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While many people agree that an occasional social drink is alright if you are HIV-positive (although it is best to consult a clinician who is aware of your entire health and medical history) and almost nobody is going to go on record saying that "recreational" use of illegal drugs is acceptable, it is agreed upon that heavy use of alcohol and drugs are not good for anyone - especially if you are HIV-positive.

In large amounts, drugs and alcohol are bad for your immune system and your overall health. Remember, if you have HIV, your immune system is already weakened.

Some of the best information about the effects of drugs and alcohol as it relates to people with HIV has been developed by the United States Department of Veteran's Affairs (VA). To follow are some of the ways that drugs and alcohol can work against you if you are HIV-positive.

Effects on your immune system

Drinking too much alcohol can weaken your immune system. A weaker immune system will have a harder time fighting off common infections, as well as AIDS-related infections. A weaker immune system also increases the chance that you will experience more side effects from your HIV medications.

Smoking marijuana or any other drug irritates the lungs. You may be more likely to get serious lung infections, such as pneumonia.

Other common recreational drugs, such as cocaine or crystal meth, can leave your body dehydrated and exhausted, as well as lead to skin irritation. All of these things can make it easier for you to get infections.

The organ in your body that alcohol and other drugs affect most is your liver. The liver rounds up waste from chemicals that you put in your body. Those chemicals include recreational drugs as well as prescription drugs, such as your HIV medications. A weaker liver means it's less efficient at best.

If you also have hepatitis C (or any other kind of hepatitis), your liver is already working very hard to fight the disease itself and deal with the strong drugs that you may be taking for your hepatitis treatment.

Interactions with your HIV meds

HIV medications can be hard on your body, so when you are taking these medications, it is important that your liver works as well as possible. The liver is responsible for getting rid of waste products from the medications.

When you are HIV-positive, your body may react differently to alcohol and drugs. Many people find that it takes longer to recover from using pot, alcohol, or other recreational drugs than it did before they had HIV.

Remember that having HIV means a major change has taken place in your body. You may choose to use alcohol and drugs in moderation, but be sure to respect your body. Pay attention to what and how much you eat, drink, smoke, and take into your body.

Certain HIV medications can boost the level of recreational drugs in your system in unexpected and dangerous ways. For example, amphetamines (such as crystal meth) can be present at 3 to 22 times their normal levels in the bloodstream when mixed with an HIV drug called Norvir (ritonavir). That's because Norvir hampers the body's ability to break down these other drugs.

If you are going to take a recreational drug while you are on HIV medication, it is better to start with a very low amount of the recreational drug (as low as 1/4 the normal amount) and allow time to see how it affects you before increasing the amount. Keep in mind that recreational drugs aren't regulated, so you never know exactly how much you are getting.

Although you may feel uncomfortable at first, you should tell your doctor what recreational drugs you are using. That way, your doctor will know how the substances you are using affect your HIV drugs and your overall health. Most likely, your doctor will then be able to explain some things going on in your body.

Safe sex

Certain drugs, such as methamphetamine, affect your ability to make decisions. Even though you use condoms regularly and practice safe sex when you're not high, you may be willing to take more risks and not use a condom when you're under the influence of methamphetamine or other drugs.

Alcohol can also affect the decisions you make about safe sex. For example, if you have too much to drink, you may not be able to remember where you put the condoms, and decide simply not to use them. These are decisions you probably would not make if you were sober.

These actions put your partner at risk for HIV and put you at risk for other sexually transmitted diseases.

Remember to keep condoms handy in places where you might have sex. Also, try to limit the amount of alcohol you drink if you know you are going to have sex.

HIV and injection drug use

Sharing a needle or any equipment when injecting drugs is dangerous for you and for the people you are sharing with. They could get HIV from you, and you could get another disease, such as hepatitis, from them.

The safest option is not to share. Use clean needles and syringes each time or keep your own equipment to yourself.

Because of the dangers of injection drug use, the best way to lower your risk is to stop injecting drugs and to enter and complete a substance abuse treatment plan. You can talk to your health care provider about this.

If you do inject drugs, follow these reminders:

• Never reuse or "share" syringes, water, or drug preparation equipment.
• Use only syringes obtained from a reliable source (such as drugstores and needle or syringe exchange programs).
• Use a new, sterile syringe each time to prepare and inject drugs.
• If possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (such as fresh tap water).
• Use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs.
• Clean the injection site with a new alcohol swab prior to injection.
• Safely dispose of syringes after one use.

Points to remember - Most people are willing to take some risks, and using drugs and alcohol is no exception. But when alcohol or other drugs become an escape that you rely upon, it can be dangerous to your mental and physical health.

- Before you drink or use drugs, it is important to think about what risks you are willing to take.

- If you would like to cut back on your use of alcohol or other drugs, talk to your doctor about getting help and finding the treatment you need.

Copyright 2018, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!