What you should know about using street drugs while on HIV treatment, Methadone Replacement Therapy or both

Using street drugs can cause additional stress on the body, making it harder to fight HIV. Sharing needles and syringes or having sex without a condom increases the risk of getting other infections, such as hepatitis and STIs, which can be harmful to health and complicate HIV treatment. Antiretroviral therapy (ART) or opportunistic infection (OI) medications can interact with street drugs in a harmful way, causing serious health problems and complications. These interactions can lead to increased side effects from ART, decreased effectiveness of ART, increased risk of harm from drugs, and strain on important organs like the liver and heart. Many street drugs can damage the liver, which is a serious problem for people with HIV. Heroin, for example, can decrease the levels of heroin in the body when mixed with some ARVs and OI drugs, potentially causing withdrawal. Methadone, a strong drug used for opioid replacement therapy, can interact with other medications, including ARVs and OI drugs, and can cause excessive sedation and respiratory depression. Medicines that reduce the effect of methadone and may cause withdrawal include anti-epileptic drugs, anti-retroviral drugs, anti-TB drugs, and cocaine. Medicines that increase the effect of methadone include anti-depressant drugs, drugs to treat stomach acidity, and anti-fungal drugs. Naltrexone and buprenorphine can block the effect of methadone in the brain and cause withdrawal. Drugs that interact with methadone to cause excessive sedation and may lead to respiratory depression include alcohol and benzodiazepines. Methadone can also increase the dose of AZT in the blood and cause bad side effects. Sedatives like Valium can interact with some ARVs and OI drugs, resulting in an increase in their sedative effect and possible overdose. Anabolic steroids can cause serious liver problems when taken with ARVs and OI drugs, especially in people with HIV. Mixing ecstasy and some ARVs/OI drugs can increase ecstasy levels to dangerously high levels, and some people on ARVs have died from taking ecstasy. Mixing amphetamines and some ARVs can also increase amphetamine levels to dangerously high levels and put a great strain on the body. Chronic alcohol use can lower levels of many ARVs and damage internal organs.