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Recreational drugs
      #195 - 03/29/00 05:46 PM

i am going to be starting meds soon and i was wondering what treatments i should avoid. i occasionally do recreational drugs such as ecstasy, ghb, and special k. what kind of reactions can be deadly? i don't want to tell my doctor about my use of these drugs-- he's very strict.

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Steve K.

Re: Recreational drugs new
      #196 - 03/29/00 05:47 PM

There are warnings about recreational drugs sometimes posted at The Body--look:

Be careful!

Steve. K.

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Re: Recreational drugs new
      #197 - 03/29/00 05:47 PM

Here is an article from the July 1997 POZ magazine.

Cocktails That Kill?
Mixing ritonavir and street drugs may be dangerous
Bruce Mirken

Using certain recreational drugs while taking protease inhibitors, particularly Abbott's ritonavir (Norvir), may be dangerous. But while the broad outlines of the risk are clear, the supportive data is maddeningly sketchy, and little organized research is in sight.

It has long been known that ritonavir, and to a lesser extent the other protease inhibitors, inhibit certain enzymes the liver uses to metabolize a variety of pharmaceuticals, often causing much higher levels of those drugs to build up in the bloodstream. That's why ritonavir comes with an extensive list of medicines that cannot be taken with it, or whose dose must be adjusted to compensate for ritonavir's effect.

Some of those same chemical pathways in what is termed the P450 system also help process certain street drugs, but studies to determine the exact interactions have never been done. And in the present War-on-Drugs era, don't hold your breath waiting for that kind of research to happen.

Most of what is known comes from Abbott's written response to Jim Lumb, whose partner, Phillip Kay, died after taking ecstasy (MDMA) while he was on ritonavir. Lumb insists Kay only took two-and-a-half tabs, but the autopsy showed a blood level equivalent to 22.

In March, ACT UP/Golden Gate sent Abbott a strongly worded letter urging that an immediate warning about dangerous interactions between the two drugs be sent to doctors and drug-treatment programs. Abbott has thus far refused, at times claiming that to do so might seem to condone illegal substances, and at other times saying there is inadequate data. Yet the company has also stated flatly that it won't do studies involving recreational drugs -- despite its own theoretical calculations suggesting that ritonavir could cause a two- to threefold increase in ecstasy levels. Further, some individuals have a genetic shortage of the enzyme involved in processing ecstasy, which can lead to levels as much as ten times greater than expected. These individuals can experience increased levels even without ritonavir.

The company also estimated that ritonavir could increase amphetamine levels by two- or threefold. While little or no interaction with cocaine is likely, and heroin levels might be decreased by roughly 50 percent, blood levels of methadone -- used to treat heroin addiction -- are likely to increase more than threefold.

As for the other protease inhibitors, the manufacturers say they haven't done studies because of the legal obstacles to researching illegal drugs. (Such research isn't illegal, but government rules can make it near-impossible, as would-be medical marijuana researchers can attest.) Merck spokesperson Michael Seggev said that, in general, indinavir (Crixivan) has much less effect than ritonavir on the relevant metabolic routes, so any interaction should be less pronounced, but he cautioned that without hard data it is impossible to know for sure. Street drugs can vary wildly in purity, adding another layer of uncertainty.

Some data is on the way regarding methadone. Abbott says a study of methadone/ritonavir interactions is under way, and Merck has a methadone/Crixivan study nearing completion. (Seggev says Merck has received anecdotal reports from methadone users of a lessened effect possibly connected to Crixivan.) Agouron spokesperson Joy Schmitt says their recently approved drug nelfinavir (Viracept) does suppress the enzyme that metabolizes methadone, but to a lesser degree than is seen with ritonavir. The company is considering a study.

Everyone emphasizes that no estimate based on test-tube studies or theoretical calculations can give more than the roughest guess as to what happens with real drugs in real people. Without hard data, extreme caution is clearly advisable.

Doctors seeking information on possible interactions between ritonavir and other drugs can call Abbott's medical department at 800.633.9110.

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Reged: 10/20/07
Posts: 29
Loc: South West Ohio
Re: Recreational drugs new
      #233026 - 10/27/07 02:07 AM

give them up, they add more stress on your body. you can do it

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