The information presented is intended for educational purposes only. BCPWA neither endorses nor encourages use of the drug(s) described. It should not be regarded in any way as a substitute for medical advice from a qualified physician who is familiar with all the details of your situation.

Alcohol
Occasional and light use of alcohol is not known to interact with HIV medications, with one notable exception: using Videx^® (ddI) can increase the risk of pancreatitis (intense stomach pain that feels like it’s going all the way to your back). So, if you’re using alcohol regularly don’t use Videx.^® Choose an alternative HIV medication. On the other hand, chronic, heavy alcohol use can be destructive to the liver, which can be especially problematic for people co-infected with hepatitis C. Studies have shown that excessive alcohol consumption greatly increases the risk of hepatitis C progression, which may lead to liver death.

Cocaine/Crack
Little is known about coke’s interaction with HIV medications—no studies exist. But if you have HIV, smoking, shooting, or even snorting cocaine is no party for your immune system. In one test-tube study, coke made HIV reproduce 20 times faster than normal.

Ecstasy (X, MDMA)
Little information is available regarding the interaction of X and HIV medications, though evidence exists that X and protease inhibitors may cause potentially deadly interactions. For example, in England a man on the protease inhibitor Ritonavir recently collapsed and died with the equivalent of 22 hits of X in his body. Researchers at Ritonavir’s manufacturer, Abbot, acknowledged the theoretical possibility that interactions between their drug and ecstasy could boost X levels by "as high as five to ten fold."
To reduce the effects of ecstasy, divide the dose. Take one-quarter or one-half tablet and wait to see how you feel. Since X is often cut with ketamine, speed, ephedrine or even caffeine, which mimic MDMA’s effects, factor in these risks. Crixivan users—guzzle water the day after to lower the chance of kidney stones.

GBH
Combining GBH, aka Grievous Bodily Harm, with HIV medications is another unknown. Like many party drugs, GBH may suppress the immune system. Minimize the potential impact of GBH by starting with a teaspoon and giving it half an hour to work before taking more. Avoid mixing with alcohol.

Heroin
From what little is known, it appears that some HIV medications may cause the body to metabolize heroin more quickly. Other evidence suggests that Ritonavir lowers heroin levels in the body. Persons taking heroin while taking HIV medications report less of a hit, less buzz, and greater withdrawal symptoms.

K
Little is known about long-term K use or how K interacts with HIV or HIV medications. The available evidence suggests that combining K with HIV medications leads to increased sedation, disorientation and hallucinations, with the effects lasting longer. To minimize the impact, try taking only one-third to one-half of the usual dose. Wait for effect. Only re-K if you feel OK.

Marijuana
HIV medications may increase THC levels (the active ingredient in marijuana), so smaller doses may make you more stoned. This is also true of the synthetic version (Marinol^®) used in the treatment of weight loss by stimulating appetite. Since THC overdose is impossible, this interaction is not dangerous.

Poppers
Poppers get their name from the days when the drug came in small glass tubes that made a popping noise when you broke them open and inhaled the released fumes. While the evidence is pretty sparse, a small study found that using poppers even once or twice a week can suppress or weaken your immune system for days afterward. If you have HIV, poppers may be even more dangerous for you. People report that using poppers during sex made them less conscious of pain, which may be an important signal to stop risky behaviour.

Sedatives
The sedatives Halcion^® (triazolam), Valium^® (diazepam), Ambiem^® (zolpiderm) and Versed^® (midazolam) can also be deadly if mixed with HIV medications. Norvir^® has the most severely negative effect. At high doses these drugs can stop your breathing. Ativan^® (lorazepam), Serax^® (oxazepam) and Restoril^® (temazepam) are safer with Norvir^® and may actually be weakened by it. If you are going to use sedatives in combination with HIV medicaations, reduce your usual dose and observe effects.

Speed/Methadrone (Meth)
Studies report a 2- to 3-fold build-up of methadrone in the blood of persons taking HIV medications. Other observed effects include increased anxiety, manic behaviour, shortness of breath, racing heart beat, and dehydration.

For More Information...
Always consult with a medical professional about the impact of any other drug(s) while taking HIV medications. You may also wish to talk with other users about what they do. Remember that medical science knows very little about the ramifications of street drugs on the human body, and what little research has been done more than likely used "pure" forms of drugs that may not reflect what is actually available on the street. Additional information can be gleaned from the sources listed below. They can be found on the Internet or at the PARC library, 1107 Seymour Street, Vancouver, BC.

References
Anti-HIV Medications + Street Drugs: Some Cocktails Don’t Mix. San Francisco: San Francisco Project Inform, Oct. 1999.
Drugs in Partyland: Think Thru the Buzz. New York: Gay Men’s Health Crisis, 16 Dec. 1999 http://www.gmhc.org/basics/men/drugs.html.
Horn, Gabi. "Party Favors." POZ Jun. 1998. 15 Dec. 1999