Question

Can we take recreational drugs when on HIV meds?

30 July 2010. Related: All topics, Drug interactions, Recreational drugs.

My partner and I are both on meds and once a month or so spend about 1-2 days taking recreational drugs – namely speed and less often ecstasy. During these ‘benders’ we are really careful to take our meds on time which is of course a priority for us, although during this time we don’t tend to sleep or eat. Are we putting ourselves at greater risk due to our status or are the risks similar to 2 negative people doing the same thing? Would really appreciate your feedback on this…..Cheers xx

Answer

Answer: Charlotte Walker

Thank you for your question.

To enable me to answer the question I would need to know the HIV treatments you were on as some treatments (mainly protease inhibitors and especially ritonavir)  interact with recreational drugs such as ‘ecstasy’ (MDMA). Ritonavir can dramatically increase the levels of recreational drugs.

In general, the risks of taking recreational drugs are similar to that of negative people. This will depend on other factors though including your age, general health and medical history. However, if your HIV treatments interact with the ecstasy the levels of ecstasy in your blood are greatly increased. This in turn will increase the risk associated with taking recreational drugs.

The information on drug interactions is limited because street drugs are not made of the same consistent ingredients and are usually mixed with other substances, some of which can be very toxic. Different people absorb and clear drugs (recreational or medicinal) at different rates. Starting with a low dose until you understand your reaction each time will help you stay in control.

This is also a reason to talk about this with your doctor, who knows more about your individual health. Your doctor will treat this information in confidence, but needs to know this information to advise you specifically.

If this is am important part of your life, then moderation is likely to be safer than ‘benders’.  If your viral load is undetectable and your adherence stays on time, and you remember to rest and eat well afterwards, then the impact is likely to be the same as for an HIV-negative person.

Further information on recreational drugs and HIV meds:

• Fact sheet from the Chelsea and Westminster Hospital (PDF format).
• Leaflet from HIV group in Australia (PDF format).
• Information from Introduction to combination therapy.