, ketamine, crystal meth, speed, Viagra and other erection drugs | Taking these drugs at the same time as protease inhibitors (especially Ritonavir) can raise levels of the street drug to dangerous levels. The most serious problems are thought to happen with Ecstasy and GHB. |
| Efavirenz (Sustiva) + acid, ecstasy, GBH, GBL, ketamine | It’s possible that taking these drugs at the same time as Efavirenz (Sustiva) may raise levels of the street drug in the body. |
| Protease inhibitors + anabolic steroids | This combination may raise levels of steroids in the body, increasing the risk of side- effects. Steroids and protease inhibitors can both raise cholesterol levels. |
| Cannabis + protease inhibitors | It’s possible that taking cannabis at the same time as protease inhibitors may raise levels of cannabis in the body. On the other hand, when taken with Efavirenz (Sustiva) or Nevirapine (Viramune) cannabis levels may be lower. |
| Protease inhibitors + Viagra and poppers | Taking Viagra and protease inhibitors can raise the levels of Viagra. It’s recommended to have only a half dose of the erection drug. Taking poppers, Viagra and protease inhibitors together can mean a dangerous drop in blood pressure. |
| Alcohol, cocaine and crack | No known dangerous interactions with anti-HIV drugs, although excessive alcohol drinking can affect levels of HIV drugs in the body. |
Taking things easy
The risk of an interaction could be higher when someone has just started to take HIV medication. In the weeks and months after starting treatment your body is getting used to processing your medicine, so adding a street drug at this time could have added risks. Some people advise caution by either avoiding street drugs or starting off with lower amounts in the weeks and months after starting combination therapy.
Of course, another danger of taking drugs when you’re on HIV medication is you forget to take the HIV meds the right time – or at all.
If you are planning to take recreational drugs it’s always advisable to check whether it is safe with your HIV doctor. They should be used to dealing with questions about illegal drugs, but if you feel you can’t talk to your doctor, there’s also the i-Base helpline:
i-Base
Phone: 0808 800 6013, Mon-Wed 12-4pm.
To find out how your HIV medication might interact with recreational drugs, visit the Disco.
This article was last reviewed on: 28/10/11
Date due for next review: 28/10/13
