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Real Answers to Methamphetamine Questions
Aug 24, 2006

As Clinical Research Coordinator I spent my time recruiting patients by weeding out all those who were managing their fatigue using crystal methamphetamine (CMA) particularly those who were in their teens and among the entire gay population. The message we were indoctrinated to send to these patients was that CMA destroys the immune system and has no benefits. Meanwhile, research has been indicative that the contrary is true. There have been terminally ill cancer patients who were sent home with their HIV meds and told to avoid crystal. Many of them trashed the HIV meds in favor of CMA. Ironically, they are the ones who are alive today. Reason: Any nurse or clinician knows that CMA like other stimulants causes spikes in CD4 T cell production. In those cases where patients had less than one CD4 cell per cubic mm, this spiking effect gave them an edge over those patients who were taking meds to counteract the virus but left them exposed to OIs during a very fragile period. Five years later, it is quite evident that these patients would not have survived had they not used CMA in responsible doses. Then a year ago this month, the Terry Jernigan report became coffee-table literature in West Hollywood when the resport maintained there were noteworthy volume increases in basal ganglia and the partietal cortex due to CMA. Other patients have remarked that without CMA they would never have survived depression. Despite all these findings, physicians sheepishly hide behind the ignorance that has compelled our society to discredit CMA zeroing in on those who binge and abuse the drug just to get their kicks. From my perspective, I could care less about those who know better but choose to misuse the drug. But I think it's a disgrace to the healthcare profession that we cannot take the time to: 1) conduct testing on CMA that focuses on the positive aspects of this drug rather than reiterating the same old studies that focus on side effects; 2)educate the public on the proper administration of such medication; 3) enable the presecription drug Desoxyn (MA hydrochloride) to be prescribed to patients rather than allowing patients to by the street version which impacts not only the health of those patients but also fuels the wrong segment of our economy. If there is any kind of substance out there that can be a benefit to an HIV/AIDS patient, it should be made available. Does it matter that these patients are teenagers or homosexuals? There is no room for discrimination in healthcare. Every person should and must be treated equally. Furthermore, education is the key to HIV prevention and it is the foundation of Harm Reduction. Gradualism and ineffective substitutions do not serve as the basis of harm reduction. If we know that there are users of CMA who benefit medically, we must be honest; we must provide them with maximum support.

Response from Dr. Frascino

Hello,

You were (are?) a clinical research coordinator??? Yikes! (Damn good thing you are only coordinating and not designing clinical studies!)

"Any nurse or clinician knows CMA like other stimulants causes spikes in CD4 T-cell production!??" What??? (I must be the exception.)

Physicians sheepishly hide behind the ignorance that has compelled our society to discredit CMA??? What??? (CMA is indeed discredited, but not due to ignorance, physicians, or sheep.)

You'd like us to "educate the public on the proper administration" of CMA??? What??? (Exactly what is the proper therapeutic dose of Tina these days?)

Listen up, zippy, your theories about methamphetamines are not scientifically valid. And just in case you've been too busy partying for the last decade to read a newspaper, magazine or scientific paper, crystal meth use is one of the major factors that is continuing to fuel the flames of the HIV epidemic.

I'll post a question form the archives below. You might want to check out tweaker.org or other sites to learn a bit more about the compound you are promoting. Oh and by the way, I've seen many West Hollywood coffee-tables and none have ever been adorned with information about basal ganglia! (When is the last time your were walking down Santa Monica and heard someone say "Damn, look at the size of the basal ganglia on that stud?"

Dr. Bob

Meth and HIV

Jun 27, 2006

Dr. Bob,

I'm a grateful, recovering Crystal Meth Addict. I have just passed my 8 month mark of being clean. At my partner's prompting, he suggested I use my gift of voice somehow. I have decided and am in the process of making a documentary of my addiction and my recovery. I asked my Infectious Disease Specialist if he would let me interview him specifically on how Meth has affected my health only. I was always very honest with him about my injecting meth and we would often discuss what meth was doing to my health. 2 years ago when I tested Positive my CD4 was 914, VL was 4000. CD4 is now 241, VL 72000. I have started HIV Meds on my 2 year anniversary of being Positive. My doctor said he would not be part of my film since he can not prove meth had any connection to the degeneration of my health. I have read the research and understand the effects meth has on one's body so I know he is full of you know what. So, for others who may not understand meth's affects; Dr. Bob, what effects does meth have on a Positive person's health and if there are affects, what are they? I respect your words tremendously.

Former Meth Man in FL

Response from Dr. Frascino

Hello Former Meth Man,

Congratulations on your eight months of sobriety! Regarding meth effects on HIV pozatoids, I'll reprint an article from the archives that addresses that issue. Stay well! Good luck with your film!

Dr. Bob

Scientists Explore Meth's Role in Immune System

February 25, 2005

Crystal methamphetamine's effect on the immune system, HIV's progression and the overall AIDS epidemic is receiving fresh scrutiny after New York City health officials reported that a meth-using resident acquired multiple drug-resistant HIV and quickly progressed to AIDS. Experts fear more people, especially gay men, are using the drug -- in many cases, with Viagra -- to engage in unprotected sex with multiple partners.

In the Explore Project -- a long-term study of more than 4,000 gay men sexually active with more than one partner -- researchers found a quarter of the men had tried crystal methamphetamine in the previous six months. All the meth users were HIV-negative at the study's start, but by the end, about 2.1 percent had seroconverted. Independent of behaviors such as unprotected sex with multiple partners -- which was strongly associated with infection -- and injection drug use, men reporting crystal use were twice as likely to contract HIV.

While research is limited, studies in animals and on cell cultures have found that methamphetamine suppresses killer T cells. That, combined with the drug's propensity to dry out mucous membranes, could cause abrasions in the mouth and rectum and slightly increase a person's vulnerability to the virus, said Dr. Antonio Urbina, lead author of a study on crystal meth and HIV published last year in Clinical Infectious Diseases.

In a Journal of Infectious Diseases study of 230 HIV-positive people, two-thirds were either current or former crystal users. Those on antiretroviral medication who used crystal had much higher viral loads than other subjects. One explanation is that meth users, like many drug users, failed to adhere to their drug regimens, said Dr. Igor Grant, a study author. Such irregular adherence can also allow drug-resistant HIV to emerge, according to experts. Nevertheless, it is meth's role on behavior that most alarms experts. "Being in a sex club for 36 hours on crystal meth and engaging in unprotected anal sex is really the most profound effect," said Dr. Steve Shoptaw, a research psychologist at University of California-Los Angeles' Integrated Substance Abuse programs.

The studies cited include "Crystal Methamphetamine, Its Analogues, and HIV Infection: Medical and Psychiatric Aspects of a New Epidemic," published in Journal of Infectious Diseases (2004;38:890-894) and "Increased Human Immunodeficiency Virus Loads in Active Methamphetamine Users Are Explained by Reduced Effectiveness of Antiretroviral Therapy," published in Journal of Infectious Diseases (2003;188:1820-1826).


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