If you're a drug user with HIV, it's not easy to get the kind of care that you need-a doc whose aware of drug interactions, a support group that understands your adherence struggles, a hospital that will give you adequate pain meds.  Our northern neighbor's leading HIV agency, Canadian AIDS Treatment Information Exchange, or CATIE, is about to publish pre+fix: harm reduction for positive users, a complete in-the-life guide to HIV drug users.  It will be available this fall www.catie.ca or by calling 416.203.7122 (free, but a small charge for shipping).  Check out this excerpt for a sense of that pre+fix flavor.

DRUG INTERACTIONS

If you're using drugs, drinking alcohol regularly, or taking methadone while you're taking HIV meds, you need to know that sometimes there substances interact.  It can work both ways.  Drugs can make your HIV less effective.  Or your HIV meds can make you have a bad trip, on some drugs. Even worse, some HIV meds can increase the level of drugs or alcohol in your blood so much that you could overdose. This is why it's important to tell your doctor about all the drugs you are taking.  Here are some steps you can take to reduce the risk of having a bad drug interaction:

  • Talk to your doctor or a pharmacist about the drugs you take, including methadone. He or she should be able to give you information about any potential drug interactions. Your doctor may recommend changing your HIV treatment.
  • Consider switching to drugs that appear to be safe with HIV treatment, such as marijuana.
  • If you use drugs after you begin HIV treatment, start slowly.  Just half of your usual hit may have the same effect that the full hit used to have. Take a small dose of your drug. Wait to see how you feel and how it affects you. Take more only if you need it.
  • Some HIV meds decrease the strength of methadone, which means you, could go into methadone withdrawal.  Check whether your methadone dose needs to be adjusted. Though not much is known about how HIV meds interact with drugs, alcohol, or methadone, it is a good idea to talk to your doctor, a nurse, a pharmacist about what is known so you can stay as healthy as possible.  Also, talk with other people with HIV who use drugs about their experiences and carefully monitor your