December #97 : Cocaine & Heroin

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Table of Contents

Born Again

Knowing When to Stop

The Divine Miss Em


Cocaine & Heroin

Crystal Meth

Harm Reduction


Recovery Rooms


A for Africa


WHO’s on First

Dying for ADAP


Bombing Gilead

Pos & Neg

Wishful Thinking

Unwrapper’s Delight

Study Hell

Tech Talk


Diarrhea Diary

HAART to Heart

Eradication II?


Breaks: What’s Up?

Safe Spliffs

Slumber Party

Bone Loss

Gimme Shelter


IRSA’s Rochelle advises HIVer refugees:

Editor's Letter


Sale of a Lifetime

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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December 2003

Cocaine & Heroin

They may make you comfortably numb, but trust us: Things don’t go better with coke and smack

The HIVer Appeal:
Cocaine (and its more potent, free-based form, crack) releases a rush of the brain’s feel-good chemical dopamine, while heroin (and its pharmaceutical derivatives, like some painkillers) induces drowsy euphoria by attaching to the brain’s opiate receptors, which control how we feel pain. Both drugs offer short-term relief to HIVers suffering from depression, fatigue or pain.

Why snorting, shooting and HIV don’t mix:
Where to begin? Coming down from cocaine can cause extreme depression and fatigue, while heroin withdrawal means severe diarrhea, headaches, vomiting and body aches. Inject with shared needles, and you up the risk of passing HIV to others, contracting hepatitis B or C or being reinfected with a strain of drug-resistant HIV. Doing heroin while taking the protease inhibitor Norvir (ritonavir) will dampen your high, prompting you to need more, which could cause a fatal overdose if you ever go off Norvir. Crack cocaine has displayed no known harmful interactions with HIV meds but can savage the immune system, speeding HIV replication by as much as 200 percent. Studies show both injection and non-injection users are far more likely to miss HIV med doses, spurring treatment failure.

The Big Fix:
You have many options (see “Recovery Rooms” ). Research reveals that HIVer heroin users who join a methadone program, taking a legal, synthetic opiate that blunts withdrawal, are hospitalized less often and live longer than those who don’t, but the treatment is controversial. Some studies conclude that methadone is more addictive than heroin; others say it interacts negatively with HAART meds. Addicts have many in- and out-patient choices, some HIVer-oriented. Narcotics Anonymous (NA) and Cocaine Anonymous (CA) are 12-step programs with meetings in most major cities. They don’t require that you stop using drugs—only that you want to.

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