Addiction is a serious problem in the HIV community. Using drugs or alcohol can lead to exposure to HIV, but they can also cause severe physical, social, emotional, and psychological problems after a person becomes infected.

Some people get infected directly through addiction behaviors, such as re-using a needle that was contaminated with HIV. Some get infected indirectly as a result of drugs or alcohol, like getting drunk, going home with a stranger, and forgetting about safer sex.

Do you have a problem with addiction? Take a quick quiz to find out: (The questions ask about drinking, but you can substitute the words “drug use.”)

• Have you ever felt you should cut down on your drinking?
• Have people annoyed you by criticizing your drinking?
• Have you ever felt bad or guilty about your drinking?
• Have you ever had a drink first thing in the morning (an eye-opener) to steady your nerves or get rid of a hangover?

If you answered yes to one question, you might have a problem with drug or alcohol abuse. If you answered yes to two or more, chances are good that you are addicted to drugs or alcohol.

Some HIV+ people get defensive about their drug or alcohol use. They say it’s tough living with a life-threatening disease, that they need something to help them relax, etc.

But the truth is that the combination of HIV and either drugs or alcohol can be deadly, either in the short run or the long run. Why?

HIV infection can make your body more fragile. You may lose muscle mass and/or body fat. You may not be able to handle the same amount of drugs or alcohol you could tolerate in the old days – and can end up in the Emergency Room or worse as a result.

If you are overusing drugs or alcohol, chances are you are not taking your HIV and medications correctly. Remember, if you take your HIV drugs incorrectly, you take the risk that your virus will mutate and become resistant to the medications. Eventually, you could end up in a situation where none of the HIV medications will work for you.

Haven’t been honest with your physician about what street drugs you use, or how much alcohol you drink? You’re headed for trouble! You can end up with drug interactions. These can affect the levels of other drugs in your system – and make normal doses of medication end up as super-high or super-low in your system. Some combinations can even result in a heart attack or stroke.

Want to make the HIV in your system go wild, and cross the barrier into your brain faster? Do some cocaine or crack – it’s like stepping on the gas pedal. Your HIV can progress much faster than normal, and you can also end up with HIV dementia, a disorder of the brain.

Want to do something stupid? Get high or drunk. When your judgment is off, who knows what you’ll do – including putting yourself at risk for physical or sexual assault, or at risk for other sexually transmitted diseases. Think HIV is a drag? You’ll really be sorry if you add hepatitis C, anal or vaginal warts, and herpes!

So if you know you have a problem with addiction, what do you do? There is no one right answer for everyone. Each person is different. But there are two basic steps:

1. Talk to your doctor -

Even if you are not ready to cut down or stop using drugs or alcohol, your HIV physician needs to know what you are doing in order to be able to treat you.

2. Consider your treatment options -

Inpatient or outpatient? Group counseling or individual? Twelve-step or not? A mental health professional, case manager, peer counselor, physician, nurse, or substance abuse professional can help you sort through the options and make healthy decisions. Many free or low cost recovery programs are available that you may not know about.

Whatever options you choose, taking the first step towards beating your addiction can be the healthiest decision you ever make!

1		Ewing, J.A. (1984). Detecting alcoholism: The CAGE questionnaire. Journal of the American Medical Association, 252(14). 1905-1907.
2		Howard, A.A., et. al. (2002). A prospective study of adherence and viral load in a large multi-center cohort of HIV-infected women. AIDS 16(16). 2175-2182.
3		Roth, A., et. al. (2002). Cocaine enhances human immunodeficiency viral replication in a model of severe combined immunodeficient mice implanted with human peripheral blood leukocytes. Journal of Infectious Diseases 185(5). 701-705.